Attitudes, barriers, and enablers towards conducting primary care research in Banda Aceh, Indonesia: a qualitative research study

Abstract Background The postpartum period is redefined as 12 weeks following childbirth. Primary care physicians (PCP) often manage postpartum women in the community after uneventful childbirths. Postpartum care significantly impacts on the maternal and neonatal physical and mental health. However, evidence has revealed unmet needs in postpartum maternal care. Aim The study aimed to explore the experiences of PCPs in managing postpartum mothers. Methods Four focus group discussions and eleven in-depth interviews with twenty-nine PCPs were conducted in this qualitative research study in urban Singapore. PCPs of both gender and variable postgraduate training background were purposively enrolled. Audited transcripts were independently coded by two investigators. Thematic content analysis was performed using the codes to identify issues in the “clinician”, “mother”, “postpartum care” and “healthcare system & policy” domains stipulated in “The Generalists’ Wheel of Knowledge, Understanding and Inquiry” framework. Findings PCPs’ personal attributes such as gender and knowledge influenced their postpartum care delivery. Prior training, child caring experience and access to resource materials contributed to their information mastery of postpartum care. Their professional relationship with local multi-ethic and multi-lingual Asian mothers was impacted by their mutual communication, language compatibility and understanding of local confinement practices. Consultation time constraint, awareness of community postnatal services and inadequate handover of care from the specialists hindered PCPs in the healthcare system. Discussion Personal, maternal and healthcare system barriers currently prevent PCPs from delivering optimal postpartum care. Conclusion Interventions to overcome the barriers to improve postpartum care will likely be multi-faceted across domains discussed.

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Primary Care Physicians Managing Postpartum Care - What Are Their Barriers and Enablers? A Qualitative Research Study.

10.21203/rs.3.rs-393099/v1 ◽

2021 ◽

Author(s):

Zhimin Poon ◽

Esther Cui Wei Lee ◽

Li Ping Ang ◽

Ngiap Chuan Tan

Keyword(s):

Primary Care ◽

Qualitative Research ◽

Healthcare System ◽

Primary Care Physicians ◽

Research Study ◽

Care Delivery ◽

Postpartum Care ◽

Physical And Mental Health ◽

Professional Relationship ◽

Qualitative Research Study

Abstract BackgroundThe postpartum period is redefined as 12 weeks following childbirth. Primary care physicians (PCP) often manage postpartum women in the community after uneventful childbirths. Postpartum care significantly impacts on the maternal and neonatal physical and mental health. However, evidence has revealed unmet needs in postpartum maternal care. AimThe study aimed to explore the issues faced by PCPs in managing postpartum mothers. MethodsFour focus group discussions and eleven in-depth interviews with twenty-nine PCPs were conducted in this qualitative research study in urban Singapore. PCPs of both gender and variable postgraduate training background were purposively enrolled. Audited transcripts were independently coded by two investigators. Thematic content analysis was performed using the codes to identify issues in the “clinician”, “mother”, “postpartum care” and “healthcare system & policy” domains stipulated in “The Generalists’ Wheel of Knowledge, Understanding and Inquiry” framework.FindingsPCPs’ personal attributes such as gender and knowledge influenced their postpartum care delivery. Prior training, child caring experience and access to resource materials contributed to their information mastery of postpartum care. Their professional relationship with local multi-ethic and multi-lingual Asian mothers was impacted by their mutual communication, language compatibility and understanding of local confinement practices. Consultation time constraint, awareness of community postnatal services and inadequate handover of care from the specialists hindered PCPs in the healthcare system.DiscussionPersonal, maternal and healthcare system barriers currently prevent PCPs from delivering optimal postpartum care.ConclusionInterventions to overcome the barriers to improve postpartum care will likely be multi-faceted across domains discussed.

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Patient perspectives on health care provider practices leading to an axial spondyloarthritis diagnosis: an exploratory qualitative research study

BMC Family Practice ◽

10.1186/s12875-021-01599-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Kate L. Lapane ◽

Catherine Dubé ◽

Katarina Ferrucci ◽

Sara Khan ◽

Kristine A. Kuhn ◽

...

Keyword(s):

Primary Care ◽

Qualitative Research ◽

Focus Groups ◽

Research Study ◽

Axial Spondyloarthritis ◽

Diagnostic Delay ◽

The United States ◽

Patient Experiences ◽

Qualitative Research Study ◽

Diagnostic Delays

Abstract Background The average time to a diagnosis for people with axial spondyloarthritis (axSpA) is 7-10 years. Delayed diagnosis may result in increased structural damage, worse physical function, and worse quality of life relative to patients with a timely axSpA diagnosis. Understanding patient experiences may provide insights for how to reduce diagnostic delays. Objective To provide foundational knowledge about patient experiences with healthcare providers leading to an axSpA diagnosis. Methods We conducted an exploratory qualitative research study with six focus groups interviews with participants recruited from three rheumatology clinics within the United States (MA (n = 3); CO (n = 2); PA (n = 1)) that included a total of 26 adults (10 females, 16 males) with rheumatologist confirmed diagnosis of axSpA in 2019. Focus groups were ~ 2 h, audio recorded, transcribed, and subject to dual coding. The codes reviewed were in relation to the patients’ diagnostic experiences. Results Patients described frustrating and lengthy diagnostic journeys. They recognized that the causes of diagnostic delays in axSpA are multifactorial (e.g., no definitive diagnostic test, disease characteristics, lack of primary care provider’s awareness about axSpA, trust). Patients described how doctors minimized or dismissed complaints about symptoms or told them that their issues were psychosomatic. Patients believed the healthcare system contributed to diagnostic delays (e.g., lack of time in clinical visits, difficulty accessing rheumatologists, health insurance challenges). Advice to physicians to reduce the diagnostic delay included allowing time for patients to give a complete picture of their illness experience, listening to, and believing patients, earlier referral to rheumatology, provision of HLA-B27 gene testing, and that physicians need to partner with their patients. Conclusions Patients desire a definitive test that could be administered earlier in the course of axSpA. Until such a test is available, patients want clinicians who listen to, believe, and partner with them, and who will follow them until a diagnosis is reached. Educating primary care clinicians about guidelines and referral for diagnosis of axSpA could reduce diagnostic delay.

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