Identity of primary health care nurses: perception of "doing everything"

ABSTRACT Objective: To analyze, in the speeches of nurses, the habitus that conforms their professional identity in the primary health care area. Method: Qualitative study, carried out from March to October 2015, with nurses of primary healthcare units in the cities of Cajazeiras, in the state of Paraíba, and Maracanaú, in the state of Ceará. Data were collected by means of semi-structured interviews, and analyzed through discourse analysis. Results: Nurses, in their practice and perception, perceive that professional identity is linked to the meaning that involves the word "everything". This situation constitutes a habitus that directs the range of daily actions, often distant from the profession's core of knowledge. Final considerations: Trying to be and do everything in primary health care involves negative repercussions in the professional identity of nurses. Strategic guidance is necessary in order to achieve and embrace elements that reflect the essence of this category.

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Provision and accessibility of primary healthcare services for people who are homeless: a qualitative study of patient perspectives in the UK

British Journal of General Practice ◽

10.3399/bjgp19x704633 ◽

2019 ◽

Vol 69 (685) ◽

pp. e526-e536 ◽

Cited By ~ 15

Author(s):

Ellie Gunner ◽

Sat Kartar Chandan ◽

Sarah Marwick ◽

Karen Saunders ◽

Sarah Burwood ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Qualitative Study ◽

Primary Healthcare ◽

Primary Care Providers ◽

Healthcare Services ◽

Negative Experiences ◽

Healthcare Centre ◽

Primary Health ◽

Primary Healthcare Centre

BackgroundAnecdotal reports of people who are homeless being denied access and facing negative experiences of primary health care have often emerged. However, there is a dearth of research exploring this population’s views and experiences of such services.AimTo explore the perspectives of individuals who are homeless on the provision and accessibility of primary healthcare services.Design and settingA qualitative study with individuals who are homeless recruited from three homeless shelters and a specialist primary healthcare centre for the homeless in the West Midlands, England.MethodSemi-structured interviews were audiorecorded, transcribed verbatim, and analysed using a thematic framework approach. The Theoretical Domains Framework (TDF) was used to map the identified barriers in framework analysis.ResultsA total of 22 people who were homeless were recruited. Although some participants described facing no barriers, accounts of being denied registration at general practices and being discharged from hospital onto the streets with no access or referral to primary care providers were described. Services offering support to those with substance misuse issues and mental health problems were deemed to be excluding those with the greatest need. A participant described committing crimes with the intention of going to prison to access health care. High satisfaction was expressed by participants about their experiences at the specialist primary healthcare centre for people who are homeless (SPHCPH).ConclusionParticipants perceived inequality in access, and mostly faced negative experiences, in their use of mainstream services. Changes are imperative to facilitate access to primary health care, improve patient experiences of mainstream services, and to share best practices identified by participants at the SPHCPH.

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Sarcopenia screening in elderly in primary health care: nurse knowledge and practices

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2020-0421 ◽

2020 ◽

Vol 73 (suppl 3) ◽

Author(s):

Rutielle Ferreira Silva ◽

Maria do Livramento Fortes Figueiredo ◽

Juan José Tirado Darder ◽

Ana Maria Ribeiro dos Santos ◽

Maria Antonieta Rubio Tyrrell

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

The Elderly ◽

Care Plan ◽

Structured Interviews ◽

Care Nurse ◽

Primary Health ◽

Primary Health Care Nurses ◽

Nurse Knowledge

ABSTRACT Objective: Describe the knowledge and practices of the Primary Health Care nurse on sarcopenia screening in the elderly. Methods: Qualitative study conducted with 24 Primary Health Care nurses. The data was collected through semi-structured interviews, recorded and later transcribed. The speeches were grouped in thematic categories, later analyzed, supported by Paulo Freire’s reference. Results: The findings showed that the primary care nurses’ knowledge of sarcopenia screening in the elderly was incipient and fragile. This reality is reflected in a gap in practice, although some instruments already require the registration of characteristics indicative of sarcopenia, such as the evaluation of the calf circumference. Final Considerations: The need to train nurses to perform sarcopenia screening and to implement a promotional and preventive care plan, which will result in improving the quality of life of the elderly assisted in Primary Care, was highlighted.

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Primary Health Care Nurses’ Experiences of Consultations With Internet-Informed Patients: Qualitative Study

JMIR Nursing ◽

10.2196/14194 ◽

2019 ◽

Vol 2 (1) ◽

pp. e14194 ◽

Cited By ~ 2

Author(s):

Anna E Sjöström ◽

Åsa Hörnsten ◽

Senada Hajdarevic ◽

Agneta Emmoth ◽

Ulf Isaksson

Keyword(s):

Health Care ◽

Primary Health Care ◽

Qualitative Study ◽

The Internet ◽

Negative Consequences ◽

Related Information ◽

Primary Health ◽

Internet Information ◽

Health Related ◽

Primary Health Care Nurses

Background Most people in modern societies now use the Internet to obtain health-related information. By giving patients knowledge, digital health information is considered to increase patient involvement and patient-centered interactions in health care. However, concerns are raised about the varying quality of health-related websites and low health literacy in the population. There is a gap in the current knowledge of nurses’ experiences with Internet-informed patients. Objective The objective of this study was to explore primary health care nurses’ experiences of consultations with patients who present health-related information from the Internet. Methods This is a qualitative study based on interviews with 9 primary health care nurses. Data were analyzed using qualitative content analysis. Results are reported according to the consolidated criteria for reporting qualitative research guidelines. Results The phenomenon of Internet-informed patients was considered to change the usual rules in health care, affecting attributes and actions of patients, patterns of interactions in consultations, and roles of nurses and patients. Three categories were identified: (1) Facing the downsides of Googling, (2) Patients as main actors, and (3) Nurse role challenged. Although the benefits of health-related Internet information were described, its negative consequences were emphasized overall. The problems were mainly ascribed to inaccurate Internet information and patients’ inability to effectively manage the information. Conclusions Our study suggests ambivalent attitudes among nurses toward health-related Internet information. In order to promote equitable care in the digital era, increased awareness in health care about useful strategies for overcoming the difficulties and embracing the benefits of conferring with Internet-informed patients seems to be a legitimate goal.

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General Practitioners’ Perspectives Over Solutions To Change BZD Prescription Trends – A Qualitative Study

10.21203/rs.3.rs-889021/v1 ◽

2021 ◽

Author(s):

Teresa Reis ◽

Helena Serra ◽

Inês Faria ◽

Miguel Xavier

Keyword(s):

Health Care ◽

Primary Health Care ◽

Qualitative Study ◽

General Practitioners ◽

Public Health Issue ◽

Structured Interviews ◽

Health Care Settings ◽

Prescription Practices ◽

Primary Health ◽

Primary Health Care Settings

Abstract Background: This qualitative study explores General Practitioners’ (GPs) perspectives on solutions to address the problem of excessive prescription of benzodiazepines (BZDs). Over-prescription of BZDs at a primary health care settings is a prevalent issue in the region under analysis, but also elsewhere internationally. GPs are the gatekeepers to these medicines in primary care, but for several subjective, organizational and external reasons, they find it difficult to change current prescription patterns. Simultaneously, GPs recognize the issue of BZD excessive prescription practices, and propose possible solutions to invert the trend.Methods: Qualitative data were collected in seven primary health care centers in an interior and mostly rural region of Portugal. We conducted 12 semi-structured interviews with GPs. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis. The themes were integrated and organized into eight axes for action.Results: Solutions proposed by GPs focused on organizational aspects, such as human resources, infrastructure and training (including on withdrawal schemes), alternative approaches, and wider community-based initiatives to counter societal aspects affecting mental health in the identified region. The themes were integrated and organized into eight axes for action.Conclusions: The findings provide an assessment of the priorities to change excessive BZDs prescription, as suggested by the GPs in primary health care settings, and hence reflecting what they consider to be context specific needs. Both experts and multi-stakeholders bottom-up perspectives should be taken into account when proposing new policies and local strategies to tackle current excessive BZD prescription, especially considering the failure of previous strategies to change this well-known public health issue. We consider that our results to be generalizable to all countries where primary health care plays a central role in care provision.Trial registration: ClinicalTrials.gov number NCT04925596

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Suffering and defense mechanisms: an analysis of the work of Primary Health Care nurses

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2020-0419 ◽

2022 ◽

Vol 75 (suppl 3) ◽

Author(s):

Grizielle Sandrine de Araujo Rocha ◽

Darine Marie Rodrigues da Silva ◽

Maria Sandra Andrade ◽

Bárbara Bruna Fernandes de Andrade ◽

Sílvia Elizabeth Gomes de Medeiros ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Defense Mechanisms ◽

Support Network ◽

Structured Interviews ◽

Team Members ◽

Defensive Strategies ◽

Primary Health ◽

And Coping ◽

Primary Health Care Nurses

ABSTRACT Objective: To analyze the suffering and coping strategies of nurses working in Primary Health Care considering the psychodynamics of their work. Methods: Descriptive study with a qualitative approach, carried out with 11 nurses working in Primary Health Care. Data were collected through semi-structured interviews, systematized, and interpreted using Bardin’s content analysis method applied to recurrent themes. Results: The suffering factors related to work in Primary Health Care are difficulties with management, the fragile structure of the health support network, and conflicts with the users. Defensive strategies to minimize these difficulties are the support of hierarchical superiors, the empowerment of the community and users, and communication between team members. Final considerations: It is important that there be changes in the organization of this line of work to improve the workers’ health.

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A criança e sua família na atenção primária em saúde

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963.2019.241426 ◽

2019 ◽

Vol 13 ◽

Author(s):

Luma Guida Menezes ◽

Lia Leão Ciuffo ◽

Aline Pereira Gonçalves ◽

Juliana Rezende Montenegro Medeiros de Moraes ◽

Tania Vignuda de Souza ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Context ◽

Structured Interviews ◽

Categorical Analysis ◽

Primary Health ◽

Qualitative Descriptive ◽

Primary Health Care Nurses

Objetivo: analisar a atuação do enfermeiro da atenção primária em saúde na assistência à criança e sua família. Método: trata-se de estudo qualitativo, descritivo, com quinze enfermeiros. Realizou-se a coleta de dados por meio de entrevistas semiestruturadas guiadas por um roteiro com a seguinte questão << Qual a função do enfermeiro na assistência à criança na atenção primária em saúde? >>. Utilizou-se, para a análise das falas, a técnica de Análise de Conteúdo na modalidade Análise Categorial. Resultados: emergiram-se duas categorias: Acompanhamento da criança por meio da consulta de Puericultura e Consultas em grupo como estratégia de orientação da criança e suas famílias. Conclusão: perpassa-se a atuação do enfermeiro pelo contexto biopsicossocial e familiar da criança na identificação de problemas de saúde, na detecção de situações de risco e vulnerabilidades e nas orientações pertinentes a cada caso. Descritores: Enfermagem; Consulta de Enfermagem; Atenção Primária à Saúde; Saúde da Criança; Criança; Família. Abstract Objective: to analyze the role of primary health care nurses in the care of children and their families. Method: this is a qualitative, descriptive study with fifteen nurses. Data were collected through semi-structured interviews guided by a script with the following question << What is the role of nurses in child care in primary health care? >>. For the analysis of the speeches, the technique of Content Analysis in the Categorical Analysis modality was used. Results: two categories emerged: Child follow-up through the Childcare consultation and Group consultations as a strategy for guiding the child and their families. Conclusion: the role of the nurse is analyzed by the child's biopsychosocial and family context in the identification of health problems, in the detection of risk situations and vulnerabilities, and in the guidance relevant to each case. Descriptors: Nursing; Nursing Consultation; Primary health Care; Child Health; Child; Family.Resumen Objetivo: analizar el papel del enfermero de atención primaria de salud en el cuidado de los niños y sus familias. Método: se trata de un estudio cualitativo, descriptivo con quince enfermeros. Los datos fueron recolectados a través de entrevistas semiestructuradas guiadas por un guión con la siguiente pregunta << ¿Cuál es el papel del enfermero en el cuidado infantil en la atención primaria de salud? >>. Para el análisis de los discursos, se utilizó la técnica de Análisis de Contenido en la modalidad de Análisis Categórico. Resultados: surgieron dos categorías: Seguimiento del niño a través de la consulta de Puericultura y Consultas grupales como una estrategia para guiar al niño y sus familias. Conclusión: el papel del enfermero está impregnado por el contexto biopsicosocial y familiar del niño en la identificación de problemas de salud, en la detección de situaciones de riesgo y vulnerabilidades, y en las orientaciones relevantes para cada caso. Descriptores: Enfermeira; Consulta de Enfermeira; Atención Primaria a la Salud; Salud del Niño; Niño; Família.

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Self-perceived factors associated with smoking cessation among primary health care nurses: a qualitative study

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692011000600022 ◽

2011 ◽

Vol 19 (6) ◽

pp. 1437-1444 ◽

Cited By ~ 2

Author(s):

Miguel Bennasar Veny ◽

Jordi Pericas Beltrán ◽

Susana González Torrente ◽

Priscila Segui González ◽

Antoni Aguiló Pons ◽

...

Keyword(s):

Health Care ◽

Smoking Cessation ◽

Primary Health Care ◽

Qualitative Study ◽

Family Environment ◽

Structured Interview ◽

Spanish Law ◽

Primary Health ◽

Shame And Guilt ◽

Primary Health Care Nurses

The aim of this work was to characterize the views of nurses about factors modulating smoking cessation. Results of this study will allow us to design helping interventions with the maximum specificity for nurses. A qualitative study through a semi-structured interview of 15 Primary Health Care nurses who were smokers was performed. In contrast with other studies in which nurses were not aware of any particular social pressure to give up smoking, 18 months after the application of the Anti-Smoking Spanish Law, this feeling was expressed. Therefore, the main reasons for giving up smoking include that smoking in public is every day worse seen, together with a sense of shame and guilt in front of their social and family environment, especially for being a professional group dedicated to health.

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Primary Health Care Nurses’ Perceptions of Risk During COVID‐19: A Qualitative Study

Journal of Nursing Scholarship ◽

10.1111/jnu.12698 ◽

2021 ◽

Author(s):

Christine Ashley ◽

Sharon James ◽

Catherine Stephen ◽

Ruth Mursa ◽

Susan McInnes ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Qualitative Study ◽

Perceptions Of Risk ◽

Primary Health ◽

Nurses Perceptions ◽

Primary Health Care Nurses

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Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.460 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Pinto ◽

J V Santos ◽

M Lobo ◽

J Viana ◽

J Souza ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Primary Healthcare ◽

Pay For Performance ◽

Care Quality ◽

Organizational Model ◽

Avoidable Hospitalizations ◽

Primary Health ◽

Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

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