Primary Care Doctors’ Role in Antenatal Detection and Management of Fetal Bilateral Pleural Effusions: A Report of 2 Cases

Journal of Community Health Research ◽

10.18502/jchr.v10i2.6585 ◽

2021 ◽

Author(s):

Chai Li Tay ◽

Noor Afiqah AW

Keyword(s):

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Healthcare Providers ◽

Hydrops Fetalis ◽

Pleural Effusions ◽

Maternal Complications ◽

Primary Care Doctors ◽

Antenatal Detection ◽

Primary Healthcare Providers

Introduction: Fetal pleural effusion is rarely seen in primary care setting. It is more commonly diagnosed among women with diabetes mellitus in pregnancy. Method: This report illustrates two patients with fetal bilateral pleural effusions, detected at 18-week and 24-week period of amenorrhea (POA) during routine antenatal scans by primary care doctors. Result: These two pregnancies were complicated with hydrops fetalis and resulted in fresh stillbirth and intra-uterine death. Conclusion: Primary healthcare providers play an important role in the early diagnosis of fetal congenital anomaly, counseling regarding the ultrasonography findings, neonatal outcome, and referral to obstetrician for further management and monitoring for maternal complications, such as polyhydramnios, preeclampsia, mirror syndrome, and depression as a result of hydrops fetalis.

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Perspectives of LGBTQ Youth and Pediatricians in the Primary Care Setting: A Systematic Review

Journal of Primary Care & Community Health ◽

10.1177/21501327211044357 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110443

Author(s):

Molly Stern

Keyword(s):

Systematic Review ◽

Primary Care ◽

Sexual Minority ◽

English Language ◽

Care Setting ◽

Primary Care Setting ◽

Healthcare Providers ◽

Healthcare Setting ◽

Pediatric Primary Care ◽

Lgbtq Youth

Objectives: Conduct a systematic review designed to determine needs and experiences of LGBTQ adolescents in the pediatric primary care setting and to the ability of primary care practitioners to provide the most inclusive care to LGBTQ adolescents. Methods: PubMed, CINAHL, and Embase searches using the following keywords: LGBTQ, Adolescents, Pediatrics, Sexual-Minority, Gender-Identity, and primary care, to identify peer-reviewed publications from 1998 to 2017 that focused on stigma in the healthcare setting related to LGBTQ youth and the knowledge of healthcare providers on enhancing care for their sexual and gender minority patients. Article inclusion criteria include: primary research studies conducted in a pediatric primary care describing LGBTQ patients, pediatric patients as described by the American Academy of Pediatrics (AAP), and written in the English language. Articles were excluded if they used inaccurate definitions for LGBTQ identity, inappropriate patient ages outside of those defined by the AAP, and studies not in a pediatric primary care setting. Results: Four articles were identified for the review. Of the included articles, the majority of LGBTQ adolescents experience stigma in the healthcare setting. A limited number of physicians providing care to LGBTQ adolescents felt equipped to care for their sexual-minority patients due to lack of education and resources. Conclusions: The education of physicians should include a more detailed approach to providing care to the LGBTQ population, particularly to those training to become pediatricians. A standard guide to treating LGBTQ adolescents could eliminate stigma in the healthcare setting.

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Spiritual care at the end of life in the primary care setting: experiences from spiritual caregivers - a mixed methods study

BMC Palliative Care ◽

10.1186/s12904-019-0484-8 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 2

Author(s):

Ian Koper ◽

H. Roeline W. Pasman ◽

Bart P. M. Schweitzer ◽

Annemieke Kuin ◽

Bregje D. Onwuteaka-Philipsen

Keyword(s):

Primary Care ◽

Palliative Care ◽

Mixed Methods ◽

Focus Group ◽

End Of Life ◽

Spiritual Care ◽

Care Setting ◽

Primary Care Setting ◽

Healthcare Providers ◽

Spiritual Issues

Abstract Background Spiritual care is an important aspect of palliative care. In the Netherlands, general practitioners and district nurses play a leading role in palliative care in the primary care setting. When they are unable to provide adequate spiritual care to their patient, they can refer to spiritual caregivers. This study aimed to provide an overview of the practice of spiritual caregivers in the primary care setting, and to investigate, from their own perspective, the reasons why spiritual caregivers are infrequently involved in palliative care and what is needed to improve this. Method Sequential mixed methods consisting of an online questionnaire with structured and open questions completed by 31 spiritual caregivers, followed by an online focus group with 9 spiritual caregivers, analysed through open coding. Results Spiritual caregivers provide care for existential, relational and religious issues, and the emotions related to these issues. Aspects of spiritual care in practice include helping patients find meaning, acceptance or reconciliation, paying attention to the spiritual issues of relatives of the patient, and helping them all to say farewell. Besides spiritual issues, spiritual caregivers also discuss topics related to medical care with patients and relatives, such as treatment wishes and options. Spiritual caregivers also mentioned barriers and facilitators for the provision of spiritual care, such as communication with other healthcare providers, having a relationship of trust and structural funding.. In the online focus group, local multidisciplinary meetings were suggested as ideal opportunities to familiarize other healthcare providers with spirituality and promote spiritual caregivers’ services. Also, structural funding for spiritual caregivers in the primary care setting should be organized. Conclusion Spiritual caregivers provide broad spiritual care at the end of life, and discuss many different topics beside spiritual issues with patients in the palliative phase, supporting them when making medical end-of-life decisions. Spiritual care in the primary care setting may be improved by better cooperation between spiritual caregiver and other healthcare providers, through improved education in spiritual care and better promotion of spiritual caregivers’ services.

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A survey of the involvement of primary care doctors in HIV prevention and care in a low-prevalence, high-income setting

BMC Family Practice ◽

10.1186/s12875-021-01376-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Greta Tam ◽

Ngai Sze Wong ◽

Shui Shan Lee

Keyword(s):

Primary Care ◽

Hong Kong ◽

High Risk ◽

Hiv Prevention ◽

Primary Healthcare ◽

Healthcare Providers ◽

High Income ◽

High Involvement ◽

Primary Care Doctors ◽

Primary Healthcare Providers

Abstract Background In high-income countries with a low HIV prevalence, primary care doctors are likely the first point of medical contact for people at high risk of HIV. One of the key factors for successful implementation of preventive measures is the cooperation of primary healthcare providers. Hong Kong’s population mostly seek primary care in the private sectors. Our study evaluated the involvement of private primary healthcare providers in HIV prevention and care. Methods A cross-sectional postal structured questionnaire was administered to 1102 private primary care doctors in Hong Kong in December 2017. Responses were received via postal mail, fax or online. Non-respondents received a phone-call reminder to complete the survey. Descriptive analyses were performed for all the question items. Chi-square test was used to assess the association between participants’ level of involvement in HIV prevention and care and their demographics and medical practice characteristics. Results The response rate was 17.9% (197/1102). Most of the respondents were Chinese (95%) and have obtained their primary medical qualifications in Hong Kong (72%). More than half of the doctors have practiced in the private sector for more than 20 years (54%). Six aspects were used to evaluate practices or involvements in HIV prevention or care: Most of the responding doctors had offered advice (61%) and/or HIV test (76%) to patients with high-risk behaviors. However, fewer doctors had diagnosed HIV (27%), provided care for HIV positive patients (21%), reported HIV cases (19%) or prescribed antiretrovirals (4%). Nine (4.5%) did not answer all six questions on their practices or involvements in HIV prevention or care. The remaining respondents were then categorized into no/low involvement group and high involvement group. Overall,71% had no/low involvement (133/188) compared to 29% who had high involvement (55/188). Factors associated with high involvement included being in the 50–59 age group (OR: 2.48, 95% CI: 1.12–5.5), and belonging to a large practice (OR: 3.16, 95% CI: 1.4–7.12). Conclusions Overall, most private primary care doctors in Hong Kong have no or low involvement in HIV prevention and care. However, most were willing and experienced in providing general preventive services, such as HIV testing and advice.

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