scholarly journals Barriers, Facilitators, and Proposals for Improvement in the Implementation of a Collaborative Care Program for Depression: A Qualitative Study of Primary Care Doctor and Nurse Experiences

2021 ◽  
Author(s):  
Enric Aragonès ◽  
Germán López-Cortacans ◽  
Narcís Cardoner ◽  
Catarina Tomé-Pires ◽  
Daniel Porta-Casteràs ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Collaborative Care ◽  
Health Care Professionals ◽  
Care Program ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background: Primary care plays a central role in the treatment of depression. Nonetheless, shortcomings in its management and suboptimal outcomes have been identified. Collaborative care models improve processes for the management of depressive disorders and associated outcomes. We developed a strategy to implement the INDI collaborative care program for the management of depression in primary health care centers across Catalonia. The aim of this qualitative study was to evaluate a trial implementation of the program to identify barriers, facilitators, and proposals for improvement. Methods: One year after the implementation of the INDI program in 18 public primary health care centers we performed a qualitative study in which the opinions and experiences of 23 primary care doctors and nurses from the participating centers were explored in focus groups. We performed thematic content analysis of the focus group transcripts. Results: The results were organized into three categories: facilitators, barriers, and proposals for improvement as perceived by the health care professionals involved. The most important facilitator identified was the perception that the INDI collaborative care program could be a useful tool for reorganizing processes and improving the management of depression in primary care, currently viewed as deficient. The main barriers identified were of an organizational nature: heavy workloads, lack of time, high staff turnover and shortages, and competing demands. Additional obstacles were inertia and resistance to change among health care professionals. Proposals for improvement included institutional buy-in to guarantee enduring support and the organizational changes needed for successful implementation.Conclusions: The INDI program is perceived as a useful, viable program for improving the management of depression in primary care. Uptake by primary care centers and health care professionals, however, was poor. The identification and analysis of barriers and facilitators will help refine the strategy to achieve successful, widespread implementation.Trial registration: ClinicalTrials.gov identifier: NCT03285659; Registered 18th September, 2017.

scholarly journals Medical Audit of the Quality of Diabetes Care

2011 ◽  
Vol 3 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Abdulbari Bener ◽  
Mariam Abdulmalik ◽  
Mohammed Al-Kazaz ◽  
Abdul-Ghani Mohammed ◽  
Rahima Sanya ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Diabetes Care ◽  
Diabetic Patients ◽  
Primary Health ◽  
Primary Care Patients ◽  
Primary Health Care Centers ◽  
Health Care Centers

Objective: To assess the quality of diabetes care provided to patients attending primary care settings and hospitals in the State of Qatar. Design: Observational cohort study. Setting: The survey was carried out in primary health care centers and hospitals. Subjects and Methods: The study was conducted from January 2010 to August 2010 among diabetic patients attending primary health care centers and hospitals. Among the patients participating, 575 were from hospitals and 1103 from primary health care centers. Face-to-face interviews were conducted using a structured questionnaire including sociodemographic, clinical, and satisfaction score of the patients. Results: The mean age of the primary care diabetic patients was 46.1 ± 15.1 years and 44.5 ± 14.8 years for hospital patients ( P = .03). There was a significant difference observed in terms of age group, gender, marital status, occupation, and consanguinity of the diabetic patients in both medical settings ( P < .001). Overweight was less prevalent in primary care patients than in hospital diabetes mellitus patients (40.4% vs 46.4%). A significant variation was observed in the mean values of blood glucose (−0.76), HbA1C (−0.78), LDL (−0.01), albumin (−0.37), bilirubin (−0.76), and triglyceride (−0.01) in primary care patients compared to the mean values of the preceding year. Overall, complications were lower in primary care diabetic patients, and patients attending primary care were more satisfied with the diabetes care. Conclusion: The present study revealed that in general, primary health care provided a better quality of care to diabetic patients compared to that of hospitals. Also, primary care patients had a better satisfaction score towards diabetes care.

scholarly journals The evaluation of knowledge and activities of primary health care professionals in promoting breast-feeding

Medicina ◽  
2009 ◽  
Vol 45 (3) ◽  
pp. 238 ◽  
Author(s):  
Giedra Levinienė ◽  
Aušra Petrauskienė ◽  
Eglė Tamulevičienė ◽  
Jolanta Kudzytė ◽  
Liutauras Labanauskas
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
Breast Feeding ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Primary Health ◽  
Breast Feed ◽  
Primary Health Care Centers ◽  
Health Care Centers

The objective of this study was to evaluate the knowledge and activities of Kaunas primary health care center professionals in promoting breast-feeding. Material and methods. A total of 84 general practitioners and 52 nurses participated in the survey, which was carried out in Kaunas primary health care centers in 2006. Data were gathered from the anonymous questionnaire. Results. Less than half of general practitioners (45.1%) and 65% of nurses were convinced that baby must be exclusively breast-fed until the age of 6 months, but only 21.6% of general practitioners and 27.5% of nurses knew that breast-feeding with complementary feeding should be continued until the age of 2 years and longer. Still 15.7% of general practitioners and 25% of nurses recommended pacifiers; 7.8% of general practitioners advised to breast-feed according to hours. Half of the health professionals recommended additional drinks between meals; onethird of them – to give complementary food for the babies before the age of 6 months. One-third (29.6%) of the health professionals surveyed recommended mothers to feed their babies more frequently in case the amount of breast milk decreased. Conclusions. The survey showed that knowledge of medical personnel in primary health care centers about the advantages of breast-feeding, prophylaxis of hypogalactia, and duration of breast-feeding was still insufficient.

scholarly journals Perceptions of Type 2 Diabetes Patients Towards Diabetes Management Visits at Public Primary Health Care Centers with Diverse Opinions Towards Nurse-led Clinics in Muscat, Oman: A Pilot Qualitative Study

2020 ◽  
Vol 35 (6) ◽  
pp. e196-e196
Author(s):  
Kamila Al-Alawi ◽  
Ahmed Al-Mandhari
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Diabetes Management ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers ◽  
Diabetes Patients

Objectives: The literature has described several positive outcomes related to diabetes management via nurse-led clinics. This is especially true where a shortage of physicians is recorded within a team-based approach. We sought to explore the perceptions of patients with type 2 diabetes towards the current diabetes management visits at public primary health care centers in Muscat, Oman and their opinions towards nurse-led diabetes management clinics. Methods: This pilot qualitative study included seven semi-structured interviews with type 2 diabetes patients from four purposely selected public primary health care centers in Muscat. Qualitative thematic analysis was applied. Results: Patients with type 2 diabetes expressed their satisfaction with the present diabetes management visits at public primary health care. Their opinions towards nurse-led clinic were diverse and divided patients into three categories: those who totally refused the nurse-led clinics, those who accepted the clinics but with reservations, and patients that totally accepted the nurse-led clinics. The patients’ main concern was the nurses’ abilities to handle and understand the disease and its management. Conclusions: Our pilot study revealed type 2 diabetes patients’ satisfaction with the current diabetes management clinics. However, transformation to nurse-led clinics within team-based approach requires further studies with a bigger sample size. Further studies on requirements related to the Omani health care system and a better understanding of patients’ worries and their readiness to accept the concept of nurse-led clinics and their outcomes are also recommended.

scholarly journals The Perceived Health Needs of Primiparous Mothers Referring to Primary Health Care Centers: A Qualitative Study

2020 ◽  
Vol Volume 12 ◽  
pp. 745-753
Author(s):  
Shahin Salarvand ◽  
Masoumeh-Sadat Mousavi ◽  
Darya Esmaeilbeigy ◽  
Farahnaz Changaee ◽  
Mohammad Almasian
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Perceived Health ◽  
Health Needs ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

scholarly journals Integrative and complementary practices in Primary Care: unveiling health promotion

2020 ◽  
Vol 28 ◽  
Author(s):  
Indiara Sartori Dalmolin ◽  
Ivonete Teresinha Schülter Buss Heidemann
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Health Care Professionals ◽  
Daily Life ◽  
Disease Process ◽  
Primary Health ◽  
Three Stages

Objective: to understand the use of integrative and complementary practices as a health promotion action. Method: qualitative study, action-participant type, with the application of Paulo Freire’s Research Itinerary, in which 30 Primary Health Care professionals participated. Thematic research was developed with two Primary Care Units, one that used integrative and complementary practices in daily life and another that focused more on allopathic concepts of assistance. To carry out the three stages of the method used, seven Culture Yarning Circles took place. The critical unveiling took place concurrently with the participation of those surveyed. Results: integrative and complementary practices constitute a form of health care, with the purpose of understanding the human being in the health-disease process, making it possible to work with the different aspects that involve them. In this way, they reduce damages resulting from the excessive use of medications, stimulate comprehensiveness and promote health. Conclusion: integrative and complementary practices are resources for health promotion, through comprehensive care and reducing the use of medications.

Knowledge and behavior of Greek female health care professionals working in primary health care centers

1992 ◽  
Vol 15 (6) ◽  
pp. 415???421 ◽  
Author(s):  
Evangelia Patistea ◽  
Joannes Chliaoutakis ◽  
Christina Darviri ◽  
Aglaia Tselika
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
And Behavior ◽  
Health Care Centers

Antibiotics Prescription Patterns in Primary Health Care in Qatar – A Population based study from 2017 to 2018

2020 ◽  
Author(s):  
Hanan Khudadad ◽  
Lukman Thalib
Keyword(s):  
Health Care ◽  
Antibiotic Resistance ◽  
Primary Health Care ◽  
Respiratory System ◽  
Population Based ◽  
Antibiotics Resistance ◽  
Prescription Patterns ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Background: Antibiotics are antimicrobial drugs used in the treatment and prevention of bacterial infections. They played a pivotal role in achieving major advances in medicine and surgery (1). Yet, due to increased and inappropriate use of antibiotics, antibiotic resistance (AR) has become a growing public health problem. Information on antibiotic prescription patterns are vital in developing a constructive approach to deal with growing antibiotic resistance (2). The study aims to describe the population based antibiotic prescriptions among patients attending primary care centers in Qatar. Methodology: A population based observational study of all medications prescribed in the all Primary Health Care Centers during the period of 2017-2018 in Qatar. Records with all medication prescriptions were extracted and linked to medical diagnosis. Antibiotics prescriptions records were compared to non- antibiotics records using logistic regression model in identifying the potential predictors for antibiotic prescriptions. Results: A total of 11,069,439 medication prescriptions given over a period of two-years, we found about 12.1% (n= 726,667) antibiotics prescriptions were antibiotics, and 65% of antibiotics are prescribed and received by the patients at the first visits. Paracetamol (22.3%) was the first highest medication prescribed followed by antibiotics (12.1 %) and vitamin D2 (10.2 %). More than half of all antibiotics prescribed during the period of January 2017 to December 2018 were Penicillin (56.9%). We found that half of the antibiotics (49.3 %) have been prescribed for the respiratory system comparing to the other body system. We found that males were 29% more likely be given an antibiotic compared to females (OR=1.29, 95% CI= 1.24- 1.33). Implications: The study provides a baseline data to enable PHCC management to design effective intervention program to address the problem of antibiotics resistance. Furthermore, it will help the policymakers to comprehend the size of the issue and develop a system to manage the antibiotics therapy. Conclusion: Antibiotics was the second highest medication prescribed in the Primary Health Care Centers in Qatar after paracetamol and most of the patients received it at the first visit. Most of the prescriptions in Primary Health Care Centers in Qatar were for the respiratory system, and Penicillin was the highest class prescribed. Male visitors were prescribed antibiotics more than female visitors.

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