scholarly journals General practice trainee strategies for seeking in-consultation assistance from supervisors, and their perceptions of patient-related barriers to help-seeking: a survey study

2020 ◽  
Author(s):  
Nancy Sturman ◽  
Amanda Tapley ◽  
Mieke van Driel ◽  
Elizabeth Holliday ◽  
Jean Ball ◽  
...  
Keyword(s):  
General Practice ◽  
Help Seeking ◽  
Survey Study ◽  
Just In Time ◽  
Workplace Interventions ◽  
Face To Face ◽  
Frequency Of Use ◽  
Educational Implications ◽  
Perceived Change ◽  
Electronic Messaging

Abstract Background General practice (GP) trainees may seek supervisor assistance when hesitant to complete patient consultations independently. Trainees describe patient-related barriers to this in-consultation help-seeking, despite its key role in supervisory oversight. Little is known, however, about trainee strategies for seeking assistance, or the frequency and associations of trainee concerns about these barriers. Methods Australian GP trainees rated their frequency of use of five specific strategies for obtaining in-consultation assistance, perceived change in patient impressions of their competence after this assistance, and relative trainee comfort presenting patients outside, compared to within, patients’ hearing. Statistical analyses included descriptive statistics and multivariable logistic regression. Results Responses were received from 778 Australian GP trainees (response rate 89%). Help-seeking strategies did not differ between trainees at different training stages, except for greater use of electronic messaging in later stages. In-consultation assistance was most commonly provided by phone between trainee and supervisor consulting rooms, or outside the trainee’s patient’s hearing. Supervisor assistance in the trainee’s room face-to-face with the patient was reported as either never or rarely obtained by 12% of respondents. More trainees (25%) perceived that patient impressions of their competence increased after help-seeking than perceived that these impressions decreased (19%). Most trainees (55%) preferred to present patients outside their hearing. Trainee age was the only variable associated with both patient-related barriers. Conclusion Supervisors appear to have considerable influence over trainee help-seeking barriers and strategies, including whether or not face-to-face in-consultation supervision is sought. In-consultation supervision may actually increase trainee perceptions of patient impressions of their competence. Many supervisors and trainees may benefit from additional educational and workplace interventions to facilitate comfortable and effective trainee help-seeking in front of patients. More work is required to understand the clinical and educational implications of different help-seeking strategies when trainees require ‘just in time’ supervisor assistance.

scholarly journals Configurations for obtaining in-consultation assistance from supervisors in general practice training, and patient-related barriers to trainee help-seeking: a survey study.

2020 ◽  
Author(s):  
Nancy Sturman ◽  
Amanda Tapley ◽  
Mieke van Driel ◽  
Elizabeth Holliday ◽  
Jean Ball ◽  
...  
Keyword(s):  
General Practice ◽  
Help Seeking ◽  
Survey Study ◽  
Just In Time ◽  
Face To Face ◽  
Frequency Of Use ◽  
Perceived Change ◽  
Seeking Help ◽  
Electronic Messaging ◽  
General Practice Training

Abstract BackgroundGeneral practice (GP) trainees may seek supervisor assistance to complete their patient consultations. This in-consultation assistance plays a key role in the supervisory oversight of trainees and in trainee learning. It may be obtained face-to-face, or using phone or messaging systems, and either in front of patients or outside their hearing. Trainee concerns about decreased patient impressions of their competence, and discomfort presenting patients within their hearing, act as barriers to seeking help during consultations. Little is known about the frequency and associations of trainee concerns about these patient-related barriers, or the various trainee-supervisor-patient configurations used to obtain in-consultation assistance.MethodsAustralian GP trainees rated their frequency of use of five specific configurations for obtaining in-consultation assistance, perceived change in patient impressions of their competence after this assistance, and relative trainee comfort presenting patients outside, compared to within, patients’ hearing. Statistical analyses included descriptive statistics and multivariable logistic regression.ResultsResponses were received from 778 Australian GP trainees (response rate 89%). Help-seeking configurations did not differ between trainees at different training stages, except for greater use of electronic messaging in later stages. In-consultation assistance was most commonly provided by phone between trainee and supervisor consulting rooms, or outside the trainee’s patient’s hearing. Supervisor assistance in the trainee’s room face-to-face with the patient was reported as either never or rarely obtained by 12% of respondents. More trainees (25%) perceived that patient impressions of their competence increased after help-seeking than perceived that these impressions decreased (19%). Most trainees (55%) preferred to present patients outside their hearing. Trainee age was the only variable associated with both patient-related barriers.ConclusionSupervisors appear to have considerable influence over trainee help-seeking, including which configurations are used and trainee perceptions of patient-related barriers. In-consultation supervision may actually increase trainee perceptions of patient impressions of their competence. Many supervisors and trainees may benefit from additional educational and workplace interventions to facilitate comfortable and effective trainee help-seeking in front of patients. More work is required to understand the clinical and educational implications of different help-seeking configurations when trainees require ‘just in time’ supervisor assistance.

scholarly journals Configurations for obtaining in-consultation assistance from supervisors in general practice training, and patient-related barriers to trainee help-seeking: a survey study.

2020 ◽  
Author(s):  
Nancy Sturman ◽  
Amanda Tapley ◽  
Mieke van Driel ◽  
Elizabeth Holliday ◽  
Jean Ball ◽  
...  
Keyword(s):  
General Practice ◽  
Help Seeking ◽  
Survey Study ◽  
Just In Time ◽  
Face To Face ◽  
Frequency Of Use ◽  
Perceived Change ◽  
Seeking Help ◽  
Electronic Messaging ◽  
General Practice Training

Abstract Background General practice (GP) trainees may seek supervisor assistance to complete their patient consultations. This in-consultation assistance plays a key role in the supervisory oversight of trainees and in trainee learning. It may be obtained face-to-face, or using phone or messaging systems, and either in front of patients or outside their hearing. Trainee concerns about decreased patient impressions of their competence, and discomfort presenting patients within their hearing, act as barriers to seeking help during consultations. Little is known about the frequency and associations of trainee concerns about these patient-related barriers, or the various trainee-supervisor-patient configurations used to obtain in-consultation assistance. Methods Australian GP trainees rated their frequency of use of five specific configurations for obtaining in-consultation assistance, perceived change in patient impressions of their competence after this assistance, and relative trainee comfort presenting patients outside, compared to within, patients’ hearing. Statistical analyses included descriptive statistics and multivariable logistic regression. Results Responses were received from 778 Australian GP trainees (response rate 89%). Help-seeking configurations did not differ between trainees at different training stages, except for greater use of electronic messaging in later stages. In-consultation assistance was most commonly provided by phone between trainee and supervisor consulting rooms, or outside the trainee’s patient’s hearing. Supervisor assistance in the trainee’s room face-to-face with the patient was reported as either never or rarely obtained by 12% of respondents. More trainees (25%) perceived that patient impressions of their competence increased after help-seeking than perceived that these impressions decreased (19%). Most trainees (55%) preferred to present patients outside their hearing. Trainee age was the only variable associated with both patient-related barriers. Conclusion Supervisors appear to have considerable influence over trainee help-seeking, including which configurations are used and trainee perceptions of patient-related barriers. In-consultation supervision may actually increase trainee perceptions of patient impressions of their competence. Many supervisors and trainees may benefit from additional educational and workplace interventions to facilitate comfortable and effective trainee help-seeking in front of patients. More work is required to understand the clinical and educational implications of different help-seeking configurations when trainees require ‘just in time’ supervisor assistance.

scholarly journals Configurations for obtaining in-consultation assistance from supervisors in general practice training, and patient-related barriers to trainee help-seeking: a survey study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nancy J. Sturman ◽  
Amanda Tapley ◽  
Mieke L. van Driel ◽  
Elizabeth G. Holliday ◽  
Jean I. Ball ◽  
...  
Keyword(s):  
General Practice ◽  
Help Seeking ◽  
Survey Study ◽  
Just In Time ◽  
Face To Face ◽  
Frequency Of Use ◽  
Perceived Change ◽  
Seeking Help ◽  
Electronic Messaging ◽  
General Practice Training

Abstract Background General practice (GP) trainees may seek supervisor assistance to complete their patient consultations. This in-consultation assistance plays a key role in the supervisory oversight of trainees and in trainee learning. It may be obtained face-to-face, or using phone or messaging systems, and either in front of patients or outside their hearing. Trainee concerns about decreased patient impressions of their competence, and discomfort presenting patients within their hearing, act as barriers to seeking help during consultations. Little is known about the frequency and associations of trainee concerns about these patient-related barriers, or the various trainee-supervisor-patient configurations used to obtain in-consultation assistance. Methods Australian GP trainees rated their frequency of use of five specific configurations for obtaining in-consultation assistance, perceived change in patient impressions of their competence after this assistance, and relative trainee comfort presenting patients outside, compared to within, patients’ hearing. Statistical analyses included descriptive statistics and multivariable logistic regression. Results Responses were received from 778 Australian GP trainees (response rate 89%). Help-seeking configurations did not differ between trainees at different training stages, except for greater use of electronic messaging in later stages. In-consultation assistance was most commonly provided by phone between trainee and supervisor consulting rooms, or outside the trainee’s patient’s hearing. Supervisor assistance in the trainee’s room face-to-face with the patient was reported as either never or rarely obtained by 12% of respondents. More trainees (25%) perceived that patient impressions of their competence increased after help-seeking than perceived that these impressions decreased (19%). Most trainees (55%) preferred to present patients outside their hearing. Trainee age was the only variable associated with both patient-related barriers. Conclusion Supervisors appear to have considerable influence over trainee help-seeking, including which configurations are used and trainee perceptions of patient-related barriers. In-consultation supervision may actually increase trainee perceptions of patient impressions of their competence. Many supervisors and trainees may benefit from additional educational and workplace interventions to facilitate comfortable and effective trainee help-seeking in front of patients. More work is required to understand the clinical and educational implications of different help-seeking configurations when trainees require ‘just in time’ supervisor assistance.

scholarly journals Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study

10.2196/10735 ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e10735 ◽  
Author(s):  
Jennifer Apolinário-Hagen ◽  
Mathias Harrer ◽  
Fanny Kählke ◽  
Lara Fritsche ◽  
Christel Salewski ◽  
...  
Keyword(s):  
Attachment Style ◽  
Help Seeking ◽  
Public Attitudes ◽  
Perceived Usefulness ◽  
Survey Study ◽  
Convenience Sample ◽  
Web Based ◽  
Face To Face ◽  
Internet Interventions ◽  
Treatment Implementation

Background Internet interventions have been proposed to improve the accessibility and use of evidence-based psychological treatments. However, little is known about attitudes toward such treatments, which can be an important barrier to their use. Objective This study aimed to (1) determine attitudes toward guided internet interventions, (2) assess its acceptability compared with other internet-based formats, and (3) explore predictors of acceptance. Methods A convenience-sample Web-based survey (N=646) assessed attitudes toward guided internet therapies (ie, perceived usefulness and helpfulness, and advantage relative to face-to-face therapy), preferences for delivery modes (ie, e-preference: guided internet interventions, unguided internet interventions, or videoconferencing psychotherapy), and potential predictors of attitudes and preferences: sociodemographics, help-seeking–related variables, attachment style, and perceived stress. Results Although most participants perceived internet interventions as useful or helpful (426/646, 65.9%), a few indicated their advantage relative to face-to-face therapy (56/646, 8.7%). Most participants preferred guided internet interventions (252/646, 39.0%) over videoconferencing psychotherapy (147/646, 22.8%), unguided internet interventions (124/646, 19.2%), and not using internet interventions (121/646, 18.8%; missing data: 1/646, 0.2%). Attachment avoidance and stress were related to e-preference (all P<.05). Moreover, preference for therapist-guided internet interventions was higher for individuals who were aware of internet-based treatment (χ26=12.8; P=.046). Conclusions Participants assessed therapist-guided internet interventions as helpful, but not equivalent to face-to-face therapies. The vast majority (523/646, 81.0%) of the participants were potentially willing to use internet-based approaches. In lieu of providing patients with only one specific low-intensity treatment, implementation concepts should offer several options, including guided internet interventions, but not limited to them. Conversely, our results also indicate that efforts should focus on increasing public knowledge about internet interventions, including information about their effectiveness, to promote acceptance and uptake.

scholarly journals Experiences of Psychotherapists With Remote Psychotherapy During the COVID-19 Pandemic: Cross-sectional Web-Based Survey Study

10.2196/20246 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e20246 ◽  
Author(s):  
Elke Humer ◽  
Peter Stippl ◽  
Christoph Pieh ◽  
Rüdiger Pryss ◽  
Thomas Probst
Keyword(s):  
Survey Study ◽  
Personal Contact ◽  
The Internet ◽  
Cross Sectional ◽  
Protective Measures ◽  
Web Based ◽  
Face To Face ◽  
Frequency Of Use ◽  
Positive Experiences ◽  
Remote Therapy

Background The current situation around the COVID-19 pandemic and the measures necessary to fight it are creating challenges for psychotherapists, who usually treat patients face-to-face with personal contact. The pandemic is accelerating the use of remote psychotherapy (ie, psychotherapy provided via telephone or the internet). However, some psychotherapists have expressed reservations regarding remote psychotherapy. As psychotherapists are the individuals who determine the frequency of use of remote psychotherapy, the potential of enabling mental health care during the COVID-19 pandemic in line with the protective measures to fight COVID-19 can be realized only if psychotherapists are willing to use remote psychotherapy. Objective This study aimed to investigate the experiences of psychotherapists with remote psychotherapy in the first weeks of the COVID-19 lockdown in Austria (between March 24 and April 1, 2020). Methods Austrian psychotherapists were invited to take part in a web-based survey. The therapeutic orientations of the psychotherapists (behavioral, humanistic, psychodynamic, or systemic), their rating of the comparability of remote psychotherapy (web- or telephone-based) with face-to-face psychotherapy involving personal contact, and potential discrepancies between their actual experiences and previous expectations with remote psychotherapy were assessed. Data from 1162 psychotherapists practicing before and during the COVID-19 lockdown were analyzed. Results Psychotherapy conducted via telephone or the internet was reported to not be totally comparable to psychotherapy with personal contact (P<.001). Psychodynamic (P=.001) and humanistic (P=.005) therapists reported a higher comparability of telephone-based psychotherapy to in-person psychotherapy than behavioral therapists. Experiences with remote therapy (both web- and telephone-based) were more positive than previously expected (P<.001). Psychodynamic therapists reported more positive experiences with telephone-based psychotherapy than expected compared to behavioral (P=.03) and systemic (P=.002) therapists. In general, web-based psychotherapy was rated more positively (regarding comparability to psychotherapy with personal contact and experiences vs expectations) than telephone-based psychotherapy (P<.001); however, psychodynamic therapists reported their previous expectations to be equal to their actual experiences for both telephone- and web-based psychotherapy. Conclusions Psychotherapists found their experiences with remote psychotherapy (ie, web- or telephone-based psychotherapy) to be better than expected but found that this mode was not totally comparable to face-to-face psychotherapy with personal contact. Especially, behavioral therapists were found to rate telephone-based psychotherapy less favorably than therapists with other theoretical backgrounds.

scholarly journals Experiences of Psychotherapists With Remote Psychotherapy During the COVID-19 Pandemic: Cross-sectional Web-Based Survey Study (Preprint)

2020 ◽  
Author(s):  
Elke Humer ◽  
Peter Stippl ◽  
Christoph Pieh ◽  
Rüdiger Pryss ◽  
Thomas Probst
Keyword(s):  
Survey Study ◽  
Personal Contact ◽  
The Internet ◽  
Cross Sectional ◽  
Protective Measures ◽  
Web Based ◽  
Face To Face ◽  
Frequency Of Use ◽  
Positive Experiences ◽  
Remote Therapy

BACKGROUND The current situation around the COVID-19 pandemic and the measures necessary to fight it are creating challenges for psychotherapists, who usually treat patients face-to-face with personal contact. The pandemic is accelerating the use of remote psychotherapy (ie, psychotherapy provided via telephone or the internet). However, some psychotherapists have expressed reservations regarding remote psychotherapy. As psychotherapists are the individuals who determine the frequency of use of remote psychotherapy, the potential of enabling mental health care during the COVID-19 pandemic in line with the protective measures to fight COVID-19 can be realized only if psychotherapists are willing to use remote psychotherapy. OBJECTIVE This study aimed to investigate the experiences of psychotherapists with remote psychotherapy in the first weeks of the COVID-19 lockdown in Austria (between March 24 and April 1, 2020). METHODS Austrian psychotherapists were invited to take part in a web-based survey. The therapeutic orientations of the psychotherapists (behavioral, humanistic, psychodynamic, or systemic), their rating of the comparability of remote psychotherapy (web- or telephone-based) with face-to-face psychotherapy involving personal contact, and potential discrepancies between their actual experiences and previous expectations with remote psychotherapy were assessed. Data from 1162 psychotherapists practicing before and during the COVID-19 lockdown were analyzed. RESULTS Psychotherapy conducted via telephone or the internet was reported to not be totally comparable to psychotherapy with personal contact (<i>P</i>&lt;.001). Psychodynamic (<i>P</i>=.001) and humanistic (<i>P</i>=.005) therapists reported a higher comparability of telephone-based psychotherapy to in-person psychotherapy than behavioral therapists. Experiences with remote therapy (both web- and telephone-based) were more positive than previously expected (<i>P</i>&lt;.001). Psychodynamic therapists reported more positive experiences with telephone-based psychotherapy than expected compared to behavioral (<i>P</i>=.03) and systemic (<i>P</i>=.002) therapists. In general, web-based psychotherapy was rated more positively (regarding comparability to psychotherapy with personal contact and experiences vs expectations) than telephone-based psychotherapy (<i>P</i>&lt;.001); however, psychodynamic therapists reported their previous expectations to be equal to their actual experiences for both telephone- and web-based psychotherapy. CONCLUSIONS Psychotherapists found their experiences with remote psychotherapy (ie, web- or telephone-based psychotherapy) to be better than expected but found that this mode was not totally comparable to face-to-face psychotherapy with personal contact. Especially, behavioral therapists were found to rate telephone-based psychotherapy less favorably than therapists with other theoretical backgrounds.

scholarly journals Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study (Preprint)

2018 ◽  
Author(s):  
Jennifer Apolinário-Hagen ◽  
Mathias Harrer ◽  
Fanny Kählke ◽  
Lara Fritsche ◽  
Christel Salewski ◽  
...  
Keyword(s):  
Attachment Style ◽  
Help Seeking ◽  
Public Attitudes ◽  
Perceived Usefulness ◽  
Survey Study ◽  
Convenience Sample ◽  
Web Based ◽  
Face To Face ◽  
Internet Interventions ◽  
Treatment Implementation

BACKGROUND Internet interventions have been proposed to improve the accessibility and use of evidence-based psychological treatments. However, little is known about attitudes toward such treatments, which can be an important barrier to their use. OBJECTIVE This study aimed to (1) determine attitudes toward guided internet interventions, (2) assess its acceptability compared with other internet-based formats, and (3) explore predictors of acceptance. METHODS A convenience-sample Web-based survey (N=646) assessed attitudes toward guided internet therapies (ie, perceived usefulness and helpfulness, and advantage relative to face-to-face therapy), preferences for delivery modes (ie, e-preference: guided internet interventions, unguided internet interventions, or videoconferencing psychotherapy), and potential predictors of attitudes and preferences: sociodemographics, help-seeking–related variables, attachment style, and perceived stress. RESULTS Although most participants perceived internet interventions as useful or helpful (426/646, 65.9%), a few indicated their advantage relative to face-to-face therapy (56/646, 8.7%). Most participants preferred guided internet interventions (252/646, 39.0%) over videoconferencing psychotherapy (147/646, 22.8%), unguided internet interventions (124/646, 19.2%), and not using internet interventions (121/646, 18.8%; missing data: 1/646, 0.2%). Attachment avoidance and stress were related to e-preference (all P<.05). Moreover, preference for therapist-guided internet interventions was higher for individuals who were aware of internet-based treatment (χ26=12.8; P=.046). CONCLUSIONS Participants assessed therapist-guided internet interventions as helpful, but not equivalent to face-to-face therapies. The vast majority (523/646, 81.0%) of the participants were potentially willing to use internet-based approaches. In lieu of providing patients with only one specific low-intensity treatment, implementation concepts should offer several options, including guided internet interventions, but not limited to them. Conversely, our results also indicate that efforts should focus on increasing public knowledge about internet interventions, including information about their effectiveness, to promote acceptance and uptake.

scholarly journals Standing order use in general practice: the views of medicine, nursing and pharmacy stakeholder organisations

2017 ◽  
Vol 9 (1) ◽  
pp. 47 ◽  
Author(s):  
Robyn Taylor ◽  
Eileen McKinlay ◽  
Caroline Morris
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Access To Health Care ◽  
Timely Manner ◽  
Face To Face ◽  
Standing Order ◽  
Access To Health ◽  
General Practices ◽  
Pharmacy Data ◽  
The Impact

ABSTRACT INTRODUCTION Standing orders are used by many general practices in New Zealand. They allow a practice nurse to assess patients and administer and/or supply medicines without needing intervention from a general practitioner. AIM To explore organisational strategic stakeholders’ views of standing order use in general practice nationally. METHODS Eight semi-structured, qualitative, face-to-face interviews were conducted with participants representing key primary care stakeholder organisations from nursing, medicine and pharmacy. Data were analysed using a qualitative inductive thematic approach. RESULTS Three key themes emerged: a lack of understanding around standing order use in general practice, legal and professional concerns, and the impact on workforce and clinical practice. Standing orders were perceived to extend nursing practice and seen as a useful tool in enabling patients to access medicines in a safe and timely manner. DISCUSSION The variability in understanding of the definition and use of standing orders appears to relate to a lack of leadership in this area. Leadership should facilitate the required development of standardised resources and quality assurance measures to aid implementation. If these aspects are addressed, then standing orders will continue to be a useful tool in general practice and enable patients to have access to health care and, if necessary, to medicines without seeing a general practitioner.

Somatization among Chinese Depressives in General Practice

1981 ◽  
Vol 10 (4) ◽  
pp. 361-374 ◽  
Author(s):  
Fanny M. Cheung ◽  
Bernard W. K. Lau ◽  
Edith Waldmann
Keyword(s):  
General Practice ◽  
Emotional Disturbance ◽  
Age Differences ◽  
Help Seeking ◽  
Sleep Disturbances ◽  
Depressive Illness ◽  
Clinical Syndrome ◽  
General Malaise ◽  
Psychological Features ◽  
Dysphoric Mood

Depressive illness was a common clinical syndrome found in general practice in Hong Kong. The phenomenon of somatization among Chinese depressives in general practice was investigated. Patients clinically identified as depressed were compared with organic patients in terms of their presenting complaints and responses to a symptom checklist. Sleep disturbances, general malaise, pains and aches, dizziness, and menopausal symptoms were the most frequent disturbances that prompted Chinese depressives to seek help in general practice. When directly asked, these patients admitted having various psychological features including dysphoric mood, self-reproach, loss of interest in social activities and in sex. Subgroup comparisons showed little sex difference in initial complaints and admitted symptomatology among the depressives. Some age differences were observed in the presenting complaints. The discrepancy between the pattern of presenting complaints and admitted symptoms suggested that patients were aware of their emotional disturbance even though they tended to express these disturbances in somatic terms in their help-seeking processes. Distinction between the expression mode and the recognition mode of somatization was discussed.

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