The ‘Research Magnificent’ in Late Life: Psychiatric Epidemiology and the Primary Health Care of Older Adults

1997 ◽  
Vol 27 (3) ◽  
pp. 185-204 ◽  
Author(s):  
Joseph J. Gallo ◽  
Peter V. Rabins ◽  
Steve Iliffe
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Health Care ◽  
Primary Care Physicians ◽  
Care Setting ◽  
Primary Care Setting ◽  
Psychiatric Epidemiology ◽  
Primary Health ◽  
Mental Disturbances

Objective: Primary care occupies a strategic position in the evaluation, treatment, and prevention of the mental disturbances of later life. This article highlights four themes that are crucial to understanding mental disturbances among older adults: 1) subsyndromal depression, 2) coexisting depression and anxiety, 3) comorbidity of depression and chronic medical conditions, and 4) risk factors for cognitive impairment. Method: The literature was selectively reviewed for each theme to ask the central question, “What can primary care physicians learn about mental disturbances of their older patients from epidemiologic and community studies?” Results: The primary care setting itself is an important venue for an examination of aging issues and mental health. Workers in the “middle ground of psychiatric epidemiology”—primary health care—have not yet reached a full appreciation for the value of research in the primary care setting for enhancing our understanding of the mental disturbances of late life, and how these intersect with other salient factors. Conclusions: Primary care physicians and others who work in primary care should advocate for further mental health integration and research in primary care. Research is needed that will lead to new ways of maximizing the health and quality of life of older adults and their families.

scholarly journals Treatment of depression in a low-income primary care setting with colocated mental health care.

2009 ◽  
Vol 27 (2) ◽  
pp. 161-171 ◽  
Author(s):  
Lisa A. Uebelacker ◽  
Marcia Smith ◽  
Angelique W. Lewis ◽  
Ryan Sasaki ◽  
Ivan W. Miller
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Low Income ◽  
Care Setting ◽  
Primary Care Setting ◽  
Treatment Of Depression

scholarly journals Facilitating Guideline Implementation in Primary Health Care Practices

2020 ◽  
Vol 11 ◽  
pp. 215013272091626
Author(s):  
Sanne Peters ◽  
André Bussières ◽  
Bart Depreitere ◽  
Stijn Vanholle ◽  
Julie Cristens ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Care Setting ◽  
Primary Care Setting ◽  
Guideline Implementation ◽  
Multidisciplinary Teams ◽  
Primary Health ◽  
Care Practices

Introduction: Many patients continue to receive suboptimal services, inappropriate, unsafe, and costly care. Underutilization of research by health professionals is a common problem in the primary care setting. Although many theoretical frameworks can be used to help address such evidence-practice gaps, health care professionals may not be aware of the benefits of frameworks or of the most appropriate ones for their context and thus, may be faced with the challenge of selecting and using the most relevant one. Aim: The aim of this article was to describe the process used to adapt a knowledge translation framework to meet the local needs of health professionals working in one large primary care setting. Methods: The authors developed a 5-step approach for guideline implementation. This approach was informed by prior research and the authors’ experiences in supporting multidisciplinary teams of health care professionals during the implementation of evidence-based clinical guidelines into primary care practices. To ensure that the 5-step approach was practical and suitable for the context of guideline implementation by multidisciplinary teams in primary health care, the implementation team adapted the “knowledge-to-action” framework using a multistep process. Results: The implementation approach consisted of the following 5 steps: identification, context analysis, development of implementation plan, evaluation, and sustainability. All 5 steps were described alongside details about a national low back pain project. Discussion: This article describes a collaborative, grassroots process that addressed an identified need in one complex context by adapting a knowledge translation framework to meet the local needs of health professionals working in primary care settings. Existing implementation frameworks may be too complex or abstract for use in busy clinical contexts. The 5-step approach presented in this paper resulted in practical steps that are more readily understood by health care professionals and staff on “the ground.”

scholarly journals Body Mass Index Assessment of Health Care Professionals in a Primary Care Setting in Portugal: a Cross Sectional Study

2014 ◽  
Vol 27 (5) ◽  
pp. 609 ◽  
Author(s):  
Inês Campos-Matos ◽  
André Peralta-Santos ◽  
Bernardo Gomes ◽  
Gustavo Borges ◽  
Pedro Aguiar
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Body Mass Index ◽  
Primary Health Care ◽  
Body Mass ◽  
Health Care Professionals ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cross Sectional ◽  
Primary Health

<p><strong>Introduction:</strong> Obesity is an important public health problem because it is a risk factor for numerous diseases and is associated with a higher death risk. Evidence concerning the prevalence of excess weight in health professionals is scarce and this group is often overlooked in weight interventions programs. This paper aims to estimate the prevalence of obesity and overweight among Portuguese primary health care professionals and to describe differences between occupational groups.<br /><strong>Material and Methods:</strong> This was a cross sectional study based on a primary care setting in Portugal in 2011. We collected data on occupation, age, sex and height of professionals from four primary care centers. We did a descriptive analysis of the main variables and an analysis of covariance to compare mean Body Mass Index.<br /><strong>Results:</strong> Our sample represented 52.8% of the total population of the four primary care centers, and 38.6% were overweight and 16.9% were obese. When adjusted for age and gender, health service personnel had the highest average Body Mass Index, followed by nurses, physicians, and superior technicians, in that order.<br /><strong>Discussion:</strong> Although we can’t ensure the generalisation of the results and cannot exclude the possibility of sampling bias, these results suggest high prevalence obesity and overweight in workers of primary health care in Portugal.<br /><strong>Conclusion:</strong> In this primary care setting more than half of the health care professionals were overweight or obese. Tailored interventions might be needed to tackle this issue.</p><p><br /><strong>Keywords:</strong> Body Mass Index; Health Personnel; Obesity; Portugal; Primary Health Care; Prevalence.</p>

scholarly journals Strategies to strengthen the provision of mental health care at the primary care setting: An Evidence Map

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0222162 ◽  
Author(s):  
Witness Mapanga ◽  
Daleen Casteleijn ◽  
Carmel Ramiah ◽  
Willem Odendaal ◽  
Zolani Metu ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Evidence Map

scholarly journals Grounded Theory of Barriers and Facilitators to Mandated Implementation of Mental Health Care in the Primary Care Setting

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Justin K. Benzer ◽  
Sarah Beehler ◽  
Christopher Miller ◽  
James F. Burgess ◽  
Jennifer L. Sullivan ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Organizational Factors ◽  
Barriers And Facilitators ◽  
Health Staff ◽  
Provider Experiences

Objective. There is limited theory regarding the real-world implementation of mental health care in the primary care setting: a type of organizational coordination intervention. The purpose of this study was to develop a theory to conceptualize the potential causes of barriers and facilitators to how local sites responded to this mandated intervention to achieve coordinated mental health care.Methods. Data from 65 primary care and mental health staff interviews across 16 sites were analyzed to identify how coordination was perceived one year after an organizational mandate to provide integrated mental health care in the primary care setting.Results. Standardized referral procedures and communication practices between primary care and mental health were influenced by the organizational factors of resources, training, and work design, as well as provider-experienced organizational boundaries between primary care and mental health, time pressures, and staff participation. Organizational factors and provider experiences were in turn influenced by leadership.Conclusions. Our emergent theory describes how leadership, organizational factors, and provider experiences affect the implementation of a mandated mental health coordination intervention. This framework provides a nuanced understanding of the potential barriers and facilitators to implementing interventions designed to improve coordination between professional groups.

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