Unified Health Services and Family-Focused Primary Care

1975 ◽  
Vol 6 (4) ◽  
pp. 501-515 ◽  
Author(s):  
Stephen Fleck
Keyword(s):  
Primary Care ◽  
Family Health ◽  
Ecological Systems ◽  
Functional Evaluation ◽  
Family Coping ◽  
Care Services ◽  
Primary Care Services ◽  
Dying Patients ◽  
The Family ◽  
The Many

Unified health and primary care services must focus on family health and the family as the clinical unit. Understanding the family as the basic social system and assessing its functioning from the standpoints of evolutionary family tasks, family health behavior and family coping capacities are as important as is knowledge of body systems and their functional evaluation, and of social and ecological systems which also can be pathogenic for individuals or families. The concept of psychosomatic medicine must include familio-somatic and somato-familial medicine. Families are involved in the pathogenicity of some diseases and psychiatric disorders, and in the treatment and management of all chronic disease. Coping with dying patients and mourning are also basic family tasks. Only unified clinical services, whether hospitals or health stations, can render realistic care and relate to the many relevant systems in the community, beginning with the patient's family. Clinicians must evaluate these systems as to their wholesome or unwholesome impact on a particular health issue or problem, seeking corrective as well as preventive measures.

scholarly journals Health-Care Waste: Knowledge of Primary Care nurses

2018 ◽  
Vol 71 (5) ◽  
pp. 2367-2375 ◽  
Author(s):  
Ana Paula Mhirdaui Sanches ◽  
Karen Sayuri Mekaro ◽  
Rosely Moralez de Figueiredo ◽  
Silvia Carla da Silva André
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Family Health ◽  
Chemical Waste ◽  
Know How ◽  
Paulo State ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Nurses ◽  
Health Care Waste

ABSTRACT Objective: to describe the knowledge of nurses on Health-Care Waste Management (HCW) in Family Health Units (FHU) of São Carlos city, São Paulo State. Method: exploratory, descriptive and quantitative approach. The research was carried out with nurses of 16 FHU of the municipality of São Carlos-SP. Data were collected through an interview using a tool validated and analyzed using descriptive statistics. Results: it is noteworthy that 68.7% (11) of the nurses did not know how to describe how chemical waste was sorted. In addition, regarding the treatment of HCW, 50.0% (8) of the nurses did not know if the general waste were subjected to some type of treatment. Conclusion: the HCW management can be considered a challenge in the nurses' agenda inserted in the Primary Care services, which refers to the need to implement periodic training on the management of this waste.

scholarly journals Out-of-hours primary care end of life prescribing: a data linkage study

2019 ◽  
Vol 10 (4) ◽  
pp. e45-e45 ◽  
Author(s):  
Rachel Brettell ◽  
Rebecca Fisher ◽  
Helen Hunt ◽  
Sophie Garland ◽  
Daniel Lasserson ◽  
...  
Keyword(s):  
Primary Care ◽  
End Of Life ◽  
Linkage Study ◽  
Mortality Data ◽  
Out Of Hours ◽  
Care Services ◽  
Primary Care Services ◽  
Dying Patients ◽  
Syringe Driver ◽  
Strong Opioids

ObjectivesOut-of-hours (OOH) primary care services are contacted in the last 4 weeks of life by nearly 30% of all patients who die, but OOH palliative prescribing remains poorly understood. Our understanding of prescribing demand has previously been limited by difficulties identifying palliative patients seen OOH. This study examines the volume and type of prescriptions issued by OOH services at the end of life.MethodsA retrospective cohort study was performed by linking a database of Oxfordshire OOH service contacts over a year with national mortality data, identifying patients who died within 30 days of OOH contact. Demographic, service and prescribing data were analysed.ResultsA prescription is issued at 14.2% of contacts in the 30 days prior to death, compared with 29.9% of other contacts. The most common prescriptions were antibiotics (22.2%) and strong opioids (19%). 41.8% of prescriptions are for subcutaneously administered medication. Patients who were prescribed a syringe driver medication made twice as many OOH contacts in the 30 days prior to death compared with those who were not.ConclusionAbsolute and relative prescribing rates are low in the 30 days prior to death. Further research is required to understand what occurs at these non-prescribing end of life contacts to inform how OOH provision can best meet the needs of dying patients. Overall, relatively few patients are prescribed strong opioids or syringe drivers. When a syringe driver medication is prescribed this may help identify patients likely to be in need of further support from the service.

Patient Reports of: Lifestyle Advice in Primary Care

2012 ◽  
Vol 73 (3) ◽  
pp. 122-127 ◽  
Author(s):  
Paula M. Brauer ◽  
Lee Anne Sergeant ◽  
Bridget Davidson ◽  
Rick Goy ◽  
Linda Dietrich
Keyword(s):  
Primary Care ◽  
Family Health ◽  
Care Practice ◽  
Health Networks ◽  
Patient Reports ◽  
Care Services ◽  
Primary Care Services ◽  
Mailing Lists ◽  
Care Assessment ◽  
Diet And Exercise

Purpose: Patients’ perceptions of preventive lifestyle in primary care practice were examined. Methods: Practice was assessed with a modified version of the Primary Care Assessment Survey (PCAS). This was mailed to random samples of patients twice, using practice mailing lists from three Ontario Family Health Networks (FHNs). Family Health Networks are physician-based group practices, with additional nurse-led telephone advisory services to provide care 24 hours a day, seven days a week. The PCAS questionnaire consisted of nine scales (ranging from 0 to 100). For preventive counselling, additional questions on diet and exercise counselling were included to determine how the physician delivered the intervention. Results: Of the 2184 survey questionnaires mailed to patients, 22% were undeliverable. The response rate was 62% at valid addresses (49% of all mailed questionnaires). Of the nine scales, scores (± standard deviation) for preventive counselling were lowest at 33 ± 25. In particular, rates of diet (37%) and exercise (24%) counselling were low in the FHNs. For most other aspects of primary care services, patients generally rated FHNs highly. The majority of patients advised about diet and exercise were given verbal advice or pamphlets. Conclusions: In these primary health care organizations, considerable room exists for increased preventive counselling, especially about diet and exercise.

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