scholarly journals Expectations Among Patients and Health Professionals Regarding Web-Based Interventions for Depression in Primary Care: A Qualitative Study

2015 ◽  
Vol 17 (3) ◽  
pp. e67 ◽  
Author(s):  
Jesús Montero-Marín ◽  
Javier Prado-Abril ◽  
Cristina Botella ◽  
Fermin Mayoral-Cleries ◽  
Rosa Baños ◽  
...  
2013 ◽  
Vol 63 (611) ◽  
pp. e378-e385 ◽  
Author(s):  
Miren I Jones ◽  
Sheila M Greenfield ◽  
Emma P Bray ◽  
FD Richard Hobbs ◽  
Roger Holder ◽  
...  

2018 ◽  
Author(s):  
Bridget Kool ◽  
Rosie Dobson ◽  
Sarah Sharpe ◽  
Gayl Humphrey ◽  
Robyn Whittaker ◽  
...  

BACKGROUND Alcohol use is a major public health concern associated with an increased risk of morbidity and mortality. Health professionals in primary care commonly see patients with a range of alcohol-related risks and problems, providing an ideal opportunity for screening and brief intervention (BI). OBJECTIVE This study aimed to develop a prototype for a Web-based tool for use by primary care health professionals (eg, doctors and nurses) to communicate alcohol harm risk to their patients and to engage with them regarding ways this risk could be reduced. METHODS Following conceptualization and development of prototype wireframes, formative work and pretesting were undertaken. For the formative work, focus groups and key informant interviews were conducted with potential end users of the risk communication tool, including health professionals and consumers. The focus groups and interviews explored perceptions of alcohol risk communication and obtained feedback on the initial prototype. For pretesting, participants (primary care doctors and nurses) completed a Web-based survey followed by a period of pretesting before completion of a follow-up survey. The study was designed to gain feedback on the tool’s performance in real-world settings as well as its relevance, ease of use, and any suggested refinements. RESULTS In the formative work stage, 11 key informants and 7 consumers participated in either focus groups or individual interviews. Participants were very positive about the prototype and believed that it would be useful and acceptable in practice. Key informants identified that the key point of difference with the tool was that it provided <italic>all the pieces</italic> in 1 place (ie, assessment, interpretation, and resources to support change). Participants provided feedback on how the tool could be improved, and these suggestions were incorporated into the prototype where possible. In the pretesting stage, 7 people (5 doctors and 2 primary care nurses) completed the pretesting. Participants reported that the tool provided a useful framework for an intervention, that it would be acceptable to patients, that it was easy to use, that they would be likely to use it in practice, and that there were no technical issues. CONCLUSIONS The alcohol risk communication tool was found to be acceptable and has the potential to increase the confidence of health professionals in assessing risk and providing BI.


2020 ◽  
Vol 70 (691) ◽  
pp. e138-e145 ◽  
Author(s):  
Christina Avgerinou ◽  
Cini Bhanu ◽  
Kate Walters ◽  
Helen Croker ◽  
Remco Tuijt ◽  
...  

BackgroundMalnutrition is associated with increased morbidity and mortality, and is very common in frail older people. However, little is known about how weight loss in frail older people can be managed in primary care.AimsTo explore the views and practices of primary care and community professionals on the management of malnutrition in frail older people; identify components of potential primary care-based interventions for this group; and identify training and support required to deliver such interventions.Design and settingQualitative study in primary care and community settings.MethodSeven focus groups and an additional interview were conducted with general practice teams, frailty multidisciplinary teams (MDTs), and community dietitians in London and Hertfordshire, UK (n = 60 participants). Data were analysed using thematic analysis.ResultsPrimary care and community health professionals perceived malnutrition as a multifaceted problem. There was an agreement that there is a gap in care provided for malnutrition in the community. However, there were conflicting views regarding professional accountability. Challenges commonly reported by primary care professionals included overwhelming workload and lack of training in nutrition. Community MDT professionals and dietitians thought that an intervention to tackle malnutrition would be best placed in primary care and suggested opportunistic screening interventions. Education was an essential part of any intervention, complemented by social, emotional, and/or practical support for frailer or socially isolated older people.ConclusionsFuture interventions should include a multifaceted approach. Education tailored to the needs of older people, carers, and healthcare professionals is a necessary component of any intervention.


BMJ ◽  
2011 ◽  
Vol 342 ◽  
pp. d1773 ◽  
Author(s):  
Merryn Gott ◽  
Christine Ingleton ◽  
Michael I Bennett ◽  
Clare Gardiner

Objective To explore how transitions to a palliative care approach are perceived to be managed in acute hospital settings in England.Design Qualitative study.Setting Secondary or primary care settings in two contrasting areas of England.Participants 58 health professionals involved in the provision of palliative care in secondary or primary care.Results Participants identified that a structured transition to a palliative care approach of the type advocated in UK policy guidance is seldom evident in acute hospital settings. In particular they reported that prognosis is not routinely discussed with inpatients. Achieving consensus among the clinical team about transition to palliative care was seen as fundamental to the transition being effected; however, this was thought to be insufficiently achieved in practice. Secondary care professionals reported that discussions about adopting a palliative care approach to patient management were not often held with patients; primary care professionals confirmed that patients were often discharged from hospital with “false hope” of cure because this information had not been conveyed. Key barriers to ensuring a smooth transition to palliative care included the difficulty of “standing back” in an acute hospital situation, professional hierarchies that limited the ability of junior medical and nursing staff to input into decisions on care, and poor communication.Conclusion Significant barriers to implementing a policy of structured transitions to palliative care in acute hospitals were identified by health professionals in both primary and secondary care. These need to be addressed if current UK policy on management of palliative care in acute hospitals is to be established.


2015 ◽  
Vol 65 (632) ◽  
pp. e152-e160 ◽  
Author(s):  
Tom Nolan ◽  
Charlotte Dack ◽  
Kingshuk Pal ◽  
Jamie Ross ◽  
Fiona A Stevenson ◽  
...  

2017 ◽  
Vol 17 (suppl 1) ◽  
pp. S171-S184
Author(s):  
Sabado Nicolau Girardi ◽  
Ana Cristina de Sousa van Stralen ◽  
Thais Viana Lauar ◽  
Joana Natalia Cella ◽  
Jackson Freire Araújo ◽  
...  

Abstract Objectives: The review on scopes of practice tends to gain importance in Human Resource in Health agenda in Brazil. The aim of this study was to investigate the scope of practice of physicians and nurses who work in the Atenção Primária em Saúde (APS) (Primary Healthcare) and their main barriers. Methods: this is an exploratory qualitative study conducted in 2015 and 2016, through interviews with 26 physicians and 26 nurses who work in the APS in 12 cities distributed in five Brazilian health regions. Results: physicians and nurses in the health region of the North and Northeast performed a great number of procedures, and those physicians who work in units located in rural areas. Both professional categories indicated that they knew how to carry out several procedures that were not performed in practice. The main barriers for not performing those procedures include, lack of access to exams, materials and inadequate infrastructure, protocols and city guides restrictions, legal restrictions and lack of training. Conclusions: the results suggests the need to ease the health professionals’ attributions, facilitate the integration between the professionals’ practices and optimizing their work, especially in remote and unassisted regions, in order to be in favor of expanding the access and problem solving in APS.


10.2196/13224 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e13224
Author(s):  
Bridget Kool ◽  
Rosie Dobson ◽  
Sarah Sharpe ◽  
Gayl Humphrey ◽  
Robyn Whittaker ◽  
...  

Background Alcohol use is a major public health concern associated with an increased risk of morbidity and mortality. Health professionals in primary care commonly see patients with a range of alcohol-related risks and problems, providing an ideal opportunity for screening and brief intervention (BI). Objective This study aimed to develop a prototype for a Web-based tool for use by primary care health professionals (eg, doctors and nurses) to communicate alcohol harm risk to their patients and to engage with them regarding ways this risk could be reduced. Methods Following conceptualization and development of prototype wireframes, formative work and pretesting were undertaken. For the formative work, focus groups and key informant interviews were conducted with potential end users of the risk communication tool, including health professionals and consumers. The focus groups and interviews explored perceptions of alcohol risk communication and obtained feedback on the initial prototype. For pretesting, participants (primary care doctors and nurses) completed a Web-based survey followed by a period of pretesting before completion of a follow-up survey. The study was designed to gain feedback on the tool’s performance in real-world settings as well as its relevance, ease of use, and any suggested refinements. Results In the formative work stage, 11 key informants and 7 consumers participated in either focus groups or individual interviews. Participants were very positive about the prototype and believed that it would be useful and acceptable in practice. Key informants identified that the key point of difference with the tool was that it provided all the pieces in 1 place (ie, assessment, interpretation, and resources to support change). Participants provided feedback on how the tool could be improved, and these suggestions were incorporated into the prototype where possible. In the pretesting stage, 7 people (5 doctors and 2 primary care nurses) completed the pretesting. Participants reported that the tool provided a useful framework for an intervention, that it would be acceptable to patients, that it was easy to use, that they would be likely to use it in practice, and that there were no technical issues. Conclusions The alcohol risk communication tool was found to be acceptable and has the potential to increase the confidence of health professionals in assessing risk and providing BI.


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