scholarly journals General Practitioners' Experiences During the First Phase of the COVID-19 Pandemic in Italy: A Critical Incident Technique Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Peter Konstantin Kurotschka ◽  
Alice Serafini ◽  
Michela Demontis ◽  
Arianna Serafini ◽  
Alessandro Mereu ◽  
...  
Keyword(s):  
Primary Care ◽  
At Risk ◽  
General Practitioners ◽  
Critical Incident ◽  
Online Survey ◽  
Positive Impact ◽  
Daily Practice ◽  
Dropout Rate ◽  
Critical Incident Technique ◽  
Care Provision

Since February 2020, when coronavirus disease began to spread in Italy, general practitioners (GPs) were called to manage a growing number of health situations. The challenges experienced by Italian GPs remained unrevealed. This study aimed at exploring Italian GPs' care experiences and practices associated with critical incidents during the first wave of the pandemic. A qualitative study design involving the critical incident technique through an online survey was applied. Sociodemographic data and open-ended responses were collected. While participants' characteristics were analyzed through descriptive statistics, qualitative data were thematically analyzed employing the framework method. 149 GPs responded to the survey and 99 participants completed the survey (dropout rate = 33%). Eight themes emerged indicating factors related to the organization of the healthcare system and factors related to the clinical management of patients, that were perceived as impacting on the GPs' care provision. The analysis revealed difficulties in communicating with other local services. This, together with the lack of coordination among services, was reported as a major challenge. Primary care was perceived as having been undervalued and criticalities in the organization of GP courses, led in a bureaucratic fashion, posed at risk some trainees to be infected. The digital technologies adopted for remote patient consultations were seen as useful tools for daily practice helping the GPs to stay emotionally connected with their patients. Besides, the improvement in the GP–patient relationship in terms of solidarity between patients and doctors and compliance to rules, had a positive impact. Moreover, many respondents addressed the importance of professional collaboration and teamwork, in terms of both support in practical issues (to find PPE, diagnostics and guidelines) and emotional support. At the same time, the lack of resources (e.g., PPE, swabs) and of specific guidelines and protocols impacted on the care provision. Our findings suggest that GPs in Italy are at risk of being left behind within the epidemic management. Communication and coordination among services are essential and should be substantially improved, and primary care research should be initiated to collect the context-specific evidence necessary to enhance the system's preparedness to public health emergencies and the quality of primary care services.

The Critical Incident Technique: Method or Methodology?

2019 ◽  
Vol 29 (7) ◽  
pp. 1065-1079 ◽  
Author(s):  
Roderik F. Viergever
Keyword(s):  
Data Collection ◽  
Critical Incident ◽  
Quality Care ◽  
Critical Incident Technique ◽  
Satisfaction With Care ◽  
Care Provision ◽  
Services Research ◽  
Data Collection And Analysis ◽  
Or Methodology ◽  
Good Quality Care

The critical incident technique (CIT) is a qualitative research tool that is frequently used in health services research to explore what helps or hinders in providing good quality care or achieving satisfaction with care provision. However, confusion currently exists on the nature of the CIT: Is it a method for data collection and analysis or a methodology? In this article, I explain why this distinction is important and I argue that the CIT is a methodology (and not a method) for the following reasons: Key methodological dimensions are described for the CIT; it has a clear focus; studies that apply this technique make use of various methods for data collection and analysis; it describes, explains, evaluates, and justifies the use of a specific format for those methods; it implies philosophical and practical assumptions; and studies that use the CIT cannot easily make use of additional methodologies simultaneously.

scholarly journals Clinical pathways for primary care: current use, interest and perceived usability

2018 ◽  
Vol 25 (7) ◽  
pp. 901-906 ◽  
Author(s):  
Jennifer M Toy ◽  
Adam Drechsler ◽  
Richard C Waters
Keyword(s):  
Primary Care ◽  
Online Survey ◽  
Clinical Pathways ◽  
Decision Support Tool ◽  
Daily Practice ◽  
Support Tool ◽  
System Usability Scale ◽  
Primary Care Clinicians ◽  
Perceived Usability ◽  
Tool Types

Abstract Objective Translating clinical evidence to daily practice remains a challenge and may improve with clinical pathways. We assessed interest in and usability of clinical pathways by primary care professionals. Methods An online survey was created. Interest in pathways for patient care and learning was assessed at start and finish. Participants completed baseline questions then pathway-associated question sets related to management of 2 chronic diseases. Perceived pathway usability was assessed using the system usability scale. Accuracy and confidence of answers was compared for baseline and pathway-assisted questions. Results Of 115 participants, 17.4% had used clinical pathways, the lowest of decision support tool types surveyed. Accuracy and confidence in answers significantly improved for all pathways. Interest in using pathways daily or weekly was above 75% for the respondents. Conclusion There is low utilization of, but high interest in, clinical pathways by primary care clinicians. Pathways improve accuracy and confidence in answering written clinical questions.

scholarly journals Use of the critical incident technique in primary care in the audit of deaths by suicide.

1997 ◽  
Vol 6 (1) ◽  
pp. 25-28 ◽  
Author(s):  
L Redpath ◽  
A Stacey ◽  
E Pugh ◽  
E Holmes
Keyword(s):  
Primary Care ◽  
Critical Incident ◽  
Critical Incident Technique

scholarly journals Influenza Vaccination in Coronavirus Times: Intention to Be Vaccinated by Primary Care Professionals in Central Catalonia (VAGCOVID)

2021 ◽  
Author(s):  
Raquel Muñoz-Miralles ◽  
Anna Bonet-Esteve ◽  
Anna Rufas Cebollero ◽  
Xavier Pelegrin Cruz ◽  
Josep Vidal Alaball
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Health Professionals ◽  
Online Survey ◽  
Health Workers ◽  
Cross Sectional ◽  
History Of ◽  
Primary Care Professionals

Abstract BackgroundInfluenza vaccination is the main measure of prevention against the epidemic flu, which annually produces a significant increase in the pressure on healthcare systems, in addition to influencing the absenteeism of health workers. Although it is recommended that health professionals be vaccinated, their vaccination coverage is low. The lack of knowledge about the evolution of influenza in the context of the SARS-CoV-2 coronavirus pandemic led to the continued recommendation of influenza vaccination to people at risk and to professionals. The aim of the study is to determine the intention to vaccinate against seasonal flu of health professionals in the 2020-21 campaign in the context of the SARS-CoV-2 pandemic, and to analyse the factors that influence it.MethodsCross-sectional study through a structured online survey aimed at Primary Care professionals in the region of central Catalonia.ResultsA total of 610 participants responded to the survey, 65.7% of whom intended to be vaccinated against the flu in this campaign and 11.1% did not yet know or did not answer. The intention to be vaccinated against flu is associated with the professional category, the years of professional practice, the fact of making face-to-face guards, and the perception of the risk of suffering from flu. It is also related to a history of influenza vaccination in the previous year and to having been vaccinated on another occasion. The profile of professionals who intend to be vaccinated against flu includes professionals with a history of vaccination, who were on duty and perceived that their staff were at risk of becoming ill with flu.ConclusionsDuring the SARS-CoV-2 pandemic, many professionals show a clear intention to get vaccinated against the flu, but there are still some who doubt it. In order to improve influenza vaccination coverage among health professionals, it is necessary to design strategies aimed at professionals who are hesitant or reluctant to vaccination.

scholarly journals A preliminary qualitative study of general practitioners’ views on malnutrition management and oral nutritional supplementation prescription in the community

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Patricia Domínguez Castro ◽  
Sharon Kennelly ◽  
Barbara Clyne ◽  
Gerard Bury ◽  
Catriona Bradley ◽  
...  
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Qualitative Study ◽  
General Practitioners ◽  
Health Care Professionals ◽  
Inappropriate Prescribing ◽  
Community Setting ◽  
Community Dwelling ◽  
Care Community ◽  
Oral Nutritional Supplements

AbstractMalnutrition, arising from a deficiency of energy and protein intake, occurs commonly among community-dwelling individuals. Oral nutritional supplements (ONS) are an effective method of managing malnutrition if prescribed for patients who are malnourished or at risk of malnutrition. However, previous research indicates that inappropriate prescribing of ONS occurs frequently in the community setting (30–70% prevalence). Moreover, it has been previously shown that the management of patients ‘at risk’ of malnutrition in the primary care/community setting in Ireland is sub-optimal, with low awareness of the condition and its management among non-dietetic health care professionals (HCPs). In Ireland, general practitioners (GPs) are the main prescribers of ONS in primary care. They are also on many occasions the first point of contact for individuals in the community who are malnourished or at risk of malnutrition. Therefore, exploring their experiences and perceptions can provide insight into the complexities of managing malnutrition and ONS prescribing in the community. The aim of this qualitative study was to explore GPs’ experiences and opinions on the management of malnutrition and the prescription of ONS in the primary care/community setting in Ireland. Semi-structured interviews were conducted with nine GPs. The interview explored among others the following domains; Barriers and facilitators in the management of malnutrition, ONS prescribing in the primary care/community setting, and future directions in the management of malnutrition and ONS prescribing. Recorded interviews were transcribed and analysed using inductive thematic analysis. Three main themes were identified; i) Malnutrition a secondary concern, encapsulating the idea that malnutrition is not something that GPs screen for in isolation ii) Resources and support for managing malnutrition are needed in the community iii) Reluctance to prescribe ONS. GPs reported not screening for malnutrition, but viewed it as a consequence of other conditions and social factors. According to the GPs, they should not have sole responsibility for malnutrition management and more dietitians and trained community nurses would be desirable to support them to deal with malnutrition in the community. A preference to avoid supplementation and implement dietary changes first was expressed by GPs. As main prescribers, GPs thought that they should receive further independent trainingon the different ONS available in the market as currently they did not feel confident prescribing a range of them. Awareness of ONS cost and its misuse by certain patients were reported as reasons that made GPs reluctant to prescribe them, potentially leading to under prescribing.

Detection, assessment and management of eating disorders; how involved are GPs?

2006 ◽  
Vol 23 (3) ◽  
pp. 96-99 ◽  
Author(s):  
Claire Flahavan
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Eating Disorders ◽  
General Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Tools ◽  
Current Evidence ◽  
Eating Disordered ◽  
Screening Assessment

AbstractObjectives: To determine the extent to which general practitioners are currently active in the screening, assessment, diagnosis and management of eating disorders. To identify current deficits in service delivery for eating disordered patients, as identified by general practitioners.Method: A postal questionnaire was circulated to 360 general practitioners within the greater Dublin area and North Eastern Health Service Executive.Results: Response rate was 25%. Respondents had lower case-loads of eating disordered patients than would be expected given the epidemiology of anorexia and bulimia nervosa. Most do not routinely screen for eating disorders, even in at-risk populations and are unaware of the current evidence-based data for guidance. GPs do not feel confident at managing eating disorders within the primary care setting and see their chief role as that of referral to psychiatric services. Treatment outcomes are typically poor. Concern was expressed at the lack of access to specialist treatment in the public sector. Specific deficits in service provision were highlighted including delays in assessment, lack of services appropriate to the adolescent population, poor service transition, and poor availability of psychotherapy at primary care level.Conclusions: Eating disorders are currently underdiagnosed in the primary care setting. Use of simple screening tools might aid detection of pathological eating patterns, particularly in at-risk groups. General practitioners feel under-equipped to manage these complex disorders, given that the resources required to provide high quality care are not widely available. Better integration of primary and secondary services, coupled with training for GPs in the area of screening, assessment and diagnosis, may lead to earlier intervention and improved outcomes.

scholarly journals Strategies in Primary Care to Face the SARS-CoV-2 / COVID-19 Pandemic: An Online Survey

2021 ◽  
Vol 8 ◽  
Author(s):  
Marion Eisele ◽  
Nadine Janis Pohontsch ◽  
Martin Scherer
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Health Care Providers ◽  
Online Survey ◽  
Qualitative Content Analysis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Sources Of Information ◽  
Pandemic Preparedness ◽  
Team Meetings

Background: Primary care plays a key role in pandemics like the SARS-CoV-2 pandemic in 2020. We aimed to investigate the challenges faced and the solutions implemented in primary care.Methods: One hundred and twenty-one general practitioners in Germany completed the online survey. We used open questions to examine challenges experienced and solutions implemented during the early pandemic and chose qualitative content analysis to extract and describe the meaning of the answers. We derived deductive categories from the research questions and formed inductive categories during the material reviews.Results: Main challenges were: insufficient information, lack of protective equipment, need to restructure practice procedures and insufficient individual and structural pandemic preparedness, resulting in secondary challenges: fear of infection, impaired patient care, aggravated steering of patients, difficult cooperation with external entities and a not viable hygiene concept advised by authorities. Strategies to address these challenges included establishing regular team-meetings to develop new solutions, focusing on few reliable sources of information, working in alternating shifts, increasing telemedicine, establishing window and open-air practices and building networks with other health care providers. Respondents criticized the lack of consideration of their experiences in planning pandemic measures within primary care.Conclusions: General practitioners successfully applied pragmatic and creative strategies in their practices during the early phase of the pandemic. Among these, communication within and between practices emerged as a key strategy. These strategies should be provided with pandemic preparedness plans. The lacking consideration of the primary care providers' experiences in planning and implementing pandemic measures needs to be addressed by stakeholders.

Using Critical Incident Technique to Investigate Anxiety in Physical Activity Settings

2021 ◽  
Vol 43 (2) ◽  
pp. 171-177
Author(s):  
Timothy M. Dasinger ◽  
Melinda A. Solmon
Keyword(s):  
Physical Activity ◽  
Critical Incident ◽  
Online Survey ◽  
Critical Incident Technique ◽  
Goal Theory ◽  
Social Evaluation ◽  
Activity Settings ◽  
Future Behavior ◽  
Activity Setting ◽  
The Impact

Physical activity participation is linked with many benefits including a reduction in anxiety; it is, however, also important to explore aspects of activity that incite anxiety. One way to investigate sources of anxiety in physical activity is to use the critical incident technique (CIT). The purpose of this study was to explore anxiety-inducing events in physical activity settings and to evaluate the impact on future behavior. A total of 122 participants (M = 21.23 ± 1.77 years) completed an online survey asking when a physical activity setting incited anxiety using the CIT. Four common sources of anxiety were evident in the responses: fragile self-beliefs, social interaction and the threat of negative social evaluation, competition, and a lack of knowledge or unfamiliarity with surroundings. Tenets from achievement goal theory can help to explain the incitement of anxiety and can help shape physical activity settings to be more inclusive and welcoming for all.

Sign in / Sign up

Export Citation Format

Share Document