scholarly journals Barriers and Benefits of the Scheduled Telephone Referral Model (DETELPROG): A Qualitative Approach

2021 ◽  
Vol 18 (10) ◽  
pp. 5280
Author(s):  
Luis Miguel Azogil-López ◽  
Valle Coronado-Vázquez ◽  
Juan José Pérez-Lázaro ◽  
Juan Gómez-Salgado ◽  
Esther María Medrano-Sánchez
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Descriptive Study ◽  
Mobile Telephone ◽  
Structured Interviews ◽  
Face To Face ◽  
Healthcare Burden ◽  
Qualitative Descriptive ◽  
Attending Physicians ◽  
The Relationship

The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians (HAPs) regarding its use. For this, a qualitative descriptive study was carried out through six semi-structured interviews and two focus groups in a sample of eleven PCPs and five HAPs. Interviews were carried out from September 2019 to February 2020. Data were analysed by creating the initial categories, recording the sessions, transcribing the information, by doing a comprehensive reading of the texts obtained, and analysing the contents. The results show that DETELPROG gives the PCP greater prominence as a patient’s health coordinator by improving their relationship and patient safety; it also improves the relationship between PCP and HAP, avoiding unnecessary face-to-face referrals and providing safety to the PCP when making decisions. The barriers for DETELPROG to be used by PCP were defensive medicine, patients’ skepticism in DETELPROG, healthcare burden, and inability to focus on the patient or interpret a sign, symptom, or diagnostic test. For HAP, the barriers were lack of confidence in the PCP and complexity of the patient. As a conclusion, DETELPROG referral model provides a lot of advantages and does not pose any new barrier to face-to-face referral or other non-face-to-face referral models, so it should be implemented in primary care.

scholarly journals Administrative Work and Job Role Beliefs in Primary Care Physicians: An Analysis of Semi-Structured Interviews

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401989909
Author(s):  
Eric Apaydin
Keyword(s):  
Primary Care ◽  
Los Angeles ◽  
Primary Care Physicians ◽  
Theory Approach ◽  
Structured Interviews ◽  
Job Roles ◽  
Face To Face ◽  
Administrative Work ◽  
Job Role ◽  
The Relationship

Primary care physicians face increasing amounts of administrative work (e.g., entering notes into electronic health records, managing insurance issues, delivering test results, etc.) outside of face-to-face patient visits. The objective of this study is to qualitatively describe the experience that primary care physicians have with administrative work, with an emphasis on their beliefs about their job role. I conducted semi-structured interviews with 28 family physicians and internists in Chicago, Los Angeles, and Miami and qualitatively analyzed themes from interview transcripts using the grounded theory approach. Two major themes concerning the relationship between primary care physicians and administrative work were discovered: (a) Administrative work was not central to primary care physicians’ job role beliefs, and (b) “below license” work should be delegated to nonphysicians. Job roles should be considered in future efforts to reduce physician administrative work in primary care.

scholarly journals Digital consultations in Swedish primary health care: a qualitative study of physicians’ job control, demand and support

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanna Fernemark ◽  
Janna Skagerström ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Per Nilsen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Environment ◽  
Primary Care Physicians ◽  
Psychosocial Work Environment ◽  
Mobile Telephone ◽  
Full Time ◽  
Psychosocial Work ◽  
Structured Interviews ◽  
Demand Control

Abstract Background Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients. Methods The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data. Results Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care. Conclusions This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.

scholarly journals Digital Consultations in Swedish Primary Health Care: A Qualitative Study of Physicians’ Job control, Demand and Support

2020 ◽  
Author(s):  
Hanna Fernemark ◽  
Janna Skagerstrom ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Per Nilsen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Environment ◽  
Primary Care Physicians ◽  
Psychosocial Work Environment ◽  
Mobile Telephone ◽  
Full Time ◽  
Psychosocial Work ◽  
Structured Interviews ◽  
Demand Control

Abstract Background: Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients.Methods: The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data.Results: Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care.Conclusions: This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.

scholarly journals Digital Consultations in Swedish Primary Health Care: A Qualitative Study of Physicians’ Job control, Demand and Support

2020 ◽  
Author(s):  
Hanna Fernemark ◽  
Janna Skagerstrom ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Per Nilsen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Environment ◽  
Primary Care Physicians ◽  
Psychosocial Work Environment ◽  
Mobile Telephone ◽  
Full Time ◽  
Psychosocial Work ◽  
Structured Interviews ◽  
Demand Control

Abstract Background: Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients.Methods: The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data.Results: Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care.Conclusions: This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.

scholarly journals Digital Consultations in Swedish Primary Health Care: A Qualitative Study of Physicians’ Job control, Demand and Support

2020 ◽  
Author(s):  
Hanna Fernemark ◽  
Janna Skagerstrom ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Per Nilsen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Environment ◽  
Primary Care Physicians ◽  
Psychosocial Work Environment ◽  
Mobile Telephone ◽  
Full Time ◽  
Psychosocial Work ◽  
Structured Interviews ◽  
Demand Control

Abstract Background Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients.Methods The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data.Results Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care.Conclusions This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.

scholarly journals Understanding the clinical reasoning processes involved in the management of multimorbidity in an ambulatory setting: study protocol of a stimulated recall research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M.-C. Audétat ◽  
S. Cairo Notari ◽  
J. Sader ◽  
C. Ritz ◽  
T. Fassier ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Reasoning ◽  
Primary Care Physicians ◽  
Video Sequence ◽  
Structured Interview ◽  
Ambulatory Setting ◽  
Structured Interviews ◽  
Stimulated Recall ◽  
Study Results

Abstract Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. Methods A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a “button camera” (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. Conclusion Study results will contribute to the scientific community’s overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient’s care and treatments.

Abstract NS3: The Influence of Chinese Culture on Caregiving Role Perceptions Among Stroke Caregivers

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Xichenhui Qiu ◽  
Janet W SIT ◽  
Haixia Feng
Keyword(s):  
Filial Piety ◽  
Chinese Culture ◽  
Qualitative Content Analysis ◽  
Descriptive Study ◽  
Structured Interviews ◽  
Day Range ◽  
Analysis Process ◽  
The Family ◽  
Qualitative Descriptive ◽  
Spouse Caregivers

Introduction: Among the estimated 22.5 million stroke survivors in China, 78% of them require home care. Previous research has indicated that culture can have a significant impact on caregivers’ perceptions of the caregiving role. There is a dearth of research on stroke caregivers’ perceptions within the Chinese culture. Objective: To explore how Chinese culture influences the perceptions of the caregiving role among stroke caregivers. Methods: In this qualitative descriptive study, 14 stroke caregivers were recruited from a 1800-bed regional hospital in China. Caregivers were on average 58 years old (range 46-74), 78% female, 50% spouse-caregivers and 50% children-caregivers. Caregivers spent on average 14 hours per day (range 5-24) providing care. All were 1st time caregivers who had provided stroke caregiving < 12 months. Individual, semi-structured interviews were conducted. Qualitative content analysis was performed. Strategies to achieve trustworthiness include triangulation of the data in the analysis process, member checking and peer debriefing. Results: Three themes emerged from the interviews. (1) Caregiving is a natural expected part of life. All caregivers accepted caregiving for the sick family member as an expected part of life. This perception is deeply rooted in Chinese culture. (2) Caregiving is a culturally prescribed obligation. Spouse caregivers believe that it is their moral obligation to take care of their sick life partner. Female caregivers emphasized their position and role in the family to take up caregiving for sick relative. (3) Caregiving is an expression of reciprocal love within the immediate family. Tangible caregiving and support during adversity are viewed as expression of reciprocal love among family members. Particularly, the children-caregivers believed in the virtue of filial piety and perceived stroke caregiving as a means of repaying their parents. Conclusions: Our findings highlight an underlying acceptance and devotion of undertaking stroke caregiving within the Chinese culture. Researchers and clinicians that plan to develop an intervention to support Chinese stroke caregivers need to consider integrating these findings.

scholarly journals Investigating information-seeking behaviors of primary care physicians who care for older depressed patients and their family caregivers: a pilot study

2005 ◽  
Vol 26 (4) ◽  
pp. 111 ◽  
Author(s):  
Mary Jo Dorsey ◽  
Ellen Detlefsen
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Information Seeking ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Structured Interviews ◽  
Depressed Patients ◽  
Types Of Information ◽  
Primary Care Practices ◽  
Information Seeking Behaviors

Objective – To describe preliminary findings from a study of information-seeking behaviors of primary care physicians who care for elderly and depressed patients, and the correlation between what is sought versus what is provided to the patient and (or) caregiver. Setting – Physicians in two large ambulatory primary care practices throughout urban Pittsburgh, Pennsylvania, who take care of geriatric patients. Methods – Structured interviews, with common questions, will be conducted with 12 primary care physicians to determine patterns of information-seeking behaviors. Environmental scans of physicians' offices for evidence of their existing information behaviors will complement the information obtained from the interviews. Results – This pilot study provides an analysis of the resources primary care physicians use to seek information to provide to patients and caregivers. Analyses show types of information sought, time spent seeking information, and methods used to find information given to patients. Conclusions – With mounting evidence of the Internet being used for patient self care, it is essential to understand if primary care physicians understand the scope and breadth of information readily available to their patients. The primary care physician needs to be aware of the types of information made available to their patients and the caregivers who are inclined to obtain information for the patient.

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