scholarly journals GPs’ experiences of diagnosing and managing childhood eczema: a qualitative study in primary care

2018 ◽  
Vol 68 (667) ◽  
pp. e73-e80 ◽  
Author(s):  
Emma Le Roux ◽  
Kingsley Powell ◽  
Jonathan P Banks ◽  
Mathew J Ridd
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Disease Control ◽  
Medication Use ◽  
Self Care ◽  
Trial And Error ◽  
Structured Interviews ◽  
Common Cause ◽  
Topical Treatments ◽  
The Uk

BackgroundEczema is common among children, and in the UK the majority are managed by GPs. The most common cause of poor disease control is incorrect use of topical treatments. There is a lack of research into the challenges faced by GPs in diagnosing and managing this condition.AimTo explore the experiences of GPs in assessing and managing children with eczema.Design and settingQualitative study in primary care in England.MethodSemi-structured interviews with 15 GPs were audiorecorded, transcribed verbatim, and analysed thematically using the framework method.ResultsGPs described a paucity of dermatology training. Although most GPs were confident diagnosing uncomplicated eczema, they reported using a trial-and-error approach to prescribing emollients, and were uncertain about quantities of topical treatments to issue. Mild and moderate potency topical corticosteroids (TCS) were commonly used, but most GPs lacked confidence in recommending potent TCS, and viewed parents or carers to be fearful of using all strengths of TCS. GPs perceived adherence to treatments to be low, but provision of information to support self-care was variable. Routine review of medication use or disease control was uncommon, which GPs attributed to service constraints. Participants’ views on the causes and management of eczema were perceived to be at odds with parents and carers, who were said to be overly focused on an underlying cause, such as allergy.ConclusionGP uncertainty in managing eczema, lack of routine information and review, and perceived dissonance with parents around causation and management may be contributing to low concordance with treatments.

scholarly journals Experiences of support from primary care and perceived needs of parents bereaved by suicide: a qualitative study

2020 ◽  
Vol 70 (691) ◽  
pp. e102-e110 ◽  
Author(s):  
Verity Wainwright ◽  
Lis Cordingley ◽  
Carolyn A Chew-Graham ◽  
Nav Kapur ◽  
Jenny Shaw ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Qualitative Study ◽  
Support Needs ◽  
Structured Interviews ◽  
Perceived Needs ◽  
The North ◽  
Suicide Bereavement ◽  
Additional Support ◽  
The Uk

BackgroundPeople bereaved by suicide are a vulnerable group, also at risk of dying by suicide. The importance of postvention support (intervention after suicide) has recently been highlighted; however, little is known about the support needs of parents bereaved by suicide in the UK, and the role played by general practice.AimTo explore the perspectives, experiences, and support needs of parents bereaved by suicide.Design and settingThis was a qualitative study, with semi-structured interviews conducted between 2012 and 2014 in the north of England and the Midlands, with parents bereaved by their son or daughter’s suicide.MethodInterviews explored parents’ experiences of suicide bereavement following the death of their son or daughter, with a focus on their experiences of support from primary care. Interviews were analysed thematically using constant comparison.ResultsTwenty-three interviews were conducted. Three themes were identified from the data: the importance of not feeling alone; perceived barriers to accessing support; and the need for signposting for additional support. Some parents reported having experienced good support from their general practice; others described a number of barriers to accessing help, including triage processes. Primary care was considered to be an important avenue of support but GPs were often perceived as uncertain how to respond. The need for information, signposting to avenues of support, and the helpfulness of group support were also highlighted.ConclusionParents believed it was important that people working in general practice have an awareness of suicide bereavement and understanding of their needs, including knowledge of where to direct people for further support.

scholarly journals Patient and practitioner views on cancer risk discussions in primary care: a qualitative study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0108
Author(s):  
David N Blane ◽  
Sara MacDonald ◽  
Catherine A O'Donnell
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Qualitative Study ◽  
Cancer Risk ◽  
Lifestyle Modification ◽  
Structured Interviews ◽  
It Use ◽  
Practice Nurses ◽  
Primary Care Practitioners ◽  
The Uk

BackgroundIt is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the last five years if people had healthier lifestyles, with the principle modifiable risk factors being smoking, obesity, alcohol consumption and inactivity. There is growing interest in the use of cancer risk information in general practice to encourage lifestyle modification.AimTo explore the views and experiences of patients and practitioners in relation to cancer prevention and cancer risk discussions in general practice.Design & settingQualitative study among patient and practitioners in general practices in Glasgow, UK.MethodSemi-structured interviews were conducted with nine practitioners (5 GPs and four practice nurses, recruited purposively from practices based on list size and deprivation status) and 13 patients (aged 30–60, with two or more specified co-morbidities).ResultsCurrently, cancer risk discussions focus on smoking and cancer, with links between alcohol/obesity and cancer rarely made. There was support for the use of the personalised cancer risk tool as an additional resource in primary care. Practitioners felt practice nurses were best placed to use it. Use in planned appointments (eg, chronic disease reviews) was preferred over opportunistic use. Concerns were expressed, however, about generating anxiety, time constraints, and widening inequalities.ConclusionsHealth behaviour change is complex and the provision of information alone is unlikely to have significant effects. Personalised risk tools may have a role, but important concerns about their use – particularly in areas of socio-economic disadvantage – remain.

scholarly journals GPs’ experiences and perceptions of early detection of liver disease: a qualitative study in primary care

2018 ◽  
Vol 68 (676) ◽  
pp. e743-e749 ◽  
Author(s):  
Holly C Standing ◽  
Helen Jarvis ◽  
James Orr ◽  
Catherine Exley ◽  
Mark Hudson ◽  
...  
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Qualitative Study ◽  
Early Detection ◽  
Liver Function Tests ◽  
Comparative Approach ◽  
Structured Interviews ◽  
Alcoholic Fatty Liver ◽  
Study Sites ◽  
The Uk

BackgroundThe incidence of liver disease is increasing in the UK and primary care is a key setting where improvement in the detection and management of liver disease is required. Little is known about GPs’ understanding and confidence in detecting liver disease.AimTo explore GPs’ experiences of liver disease with a focus on early detection and interpretation of liver function tests (LFTs).Design and settingA qualitative study employing semi-structured interviews of a purposive sample of GPs from five UK primary care study sites.MethodTelephone and face-to-face interviews of GPs were undertaken. Data were analysed thematically, using a constant comparative approach.ResultsFrom a total of 25 GP interviews (N = 25), four themes were identified from the data: test-requesting behaviour, confidence and challenges in diagnosing disease, access to specialist tests, and guidance and education. Participants’ descriptions of how they request and interpret LFTs varied widely. Concern over missing diagnoses was a common reason for requesting blood tests; patients with mildly abnormal LFTs and those at risk of non-alcoholic fatty liver disease (NAFLD) were a particular cause of concern. GPs saw themselves as generalists, with a reluctance to take on specialist investigations. Guidelines promoted confidence for some clinicians, but others felt that liver disease was too complex to be amenable to simple instructions. Most felt that they did not have access to relevant, focused education on liver disease.ConclusionLiver disease is not perceived as a priority in primary care. If GPs are to take on a greater role in identification and management of liver disease, support is needed to promote awareness, knowledge, and confidence.

scholarly journals Identifying Risk Factors Affecting the Usage of Digital and Social Media: A Preliminary Qualitative Study in the Dental Profession and Dental Education

2021 ◽  
Vol 9 (5) ◽  
pp. 53
Author(s):  
Rayan Sharka ◽  
Jonathan P. San Diego ◽  
Melanie Nasseripour ◽  
Avijit Banerjee
Keyword(s):  
Risk Factors ◽  
Qualitative Study ◽  
Perceived Risk ◽  
Dental Education ◽  
Dental Students ◽  
General Context ◽  
Structured Interviews ◽  
Factors Affecting ◽  
The Uk ◽  
Dental Professionals

Aims: This study aimed to identify the risk factors of using DSM to provide an insight into the inherent implications this has on dental professionals in practice and trainee professionals’ education. Materials and methods: Twenty-one participants (10 dental professionals and 11 undergraduate and postgraduate dental students) participated in this qualitative study using semi-structured interviews in a dental school in the UK. The interviews were analysed and categorised into themes, some of which were identified from previous literature (e.g., privacy and psychological risks) and others emerged from the data (e.g., deceptive and misleading information). Results: The thematic analysis of interview transcripts identified nine perceived risk themes. Three themes were associated with the use of DSM in the general context, and six themes were related to the use of DSM in professional and education context. Conclusions: This study provided evidence to understand the risk factors of using DSM in dental education and the profession, but the magnitude of these risks on the uptake and usefulness of DSM needs to be assessed.

scholarly journals University students’ understanding and perceptions of schizophrenia in the UK: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025813
Author(s):  
Charlotte Cadge ◽  
Charlotte Connor ◽  
Sheila Greenfield
Keyword(s):  
Qualitative Study ◽  
University Students ◽  
Help Seeking ◽  
Negative Symptoms ◽  
Health Campaigns ◽  
Structured Interviews ◽  
African Caribbean ◽  
Lay Understanding ◽  
The Uk ◽  
The University

ObjectiveTo explore lay understanding and perceptions of schizophrenia in university students.DesignQualitative study using semi-structured interviews and thematic analysis.SettingThe University of Birmingham, West Midlands.Participants20 UK home students of white British (n=5), Indian (n=5), Pakistani (n=5), African Caribbean (n=4) and dual white British and African Caribbean ethnicity (n=1).ResultsFindings revealed a lack of knowledge about schizophrenia, particularly the negative symptoms that were not mentioned. There were mixed ideas on the causes and sources of available help for schizophrenia; however, positively many said they would consult their general practitioner. While there was a general misconception among the students that schizophrenia caused multiple personalities and was a dangerous illness, there were some differences in perceptions and understanding between ethnic groups, with more Indian students perceiving upbringing as a causal factor in the development of the illness and more Pakistani students perceiving possession by a spirit as a cause.ConclusionsThe university students interviewed lacked knowledge about schizophrenia and stigma was widespread, both of which may delay help-seeking. Public health campaigns educating young people about schizophrenia are required to improve early identification and intervention and improve outcomes. Further research exploring ways to effectively tackle stigma is also required.

scholarly journals Personality disorder co-morbidity in primary care ‘Improving Access to Psychological Therapy’ (IAPT) services: a qualitative study exploring patient perspectives on treatment experience

2020 ◽  
pp. 1-15
Author(s):  
Gary Lamph ◽  
John Baker ◽  
Tommy Dickinson ◽  
Karina Lovell
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Personality Disorder ◽  
Qualitative Study ◽  
Patient Group ◽  
Stepped Care ◽  
Research Approach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Co Morbidity

Abstract Background: High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England. Aims: This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment. Method: A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach. Results: Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important. Conclusions: For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

Spiritual self-care in adolescents: a qualitative study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Nafiseh Hekmati Pour ◽  
Gholam Reza Mahmoodi-Shan ◽  
Abbas Ebadi ◽  
Nasser Behnampour
Keyword(s):  
Content Analysis ◽  
Qualitative Study ◽  
Self Care ◽  
Spiritual Needs ◽  
Religious Activities ◽  
Spiritual Beliefs ◽  
Structured Interviews ◽  
Purposeful Sampling ◽  
Spiritual Self ◽  
Age Range

AbstractObjectivesOne of the existential questions during adolescence is about the ambiguity in spiritual realms. Adolescents at this age not only have the spiritual, psychological, and unique needs, but also have spiritual needs that help them to relax and solve problems. Therefore, this qualitative study aimed to understand the concept of spiritual self-care in Iranian adolescents in 2019.MethodsThis qualitative study with content analysis approach was conducted on 14 adolescents with the age range of 14–20 years, who had been selected by purposeful sampling method. Data were collected by semi-structured interviews which were carried out between 4 March 2019 and 20 August 2019.ResultsThe interviews were transcribed immediately after the recording, and then were analyzed using direct content analysis. A total of 252 primary codes related to the adolescents’ spiritual self-care were extracted from the analysis, which determined 4 main aspects of spiritual self-care (spiritual belief, spiritual experience, social-religious activities, and spiritual growth).ConclusionsThe findings of this study showed that, spiritual self-care is a form of self-care by which a person uses his or her spiritual beliefs, teachings, and experiences as a source of control over stress and crises, and will be able to cope with problems.

Student paramedics' views on placements in general practice as part of a degree

2019 ◽  
Vol 11 (12) ◽  
pp. 519-525
Author(s):  
Alyesha Proctor
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Care Pathway ◽  
Structured Interviews ◽  
Learning And Development ◽  
Alternative Care ◽  
Face To Face ◽  
The Uk ◽  
University Degree

Background: Frontline paramedics are increasingly attending to non-emergency problems and calls that could be managed by a primary care provider. Alongside this, there is a growing pressure to manage patients at home or use an alternative care pathway and reduce hospital conveyance. Student paramedic training, including both placement and taught elements at university, should therefore reflect this. However, placement opportunities for student paramedics in primary care settings is variable across the UK. Aim: To explore student paramedics' views on incorporating a placement within general practice as part of their degree and its effects on their learning and development as an autonomous paramedic. Method: A small pedagogic study as part of a postgraduate certificate in academic practice for higher education, involving a case study, qualitative approach using face-to-face, semi-structured interviews and thematic analysis, was carried out. Findings: Student paramedics feel that incorporating a placement in general practice as part of their degree will significantly help in their learning and development as autonomous paramedics. Specifically, they feel it: will help them understand the role of the GP and what the GP expects of them; will help them to focus their assessments and improve confidence in decisions not to convey patients; may lead to better knowledge of alternative care pathways; and, finally, may provide an insight into the role of the paramedic in general practice as a future career opportunity. There are a few reservations about whether students would be able to use the skills and knowledge gained in this setting, as they feel they do not have access to the tools or the authority in a frontline ambulance service. Students would prefer to have a placement in a GP surgery in the final year of their university degree. Conclusion: Placement within a GP surgery for student paramedics should be included as part of a paramedic science degree as a priority. This is necessary, particularly given the changing role of the contemporary paramedic who attends to non-emergency problems.

scholarly journals General practitioners’ concepts on issuing out-of-pocket prescriptions for hypnotics and sedatives in Germany

2019 ◽  
Vol 36 (6) ◽  
pp. 785-790
Author(s):  
Katharina Schmalstieg-Bahr ◽  
Christiane A Müller ◽  
Eva Hummers
Keyword(s):  
Health Insurance ◽  
Qualitative Study ◽  
General Practitioners ◽  
Statutory Health Insurance ◽  
Medication Use ◽  
Hypnotics And Sedatives ◽  
Structured Interviews ◽  
Medication Costs ◽  
Prescription Form ◽  
To Receive

Abstract Background In Germany, almost 50% of prescriptions for benzodiazepines and drugs as Zolpidem and Zopiclone are as out-of-pocket (OOP) prescriptions—requiring patients to buy the drug at their own expense—although almost 90% of the population has statutory health insurance covering medication costs. Objective To understand why general practitioners (GPs) choose this prescribing method since needed medications are insurance covered, and unnecessary drugs should not be prescribed at all. Methods In this qualitative study, 17 semi-structured interviews with GPs were conducted, audio recorded and transcribed verbatim. Transcripts were analysed with grounded theory to extract a model explaining the described behaviour. Results Knowing the significant medical risks and insecurity about regulations makes GPs wish to avoid hypnotics and sedatives. They achieve this by ‘Creating a barrier’ (central phenomenon) and employing the strategy ‘Using an out-of-pocket prescription’, which not only generates costs for the patient but also reduces the physicians´ legal and financial accountability. The perceived patient type, expected problem duration and diagnosis influence the decision about the prescription form: patients with an alcohol or drug addiction or those with ‘uncomplicated’ insomnia are more likely to receive an OOP prescription. Patients with any psychiatric diagnosis will likely receive a statutory health insurance prescription. Discussion Current regulations do not provide guidance to GPs regarding hypnotics and sedatives. A clear regulatory framework and guidelines could possibly reduce physicians’ defensive attitudes about these drugs and their use of OOP prescriptions. The approach to use OOP prescriptions as a barrier to reduce patients’ medication use lacks evidence regarding effectiveness.

scholarly journals Conceptualizing the ‘whole university’ approach: an international qualitative study

2019 ◽  
Vol 35 (4) ◽  
pp. 730-740 ◽  
Author(s):  
Mark Dooris ◽  
Sue Powell ◽  
Alan Farrier
Keyword(s):  
Qualitative Study ◽  
Mental Health Crisis ◽  
Structured Interviews ◽  
Single Issue ◽  
Health Crisis ◽  
Global Movement ◽  
Health Promoting ◽  
Vice Chancellors ◽  
The Uk ◽  
Health Promoting University

Abstract Focusing on the conceptualization of a whole university approach, this paper reports on an international qualitative study that explored vice-chancellors’ and network members’ understanding of and commitment to Health Promoting Universities, examined perspectives on leadership and investigated the Okanagan Charter’s potential to catalyse whole university leadership and change. A multi-method qualitative approach was used: semi-structured interviews and focus groups were conducted face-to-face with vice-chancellors (n = 12) and Health Promoting University co-ordinators who were members of the UK Healthy Universities Network (n = 8); telephone interviews were conducted with a mix of UK and non-UK Health Promoting University co-ordinators (n = 5) and two online questionnaires were distributed to non-UK network co-ordinators (n = 6) and non-UK Health Promoting University co-ordinators (n = 10). Through thematic analysis, a number of key themes emerged that build a new conceptualization of the whole university approach (see Figure 1): building a broad understanding and framing of health; developing a supportive ethos and culture; embedding health into the university and joining up areas of work; focusing on the whole population and facing challenges and seizing opportunities. The study elicited rich and wide-ranging views from multiple stakeholders from universities and networks across four continents, confirming Health Promoting Universities as a truly global movement. Looking ahead, there are clear opportunities and challenges. First, the media narrative of a student mental health ‘crisis’ has focused universities’ attention on ‘health’, but from a single issue ‘illness’ perspective. This risks detracting from the whole system Health Promoting Universities approach. Second, even with the Okanagan Charter inspiring individuals and universities, there are still major challenges in translating the rhetoric of whole system approaches into meaningful action within large, complex and culturally diverse organizations.

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