scholarly journals Nasal balloon autoinflation for glue ear in primary care: a qualitative interview study

2018 ◽  
Vol 69 (678) ◽  
pp. e24-e32
Author(s):  
Jane Vennik ◽  
Ian Williamson ◽  
Caroline Eyles ◽  
Hazel Everitt ◽  
Michael Moore
Keyword(s):  
Primary Care ◽  
Low Cost ◽  
Daily Routine ◽  
Structured Interviews ◽  
Early Management ◽  
Practice Nurses ◽  
Holistic Treatment ◽  
Qualitative Interview Study ◽  
Cost Treatment ◽  
Glue Ear

BackgroundNasal balloon autoinflation is an effective, non-surgical treatment for symptomatic children with glue ear, although uptake is variable and evidence about acceptability and feasibility is limited.AimTo explore parent and healthcare professional views and experiences of nasal balloon autoinflation for children with glue ear in primary care.Design and settingQualitative study using semi-structured interviews with a maximum-variety sample of parents, GPs, and practice nurses. The study took place between February 2013 and September 2014.MethodSemi-structured face-to-face and telephone interviews were audiorecorded, transcribed verbatim, and analysed using inductive thematic analysis.ResultsIn all, 14 parents, 31 GPs, and 19 nurses were included in the study. Parents described the nasal balloon as a natural, holistic treatment that was both acceptable and appealing to children. GPs and nurses perceived the method to be a low-cost, low-risk strategy, applicable to the primary care setting. Good instruction and demonstration ensured children mastered the technique and engaged with the treatment, but uncertainties were raised about training provision and potential impact on the GP consultation. Making nasal balloon autoinflation part of a child’s daily routine enhances compliance, but difficulties can arise if children are unwell or refuse to cooperate.ConclusionNasal balloon autoinflation is an acceptable, low-cost treatment option for children with glue ear in primary care. Provision of educational materials and demonstration of the method are likely to promote uptake and compliance. Wider use of the nasal balloon has the potential to enhance early management, and may help to fill the management gap arising from forthcoming changes to care pathways.

Facilitators and barriers for promoting healthy eating among primary care patients: results of a qualitative study among practice nurses

2021 ◽  
Author(s):  
Geertruida J Groenendijk-van Woudenbergh ◽  
Marlies C van Hell-Cromwijk ◽  
Ytje J J van der Veen ◽  
Hylkje F Algra ◽  
Willemieke Kroeze
Keyword(s):  
Primary Care ◽  
Communication Skills ◽  
Healthy Eating ◽  
Patient Encounter ◽  
Structured Interviews ◽  
Good Communication ◽  
Practice Nurses ◽  
Professional Characteristics ◽  
Primary Care Patients ◽  
Facilitators And Barriers

Abstract Background Practice nurses have an important role in promoting healthy eating to prevent or delay long-term complications from chronic lifestyle-related diseases. Objective To identify the facilitators and barriers encountered by practice nurses at a professional level when promoting healthy eating among patients. Methods Face-to-face semi-structured interviews were conducted with 21 Dutch practice nurses. Data were recorded, transcribed and analysed using inductive thematic analysis. Results Two main themes were determined: professional characteristics and professional–patient encounter. Professional characteristics included good communication skills and experience facilitated the successful promotion of healthy eating, while a lack of communication skills and lack of knowledge about diet were perceived as barriers. The most frequently identified facilitators for professional–patient encounter included ensuring a personal connection with patients, creating food awareness, focussing on small changes, adopting a tailored approach, motivating and arranging extra consultations. Barriers included lack of skills to raise the topic, lack of persistence, inability to find a common understanding, lack of competence in handling patients’ own choices and underuse of existing educational materials. Conclusions Further research using the identified facilitators and barriers for promoting healthy eating in primary care patients with chronic diseases could assist in the development of future training programmes for practice nurses.

scholarly journals Operational failures and how they influence the work of GPs: a qualitative study in primary care

2020 ◽  
Vol 70 (700) ◽  
pp. e825-e832
Author(s):  
Carol Sinnott ◽  
Alexandros Georgiadis ◽  
Mary Dixon-Woods
Keyword(s):  
Primary Care ◽  
Work Environment ◽  
Information Transfer ◽  
Healthcare Providers ◽  
Comparison Method ◽  
Care Work ◽  
System Level ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Operational Failures

BackgroundOperational failures, defined as inadequacies or errors in the information, supplies, or equipment needed for patient care, are known to be highly consequential in hospital environments. Despite their likely relevance for GPs’ experiences of work, they remain under-explored in primary care.AimTo identify operational failures in the primary care work environment and to examine how they influence GPs’ work.Design and settingQualitative interview study in the East of England.MethodSemi-structured interviews were conducted with GPs (n = 21). Data analysis was based on the constant comparison method.ResultsGPs reported a large burden of operational failures, many of them related to information transfer with external healthcare providers, practice technology, and organisation of work within practices. Faced with operational failures, GPs undertook ‘compensatory labour’ to fulfil their duties of coordinating and safeguarding patients’ care. Dealing with operational failures imposed significant additional strain in the context of already stretched daily schedules, but this work remained largely invisible. In part, this was because GPs acted to fix problems in the here-and-now rather than referring them to source, and they characteristically did not report operational failures at system level. They also identified challenges in making process improvements at practice level, including medicolegal uncertainties about delegation.ConclusionOperational failures in primary care matter for GPs and their experience of work. Compensatory labour is burdensome with an unintended consequence of rendering these failures largely invisible. Recognition of the significance of operational failures should stimulate efforts to make the primary care work environment more attractive.

scholarly journals COVID-19 at the Deep End: A Qualitative Interview Study of Primary Care Staff Working in the Most Deprived Areas of England during the COVID-19 Pandemic

2021 ◽  
Vol 18 (16) ◽  
pp. 8689
Author(s):  
Claire Norman ◽  
Josephine M. Wildman ◽  
Sarah Sowden
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Care Staff ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Social Prescribing ◽  
Qualitative Interview Study ◽  
The Impact ◽  
Primary Care Staff ◽  
Deprived Areas

COVID-19 is disproportionately impacting people in low-income communities. Primary care staff in deprived areas have unique insights into the challenges posed by the pandemic. This study explores the impact of COVID-19 from the perspective of primary care practitioners in the most deprived region of England. Deep End general practices serve communities in the region’s most socioeconomically disadvantaged areas. This study used semi-structured interviews followed by thematic analysis. In total, 15 participants were interviewed (11 General Practitioners (GPs), 2 social prescribing link workers and 2 nurses) with Deep End careers ranging from 3 months to 31 years. Participants were recruited via purposive and snowball sampling. Interviews were conducted using video-conferencing software. Data were analysed using thematic content analysis through a social determinants of health lens. Our results are categorised into four themes: the immediate health risks of COVID-19 on patients and practices; factors likely to exacerbate existing deprivation; the role of social prescribing during COVID-19; wider implications for remote consulting. We add qualitative understanding to existing quantitative data, showing patients from low socioeconomic backgrounds have worse outcomes from COVID-19. Deep End practitioners have valuable insights into the impact of social distancing restrictions and remote consulting on patients’ health and wellbeing. Their experiences should guide future pandemic response measures and any move to “digital first” primary care to ensure that existing inequalities are not worsened.

scholarly journals Engagement in e-cycling and the self-management of type 2 diabetes: a qualitative study in primary care

BJGP Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. bjgpopen18X101638 ◽  
Author(s):  
Aidan Searle ◽  
Emma Ranger ◽  
Jez Zahra ◽  
Byron Tibbitts ◽  
Angie Page ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
The Self ◽  
Self Management ◽  
Post Intervention ◽  
Practice Nurses ◽  
Qualitative Interview Study ◽  
Primary Care Health ◽  
Care Health

BackgroundPhysical activity (PA) is important in the management of type 2 diabetes (T2DM), however many people find it difficult to implement and/or sustain in the self-management of the condition. Electrically assisted cycling (e-cycling) may be viewed as a means of self-management in which effort is invested to balance the interplay of lifestyle factors and disease progression.AimTo explore engagement with an e-cycling intervention conducted with adults with T2DM.Design & settingProspective qualitative interview study with adults in central Bristol (UK) and surrounding suburbs, in the context of the self-management of T2DM in primary care.MethodInterviews were conducted with 20 individuals with T2DM (42–70 years, 11 male, 9 female) prior to their participation in a 20-week e-cycling intervention. Post-intervention interviews were conducted with 18 participants (11 male, 7 female). Interviews were transcribed verbatim and inductive thematic analysis was undertaken.ResultsParticipants were aware that PA contributed to the management of their diabetes. Engagement with e-cycling was viewed as both an acceptable and a social lifestyle intervention. Furthermore, participants were unhappy with the volume of medication used to manage their diabetes and e-cycling fostered autonomy in the management of T2DM. GPs and practice nurses were regarded as an important source of reliable information, and were considered to be best placed to talk about interventions to increase PA.ConclusionE-cycling is viewed as an acceptable form of PA to aid the self-management of T2DM. E-cycling may support people with T2DM to reduce their medication intake and in turn foster greater autonomy in managing the condition. The findings have implications for the role of primary care health professionals in supporting both patients and significant others in adoption of e-cycling.

scholarly journals General practitioners’ perceptions towards the use of digital health services for citizens in primary care: a qualitative interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028251 ◽  
Author(s):  
Asbjørn Johansen Fagerlund ◽  
Inger Marie Holm ◽  
Paolo Zanaboni
Keyword(s):  
Primary Care ◽  
Health Services ◽  
General Practitioners ◽  
Computer Literacy ◽  
Large Scale ◽  
Digital Health ◽  
The Elderly ◽  
Structured Interviews ◽  
Electronic Prescription ◽  
Qualitative Interview Study

ObjectivesTo explore general practitioners’ (GPs) perceptions towards use of four digital health services for citizens: an electronic booking service to make reservations with the GP; an electronic prescription service to request renewal of maintenance drugs; a service for text-based non-clinical enquiries to the GP office and a service for text-based electronic consultation (e-consultation) with the GP.DesignA qualitative study based on semi-structured interviews.SettingPrimary care.ParticipantsNine GPs who were early adopters of the four services were interviewed.MethodOne moderator presented topics using open-ended questions, facilitated the discussion and followed up with further questions. Phone interviews were conducted, audio recorded and transcribed verbatim. Qualitative data were analysed using the framework method.ResultsThe use of digital services in primary care in Norway is growing, although the use of text-based e-consultations is still limited. Most GPs were positive about all four services, but there was still some scepticism regarding their effects. Advantages for GP offices included reduced phone load, increased efficiency, released time for medical assessments, less crowded waiting rooms and more precise communication. Benefits for patients were increased flexibility, autonomy and time and money savings. Children, the elderly and people with low computer literacy might still need traditional alternatives.ConclusionsMore defined and standardised routines, as well as more evidence of the effects, are necessary for large-scale adoption.

scholarly journals Delivering a primary care-based social prescribing initiative: a qualitative study of the benefits and challenges

2018 ◽  
Vol 68 (672) ◽  
pp. e487-e494 ◽  
Author(s):  
Kathryn Skivington ◽  
Mathew Smith ◽  
Nai Rui Chng ◽  
Mhairi Mackenzie ◽  
Sally Wyke ◽  
...  
Keyword(s):  
Primary Care ◽  
Case Management ◽  
Case Manager ◽  
Structured Interviews ◽  
Social Prescribing ◽  
Community Organisation ◽  
Health Goals ◽  
Community Organisations ◽  
Ability To Act ◽  
Qualitative Interview Study

BackgroundSocial prescribing is a collaborative approach to improve inter-sectoral working between primary health care and community organisations. The Links Worker Programme (LWP) is a social prescribing initiative in areas of high deprivation in Glasgow, Scotland, that is designed to mitigate the negative impacts of the social determinants of health.AimTo investigate issues relevant to implementing a social prescribing programme to improve inter-sectoral working to achieve public health goals.Design and settingQualitative interview study with community organisation representatives and community links practitioners (CLPs) in LWP areas.MethodAudiorecordings of semi-structured interviews with 30 community organisation representatives and six CLPs were transcribed verbatim and analysed thematically.ResultsParticipants identified some benefits of collaborative working, particularly the CLPs’ ability to act as a case manager for patients, and their position in GP practices, which operated as a bridge between organisations. However, benefits were seen to flow from new relationships between individuals in community organisations and CLPs, rather than more generally with the practice as a whole. Challenges to the LWP were related to capacity and funding for community organisations in the context of austerity. The capacity of CLPs was also an issue given that their role involved time-consuming, intensive case management.ConclusionAlthough the LWP appears to be a fruitful approach to collaborative case management, integration initiatives such as social prescribing cannot be seen as ‘magic bullets’. In the context of economic austerity, such approaches may not achieve their potential unless funding is available for community organisations to continue to provide services and make and maintain their links with primary care.

scholarly journals Family Practice Nursing in Newfoundland and Labrador: Are Reported Roles Reflective of Professional Competencies for Registered Nurses in Primary Care?

2021 ◽  
Vol 7 ◽  
pp. 237796082110534
Author(s):  
Maria Mathews ◽  
Dana Ryan ◽  
Richard Buote ◽  
Sandra Parsons ◽  
Julia Lukewich
Keyword(s):  
Primary Care ◽  
Registered Nurses ◽  
Family Practice ◽  
Newfoundland And Labrador ◽  
Secondary Analysis ◽  
Family Physicians ◽  
Scope Of Practice ◽  
Professional Competencies ◽  
Structured Interviews ◽  
Practice Nurses

Background Family practice nurses are Registered Nurses who work collaboratively in primary care and deliver a range of services. Professional competency statements have been developed to describe the skills and knowledge of family practice nurses as a distinct field. Purpose We conducted a secondary analysis of qualitative interview data to examine how family practice nurse roles/activities relate to recently developed professional competencies. Methods Family physicians and family practice nurses in Newfoundland and Labrador (NL) participated in semi-structured interviews, during which they discussed roles/activities and scope of practice surrounding family practice nursing. For this secondary analysis, we used competency statements to inform thematic coding of the transcribed interviews. Results For the initial study, a total of 8 participants (5 family practice nurses; 3 family physicians) were interviewed from diverse practices. All transcripts from the original study (n = 8) were included in the secondary analysis and analysed across 47 competencies encompassing 6 domains (Professionalism; Clinical Practice; Communication; Collaboration and Partnership; Quality Assurance, Evaluation and Research; Leadership). Roles/activities reported by participants were reflective of the competencies, but with substantial variation in expression. Conclusions Family practice nursing competency statements reflect the actual activities of family practice nurses in NL. The professional competencies can serve as a framework to examine contributions of family practice nurses and identify areas warranting further training. The use of competencies to explore family practice nurses’ roles and activities can assist with optimizing scope of practice.

Research activity and quality indicators in primary care - An explorative qualitative interview study

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697445
Author(s):  
Helen Riding ◽  
S Haining ◽  
L Robinson
Keyword(s):  
Primary Care ◽  
Quality Indicators ◽  
Quantitative Research ◽  
Sampling Strategy ◽  
Care Staff ◽  
Current Evidence ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Research Activity ◽  
Qualitative Interview Study

BackgroundEmerging evidence suggests that research activity improves healthcare performance in secondary care. Staff who contribute and participate in research studies, tend to have a greater understanding, and use, of current evidence and guidelines. The engagement in research in primary care and correlation with quality indicators (QIs) is unclear.AimThe aim of this study is exploring the link between research activity and quality indicators in primary care.Method4 GPs and 4 practice managers consented and participated in semi-structured interviews conducted in spring 2017. A purposive sampling strategy was adopted until data saturation was achieved. The interviews were digitally recorded, transcribed verbatim and analysed using thematic framework analysis.ResultsPractices with a GP research champion were more likely to undertake research. Staff directly participating in the recruitment and follow-up and the research teams adopting a participatory and active research methodology is more likely to lead to improvement in quality. Including research as Enhanced Service may influence increased participation. The QOF is most likely to reflect improvement related to research, but opinions were mixed.ConclusionClinical Commissioning Groups and NHS England should be encouraged to develop QIs for research. As the landscape changes with the creation of Accountable Care Systems, there is an opportunity address the inclusion of research into practice contracts. This paper is the first to explore this topic in primary care and the findings will contribute towards developing quantitative research to expand the findings of this exploratory study.

scholarly journals Exploring healthcare professionals’ views of the acceptability of delivering interventions to promote healthy infant feeding practices within primary care: a qualitative interview study

2020 ◽  
pp. 1-24
Author(s):  
Elaine Toomey ◽  
Caragh Flannery ◽  
Karen Matvienko-Sikar ◽  
Ellinor K Olander ◽  
Catherine Hayes ◽  
...  
Keyword(s):  
Primary Care ◽  
Infant Feeding ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Healthy Infant ◽  
Valuable Insight ◽  
Practice Nurses ◽  
Telephone Interviews ◽  
Affective Attitude ◽  
Qualitative Interview Study

Abstract Objective: Early-life nutrition plays a key role in establishing healthy lifestyles and preventing chronic disease. This study aimed to 1) explore healthcare professionals’ (HCP) opinions on the acceptability of and factors influencing the delivery of interventions to promote healthy infant feeding behaviours within primary care, and 2) identify proposed barriers/enablers to delivering such interventions during vaccination visits, to inform the development of a childhood obesity prevention intervention. Design: A qualitative study design was employed using semi-structured telephone interviews. Data were analysed using qualitative content analysis; findings were also mapped to the Theoretical Framework of Acceptability (TFA). Setting: Primary care in Ireland Participants: 21 primary care-based HCPs: 5 practice nurses, 7 general practitioners, 3 public health nurses, 3 community dietitians and 3 community medical officers. Results: The acceptability of delivering interventions to promote healthy infant feeding within primary care is influenced by the availability of resources, HCPs’ roles and priorities, and factors relating to communication and relationships between HCPs and parents. Proposed barriers and enablers to delivering interventions within vaccination visits include; time constraints versus opportunistic access, existing relationships and trust between parents and practice nurses, and potential communication issues. Barriers/enablers mapped to TFA constructs of Affective Attitude, Perceived Effectiveness and Self-Efficacy. Conclusions: This study provides a valuable insight into HCPs perspectives of delivering prevention-focused infant feeding interventions within primary care settings. While promising, factors such as coordination and clarity of HCP roles and resource allocation need to be addressed to ensure acceptability of interventions to HCPs involved in delivery.

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