scholarly journals Supporting nutrition in frail older people: a qualitative study exploring views of primary care and community health professionals

2020 ◽  
Vol 70 (691) ◽  
pp. e138-e145 ◽  
Author(s):  
Christina Avgerinou ◽  
Cini Bhanu ◽  
Kate Walters ◽  
Helen Croker ◽  
Remco Tuijt ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Older People ◽  
Community Health ◽  
Health Professionals ◽  
Multidisciplinary Teams ◽  
Frail Older People ◽  
Social Emotional ◽  
Practical Support ◽  
Socially Isolated

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.

scholarly journals Improving mobility and participation of older people with vertigo, dizziness and balance disorders in primary care using a care pathway: feasibility study and process evaluation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Eva Seckler ◽  
Verena Regauer ◽  
Melanie Krüger ◽  
Anna Gabriel ◽  
Joachim Hermsdörfer ◽  
...  
Keyword(s):  
Primary Care ◽  
Data Collection ◽  
Older People ◽  
Process Evaluation ◽  
Feasibility Study ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Care Pathway ◽  
Main Trial ◽  
Telephone Helpline

Abstract Background Community-dwelling older people are frequently affected by vertigo, dizziness and balance disorders (VDB). We previously developed a care pathway (CPW) to improve their mobility and participation by offering standardized approaches for general practitioners (GPs) and physical therapists (PTs). We aimed to assess the feasibility of the intervention, its implementation strategy and the study procedures in preparation for the subsequent main trial. Methods This 12-week prospective cohort feasibility study was accompanied by a process evaluation designed according to the UK Medical Research Council’s Guidance for developing and evaluating complex interventions. Patients with VDB (≥65 years), GPs and PTs in primary care were included. The intervention consisted of a diagnostic screening checklist for GPs and a guide for PTs. The implementation strategy included specific educational trainings and a telephone helpline. Data for mixed-method process evaluation were collected via standardized questionnaires, field notes and qualitative interviews. Quantitative data were analysed using descriptive statistics, qualitative data using content analysis. Results A total of five GP practices (seven single GPs), 10 PT practices and 22 patients were included in the study. The recruitment of GPs and patients was challenging (response rates: GP practices: 28%, PT practices: 39%). Ninety-one percent of the patients and all health professionals completed the study. The health professionals responded well to the educational trainings; the utilization of the telephone helpline was low (one call each from GPs and PTs). Familiarisation with the routine of application of the intervention and positive attitudes were emphasized as facilitators of the implementation of the intervention, whereas a lack of time was mentioned as a barrier. Despite difficulties in the GPs’ adherence to the intervention protocol, the GPs, PTs and patients saw benefit in the intervention. The patients’ treatment adherence to physical therapy was good. There were minor issues in data collection, but no unintended consequences. Conclusion Although the process evaluation provided good support for the feasibility of study procedures, the intervention and its implementation strategy, we identified a need for improvement in recruitment of participants, the GP intervention part and the data collection procedures. The findings will inform the main trial to test the interventions effectiveness in a cluster RCT. Trial registration Projektdatenbank Versorgungsforschung Deutschland (German registry Health Services Research) VfD_MobilE-PHY_17_003910, date of registration: 30.11.2017; Deutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00022918, date of registration: 03.09.2020 (retrospectively registered).

scholarly journals 092GPS’ PERSPECTIVES ON PRESCRIBING FOR OLDER PEOPLE IN PRIMARY CARE: A QUALITATIVE STUDY

2016 ◽  
Vol 45 (suppl 2) ◽  
pp. ii13.11-ii56
Author(s):  
David O Riordan ◽  
Stephen Byrne ◽  
Aoife Fleming ◽  
Rose Galvin ◽  
Patricia M Kearney ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Older People

scholarly journals Patient self-monitoring of blood pressure and self-titration of medication in primary care: the TASMINH2 trial qualitative study of health professionals’ experiences

2013 ◽  
Vol 63 (611) ◽  
pp. e378-e385 ◽  
Author(s):  
Miren I Jones ◽  
Sheila M Greenfield ◽  
Emma P Bray ◽  
FD Richard Hobbs ◽  
Roger Holder ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Qualitative Study ◽  
Health Professionals ◽  
Self Monitoring

scholarly journals Factors affecting primary care practitioners’ alcohol-related discussions with older adults: Qualitative study

2021 ◽  
pp. BJGP.2020.1118
Author(s):  
Bethany Kate Bareham ◽  
Jemma Stewart ◽  
Eileen Kaner ◽  
Barbara Hanratty
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Older People ◽  
Focus Groups ◽  
Old Age ◽  
Later Life ◽  
Long Term Conditions ◽  
Age Related ◽  
Comparison Results ◽  
Primary Care Practitioners

Background: Risk of harm from drinking is heightened in later life, due to age-related sensitivities to alcohol. Primary care services have a key role in supporting older people to make healthier decisions about alcohol. Aim: To examine primary care practitioners’ perceptions of factors that promote and challenge their work to support older people in alcohol risk-reduction. Design and Setting: Qualitative study consisting of semi-structured interviews and focus groups with primary care practitioners in Northern England. Method: Thirty-five practitioners (general practitioners, practice/district nurses, pharmacists, dentists, social care practitioners, domiciliary carers) participated in eight interviews and five focus groups. Data were analysed thematically, applying principles of constant comparison. Results: Practitioners highlighted particular sensitivities amongst older people to discussing alcohol, and reservations about older people’s resistance to making changes in old age; given drinking practices could be established, and promote socialisation and emotional wellbeing in later life. Age-related health issues increased older people’s contact with practitioners; but management of older people’s long-term conditions was prioritised over discussion of alcohol. Dedicated time to address alcohol in routine consultations with older people, and training in alcohol intervention facilitated practitioners; particularly pharmacists and practice nurses. Conclusion: There are clear opportunities to support older people in primary care to make healthier decisions about alcohol. Dedicated time to address alcohol, training in identification of alcohol-related risks, particularly those associated with old age; and tailored interventions for older people, feasible to implement in practice settings, would support primary care practitioners to address older people’s alcohol use.

scholarly journals Experiences of Falling Ill with Fibromyalgia: An Incursion into the Collective Imaginary of Women

2021 ◽  
Vol 31 ◽  
Author(s):  
Rodrigo Sanches Peres
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Qualitative Study ◽  
Health Professionals ◽  
Chronic Condition ◽  
Multidisciplinary Teams ◽  
Psychological Suffering ◽  
Group Interviews

Abstract A psychoanalytic exploration of the collective imaginary of patients about a chronic condition can help health professionals to understand the experience of falling ill in its intersubjective aspect. This study aimed to investigate the collective imaginary about fibromyalgia in women affected by this syndrome. This is a qualitative study based on the psychoanalytic investigative method. Data were collected from 18 women through group interviews guided by the Drawing-Story with Theme Procedure. Data analysis followed technical movements defined by the oscillation from a receptive passivity to an active receptivity. Results showed that, after falling ill, the participants did not feel to be the same persons they were before or, in certain cases, no longer regard themselves as persons at all. It was also verified that delegitimation generates psychological suffering described by the participants as a kind of pain. Therefore, it is recommended to value relational technologies in health care offered by multidisciplinary teams to women with fibromyalgia

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