scholarly journals Supporting bereavement and complicated grief in primary care: a realist review

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0008
Author(s):  
Caroline Pearce ◽  
Geoff Wong ◽  
Isla Kuhn ◽  
Stephen Barclay
Keyword(s):  
Primary Care ◽  
Complicated Grief ◽  
Realist Review ◽  
Physical And Mental Health ◽  
Prolonged Grief ◽  
Causal Explanations ◽  
Primary Care Settings ◽  
Grief Responses ◽  
Bereavement Care

BackgroundBereavement can have significant impacts on physical and mental health, and a minority of people experience complicated and prolonged grief responses. Primary care is ideally situated to offer bereavement care, yet UK provision remains variable and practitioners feel uncertain how best to support bereaved patients.AimTo identify what works, how, and for whom, in the management of complicated grief (CG) in primary care.Design & settingA review of evidence on the management of CG and bereavement in UK primary care settings.MethodA realist approach was taken that aims to provide causal explanations through the generation and articulation of contexts, mechanisms, and outcomes.ResultsForty-two articles were included. Evidence on the primary care management of complicated or prolonged grief was limited. GPs and nurses view bereavement support as part of their role, yet experience uncertainty over the appropriate extent of their involvement. Patients and clinicians often have differing views on the role of primary care in bereavement. Training in bereavement, local systems for reporting deaths, practitioner time, and resources can assist or hinder bereavement care provision. Practitioners find bereavement care can be emotionally challenging. Understanding patients’ needs can encourage a proactive response and help identify appropriate support.ConclusionBereavement care in primary care remains variable and practitioners feel unprepared to provide appropriate bereavement care. Patients at higher risk of complicated or prolonged grief may fail to receive the support they need from primary care. Further research is required to address the potential unmet needs of bereaved patients.

Next steps for student supervision and assessment

2019 ◽  
Vol 30 (10) ◽  
pp. 496-500
Author(s):  
Shaun Heath
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Communities Of Practice ◽  
Student Nurses ◽  
Education Standards ◽  
Student Placement ◽  
Practice Nurses ◽  
Primary Care Settings ◽  
Student Supervision

Student nurses are the future of the profession. Shaun Heath explains how changes to the Nursing and Midwifery Council's education standards will effect those currently acting as mentors and how all practice nurses can get involved and contribute to student placement experiences This article explores the Nursing and Midwifery Council's 2018 education standards and how these will affect the role of general practice nurses in primary care settings. The differing roles found in the standards will be discussed, alongside how primary care and the emerging Primary Care Networks can support learners in general practice through communities of practice.

Patient experiences in behavioral health integrated primary care settings: the role of stigma in shaping patient outcomes over time

2019 ◽  
Vol 24 (10) ◽  
pp. 1182-1197 ◽  
Author(s):  
Natalie Royal Kenton ◽  
Lauren Broffman ◽  
Kyle Jones ◽  
Kayla Albrecht Mcmenamin ◽  
Maggie Weller ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Patient Outcomes ◽  
Patient Experiences ◽  
Integrated Primary Care ◽  
Primary Care Settings ◽  
Over Time

scholarly journals Barriers and facilitators to the implementation of nurse's role in primary care settings: an integrative review

2021 ◽  
Author(s):  
Erica Busca ◽  
Alessia Savatteri ◽  
Tania Lorenza Calafato ◽  
Beatrice Mazzoleni ◽  
Michela Barisone ◽  
...  
Keyword(s):  
Primary Care ◽  
Rapid Evolution ◽  
Barriers And Facilitators ◽  
Integrative Review ◽  
Mixed Method Research ◽  
Nursing Facilities ◽  
Effective Strategies ◽  
Primary Care Settings ◽  
Working Groups

Abstract Background The rapid evolution of the epidemiological picture and the recent SARS-COV-2 pandemic has expressed the vulnerabilities of health systems and focuses attention on the population's needs.The nurse's figure in the care teams is universally identified; however, the implementation of the role within some care settings turns out to be complex and challenging. This integrative review aims to identify the barriers and facilitators in implementing the role of the nurse in primary care settings.MethodsAn integrative review was conducted on the Medline and Cinahl databases until 9 June 2020. Qualitative, quantitative, and Mixed-method research studies were selected to identify studies related to the barriers and facilitators of the nurse's role in nursing facilities' primary care. For the extraction of the results, the Consolidating Framework for Research Implementation (CFIR) was used to identify the factors that influence implementation in health care.ResultsFollowing the duplicates' removal, the search identified 18257 articles, of which 56 were relevant to the inclusion criteria; therefore, they were included in the summary.The selected studies were conducted in thirteen countries, most from Oceania, Europe, North America, Latin America, and the Caribbean.The barriers reported most frequently concern the nursing profession's regulatory and regulatory aspects within the contexts of care, cultural and organizational aspects, training, and the transfer of specific skills, which were previously designated to doctors.The facilitators are mainly linked to the nurse's adaptability to the various contexts of care, recognizing the patient's role, and the desire to develop multidisciplinary and effective working groups to respond to the health needs of the population in primary care contexts.ConclusionThis review highlighted the main barriers and facilitators in implementing the nurse's role in primary care settings. These results offer useful elements for stakeholders to identify effective strategies in preparing programs and activities for implementing the nurse's role, acting on the elements identified as barriers and favouring the aspects that emerge as facilitators.

scholarly journals The Role of Trust and Hope in Antipsychotic Medication Reviews in Primary Care Settings: A Realist Review. 

2021 ◽  
Author(s):  
Lisa Marie Grünwald ◽  
Claire Duddy ◽  
Richard Byng ◽  
Nadia Crellin ◽  
Joanna Moncrieff
Keyword(s):  
Primary Care ◽  
Antipsychotic Medication ◽  
Perceived Risk ◽  
Secondary Care ◽  
Realist Review ◽  
Service Users ◽  
Programme Theory ◽  
Primary Care Settings ◽  
Low Expectations ◽  
Medication Reviews

Abstract Background: Increasing number of service users diagnosed with schizophrenia and psychosis are being discharged from specialist secondary care services to primary care, many of whom are prescribed long-term antipsychotics. It is unclear if General Practitioners have the confidence and experience to appropriately review and adjust doses of antipsychotic medication without secondary care support.Aim: To explore barriers and facilitators of conducting antipsychotic medication reviews in primary care for individuals with no specialist mental health inputDesign & Setting: Realist review in general practice settings. Method: A realist review has been conducted to synthesise evidence on antipsychotic medication reviews conducted in primary care with service users diagnosed with schizophrenia and/or psychosis. Following initial scoping searches and discussions with stakeholders, a systematic search and iterative secondary searches were conducted. Articles were systematically screened and analysed to develop a realist programme theory explaining the contexts (C) and mechanisms (M) which facilitate or prevent antipsychotic medication reviews (O) in primary care settings, and the potential outcomes of medication reviews.Results: Antipsychotic medication reviews may not occur for individuals with only primary care medical input. Several, often mutually reinforcing, mechanisms have been identified as potential barriers to carrying out meaningful reviews, including low expectations of recovery for people with severe mental illness, a perceived lack of capability to understand and participate in medication reviews, linked with a lack of information shared in appointments between GPs and Service Users, and perceived risk and uncertainty regarding antipsychotic medication and illness trajectory. Conclusions: The review identified reciprocal and reinforcing stereotypes affecting both GPs and service users. Possible mechanisms to counteract these barriers are discussed, including realistic expectations of medication, and the need for increased information sharing and trust between GPs and service users.

scholarly journals Role of Psychology in Mental Health

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Nidhi
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Behavioral Health ◽  
Social Emotional ◽  
Public And Private ◽  
Psychological States ◽  
Primary Care Settings ◽  
Clinical Counseling ◽  
Good Mental Health

Mental health describe our social, emotional, and psychological states, all wrapped up into one. Someone who experiences “good” mental health, therefore, has found a balance in his or her social, emotional, and psychological areas of life. Term “behavioral health” is being used incorrectly refer to mental illness. We explore the nature of psychology. We outline the different schools of thought and method of inquiry in psychology. Psychologists provide vital mental and behavioral health services in primary care. They identify and modify behaviors to promote individuals’ health and wellness across the lifespan. A significant and growing number of psychologists (e.g., in such areas as health, clinical, counseling, family, and rehabilitation psychology) provide inter professional, team-based care in pediatric, adult, and family-oriented primary care settings in both the public and private sectors. This paper tries to highlight the role of psychology in mental health and practically utilities of psychology in present scenario of mental health.

scholarly journals Role of Occupational Therapy in Pediatric Primary Care: Promoting Childhood Development

2021 ◽  
Vol 75 (6) ◽  
Author(s):  
Bonnie R. W. Riley ◽  
Stephanie L. de Sam Lazaro
Keyword(s):  
Primary Care ◽  
Occupational Therapy ◽  
Culturally Responsive ◽  
Childhood Development ◽  
Pediatric Primary Care ◽  
Service Delivery Models ◽  
Primary Care Settings ◽  
Delivery Models ◽  
Occupational Therapy Practitioners

Occupational therapy practitioners have the opportunity to promote development for all children as new service delivery models are established for pediatric primary care. Three action steps are identified: (1) advocacy for legislation that requires developmental screenings and surveillance, (2) support of culturally responsive developmental monitoring, and (3) building evidence for occupational therapy in primary care settings. This article describes the role of occupational therapy practitioners on pediatric interprofessional teams in encouraging family capacity within the scope of health promotion and universal developmental monitoring.

scholarly journals Review on Assessment and Evaluation of Vitiligo in Primary Care

2021 ◽  
pp. 275-283
Author(s):  
Faisal Suliman Algaows ◽  
Tala Shawkat Bukhari ◽  
Tahani Mohammed Asiri ◽  
Abdulkarim Mudbigh Almazyadi ◽  
Salma Abdul Khahar ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Multidisciplinary Approach ◽  
Calcineurin Inhibitors ◽  
Treatment Method ◽  
Treatment Modalities ◽  
Assessment And Evaluation ◽  
Primary Care Settings ◽  
Collaboration And Communication

Vitiligo is an acquired skin disorder characterised by the disappearance of melanocytes, resulting in well-defined white patches that are frequently symmetrically distributed. The lack of melanin pigment makes the lesional skin more sensitive to sunburn. Vitiligo can be cosmetically disfiguring, and it is a stigmatising condition that can lead to serious psychologic problems in daily life. Vitiligo is treated with a variety of topical and systemic medications, phototherapy, laser therapy, and surgical therapy. Corticosteroids, calcineurin inhibitors, and vitamin-D analogues are examples of topical treatment modalities. Phototherapy is a highly effective treatment method. It causes repigmentation in the majority of patients with early and localised disease. Because vitiligo is associated with other autoimmune disorders, a multidisciplinary approach is required. Collaboration and communication between primary care physicians and dermatologists are critical. This review aims to assess role of primary care physicians in assessment and management of vitiligo in primary care settings.

The role of psychologists in the care of Iraq and Afghanistan veterans in primary care settings.

2010 ◽  
Vol 41 (2) ◽  
pp. 135-142 ◽  
Author(s):  
Shira Maguen ◽  
Greg Cohen ◽  
Beth E. Cohen ◽  
G. Dawn Lawhon ◽  
Charles R. Marmar ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Settings
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