scholarly journals Parents’ expectations and experiences of the 6-week baby check: a qualitative study in primary care

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101110
Author(s):  
Gill Gilworth ◽  
Sarah Milton ◽  
Angel Chater ◽  
Irwin Nazareth ◽  
Andreas Roposch ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Maternity Care ◽  
Normal Development ◽  
Screening Programme ◽  
Structured Interviews ◽  
Care Policy ◽  
Comprehensive Health ◽  
Health And Development ◽  
Important Milestone

BackgroundThe Newborn and Infant Physical Examination (NIPE) programme requires all babies to have a comprehensive health check at 6–8 weeks of age. These are typically completed by GPs. Although person-centred care has achieved prominence in maternity care policy in recent years, there is limited empirical evidence on what parents and/or carers expect from the check, and how far experiences meet their needs.Aim To explore the expectations and experiences of parents attending their GP for a baby check.Design & settingA qualitative study was undertaken in primary care in London.MethodContent analysis was undertaken of transcripts of semi-structured interviews. Interviews were conducted with a total of 16 participants (14 mothers and two fathers) who had recently attended for a 6-week check for their baby.ResultsDespite the availability of plentiful sources of general advice on infants’ health and development, a thorough check by a trusted GP was an important milestone for most parents. They had few specific expectations of the check in terms of what examinations were undertaken, but even experienced parents anticipated reassurance about their baby’s normal development. Many also hoped for reassurance about their own parenting. Parents appreciated GPs who explained what they were doing during the examination; space to raise any concerns; and combined mother and baby checks. Referrals to secondary care were generally experienced as reassuring rather than a source of anxiety.ConclusionThe baby check meets needs beyond those of the NIPE screening programme. Protecting the time for a thorough consultation is important for parents at what can be a vulnerable time.

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.

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 Therapeutic itinerary of people with tuberculosis in face with their health needs

2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Aliéren Honório Oliveira ◽  
Antonio Germane Alves Pinto ◽  
Maria do Socorro Vieira Lopes ◽  
Tânia Maria Ribeiro Monteiro de Figueiredo ◽  
Edilma Gomes Rocha Cavalcante
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Qualitative Study ◽  
Health Needs ◽  
Smear Microscopy ◽  
Structured Interviews ◽  
X Ray ◽  
Entrance Door ◽  
One Year ◽  
The Impact

Abstract Objective: To describe the therapeutic itinerary of people with tuberculosis in face of their health needs. Method: Descriptive, qualitative study. Semi-structured interviews were carried out with ten patients. Hermeneutic-dialectic method of analysis and concept of therapeutic itinerary as driver of the analysis. Results: Most had classic symptoms at the beginning, however there was a case with coughing for more than one year. Entrance door, access to diagnosis and treatment were predominant in Primary Care, through smear microscopy and X-ray; patients had to pay for exams. Decentralization of treatment for other services when necessary or by link with the professional. The patient followed the decisions of the professionals and the support of relatives; prejudice regarding the disease was noted. Conclusions and implications for practice: Fragility in disease management, importance of bonding and family. It should be considered the impact of the disease and the need to support patients to ensure continuity of care.

scholarly journals Midwives' Perspectives of Respectful Maternity Care during Childbirth: A Qualitative Study

2019 ◽  
Author(s):  
Maryam Moridi ◽  
Farzaneh Pazandeh ◽  
Sepideh Hajian ◽  
Abbas Ebadi ◽  
Barbara Potrata
Keyword(s):  
Qualitative Study ◽  
Maternity Care ◽  
Work Experience ◽  
Public Hospitals ◽  
Respectful Maternity Care ◽  
Structured Interviews ◽  
Effective Strategies ◽  
Centered Care ◽  
One Year ◽  
Evidence Based Care

Abstract Background: The adoption of respectful maternity care during labour and birth is complex process which needs both scientific and interpersonal skills of providers. In this regard, identifying the potential barriers and applying effective strategies for implementing respectful maternity care are essential. This study aimed to explore the perceptions of Iranian midwives regarding respectful maternity care during labour and childbirth. Methods: This was a qualitative study which was conducted from September-December 2018 in two non-teaching public hospitals in Tehran, Iran. Twenty four semi-structured interviews were conducted with midwives, who had more than one year work experience in labor and childbirth units, through a purposive sampling method. The data was analyzed using conventional content analysis approach and managed by MAX QDA 10 software. Results: Three themes were extracted including showing empathy, women-centered care and protecting rights. Showing empathy reflects that establishing a friendly relationship and being with women. Women-centered care indicated keeping women safe and participating in decision making. Protecting rights reflected a need for safeguarding dignity as well as giving equal care and preparing appropriate environment. Conclusions: Iranian midwives considered respectful maternity care a broader concept rather than preventing mistreatment. Providing supportive care through friendly interaction with women was the first step for providing respectful maternity care. Promoting respectful care also should be through performing safe care by implementing evidence-based care and women’s involvement in their care as well as appropriate environment for women, families and caregivers.

scholarly journals Risks of use and non-use of antibiotics in primary care. Qualitative study of prescribers’ views

2020 ◽  
Author(s):  
Olga Boiko ◽  
Caroline Burgess ◽  
Robin Fox ◽  
Mark Ashworth ◽  
Martin C Gulliford
Keyword(s):  
Risk Assessment ◽  
Primary Care ◽  
Qualitative Study ◽  
Antimicrobial Stewardship ◽  
Inappropriate Prescribing ◽  
Warning Signs ◽  
Antibiotic Prescribing ◽  
List Type ◽  
Structured Interviews ◽  
Trade Offs

ABSTRACTPurposeThe emergence of antimicrobial resistance has led to increasing efforts to reduce unnecessary use of antibiotics in primary care, but potential hazards from bacterial infection continue to cause concern. This study investigated how primary care prescribers evaluate the risks of reduced antibiotic prescribing.MethodsQualitative study using semi-structured interviews conducted with primary care prescribers from 10 general practices in an urban area and a shire town in England. A thematic analysis was conducted.ResultsThirty participants were recruited, including 23 general practitioners, 5 nurses and 2 pharmacists. Three main themes were identified: risk assessment; balancing treatment risks; and negotiating decisions and risks. Respondents indicated that their decisions were grounded in clinical risk assessment, but this was informed by different approaches to antibiotic use, with most leaning towards reduced prescribing. Prescribers’ perceptions of risk included the consequences of both inappropriate prescribing and inappropriate withholding of antibiotics. Sepsis was viewed as the most concerning potential outcome of non-prescribing, leading to possible patient harm and potential litigation. Risks of antibiotic prescribing included antibiotic resistant and C. difficile infections, as well as side effects, such as rashes, that might lead to possible mislabelling as antibiotic allergy. Prescribers elicited patient preferences for use or avoidance of antibiotics to inform management strategies, which included educational advice, advice on self-management including warning signs, use of delayed prescriptions, and safety netting.ConclusionsAttitudes towards antibiotic prescribing are evolving, with reduced antibiotic prescribing now being approached more systematically. The safety trade-offs associated with either use or non-use of antibiotics present difficulties especially when prescribing decisions are inconsistent with patients’ expectations.Strengths and limitations of this studyThe study provides an investigation of primary care prescribers’ perceptions, emphasising safety perspectives in the context of antimicrobial stewardship.The main themes identified may inform the basis for future improvement and antimicrobial stewardship programs.The study is based on interviews with prescribers and may be susceptible to the limitations associated with qualitative interview studiesThe diverse sample of participants provide a good spread of opinions that are of a high validity and rigorously analysed.The study may lack generalisability beyond high-income countries.

scholarly journals A Family-Focused Intervention for Parental Mental Illness: A Practitioner Perspective

2021 ◽  
Vol 12 ◽  
Author(s):  
Mairead Furlong ◽  
Christine Mulligan ◽  
Sharon McGarr ◽  
Siobhan O'Connor ◽  
Sinead McGilloway
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Qualitative Study ◽  
Child Protection ◽  
Service Providers ◽  
Controlled Trial ◽  
Parental Mental Illness ◽  
Structured Interviews ◽  
Mental Health Settings

Background: Parental mental illness (PMI) is common and can lead to children developing mental disorders. Family Talk (FT) is a well-known and widely implemented intervention designed to reduce the risk of transgenerational psychopathology. However, given the research to practise “gap,” very little qualitative research, to date, has investigated practitioner experiences in implementing FT. This study aimed to explore the practitioner-perceived barriers and facilitators to the implementation and sustainability of FT within mainstream mental health settings.Methods: This qualitative study was nested within a randomised controlled trial (RCT) of Family Talk [N = 86 families (139 parents, 221 children)] within 15 adult (AMHS), child (CAMHS), primary care mental health, and child protection sites in Ireland. Semi-structured interviews and focus groups were undertaken with a purposive sample of clinicians (n = 31) and managers (n = 10), based on their experiences of implementing FT. Interview data were transcribed verbatim, analysed using constructivist grounded theory, and informed by Fixsen's implementation science framework.Results: Service providers highlighted a number of benefits for approximately two thirds of families across different diagnoses and mental health settings (AMHS/CAMHS/primary care). Sites varied in their capacity to embed FT, with key enablers identified as acquiring managerial and organisational support, building clinician skill, and establishing interagency collaboration. Implementation challenges included: recruitment difficulties, stresses in working with multiply-disadvantaged families, disruption in delivery due to the COVID-19 global pandemic, and sustainability concerns (e.g., perceived fit of FT with organisational remit/capacity, systemic and cultural barriers to change).Conclusion: This study is only the second qualitative study ever conducted to explore practitioner experiences in implementing FT, and the first conducted within the context of an RCT and national research programme to introduce family-focused practise (FFP) for families living with PMI. The findings illuminate the successes and complexities of implementing FFP in a country without a “think family” infrastructure, whilst highlighting a number of important generalisable lessons for the implementation of FT, and other similar interventions, elsewhere.

scholarly journals An exploration of GP care in outreach settings for people experiencing homelessness: a qualitative study

2021 ◽  
pp. BJGP.2020.0749
Author(s):  
Victoria Hirst ◽  
Fiona Cuthill
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Access To Health Care ◽  
Health Care Services ◽  
Community Outreach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Care Services ◽  
Outreach Services ◽  
Gp Care

Background: Although people experiencing homelessness (PEH) have the worst health outcomes in society, they have a low uptake of primary care services. GP outreach has developed as a way of increasing access into primary care but little is known about the experience of patients receiving care in this way. Aims: 1) To explore homeless patients’ experiences of GP care in community outreach settings in UK; 2) To seek staff/volunteer views on the strengths and weaknesses of the GP community outreach services. Design and setting: A qualitative study with PEH and staff/volunteers working in 3 different community outreach settings in the UK. Method: Individual semi-structured interviews with 22 PEH and two focus groups with key staff/volunteers. Data was analysed thematically using framework analysis. Findings: GP outreach services better enabled PEH to access medical care and staff/volunteers valued GP support to promote, and facilitate access to, health care services. In particular, findings illuminate the high value that PEH placed on the organisational environment of the GP outreach service. Valued aspects of GP outreach were identified as: 1) comfortable, safe and engendered a sense of belonging; 2) convenient, opportunistic and a one stop shop; and, 3) being heard, having more time and breaking down barriers. Conclusion: Organisational environment is important in enabling PEH to engage with GP services. The physical and organisational environment of the outreach settings were the most important factors: they created a space between the GP and patients where professional barriers were flattened and facilitated a therapeutic relationship.

scholarly journals “No Papers. No Doctor”: A Qualitative Study of Access to Maternity Care Services for Undocumented Immigrant Women in Denmark

2020 ◽  
Vol 17 (18) ◽  
pp. 6503
Author(s):  
Julia Kadin Funge ◽  
Mathilde Christine Boye ◽  
Helle Johnsen ◽  
Marie Nørredam
Keyword(s):  
Qualitative Study ◽  
Maternity Care ◽  
Immigrant Women ◽  
Health Clinic ◽  
Undocumented Immigrant ◽  
Structured Interviews ◽  
Governmental Organization ◽  
Safe Environment ◽  
Care Services ◽  
Fear Of Deportation

The purpose of this study is to explore undocumented immigrant women’s experiences of, as well as their access to, maternity care services during pregnancy in Denmark. Recruiting through the two branches of a non-governmental organization (NGO)-driven health clinic in Denmark, we conducted 21 semi-structured interviews with undocumented immigrant women in Denmark from January 2018 to January 2019. The undocumented immigrant women experienced barriers such as fear of deportation, concerns about payment for services, and uncertainties about rules for access. Many of them described depending on NGO-driven initiatives to access maternity care services and found these as providing a safe environment for care. Our findings contribute insights towards understanding the health behavior of undocumented immigrant women and highlight the need for inclusive care to safeguard the health of the women and their children.

scholarly journals GP views on their role in bullying disclosure by children and young people in the community: a cross-sectional qualitative study in English primary care

2019 ◽  
Vol 69 (688) ◽  
pp. e752-e759
Author(s):  
Laura Condon ◽  
Vibhore Prasad
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Young People ◽  
Qualitative Study ◽  
Health Concern ◽  
Health Consequences ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Children And Young People ◽  
Being Bullied

BackgroundBullying among children and young people (CYP) is a major public health concern that can lead to physical and mental health consequences. CYP may disclose bullying, and seek help from a GP. However, there is currently little research on GPs’ views on and perceptions of their role in dealing with disclosures of bullying in primary care.AimTo explore GPs’ views about their role in dealing with CYPs’ disclosures of being bullied, especially factors that have an impact on GPs’ roles.Design and settingIn this cross-sectional qualitative study, semi-structured interviews were conducted with GPs in primary care in England from October to December 2017.MethodPurposive sampling was used to achieve variation in GP age, professional status in practice, profile of the patients served by the practice, practice size and location, and whether the GPs considered themselves to be actively in research or teaching.ResultsData from 14 semi-structured interviews revealed three main themes: remaining clinically vigilant; impact of bullying in schools; and training and guidance on dealing with bullying and cyberbullying. GPs felt that dealing with disclosures of bullying and cyberbullying came down to their clinical experience rather than guideline recommendations, which do not currently exist, and that bullying was a precipitating factor in presentations of CYPs’ mental health issues.ConclusionGPs feel they have a role to play in managing and supporting the health of CYP who disclose being bullied during consultations. However, they feel ill-equipped to deal with these disclosures because of lack of professional development opportunities, and guidance on treating and managing the health consequences of being bullied.

scholarly journals General practitioner perceptions of telehealth services in Australia: a qualitative study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0182
Author(s):  
Keshia R De Guzman ◽  
Centaine Snoswell ◽  
Chantelle M Giles ◽  
Anthony C Smith ◽  
Helen H Haydon
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Qualitative Study ◽  
Quality Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Telephone Consultation ◽  
Practitioner Perceptions ◽  
New Research

BackgroundPrimary care providers have been rapidly transitioning from in-person to telehealth care during the 2019 coronavirus (COVID-19) pandemic. There is an opportunity for new research in a rapidly evolving area, where evidence for telehealth services in primary care in the Australian setting remains limited.AimTo explore general practitioner (GP) perceptions on providing telehealth (telephone and videoconsultation) services in primary care in Australia.Design & settingA qualitative study using semi-structured interviews to gain an understanding of GP perceptions on telehealth use in Australia.MethodsGPs across Australia were purposively sampled. Semi-structured interviews were conducted, recorded, and transcribed verbatim for analysis. Transcripts were analysed using inductive thematic analysis to identify initial codes, which were then organised into themes.ResultsFourteen GPs were interviewed. Two major themes that described GP perceptions of telehealth were 1) Existence of business and financial pressures in general practice and 2) providing quality of care in Australia. These two themes interacted with four minor themes: 3) consumer-led care, 4) COVID-19 as a driver for telehealth reimbursement and adoption, 5) refining logistical processes and 6) GP experiences shape telehealth use.ConclusionThis study found that multiple considerations influence GP choice of in-person, videoconference, or telephone consultation mode. For telehealth to be used routinely within primary care settings, evidence that supports the delivery of higher quality care to patients through telehealth and sustainable funding models will be required.

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