scholarly journals Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID

BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101143 ◽  
Author(s):  
Tom Kingstone ◽  
Anna K Taylor ◽  
Catherine A O'Donnell ◽  
Helen Atherton ◽  
David N Blane ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Methodology ◽  
Structured Interviews ◽  
Multisystem Disease ◽  
Persistent Symptoms ◽  
Heavy Work ◽  
The Right ◽  
Ongoing Support ◽  
Primary Care Professionals ◽  
Care Support

BackgroundAn unknown proportion of people who had an apparently mild COVID-19 infection continue to suffer with persistent symptoms, including chest pain, shortness of breath, muscle and joint pains, headaches, cognitive impairment (‘brain fog’), and fatigue. Post-acute COVID-19 (‘long-COVID’) seems to be a multisystem disease, sometimes occurring after a mild acute illness; people struggling with these persistent symptoms refer to themselves as ‘long haulers’.AimTo explore experiences of people with persisting symptoms following COVID-19 infection, and their views on primary care support received.Design & settingQualitative methodology, with semi-structured interviews to explore perspectives of people with persisting symptoms following suspected or confirmed COVID-19 infection. Participants were recruited via social media between July–August 2020.MethodInterviews were conducted by telephone or video call, digitally recorded, and transcribed with consent. Thematic analysis was conducted applying constant comparison techniques. People with experience of persisting symptoms contributed to study design and data analysis.ResultsThis article reports analysis of 24 interviews. The main themes include: the ‘hard and heavy work’ of enduring and managing symptoms and accessing care; living with uncertainty, helplessness and fear, particularly over whether recovery is possible; the importance of finding the 'right' GP (understanding, empathy, and support needed); and recovery and rehabilitation: what would help?ConclusionThis study will raise awareness among primary care professionals, and commissioners, of long-COVID and the range of symptoms people are experiencing. Patients require their GP to believe their symptoms and to demonstrate empathy and understanding. Ongoing support by primary care professionals during recovery and rehabilitation is crucial.

scholarly journals Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016307 ◽  
Author(s):  
Natalia Calanzani ◽  
Debbie Cavers ◽  
Gabriele Vojt ◽  
Sheina Orbell ◽  
Robert J C Steele ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Feasibility Study ◽  
Occult Blood ◽  
Secondary Outcome ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Test Kit ◽  
General Practices ◽  
Primary Care Professionals

ObjectivesWe aimed to test whether a brief, opportunistic intervention in general practice was a feasible and acceptable way to engage with bowel screening non-responders.DesignThis was a feasibility study testing an intervention which comprised a brief conversation during routine consultation, provision of a patient leaflet and instructions to request a replacement faecal occult blood test kit. A mixed-methods approach to evaluation was adopted. Data were collected from proformas completed after each intervention, from the Bowel Screening Centre database and from questionnaires. Semi-structured interviews were carried out. We used descriptive statistics, content and framework analysis to determine intervention feasibility and acceptability.ParticipantsBowel screening non-responders (as defined by the Scottish Bowel Screening Centre) and primary care professionals working in five general practices in Lothian, Scotland.Primary and secondary outcome measuresSeveral predefined feasibility parameters were assessed, including numbers of patients engaging in conversation, requesting a replacement kit and returning it, and willingness of primary care professionals to deliver the intervention.ResultsThe intervention was offered to 258 patients in five general practices: 220 (87.0%) engaged with the intervention, 60 (23.3%) requested a new kit, 22 (8.5%) kits were completed and returned. Interviews and questionnaires suggest that the intervention was feasible, acceptable and consistent with an existing health prevention agenda. Reported challenges referred to work-related pressures, time constraints and practice priorities.ConclusionsThis intervention was acceptable and resulted in a modest increase in non-responders participating in bowel screening, although outlined challenges may affect sustained implementation. The strategy is also aligned with the increasing role of primary care in promoting bowel screening.

scholarly journals Nutritionists and the comprehensive care of overweight individuals in primary care

2019 ◽  
Vol 32 ◽  
Author(s):  
Ana Luisa Souza de Paiva MOURA ◽  
Elisabetta RECINE
Keyword(s):  
Primary Care ◽  
Theoretical Domains Framework ◽  
Federal District ◽  
Theoretical Framework ◽  
Noncommunicable Diseases ◽  
Care Model ◽  
Structured Interviews ◽  
Appropriate Care ◽  
Different Types ◽  
Primary Care Professionals

ABSTRACT Objective This study sought to highlight the different types of challenges for the integral care of overweight individuals in primary care based on the perception of nutritionists. Methods This is a qualitative study with primary care professionals from the Federal District, Brazil. Semi-structured interviews were conducted to understand the perceptions regarding the organization of integral care. The analysis of the data was based on the theoretical framework Theoretical Domains Framework. Results Challenges related to 10 of the 12 different domains proposed by the theoretical framework were identifi ed. These challenges are related to the capability, opportunity and motivation of workers to act to offer moreeffective care. Conclusion The different nature of the barriers identifi ed were overlapped, which reveal the need for professional qualifi cation along with the consolidation of an appropriate care model for chronic noncommunicable diseases such as obesity.

scholarly journals The right to smoke and the right to smoke-free surroundings: international comparison of smoke-free psychiatric clinic implementation experiences

BJPsych Open ◽  
2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Tove Freiburghaus ◽  
Rie Raffing ◽  
Montse Ballbè ◽  
Antoni Gual ◽  
Hanne Tönnesen
Keyword(s):  
Qualitative Methodology ◽  
Smoking Ban ◽  
Psychiatric Clinic ◽  
Successful Implementation ◽  
Management Support ◽  
Staff Education ◽  
Structured Interviews ◽  
Implementation Processes ◽  
Compulsory Care ◽  
The Right

Background In Scandinavia, people with a severe mental disorder have a reduced life expectancy of 15–20 years compared with the general public. Smoking is a major contributor, and smoke-free policies are increasingly adopted in psychiatric clinics around the world. We compared potential facilitators and barriers among staff and management, for the implementation of smoke-free psychiatric clinics. Aims To investigate the attitudes and experiences regarding smoke-free policies among managers and staff involved in the implementation processes of smoke-free psychiatric clinics at hospitals in Malmö (Sweden) and Barcelona (Spain). Method We used a qualitative methodology, with 15 semi-structured interviews. The interviews were conducted with each participant individually, and were subsequently transcribed. The data were analysed with systematic text condensation. Results There were notable differences in how the smoke-free policies were carried out and experienced, and attitudes regarding the policy changes differed in the two settings. Key differences were the views on the right to smoke in compulsory care and to stay in smoke-free surroundings supported by smoking cessation intervention; the prioritisation of staff facilitation of smoking breaks; and views on smoking and smoke-free psychiatry. In contrast, participants agreed on the importance of staff education and management support. A smoking ban by law and belonging to a network of smoke-free hospitals were also relevant. Conclusions Staff education, and support from staff and management for the patients’ right to stay in smoke-free surroundings, facilitated successful implementation of smoke-free policies in the psychiatric clinics, whereas supporting the right to smoke was a barrier.

scholarly journals How Students' Perceptions in Narrative Class (The Lord of Flies) Through Online Collaboration Learning.

Abjadia ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 110-121
Author(s):  
Noer Doddy Irmawati ◽  
Adhe Puspita Mayasari
Keyword(s):  
Online Education ◽  
Qualitative Methodology ◽  
Phenomenological Approach ◽  
Online Collaboration ◽  
Academic Learning ◽  
Democratic Values ◽  
Structured Interviews ◽  
Writing Assignments ◽  
Positive Effects ◽  
The Right

Mariwan Hasan (2020), suggests that Golding’s novel can be used in a second language classroom to teach democratic values such as the right to free speech using reader-response theory. Curriculum requires that democratic values be taught through each subject, suggests that students can be taught about democratic values through classroom discussions and writing assignments based on the novel (Ghazal Kazim Syed, 2020). In addition to academic learning, researchers believe that students also gain confidence through the collaboration work. When students conform each other’s opinions in activities involving group work, it makes them confident and comfortable with each other. When the teacher is not around to ask a question, they will be less at pressure. against them (Cynthia S, 2020). The practice of collaborative learning in online education is increasing steadily as many curriculum creators and online course teachers are starting to understand its positive effects on the learning of students. This study aimed to analyze students' perceptions in narrative class (The Lord of Flies) through online collaboration learningu used a qualitative research design was followed by this study. As it is a study of perceptions, a qualitative methodology using a phenomenological approach, the participants of this study were twelve the eleventh grade students, data for this article was gathered through semi-structured interviews. The researcher checked part of the coding against each other to ensure trustworthiness of data. Keeping in light the usefulness of online collaboration learning shown in this study, it is recommended that teachers should take effort to include students in literature online discussion group. Furthermore, it is recommended that similar studies should be conducted in schools and colleges. As this study is recommended for future researchers to check the adaptability of the findings in other contexts.

scholarly journals Identification and management of frailty in English primary care: a qualitative study of national policy

BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101019
Author(s):  
Khulud Alharbi ◽  
Harm van Marwijk ◽  
David Reeves ◽  
Tom Blakeman
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
National Policy ◽  
Evidence Base ◽  
System Thinking ◽  
Normalisation Process Theory ◽  
Routine Practice ◽  
Ageing Population ◽  
Structured Interviews ◽  
Primary Care Professionals

BackgroundPolicymakers are directing attention to addressing the needs of an ageing population. Since 2017, general practices in England have been contractually required to identify and code ‘frailty’ as a new clinical concept and, in doing so, support targeted management for this population with the aim of improving outcomes. However, embedding frailty policies into routine practice is not without challenges and little is currently known about the success of the programme.AimTo explore the implementation of a national policy on frailty identification and management in English primary care.Design & settingQualitative study entailing interviews with primary care professionals in the North of England.MethodSemi-structured interviews were conducted with GPs (n = 10), nurses (n = 6), practice managers (n = 3), and health advisors (n = 3). Normalisation process theory (NPT) and ‘system thinking’ provided sensitising frameworks to support data collection and analysis.ResultsPrimary care professionals were starting to use the concept of frailty to structure care within practices and across organisations; however, there was widespread concern about the challenge of providing expanded care for the identified needs with existing resources. Concerns were also expressed around how best to identify the frail subpopulation and the limitations of current tools for this, and there was a professional reticence to use the term ‘frailty’ with patients.ConclusionFindings suggests that additional, focused resources and the development of a stronger evidence base are essential to facilitate professional engagement in policies to improve the targeted coding and management of frailty in primary care.

scholarly journals Engaging primary care professionals in suicide prevention: A qualitative study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242540
Author(s):  
Elke Elzinga ◽  
Anja J. T. C. M. de Kruif ◽  
Derek P. de Beurs ◽  
Aartjan T. F. Beekman ◽  
Gerdien Franx ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
The Netherlands ◽  
Mental Health Care ◽  
Suicide Prevention ◽  
Implementation Process ◽  
Theory Approach ◽  
Structured Interviews ◽  
Primary Care Professionals

In health systems with strongly developed primary care, such as in the Netherlands, effectively engaging primary care professionals (PCPs) in suicide prevention is a key strategy. As part of the national Suicide Prevention Action Network (SUPRANET), a program was offered to PCPs in six regions in the Netherlands in 2017–2018 to more effectively engage them in suicide prevention. This implementation study aimed to evaluate to what extent SUPRANET was helpful in supporting PCPs to apply suicide prevention practices. From March to May 2018, 21 semi-structured interviews have been carried out with PCPs and other non-clinical professionals from SUPRANET regions in the Netherlands. Verbatim transcripts were analysed using the grounded theory approach. Data was structured using the Consolidated Framework for Implementation Research, which enabled identifying facilitating and challenging factors for PCPs to carry out suicide prevention practices. An important challenge included difficulties in assessing suicide risk (intervention characteristics) due to PCPs’ self-perceived incompetence, burdensomeness of suicide and limited time and heavy workload of PCPs. Another important limitation was collaboration with mental health care (outer setting), whereas mental health nurses (inner setting) and SUPRANET (implementation process) were facilitating factors for applying suicide prevention practices. With regard to SUPRANET, especially the training was positively evaluated by PCPs. PCPs expressed a strong need for improving collaboration with specialized mental health care, which was not provided by SUPRANET. Educating PCPs on suicide prevention seems beneficial, but is not sufficient to improve care for suicidal patients. Effective suicide prevention also requires improved liaison between mental health services and primary care, and should therefore be the focus of future suicide prevention strategies aimed at primary care.

scholarly journals Supporting Primary Care Professionals to Stay in Work During the COVID-19 Pandemic: Views on Personal Risk and Access to Testing During the First Wave of Pandemic in Europe

2021 ◽  
Vol 8 ◽  
Author(s):  
Marta Wanat ◽  
Melanie Hoste ◽  
Nina Gobat ◽  
Marilena Anastasaki ◽  
Femke Böhmer ◽  
...  
Keyword(s):  
Primary Care ◽  
Individual Risk ◽  
Structured Interviews ◽  
Health Crisis ◽  
Analysis Techniques ◽  
Public Health Crisis ◽  
Personal Risk ◽  
Varied Response ◽  
Individual Risk Factors ◽  
Primary Care Professionals

Background: Minimising primary care professionals' (PCPs) risk of SARS-CoV-2 infection is crucial to ensure their safety as well as functioning health care system. PCPs' perspectives on the support they needed in the early stages of a public health crisis can inform future preparedness.Aim: To understand PCPs' experiences of providing care during the COVID-19 pandemic, with focus on personal risk from COVID-19 and testing.Design and Setting: Qualitative study using semi-structured interviews with PCPs in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece and Sweden, between April and July 2020.Method: Interviews were analysed using a combination of inductive and deductive thematic analysis techniques.Results: Eighty interviews were conducted, showing that PCPs tried to make sense of their risk of both contracting and severity of COVID-19 by assessing individual risk factors and perceived effectiveness of Personal Protective Equipment (PPE). They had limited access to PPE yet continued providing care as their “duty.” Some PCPs felt that they were put in high-risk situations when patients or colleagues were not flagging symptoms of COVID-19. Not having access to testing in the initial stages of the pandemic was somewhat accepted but when available, was valued.Conclusion: Access to adequate PPE and testing, as well as training for staff and education for patients about the importance of ensuring staff safety is crucial. Given PCPs' varied response in how they appraised personal risk and their tolerance for working, PCPs may benefit from the autonomy in deciding how they want to work during health emergencies.

scholarly journals The challenges of integrating signposting into general practice: qualitative stakeholder perspectives on care navigation and social prescribing in primary care

2021 ◽  
Author(s):  
Lisa Brunton ◽  
Abigail Tazzyman ◽  
Jane Ferguson ◽  
Damian Hodgson ◽  
Pauline A Nelson
Keyword(s):  
Primary Care ◽  
General Practice ◽  
National Policy ◽  
Professional Services ◽  
Structured Interviews ◽  
Practice Staff ◽  
Social Prescribing ◽  
Stakeholder Perspectives ◽  
Wide Range ◽  
The Right

Abstract Background A national policy focus in England to address general practice workforce issues has led to a commitment to employ significant numbers of non-GP roles to redistribute workload. This paper focuses on two such roles: the care navigation (CN) and social prescribing link worker (SPLW) roles, which both aim to introduce ‘active signposting’ into primary care, to direct patients to the right professional/services at the right time and free up GP time. There is a lack of research exploring staff views of how these roles are being planned and operationalised into general practice and how signposting is being integrated into primary care. Methods The design uses in-depth qualitative methods to explore a wide range of stakeholder staff views. We generated a purposive sample of 34 respondents who took part in 17 semi-structured interviews and one focus group (service leads, role holders and host general practice staff). We analysed data using a Template Analysis approach. Results Three key themes highlight the challenges of operationalising signposting into general practice: 1) Role perception – signposting was made challenging by the way both roles were perceived by others (e.g. among the public, patients and general practice staff) and highlighted inherent tensions in the expressed aims of the policy of active signposting.; 2) Role preparedness – a lack of training meant that some receptionist staff felt unprepared to take on the CN role as expected and raised patient safety issues; for SPLW staff, training affected the consistency of service offer across an area; 3) Integration and co-ordination of roles – a lack of planning and co-ordination across components of the health and care system challenged the success of integrating signposting into general practice. Conclusions This study provides new insights from staff stakeholder perspectives into the challenges of integrating signposting into general practice, and highlights key factors affecting the success of signposting in practice. Clarity of role purpose and remit (including resolving tensions inherent the dual aims of ‘active signposting’), appropriate training and skill development for role holders and adequate communication and engagement between stakeholders/partnership working across services, are required to enable successful integration of signposting into general practice.

Different Forms of Work Satisfaction

1998 ◽  
Vol 3 (3) ◽  
pp. 209-218 ◽  
Author(s):  
André Büssing ◽  
Thomas Bissels
Keyword(s):  
Work Satisfaction ◽  
Preliminary Evidence ◽  
Qualitative Approach ◽  
Extended Model ◽  
Work Situation ◽  
Structured Interviews ◽  
Global Satisfaction ◽  
Evaluative Processes ◽  
The Right ◽  
Level Of Aspiration

The extended model of different forms of work satisfaction ( Büssing, 1991 ), originally proposed by Bruggemann (1974) , is suggested as a distinctive qualitative approach to work satisfaction. Six forms of work satisfaction—progressive, stabilized, resigned satisfaction, constructive, fixated, resigned dissatisfaction—are derived from the constellation of four constituent variables: comparison of the actual work situation and personal aspirations, global satisfaction, changes in level of aspiration, controllability at work. Preliminary evidence from semi-structured interviews with 46 nurses shows that the dynamic model is headed in the right direction (qualitative differentiation of consistently high propertions of satisfied employees, uncovering processes of person-work situation interaction). Qualitative methods demonstrated their usefulness in accessing underlying cognitive and evaluative processes of the forms, which are often neglected by traditional attitude-based satisfaction research.

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