scholarly journals Vignette research on messy and confusing problems in primary mental healthcare

2017 ◽  
Vol 13 (2) ◽  
pp. 300-313 ◽  
Author(s):  
E. H. (Dineke) Smit ◽  
J. J. L. (Jan) Derksen
Keyword(s):  
Primary Care ◽  
Mixed Method ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Complex Dynamic ◽  
Negative Feedback Loops ◽  
Norms And Values ◽  
The Family ◽  
Mixed Feelings ◽  
Working Together

The average primary care psychologist feels an ever-widening gap between objective, measurable reality as described and the complex and dynamic reality they experience. To obtain a better understanding of this complex dynamic reality, we conducted an exploratory mixed-method study of primary care psychologists. We asked our participants to write vignettes about messy and confusing problems in the complex context of mental healthcare. We then examined the data in portions, exposed the patterns in the data, and subsequently analysed all in conjunction. The 113 vignettes showed experiences of psychologists dealing not only with the patient, but also with the family of the patient and/or employers, working together with other healthcare professionals, struggling with dilemmas and having mixed feelings. However, using the Cynafin Framework, 36% of the vignettes were still rated as simple. Was it because those vignettes contained fewer words (p = .006)? Or because it is difficult to grasp complexity when cause and effect are intertwined with emotions, norms and values? In the discussion, we suggest examining a complex dynamic system in terms of both the consistency of its various elements and the dynamics of the system. We also discuss how to optimize the system’s adaptive self-organizing ability and how to challenge ourselves to invent negative feedback loops that can keep the complex system in equilibrium.

scholarly journals The Family Doctor and Nurse: The Dynamic Duo of Cuban Healthcare

2017 ◽  
Vol 3 (1) ◽  
pp. 106
Author(s):  
Kelley H. Pattison
Keyword(s):  
Primary Care ◽  
Health Promotion ◽  
Family Doctor ◽  
Health Assessment ◽  
Pilot Project ◽  
Direct Care ◽  
Fidel Castro ◽  
The Family ◽  
Working Together ◽  
Care Health

Following the Revolution of 1959, Fidel Castro declared healthcare a right for all Cuban citizens. In 1983 a pilot project was established which paired a family doctor and nurse to care for all persons within a neighborhood. The success of this project led to the establishment of the family doctor-nurse partnership to care for all Cuban citizens. Working together, the pair provided direct care, health assessment, risk management, and health promotion for a specified neighborhood. This novel way of providing primary care provides each Cuban with a family doctor and nurse. This arrangement has helped change the health of a nation.

scholarly journals The Childhood Cancer Centre Is Coming Home: Experiences of Hospital-Based Home Care

2021 ◽  
Vol 18 (12) ◽  
pp. 6241
Author(s):  
Malin de Flon ◽  
Gisela Glaffey ◽  
Linda Jarl ◽  
Kristin Sellbrant ◽  
Stefan Nilsson
Keyword(s):  
Home Care ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Children With Cancer ◽  
Semistructured Interviews ◽  
The Family ◽  
Mixed Feelings ◽  
Care At Home ◽  
Time And Energy ◽  
At Home

Today, there is a shift towards care being given closer to the patient, with more children receiving care in their homes. Care at home has proven to be a viable alternative to hospital care, as shown by a project for hospital-based home care conducted in West Sweden. The aim of this study was to describe how children with cancer and parents experienced receiving care at home. After purposive sampling, six children with cancer aged 6–16 and eight parents participated. Semistructured interviews were performed, and the data were analysed using qualitative content analysis. Four main categories emerged: save time and energy in the family; maintain everyday life; feel trust in the healthcare professionals; mixed feelings about getting treatment at home. This hospital-based home care project created good conditions for both children with cancer and their parents to feel secure. In addition, home care can be very child-centric, whereby the caregivers involve the children by taking their thoughts and utterances into account.

A Mixed Method Investigation of Parent Perspectives on Behavioral Services in Primary Care

2020 ◽  
Author(s):  
Andrew Riley ◽  
Bethany L. Walker ◽  
Krishnapriya Ramanujam ◽  
Wendy M. Gaultney ◽  
Deborah J. Cohen
Keyword(s):  
Primary Care ◽  
Mixed Method ◽  
Behavioral Interventions ◽  
Parental Participation ◽  
Parent Perspectives ◽  
Delivery Methods ◽  
Behavioral Services

Primary care is a key setting for the delivery of parent-focused behavioral interventions. Various methods of intervention show promising efficacy, but fail to engage adequate parental participation. The objective of this study was to understand factors underlying parents’ attitudes towards the content, sources, and delivery methods of behavioral guidance in primary care.

Providing Care of Mild Traumatic Brain Injury by the Family Practice/Primary Care Optometrist

2018 ◽  
pp. 110-119
Keyword(s):  
Primary Care ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Family Practice ◽  
Advanced Training ◽  
Entry Level ◽  
The Family ◽  
Basic Understanding ◽  
The Brain

Primary Objectives: By extending the scope of knowledge of the primary care optometrist, the brain injury population will have expanded access to entry level neurooptometric care by optometric providers who have a basic understanding of their neurovisual problems, be able to provide some treatment and know when to refer to their colleagues who have advanced training in neuro-optometric rehabilitation.

The Evolution of Physical Activity on Prescription (FaR) in Sweden

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Healthcare Professionals ◽  
Systems Approach ◽  
Ecological Model ◽  
Controlled Trial ◽  
Professional Associations ◽  
Successful Implementation ◽  
Surgeon General ◽  
Positive Effects

In 1996, the first Report of the US Surgeon General on Physical Activity and Health provided an extensive knowledge overview about the positive effects of physical activity (PA) on several health outcomes and PA recommendations. This contributed to an enhanced interest for PA in Sweden. The Swedish Professional Associations for Physical Activity (YFA) were appointed to form a Scientific Expert Group in the project “Sweden on the Move” and YFA created the idea of Physical Activity on Prescription (FaR) and the production of a handbook (FYSS) for healthcare professionals. In Swedish primary care, licensed healthcare professionals, i.e. physicians, physiotherapists and nurses, can prescribe PA if they have sufficient knowledge about the patient’s current state of health, how PA can be used for promotion, prevention and treatment and are trained in patient-centred counselling and the FaR method. The prescription is followed individually or by visiting local FaR providers. These include sport associations, patient organisations, municipal facilities, commercial providers such as gyms, sports clubs and walking clubs or other organisations with FaR educated staff such as health promoters or personal trainers. In clinical practice, the FaR method increases the level of PA in primary care patients, at 6 and at 12 months. Self-reported adherence to the prescription was 65% at 6 months, similar to the known compliance for medications. In a randomised controlled trial, FaR significantly improved body composition and reduced metabolic risk factors. It is suggested that a successful implementation of PA in healthcare depends on a combination of a systems approach (socio-ecological model) and the strengthening of individual motivation and capability. General support from policymakers, healthcare leadership and professional associations is important. To lower barriers, tools for implementation and structures for delivery must be readily available. Examples include handbooks such as FYSS, the FaR system and the use of pedometers.

Identifying and managing eating disorders in type 1 diabetes mellitus: An all-Wales study

2021 ◽  
pp. 135910452110095
Author(s):  
Jacinta O A Tan ◽  
Imogen Spector-Hill
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Eating Disorder ◽  
Type 1 Diabetes Mellitus ◽  
Healthcare Professionals ◽  
Health And Wellbeing ◽  
Level Of Knowledge

Background: Co-morbid diabetes and eating disorders have a particularly high mortality, significant in numbers and highly dangerous in terms of impact on health and wellbeing. However, not much is known about the level of awareness, knowledge and confidence amongst healthcare professionals regarding co-morbid Type 1 Diabetes Mellitus (T1DM) and eating disorders. Aim: To understand the level of knowledge and confidence amongst healthcare professionals in Wales regarding co-morbid T1DM and eating disorder presentations, identification and treatment. Results: We conducted a survey of 102 Welsh clinicians in primary care, diabetes services and eating disorder services. 60.8% expressed low confidence in identification of co-morbid T1DM and eating disorders. Respondents reported fewer cases seen than would be expected. There was poor understanding of co-morbid T1DM and eating disorders: 44.6% identified weight loss as a main symptom, 78.4% used no screening instruments, and 80.3% consulted no relevant guidance. The respondents expressed an awareness of their lack of knowledge and the majority expressed willingness to accept training and education. Conclusion: We suggest that priority must be given to education and training of all healthcare professionals in primary care, diabetes services and mental health services who may see patients with co-morbid T1DM and eating disorders.

scholarly journals Palliative care and complex chronic conditions since the perspective of healthcare professionals

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Doñate-Martínez ◽  
L Llop ◽  
J Garcés
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Early Identification ◽  
Chronic Conditions ◽  
Healthcare Professionals ◽  
Care Pathway ◽  
Holistic View ◽  
Complex Chronic Conditions ◽  
Symptom Intensity

Abstract Background According to the WHO, palliative care (PC) is applicable early in the course of illness together with other curative therapies. Early PC has demonstrated beneficial effects on quality of life and symptom intensity among cancer patients. However, PC is not as early integrated on the care pathway of complex chronic conditions (CCC). This abstract presents barriers and needs identified to effectively implement early PC on CCC performed under the EU-funded InAdvance project (ref.: 825750). Methods Semi-structured interviews were performed with 16 healthcare professionals (HPs) from primary care and hospital settings working with older patients with CCC in Valencia (Spain). Results Interviews reported that main needs identified to provide early PC are: (a) coordinated strategies between multi-setting HPs to an early identification of CCC patients in need of PC; (b) adequate resources to attend patients' PC needs from a holistic view, i.e. psychosocial and spiritual needs; and (c) early integration of basic PC at primary care teams. The main barriers identified were: (a) stereotypes associated to the traditional PC approach; (b) poor knowledge from HPs of the PC holistic approach; and (c) lack of specific protocols or pathways for CCC in need of PC. Conclusions Specific skills and resources are the most relevant needs to effectively provide early PC among patients with CCC. First, it is urgent to demystify the negative culture-related vision of PC that is commonly associated to sedation and last days of a person's life. Also, multidisciplinary HPs require specific training to identify and provide early PC tailored to CCC. And, it is required a strategic and multi-setting organizational approach with fluent information flow and coordinated roles. Key messages Healthcare expenditure would be considerably reduced, especially at hospital and emergency units, with an early identification of patients with CCC in need of PC. Empowering primary HPs in PC would improve the quality of care of patients with CCC.

Dyspareunia

2021 ◽  
pp. 175573802110302
Author(s):  
Charlotte Morris ◽  
Catherine Briggs ◽  
Manju Navani
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Healthcare Professionals ◽  
Persistent Pain ◽  
Differential Diagnoses ◽  
Relationship Problems

Dyspareunia is persistent pain on attempted or successful vaginal penetration. It is under-reported, infrequently asked about by healthcare professionals, and affects quality of life and relationships. Dyspareunia is multifactorial and possesses biopsychosocial components. Pain may be distinct and localised, deep or persistent. Among the symptoms, women describe sensations of aching, throbbing and tearing. Disinterest in sex and relationship problems can result. This article discusses dyspareunia, its common differential diagnoses and aims to improve clinician confidence in assessing and managing dyspareunia in primary care.

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