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Retos ◽  
2022 ◽  
Vol 44 ◽  
pp. 659-666
Author(s):  
María Paola Mastrantonio Ramos ◽  
Oscar Coduras

  En el artículo se describen y analizan los resultados de un estudio realizado para investigar la relación entre la práctica físico-deportiva y la calidad de vida percibida (CVP). La muestra del estudio estuvo integrada por un colectivo de ciudadanos (968), pacientes de Atención Primaria, entrevistados mientras se encontraban en las salas de espera, de cuatro Centros de Atención Primaria (CAP) de la ciudad de Terrassa. Los objetivos del estudio fueron: 1) Evaluar la relación entre la percepción de calidad de vida y la actividad físico-deportiva; 2) Verificar si, en tal percepción, hay diferencias significativas entre hombres y mujeres. Las conclusiones fueron las siguientes: Existe una percepción mejor de la calidad de vida entre los usuarios que realizan actividad físico-deportiva que entre los pacientes sedentarios, sea la actividad moderada o intensa. Las mujeres que realizan actividad físico-deportiva mejoran su percepción de Calidad de Vida en mayor grado que los hombres. Las mujeres mejoran su CVP en el ámbito social y los hombres en el ámbito físico, por lo que la práctica deportiva es una fuente de la socialización de las mujeres. Abstract. The article describes and analyzes the results of a study carried out to investigate the relationship between physical-sports practice and perceived quality of life (QOL). The study sample was made up of a group of citizens (968), Primary Care patients, interviewed while they were in the waiting rooms of four Primary Care Centers (CAP) in the city of Terrassa. The objectives of the study were: 1) To evaluate the relationship between the perception of quality of life and physical-sports activity; 2) Verify if, in such perception, there are significant differences between men and women. The conclusions were as follows: There is a better perception of the quality of life among users who perform physical-sports activity than among sedentary patients, be it moderate or intense activity. Women who perform physical-sports activity improve their perception of Quality of Life to a greater degree than men. Women improve their CVP in the social sphere and men in the physical sphere, so sports practice is a source of women's socialization.


2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Julien A. M. Vos ◽  
Robin de Best ◽  
Laura A. M. Duineveld ◽  
Henk C. P. M. van Weert ◽  
Kristel M. van Asselt

Abstract Background With more patients in need of oncological care, there is a growing interest to transfer survivorship care from specialist to general practitioner (GP). The ongoing I CARE study was initiated in 2015 in the Netherlands to compare (usual) surgeon- to GP-led survivorship care, with or without access to a supporting eHealth application (Oncokompas). Methods Semi-structured interviews were held at two separate points in time (i.e. after 1- and 5-years of care) to explore GPs’ experiences with delivering this survivorship care intervention, and study its implementation into daily practice. Purposive sampling was used to recruit 17 GPs. Normalisation Process Theory (NPT) was used as a conceptual framework. Results Overall, delivering survivorship care was not deemed difficult and dealing with cancer repercussions was already considered part of a GPs’ work. Though GPs readily identified advantages for patients, caregivers and society, differences were seen in GPs’ commitment to the intervention and whether it felt right for them to be involved. Patients’ initiative with respect to planning, absence of symptoms and regular check-ups due to other chronic care were considered to facilitate the delivery of care. Prominent barriers included GPs’ lack of experience and routine, but also lack of clarity regarding roles and responsibilities for organising care. Need for a monitoring system was often mentioned to reduce the risk of non-compliance. GPs were reticent about a possible future transfer of survivorship care towards primary care due to increases in workload and financial constraints. GPs were not aware of their patients’ use of eHealth. Conclusions GPs’ opinions and beliefs about a possible future role in colon cancer survivorship care vary. Though GPs recognize potential benefit, there is no consensus about transferring survivorship care to primary care on a permanent basis. Barriers and facilitators to implementation highlight the importance of both personal and system level factors. Conditions are put forth relating to time, reorganisation of infrastructure, extra personnel and financial compensation. Trial registration Netherlands Trial Register; NTR4860. Registered on the 2nd of October 2014.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Patricia Peñacoba ◽  
Maria Antònia Llauger ◽  
Ana María Fortuna ◽  
Xavier Flor ◽  
Gabriel Sampol ◽  
...  

Abstract Background The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting. Methods Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed. Results 194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763–0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863–0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7–92.1) and specificity of 67.8% (95% CI 55.1–78.3). Conclusions The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry: ClinicalTrials.gov; Name: PASHOS Project: Advanced Platform for Sleep Apnea Syndrome Assessment; URL: https://clinicaltrials.gov/ct2/show/NCT02591979; Identifier: NCT02591979. Date of registration: October 30, 2015.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Rebekah Pratt ◽  
Daniel M. Saman ◽  
Clayton Allen ◽  
Benjamin Crabtree ◽  
Kris Ohnsorg ◽  
...  

Abstract Background In this paper we describe the use of the Consolidated Framework for Implementation Research (CFIR) to study implementation of a web-based, point-of-care, EHR-linked clinical decision support (CDS) tool designed to identify and provide care recommendations for adults with prediabetes (Pre-D CDS). Methods As part of a large NIH-funded clinic-randomized trial, we identified a convenience sample of interview participants from 22 primary care clinics in Minnesota, North Dakota, and Wisconsin that were randomly allocated to receive or not receive a web-based EHR-integrated prediabetes CDS intervention. Participants included 11 clinicians, 6 rooming staff, and 7 nurse or clinic managers recruited by study staff to participate in telephone interviews conducted by an expert in qualitative methods. Interviews were recorded and transcribed, and data analysis was conducted using a constructivist version of grounded theory. Results Implementing a prediabetes CDS tool into primary care clinics was useful and well received. The intervention was integrated with clinic workflows, supported primary care clinicians in clearly communicating prediabetes risk and management options with patients, and in identifying actionable care opportunities. The main barriers to CDS use were time and competing priorities. Finally, while the implementation process worked well, opportunities remain in engaging the care team more broadly in CDS use. Conclusions The use of CDS tools for engaging patients and providers in care improvement opportunities for prediabetes is a promising and potentially effective strategy in primary care settings. A workflow that incorporates the whole care team in the use of such tools may optimize the implementation of CDS tools like these in primary care settings. Trial registration Name of the registry: Clinicaltrial.gov. Trial registration number: NCT02759055. Date of registration: 05/03/2016. URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT02759055 Prospectively registered.


Author(s):  
Marc F. Österdahl ◽  
Sarah-Jo Sinnott ◽  
Ian Douglas ◽  
Andrew Clegg ◽  
Laurie Tomlinson ◽  
...  

Cureus ◽  
2022 ◽  
Author(s):  
Mohammed A AlAteeq ◽  
Latifa M AlEnazi ◽  
Modhi S AlShammari ◽  
Essa E AlAnazi ◽  
Fadel H Al-Hababi ◽  
...  

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Alexandra R. Davidson ◽  
Jaimon Kelly ◽  
Lauren Ball ◽  
Mark Morgan ◽  
Dianne P. Reidlinger

Abstract Background Improving the patient experience is one of the quadruple aims of healthcare. Therefore, understanding patient experiences and perceptions of healthcare interactions is paramount to quality improvement. This integrative review aimed to explore how patients with chronic conditions experience Interprofessional Collaborative Practice in primary care. Methods An integrative review was conducted to comprehensively synthesize primary studies that used qualitative, quantitative, and mixed methods. Databases searched were Medline, Embase, CINAHL and Web of Science on June 1st, 2021. Eligible studies were empirical full-text studies in primary care that reported experiences or perceptions of Interprofessional Collaborative Practice by adult patients with a chronic condition, in any language published in any year. Quality appraisal was conducted on included studies using the Mixed Method Appraisal Tool. Data on patients’ experiences and perceptions of Interprofessional Collaborative Practice in primary care were extracted, and findings were thematically analyzed through a meta-synthesis. Results Forty-eight (n = 48) studies met the inclusion criteria with a total of n = 3803 participants. Study quality of individual studies was limited by study design, incomplete reporting, and the potential for positive publication bias. Three themes and their sub-themes were developed inductively: (1) Interacting with Healthcare Teams, subthemes: widening the network, connecting with professionals, looking beyond the condition, and overcoming chronic condition collectively; (2) Valuing Convenient Healthcare, subthemes: sharing space and time, care planning creates structure, coordinating care, valuing the general practitioner role, and affording healthcare; (3) Engaging Self-care, subthemes: engaging passively is circumstantial, and, engaging actively and leading care. Conclusions Patients overwhelmingly had positive experiences of Interprofessional Collaborative Practice, signaling it is appropriate for chronic condition management in primary care. The patient role in managing their chronic condition was closely linked to their experience. Future studies should investigate how the patient role impacts the experience of patients, carers, and health professionals in this context. Systematic review registration PROSPERO: CRD42020156536.


Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 338
Author(s):  
Aisling A. Geraghty ◽  
Laura McBean ◽  
Sarah Browne ◽  
Patricia Dominguez Castro ◽  
Ciara M. E. Reynolds ◽  
...  

When treating malnutrition, oral nutritional supplements (ONSs) are advised when optimising the diet is insufficient; however, ONS usage and user characteristics have not been previously analysed. A retrospective secondary analysis was performed on dispensed pharmacy claim data for 14,282 anonymised adult patients in primary care in Ireland in 2018. Patient sex, age, residential status, ONS volume (units) and ONS cost (EUR) were analysed. The categories of ‘Moderate’ (<75th centile), ‘High’ (75th–89th centile) and ‘Very High’ ONS users (≥90th centile) were created. The analyses among groups utilised t-tests, Mann–Whitney U tests and chi-squared tests. This cohort was 58.2% female, median age was 76 years, with 18.7% in residential care. The most frequently dispensed ONS type was very-high-energy sip feeds (45% of cohort). Younger males were dispensed more ONSs than females (<65 years: median units, 136 vs. 90; p < 0.01). Patients living independently were dispensed half the volume of those in residential care (112 vs. 240 units; p < 0.01). ‘Moderate’ ONS users were dispensed a yearly median of 84 ONS units (median cost, EUR 153), ‘High’ users were dispensed 420 units (EUR 806) and ‘Very High’ users 892 yearly units (EUR 2402; p < 0.01). Further analyses should focus on elucidating the reasons for high ONS usage in residential care patients and younger males.


2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Guillaume Coindard ◽  
Michaël Acquadro ◽  
Raphaël Chaumont ◽  
Benoit Arnould ◽  
Philippe Boisnault ◽  
...  

Abstract Background Smoking cessation is a major public health issue. In France, primary care physicians (PCP) are the first contact points for tobacco management. The objective of this study was to understand how PCPs are involved in the management of smoking cessation: ownership, commitment, barriers. Methods A qualitative study was conducted using group and individual semi-structured techniques with PCPs. A thematic analysis of verbatim transcripts was performed to identify concepts and sub-concepts of interest. Saturation was evaluated retrospectively to ensure adequate sample size. Results A sample of 35 PCPs were interviewed, 31 in four focus groups and four in individual interviews. PCPs discussed their roles in the management of tobacco smoking cessation, including the different strategies they are using (e.g., Minimal Intervention Strategy, Motivational Interviewing), the multiple barriers encountered (e.g., lack of time, patients’ resistance to medical advice), the support resources and the treatment and intervention they prescribed (e.g. nicotine replacement therapy, supporting therapist). Conclusions This study provides a better understanding of the beliefs, attitudes, and behaviors of PCPs in managing smoking cessation. Guiding and encouraging patients toward smoking cessation remains a major objective of PCPs. While PCPs reported that progress has been made in recent years in terms of tools, technology and general awareness, they still face major barriers, some of which could be overcome by appropriate training.


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