Misbeliefs about non-specific low back pain and attitudes towards treatment by primary care providers in Spain: a qualitative study

Aim To identify misbeliefs about the origin and meaning of non-specific chronic low back pain and to examine attitudes towards treatment by primary health care providers. Design Generic qualitative study. Methods Ten semi-structured interviews were conducted between October and November 2016 with physicians and nurses from primary health care centres in Lleida. The interviews were transcribed and analysed using inductive thematic analysis via Atlas.ti-8 software. Results Five themes were identified: i. beliefs about the origin and meaning of chronic low back pain, ii. psychosocial aspects of pain modulators, iii. Therapeutic exercise as a treatment for chronic low back pain, iv. biomedical attitudes of primary health care providers, and v. difficulties in the clinical approach to chronic low back pain. Conclusion Primary health care providers have a unifactorial view of chronic low back pain and base their approach on the biomedical model. Professionals attribute chronic low back pain to structural alterations in the lumbar spine while psychosocial factors are only recognized as pain modulators. For professionals, therapeutic exercise represents a possible solution to chronic low back pain; however, they still do not prescribe it and continue to educate on postural hygiene and recommend limiting physical and/or occupational activities, as opposed to clinical practice guidelines. These findings suggest that to improve the adherence of primary health care providers to the biopsychosocial model, it may be necessary first to modify their misbeliefs about non-specific chronic low back pain by increasing their knowledge on pain neurophysiology. Trial registration ClinicalTrials.gov Identifier: NCT02962817. Date of registration: 11/11/2016.

Analysis of differences in variables related to health and safety according to the employment type of Korean workers

Introduction: The purpose of this study was to understand the differences in variables related to health and safety according to the employment type of Korean workers, specifically to identify the differences by employment type on in health status, the likelihood of wearing protective gear when working, access to manuals on emotional expression, and access to information on risk factors related to health and safety. Methods: The secondary data of four items on employment type, health type of workers and safety among the 5th Korean Working Condition Survey conducted in 2017 in Korea was used in this study. The data of workers were processed by using SPSS/WIN 23.0 Program and R 3.1.2, and demographic characteristics were quantified as frequency and percentage. Results: A total of 30,300 employed people were surveyed. The result shows that part-time workers have poorer health than full-time workers (c2 = 540.7155, p < 0.05), insufficiently wore protective gear (c2 = 24.8702, p < 0.05), had insufficient access to manuals on emotional expression (c2 = 27.7612, p < 0.05) and lacked information about risk factors (c2 = 185.0082, p < 0.05). Conclusion: Health and safety manager will need to have education and consultation, development of manual and perform an early intervention to improve safety environment as primary health care providers by understanding factors related to health and safety of part-time workers.

Erythematous plaques of the vulvo-perineal region

Skin conditions are a common reason for consulting primary health care. The public frequently expects their primary health care providers to be able to recognise and treat common skin conditions with confidence. Primary care providers must be able to identify ‘red flag’ skin conditions that require dermatology referral. However, diagnosis is often delayed due to the non-specific clinical presentation, low incidence, slow evolution and long-term history of such lesions. We report the case of a patient with extramammary Paget’s disease that presented to her primary care provider and subsequently underwent a wide local excision.

575Factor affecting job satisfaction and organizational commitment among primary health care providers in Delhi, India

Background The purpose of present study was to explore the factors affecting job satisfaction and organizational commitment of primary health care providers working in Government health facilities of Delhi, India. Methods Study was conducted on a sample of 333 health care providers who were selected using multistage simple random sampling technique. Factor analysis of job satisfaction scale, statistical test like multiple regression, correlation tests were applied using SPSS version 18. Results The seven factors affecting job satisfaction emerged from the factor analysis which are; privileges attached with job, interpersonal relation and cooperation, working environment, patient relationship, organization facilities, career development and human resource issues. Nature of job whether regular or contractual explains 25.1% of variance in the job satisfaction of staff (R Square= 0.251, p = 0.000). Nature of job along with level of education of health care providers is affecting 26.5% of variance in job satisfaction (R Square= 0.265, p = 0.015). For organization commitment type of job whether regular or contractual is responsible for 44.7% of variance in the commitment (R square 0.447; p = 0.000) and experience of health care providers is affecting 29.0% of variance in commitment (R square= 0.290; p = 0.000). Other predictors of organization commitment are salary, job security, working environment, appreciation of work and career growth. Conclusion The findings strongly suggest that the mode of entry of employee, privileges, career growth and working atmosphere contribute substantially to the job satisfaction and organization commitment. Key messages Appropriate changes are required at the policy level to keep the human resource satisfied and committed to the organization keeping in consideration the factors responsible for them.

Atopic Dermatitis - Knowledge and Attitude of Primary Health Care Providers, Majmaah, Saudi Arabia

BACKGROUND Atopic dermatitis (AD) is common in Saudi Arabia. Level of primary health care providers’ (PHCPs) knowledge about the disease is inadequate. We wanted to determine the knowledge and attitude of primary health care providers (PHCPs) in Majmaah, Saudi Arabia, toward atopic dermatitis (AD). METHODS This cross-sectional study was conducted in Majmaah, Saudi Arabia, from August to October 2020. The data was collected from eight primary healthcare centres in the city by a pre-tested questionnaire. The data was analysed using SPSS 26.0. Pearsonchi-square / Fisher Exact test were applied to observe associations between qualitative variables. A P-value of < 0.05 was considered as statistically significant. RESULTS The data was collected from 23 PHCPs. The qualification obtained by most of the PHCPs (78.3 %) was Bachelor of Medicine & Bachelor of Surgery (MBBS), 17.4 % were diploma holders and only one had master’s degree. The average AD score out of 8 items was 5.95 + 1.18. The minimum and maximum scores were 3 and 8. Converting the scores to percentages, the participants who had good knowledge about AD were 17 (73.91 %). Five (21.74 %) had average knowledge and only one (4.35 %) had poor knowledge. CONCLUSIONS The level of atopic dermatitis knowledge of PHCPs in Majmaah, Saudi Arabia, was found to be adequate, whereas the attitude was observed to be negative. Focus-group discussions, tailored sessions, or continuous medical education programs can be conducted to discuss the management guidelines on this condition with the PHCPs. KEY WORDS Atopic Dermatitis, Primary Healthcare Centres, Knowledge, Attitude, Saudi Arabia

Early Childhood Caries - Essential Information for Primary Healthcare Providers

Early Childhood Caries (ECC) is one of the most common chronic infectious diseases of childhood. It represents a significant disease burden with long-term consequences for a child's health and well-being. Primary health care providers (pediatricians, family physicians, pediatric nurses) are the first point of contact for parents for any child health-related issues as they see them repeatedly in the first few years of life for vaccinations and "well-baby" visits. However, their awareness regarding caries in primary dentition and its complications may be limited. This article has summarized important information on ECC, focusing on the health care provider's role in its early diagnosis and prevention.

Prospective SARS-CoV-2 cohort study among general practitioners during the second COVID-19 wave in Flanders, Belgium

Primary health care providers (PHCPs), especially general practitioners (GPs) are essential to organise health care efficiently. During the COVID-19 pandemic, they also keep the pressure off hospitals. PHCPs are assumed to be at high risk of a COVID-19 infection, as they are exposed to a large portion of the population (usually with less personal protective equipment than other frontline health care workers(HCWs)). Nevertheless, previous seroprevalence studies focussed on the general population or HCWs in hospital settings, rather than PHCPs. The aim of this study was to determine the seroprevalence of PHCPs after the first and during the second SARS-CoV-2 wave in Flanders (Belgium) and compare it to the seroprevalence in the general population (blood donors). A prospective cohort of PHCPs, mainly GPs (n=698) was screened for IgG antibodies against SARS-CoV-2 at five different time-points (June-December 2020). The dried blood spots they produced were analysed using a Luminex multiplex immunoassay. The seroprevalence of PHCPs remained stable between June and September 2020 (4.6-5.0%), but increased significantly from October to December (8.1-13.4%) 2020. The seroprevalence of PHCPs was not significantly higher than the seroprevalence of the blood donors at the end of December 2020. In conclusion, the sharp increase in seroprevalence during the second COVID-19 wave in Flanders shows that PHCPs were more at risk during the second wave compared to the first one. However, the increase was in line with the general population suggesting that PHCPs mainly got infected in their private settings.