Family practice最新文献

{"title":"\"A tool to support, not replace\": patient and general practitioner perceptions of digital decision support tools for back pain.","authors":"Avi Goodman, Aidan G Cashin, Isha Mishra, Mia Ryan, Jennifer McBride, Steven Marsh, Tianle Xie, Gustavo Batista, Oyungerel Byambasuren, James H McAuley, Rodrigo R N Rizzo","doi":"10.1093/fampra/cmaf098","DOIUrl":"10.1093/fampra/cmaf098","url":null,"abstract":"<p><strong>Background: </strong>Back pain is the leading musculoskeletal reason for visits in general practice. Time constraints on consultations affect diagnostic decisions and the delivery of evidence-based care. This study explored patient and general practitioner (GP) perspectives on digital tools to support decision-making in back pain management.</p><p><strong>Methods: </strong>We conducted separate focus groups between June and August 2024 with people experiencing back pain and with registered Australian GPs. We analyzed data using thematic analysis with an inductive approach.</p><p><strong>Results: </strong>We interviewed 23 participants: 13 with back pain and 10 GPs. Patients appreciated digital decision-support tools for increasing knowledge and clarifying persistent questions after consultations. GPs, in contrast, emphasized red flag screening, symptom monitoring, and time savings. Shared concerns included information trustworthiness, lack of personalization, and cost, while facilitators included integration into practice management systems and GP endorsement.</p><p><strong>Conclusions: </strong>Our findings highlight opportunities to integrate digital decision-support tools at multiple points in GPs' workflows-before, during, and after consultations-to address the needs of both patients with back pain and GPs. When used before consultations, such tools can help patients prepare by increasing their knowledge, supporting more productive discussions, informing decisions about whether a visit is necessary, and assisting GPs in identifying potential red flags. During consultations, the tools can provide clinicians with updates on current evidence and supply educational resources or prescriptions, particularly for evidence-based lifestyle interventions. After consultations, they can support follow-up by monitoring the patient's condition and addressing any persistent questions that may arise.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12754595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an academic detailing service to support appropriate prescribing and care in patients with type 2 diabetes.","authors":"Cherry Chu, Dorsa Ghahramani, Trish Rawn, Victoria Burton, Lindsay Bevan, Brooklyn Reidner, Noah Ivers, Jennifer Shuldiner, Mina Tadrous","doi":"10.1093/fampra/cmaf101","DOIUrl":"10.1093/fampra/cmaf101","url":null,"abstract":"<p><strong>Background: </strong>Academic detailing (AD), a one-on-one evidence-based educational outreach strategy for healthcare providers, has been effective in improving prescribing behavior. However, its impact on diabetes care outcomes in Canada remains underexplored.</p><p><strong>Objective: </strong>We aimed to compare prescribing and care patterns for type 2 diabetes between physicians who received AD and those who did not.</p><p><strong>Methods: </strong>We conducted a population-based matched cohort study in Ontario, Canada, using health administrative databases. We included primary care physicians with active billing from September 2020 to September 2022. Each AD physician was matched to a maximum four controls based on index year, region, sex, years in practice, and proportion of patients with diabetes. We assessed monthly clinical outcomes for 12 months pre and 18 months postintervention using mixed-effects models.</p><p><strong>Results: </strong>The cohort included 372 AD and 1450 control physicians, with balanced demographics. At baseline, AD physicians saw fewer patients (1292 vs. 1526) but delivered more appointments per patient (4.2 vs. 3.0). Both groups had 15% of patients with diabetes. Post-intervention, biosimilar insulin use increased more sharply in the AD group (9.0% vs. 5.6% monthly). AD physicians consistently had higher B12 testing among metformin users (76.5% vs. 60.0%) and greater use of SGLT2 inhibitors or GLP-1 receptor agonists (40.1% vs. 31.5%). A1C control (<8%) remained similar across groups (∼80%). Time × group differences were significant for all outcomes (P < 0.001) except B12 testing (P = 0.790) and A1C levels (P = 0.815).</p><p><strong>Conclusions: </strong>The AD group saw greater improvements in diabetes prescribing post-intervention. Engaging physicians in AD could enhance diabetes care quality.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors driving vitamin D and B12 testing in Dutch primary care from the general practitioners' perspective: a qualitative interview study.","authors":"Ralph T H Leijenaar, Céline Buurman, Jesse Jansen, Jochen W L Cals","doi":"10.1093/fampra/cmaf112","DOIUrl":"10.1093/fampra/cmaf112","url":null,"abstract":"<p><strong>Background: </strong>Unnecessary vitamin tests are among the most frequently mentioned low-value care practices among Dutch general practitioners (GPs). Understanding drivers for vitamin testing from a GP's perspective is key for developing effective interventions.</p><p><strong>Objectives: </strong>This study explored GPs' perspectives on drivers of vitamin D and B12 testing, focusing on potential differences between GPs in practices with high and low testing rates, using the Capability, Opportunity, and Motivation Model of Behaviour (COM-B) behavioural science framework.</p><p><strong>Methods: </strong>Laboratory data from 57 primary care centres (PCCs) in the South of the Netherlands (2016-2019) identified the 15 PCCs with the lowest and highest vitamin testing rates. Thirty GPs, one per PCC, were purposively sampled to ensure variation in testing rate and background. Semi-structured interviews (May-July 2020) covered general perceptions, as well as social, cognitive, and motivational factors. Interviews were analysed by mapping factors driving vitamin testing to the COM-B model.</p><p><strong>Results: </strong>Several medical and non-medical factors affecting vitamin D and B12 test ordering in general practice were identified, which could be linked to all three COM-B components at the GP (e.g. education), patient (e.g. informational material), and service level (e.g. laboratory forms).</p><p><strong>Conclusion: </strong>Education, feedback on testing behaviour, evidence-based patient informational material, clear evidence-based guidelines, and modification of laboratory request forms by adding test costs and indications of at-risk groups were identified by participants as promising strategies to reduce unnecessary vitamin testing.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomous nurse practitioners in Florida frequently practice outside their legal scope of primary care: a cross-sectional study.","authors":"Rebekah Bernard, Phillip B Shaffer, Sharon L D'Souza, Elana Pearl Ben-Joseph, Carmen M Kavali","doi":"10.1093/fampra/cmaf104","DOIUrl":"10.1093/fampra/cmaf104","url":null,"abstract":"<p><strong>Introduction: </strong>Nurse practitioner (NP) organizations have advocated for expanding the NP scope of practice as a means of meeting the increasing demand for primary care services. Florida enacted the NP unsupervised practice of medicine (UPM) as part of House Bill 607 in July 2020, with the stipulation that autonomous NPs practice within primary care. The objective of this study was to determine the extent to which autonomous NPs in Florida have limited their scope of practice to primary care.</p><p><strong>Methods: </strong>We obtained a database of the population of autonomous NPs in Florida on 27 August 2024 from the Florida Department of Health, which contained a total of 11 925 NPs. Between November 2024 and February 2025, we randomly sampled 464 autonomous NPs across the state of Florida, ultimately reaching 328 autonomous NP practices.</p><p><strong>Results: </strong>Of the 328 autonomous NP practices reached, 128 NPs were working in primary care, and 6 NPs were working in non-clinical roles. The remaining 194 autonomous NPs were working clinically in non-primary care settings, with the top five most common being (i) cosmetic and non-standard medical/surgical practices such as antiaging, IV hydration, vitamin infusions, hormonal therapy, and supplements (n = 53), (ii) psychiatry/addiction medicine (n = 53), (iii) emergency/urgent care (n = 20), (iv) inpatient medicine (n = 13), and (v) cardiology (n = 9).</p><p><strong>Conclusions: </strong>Our study provides strong evidence that many autonomous NPs in Florida have established specialty practices and other services not within the legal scope of practice of Florida law. Stricter enforcement of NP practice within the scope of training and legislation is needed.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of general practitioners in dementia diagnosis: a scoping review of clinical practice guidelines.","authors":"Mary Cronin, Aisling Jennings, Nicola Cornally, Irene Hartigan, Séan O'Dowd, Marieke Perry, Suzanne Timmons, Kieran Walsh, Tony Foley","doi":"10.1093/fampra/cmaf103","DOIUrl":"10.1093/fampra/cmaf103","url":null,"abstract":"<p><strong>Background: </strong>Timely diagnosis of dementia is a public health priority, with general practitioners (GPs) central to symptom recognition and assessment. The emergence of biomarkers and anti-amyloid therapies makes accurate, timely diagnosis more critical than ever, introducing new complexities for general practice. Clinical practice guidelines (CPGs) are vital tools to support clinical decision-making, but their applicability to the general practice setting is uncertain.</p><p><strong>Objectives: </strong>This scoping review analyses how international CPGs define and support the GP's role in the dementia diagnostic process.</p><p><strong>Methods: </strong>Following the Arksey and O'Malley scoping review framework, five electronic databases and multiple grey literature sources were searched for dementia CPGs published between 2019 and 2025. Guideline quality was assessed using selected domains of the Appraisal of Guidelines for Research & Evaluation II instrument (AGREE II).</p><p><strong>Results: </strong>Fifteen CPGs from a range of healthcare systems were included. Only two were specifically developed for general practice. While most CPGs positioned GPs as key to timely diagnosis, the recommendations were predominantly developed from a secondary-care perspective and failed to address the fundamental barrier of limited consultation time. Furthermore, practical guidance for GPs on integrating new biomarkers and anti-amyloid therapies was almost absent.</p><p><strong>Conclusions: </strong>A disconnect exists between CPG recommendations and the realities of general practice, rendering much of the guidance aspirational rather than actionable. To be effective, future guidelines must ensure recommendations are feasible, address resource constraints, and establish clear pathways for the new biological era of dementia care. Without this, general practice will remain ill-equipped to meet the growing challenges of dementia diagnosis and management.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12823279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing systemic workforce challenges in general practice-a qualitative study of general practitioners in Ireland.","authors":"Uzair Shabbir, Ray O'Connor, Joe MacDonagh, Andrew O'Regan","doi":"10.1093/fampra/cmaf094","DOIUrl":"10.1093/fampra/cmaf094","url":null,"abstract":"<p><strong>Background: </strong>General practice across Europe faces a workforce crisis, with a projected shortfall of up to 1660 general practitioners in Ireland by 2028. While policy interventions have been proposed, a gap remains between the Irish health system's strategic objectives and the day-to-day realities experienced by general practitioners.</p><p><strong>Objective: </strong>The aim of this study is to explore the perspectives of Irish general practitioners in addressing recruitment and retention challenges in general practice. Specific objectives include identifying solutions and the supports necessary for sustainable future general practice.</p><p><strong>Methods: </strong>A qualitative study design was employed, utilizing semi-structured online interviews with general practitioners recruited through a network affiliated with a university. Thematic analysis was conducted by four experienced researchers. Data collection continued until thematic saturation was achieved.</p><p><strong>Results: </strong>Three primary themes emerged: (i) Towards a More Effective Health Service-participants emphasized the necessity for a whole-system approach to address recruitment and retention shortfalls; (ii) Role Clarification, Boundary Setting, and Support-participants highlighted the need for role reallocation within multidisciplinary teams to allow them to focus on complex cases; and (iii) Practice-Level Response-digital infrastructure improvements and administrative task reallocation were identified as key strategies to reduce workload and enhance patient care.</p><p><strong>Conclusion: </strong>To address the general practice workforce crisis, systemic reforms, expanded multidisciplinary teams, and practice-level adaptations are needed. The findings reflect the importance of general practitioner involvement in healthcare planning and policy development. These insights will inform targeted policy interventions in Ireland and in healthcare systems facing similar workforce challenges.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12686944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the effect of bonding-based support given during the perinatal period on maternal bonding.","authors":"Ozge Karakaya Suzan, Nursan Cinar","doi":"10.1093/fampra/cmaf093","DOIUrl":"10.1093/fampra/cmaf093","url":null,"abstract":"<p><strong>Background: </strong>Strengthening prenatal bonding during pregnancy may enhance postpartum mother-infant bonding and improve maternal-infant interactions. This study aimed to examine the effect of Bonding-Based Support provided during the perinatal period on prenatal bonding, early period mother-infant bonding indicators, and maternal bonding.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted with 70 primigravidae with low prenatal bonding scores (intervention group: n = 34; control group: n = 36). In addition to standard hospital care, the intervention group received a \"Bonding-Based Support Program,\" designed to enhance maternal-infant bonding. This hybrid intervention included video-based online training during pregnancy and face-to-face counselling and support immediately after birth. Data were collected using the Maternal Antenatal Attachment Scale (MAAS), the Maternal Attachment Inventory (MAI), and the Early Period Mother-Infant Bonding Indicators Assessment Scale.</p><p><strong>Results: </strong>Pre-test scores from the Maternal Antenatal Attachment Scale (MAAS) and its sub-dimensions (Attachment Quality and Time Spent on Attachment) showed no significant differences between groups. However, post-test MAAS scores and sub-dimensions were significantly higher in the intervention group. Significant improvements were also observed in the intervention group on the Early Period Mother-Infant Bonding Indicators Assessment Scale. Moreover, maternal bonding assessed by the Maternal Attachment Inventory was significantly better in the intervention group compared to the control.</p><p><strong>Conclusion: </strong>The findings indicate that providing Bonding-Based Support during the early perinatal period has a positive impact on maternal bonding, as shown by both self-reported measures and observational indicators. This highlights the potential of targeted bonding support programmes to promote early and sustained maternal-infant connections.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-practice variability in registrar experiences of continuity of care: a cross-sectional analysis from the Registrar Clinical Encounters in Training study.","authors":"Adele Kincses, Alison Fielding, Amanda Tapley, Andrew Davey, Anna Ralston, Dominica Moad, Elizabeth Holliday, Jason Dizon, Mieke van Driel, Parker Magin","doi":"10.1093/fampra/cmaf096","DOIUrl":"10.1093/fampra/cmaf096","url":null,"abstract":"<p><strong>Background: </strong>Continuity of care is a defining feature of general practice, with strong evidence for improved patient outcomes. Variability in practices' rates of continuity could markedly influence general practitioner (GP) registrars' learning experience. Previous research found \"upstream\" (registrar previously seen patient) continuity of 43% and \"downstream\" (follow-up appointment arranged between registrar and patient) continuity of 49% in Australian GP registrars.</p><p><strong>Objectives: </strong>This study aimed to assess inter-practice variability in registrar experience of continuity of care.</p><p><strong>Methods: </strong>Cross-sectional analysis (2010-23) from the Registrar Clinical Encounters in Training study of GP registrars' in-consultation clinical experiences. Outcome factors were \"upstream\" and \"downstream\" continuity. Inter-practice variability was assessed using median odds ratios (MORs). Outcome variance attributable to practice was estimated within the Bayesian modeling framework using a mixed-effects logistic regression with cross-classified random effects for registrar and practice.</p><p><strong>Results: </strong>The analysis included 4643 registrars (response rate 93.3%) across 978 practices. 42.5% (289 426) of registrar consults involved \"upstream\" continuity and 45.5% (313 295) of registrar consults involved \"downstream\" continuity. The MOR values were 1.47 [credible interval [CrI] (1.44, 1.50)] and 1.40 [CrI (1.38, 1.43)], for \"upstream\" and \"downstream\" continuity, respectively, in a model with random effects for practice and registrar; and 1.35 [CrI (1.32, 1.37)] and 1.38 [CrI (1.36, 1.41)], respectively, in the model adjusted for time/registrar/patient/consultation/consultation outcome/practice variables.</p><p><strong>Conclusions: </strong>Considerable variability exists in continuity of care measures between GP training practices. This has implications for registrars' learning opportunities, particularly in chronic disease management-essential in the context of an aging population. Strategies to improve registrars' continuity of care in practices with lower rates of continuity should be considered.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Puberty assessment in general practice: between recommendations and reality-results from two qualitative studies on perceptions and use of Tanner staging.","authors":"Marie Fincker, Pauline Fontes, Claire Dumas, Camille Lépine","doi":"10.1093/fampra/cmaf106","DOIUrl":"10.1093/fampra/cmaf106","url":null,"abstract":"<p><strong>Background: </strong>The Tanner staging system is recommended to assess pubertal development and to screen for pubertal development disorders. General practitioners (GPs) play a central role in monitoring pubertal development, yet the practical application of the Tanner stages in general practice remains underexplored.</p><p><strong>Objectives: </strong>To explore the perceptions of GPs regarding Tanner stages and their experiences in performing these assessments in children and adolescents.</p><p><strong>Methods: </strong>Two studies were conducted using an inductive qualitative approach. Study 1 examined the views and practices of GPs during puberty assessments. We then asked the doctors to assess the Tanner stages before exploring their personal feelings and the challenges they faced in Study 2. Semi-structured interviews were conducted from November 2022 to November 2023.</p><p><strong>Results: </strong>GPs report that they rarely perform systematic puberty assessments using Tanner stages. Key barriers included insufficient training, lack of confidence in grading, and the sensitive nature of the examination. Participants questioned the clinical utility of Tanner staging, preferring general observation of pubertal onset over precise quantification. GPs remained sceptical about the routine use of Tanner stages in general practice and emphasized the need for additional support, training, and practical tools to enhance implementation.</p><p><strong>Conclusion: </strong>While GPs focus on how to screen for pubertal disorders, the underlying purpose and potential benefits remain less clear to them. Raising GPs' awareness of the importance of identifying pubertal disorders and providing practical strategies is essential for adolescent care. We recommend that GPs systematically check that puberty begins at the expected age in their young patients.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of comfort care combined with family participatory care during the perioperative period of cesarean section in obstetrics and gynecology.","authors":"Chunyan Wan, Ruihuan Wang, Qing Liu, Mei Xu","doi":"10.1093/fampra/cmaf091","DOIUrl":"10.1093/fampra/cmaf091","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effects of comfort care and family participatory care during the perioperative period of cesarean section in obstetrics and gynecology.</p><p><strong>Methods: </strong>This single-center, randomized controlled trial assigned 90 cesarean women to two groups: control (conventional perioperative care) and observation (comfort and family participatory care). The primary outcome measures included maternal pain [Visual Analog Scale (VAS)], anxiety [Self-Rating Anxiety Scale (SAS)], and depression [Self-Rating Depression Scale (SDS)]. Secondary outcomes included mean arterial pressure and heart rate, adrenaline and cortisol levels, lactation onset time, 24-h postpartum lactation volume, off-bed activity time, anal defecation time, and hospital stay, as well as evaluating maternal self-care ability [Exercise of Self-Care Agency Scale (ESCA)], maternal complications, and maternal satisfaction with nursing assessed using a satisfaction questionnaire at discharge.</p><p><strong>Results: </strong>The observation group possessed lower VAS at 24, 48, and 72 h postoperatively, and SAS and SDS scores postoperatively, lower mean arterial pressure, heart rate, and adrenaline and cortisol levels, higher scores of self-care skills, self-care responsibility, self-concept, and self-care health knowledge, shorter times to lactation onset, off-bed activity, anal defecation, and hospital stay, greater 24-h postpartum lactation volume, lower incidence rate of complications (4.44% vs 24.44%), and higher nursing satisfaction (97.78% vs 84.22%) compared with the control group (all P < 0.05).</p><p><strong>Conclusion: </strong>During the perioperative period of cesarean section, comfort care and family participatory care can effectively alleviate postoperative pain, reduce anxiety and depression, improve stress responses, enhance maternal self-care ability and nursing satisfaction, and decrease the incidence of complications.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 6","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}