Family practice最新文献

{"title":"From theory to practice: using the Normalization Process Theory and Theoretical Domains Framework to understand implementation of decarbonization in general practice.","authors":"Ana Raquel Nunes, Helen Atherton, Frederik Dahlmann, Abi Eccles, Olivia Geddes, Michael Gregg, Florence Karaba, Rachel Spencer, Helen Twohig, Jeremy Dale","doi":"10.1093/fampra/cmaf050","DOIUrl":"10.1093/fampra/cmaf050","url":null,"abstract":"<p><strong>Background: </strong>Decarbonization in general practice is a critical step toward achieving a net zero healthcare system. Understanding the factors that facilitate or hinder the implementation of environmentally sustainable practices is essential for effective and equitable action. Hence, the overarching aim of this study is to advance understanding of the factors influencing decarbonization in general practice. This study's objective is to map and compare the application of the Normalization Process Theory (NPT) and Theoretical Domains Framework (TDF) in understanding the key factors and sub-factors related to decarbonization in general practice.</p><p><strong>Methods: </strong>Factors derived from a systematic review and narrative synthesis were mapped to NPT constructs and TDF domains by a multidisciplinary team of 10 coders, including academic general practitioners (GPs), researchers, and patient representatives. The mapping was conducted independently, and coder agreement was evaluated for consistency and reliability in categorization.</p><p><strong>Results: </strong>The study identifies key NPT ('Coherence', 'Collective Action', and 'Cognitive Participation') and TDF domains ('Environmental Context and Resources', 'Knowledge', and 'Social/professional role and identity') associated with factors identified in previous research as being associated with achieving decarbonization in general practice. A high intercoder reliability rate (73% for NPT, 84% for TDF) supports the consistency of the analysis, particularly for structured drivers such as financial incentives and policy support.</p><p><strong>Conclusions: </strong>The findings demonstrate that the NPT and TDF frameworks provide useful, though incomplete, insights into factors influencing decarbonization in general practice. Such factors require more attention when developing evidence-based strategies for promoting decarbonization, something that future research could evaluate.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539744","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":"Motivational preferences of interdisciplinary family physician team members in delivering integrated care: a best-worst scaling study.","authors":"Weizhuo Chen, Zihui Xiong, Qiao Yang, Wenqi Xiao, Junyi Chen, Sisi Zhong, Ting Ye","doi":"10.1093/fampra/cmaf016","DOIUrl":"https://doi.org/10.1093/fampra/cmaf016","url":null,"abstract":"<p><strong>Background: </strong>In China, integrated care is facilitated by interdisciplinary Family Physician Teams (FPTs) to extend primary care services without increasing physician numbers. However, the advancement of integrated care faces challenges due to insufficient motivators for Family Physician Team Members (FPTMs).</p><p><strong>Objective: </strong>To elucidate the motivational preferences of FPTMs within integrated care, highlighting preference heterogeneity across individuals with diverse demographic and professional characteristics.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in November 2022 with 363 FPTMs at community health centers affiliated with seven hospitals in Shenzhen city. The study assessed motivational preferences using a best-worst scaling (BWS) questionnaire to collect data. Conditional logit and mixed logit models were employed to analyze overall preferences and heterogeneity.</p><p><strong>Results: </strong>The study revealed a strong preference for patient-centered motivators, particularly highlighting patient needs, trust level, and adherence as key motivators that are crucial in shaping the engagement of FPTMs with integrated care. Additionally, heterogeneity in preference patterns was observed based on sex, education level, and professional role. Specifically, male FPTMs, those with a master's degree or higher, and general practitioners demonstrated a significantly stronger preference for employment benefits and government resource allocation.</p><p><strong>Conclusion: </strong>The findings highlight the preference of FPTMs for patient-level motivators, underscoring the importance of implementing a feedback mechanism to capture patients' perspectives on services. Policymakers are urged to develop tailored motivational structures that consider the varied preferences of team members across different roles, thereby motivating the provision of integrated care by FPTMs.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324905","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":"Risk of refeeding syndrome: an observational study in primary healthcare.","authors":"Clément de Begon de Larouzière de Montlosier, Candy Guiguet-Auclair, Pierre Mély, David Julien, Laurent Gerbaud, Marie Blanquet","doi":"10.1093/fampra/cmaf038","DOIUrl":"10.1093/fampra/cmaf038","url":null,"abstract":"<p><strong>Background: </strong>Refeeding syndrome (RFS) is a complex phenomenon associated with increased mortality. However, the prevalence of risk factors for RFS has never been assessed in primary care. Our aim was to assess the prevalence of risk for developing RFS in primary care.</p><p><strong>Methods: </strong>A retrospective observational study was conducted in a general practitioner (GP) surgery in June 2022. The study included older adult patients (aged ≥75 years) or adult patients with chronic disease (aged 18-74 years), living at home and receiving care at home or at the GP's surgery between January 1 and June 30, 2021. Patients at high risk of developing RFS were identified using the National Institute for Health and Clinical Excellence (NICE) criteria. The risk of RFS was also assessed in patients aged ≥70 years using an adaptation of the NICE criterion for body mass index based on the Global Leadership Initiative on Malnutrition guidelines.</p><p><strong>Results: </strong>The prevalence of patients at risk for RFS was 2.8% (95% CI: 1.5%-4.1%) in the full population of 611 patients and 8.8% (95% CI: 6.1%-6.4%) in the subset of patients aged ≥70 years assessed using the adapted NICE criterion. The prevalence of patients at risk for RFS increased with age and chronic conditions. More severe comorbidity and home care were factors associated with higher risk of RFS.</p><p><strong>Conclusion: </strong>The risk of developing RFS in primary care settings is not negligible. GPs should consider this risk in their practice to develop a more comprehensive care programme.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283098","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":"Why do we still think cancer control is a one-time event?","authors":"Waseem Jerjes","doi":"10.1093/fampra/cmaf044","DOIUrl":"https://doi.org/10.1093/fampra/cmaf044","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283099","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":"Bright spots in dark times.","authors":"Benjamin R Colton","doi":"10.1093/fampra/cmaf051","DOIUrl":"https://doi.org/10.1093/fampra/cmaf051","url":null,"abstract":"<p><strong>Background: </strong>The current war in Gaza has created a thick cloud over the surrounding region: a cloud of anger, frustration, and despair. Palestinians make up a large portion of the population in Jordan with 2.39 million registered refugees alone, not including non-registered refugees. Many have relatives living in Gaza, making them particularly invested in the conflict.</p><p><strong>Discussion: </strong>The ongoing suffering of loved ones preoccupies them, making it difficult to focus on anything else. I also sometimes fall into despair even though I am a foreigner living in Jordan.</p><p><strong>Conclusion: </strong>A bright spot between the thick clouds occurred during my time with Ali at \"Camp for All,\" a camp for students with disabilities in Jordan.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527038","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":"Australian GPs' experiences, practices, and perspectives on postpartum care, contraception, and breastfeeding.","authors":"Keersten Cordelia Fitzgerald, Melissa Kang, Kirsten I Black","doi":"10.1093/fampra/cmaf055","DOIUrl":"10.1093/fampra/cmaf055","url":null,"abstract":"<p><strong>Background: </strong>Unintended pregnancies and short interpregnancy intervals (IPIs) are common and can be associated with adverse neonatal and maternal outcomes. Effective postpartum contraception could provide women with more control over their reproductive outcomes. Lactational amenorrhoea can be effective contraception; however, early breastfeeding discontinuation is common. This study aimed to explore and understand the experiences, practices, and perspectives of Australian general practitioners (GPs) in relation to postpartum care, contraception, and breastfeeding.</p><p><strong>Methods: </strong>Twenty-one qualitative, semi-structured interviews were conducted with GPs working in Sydney, Australia. Interviews were audio-recorded and transcribed for directed content analysis and thematic analysis.</p><p><strong>Results: </strong>Directed content analysis identified a diverse range of issues that constitute postpartum care. Thematic analysis identified four themes:(1) GPs have a holistic view of the postpartum period and play a coordinator role in postpartum care.(2) GPs identify opportunities for empowering postpartum women in their healthcare.(3) GPs perceive that women deprioritize their postpartum care and contraception.(4) GPs identify barriers and facilitators for postpartum care delivery.Subthemes provided further detail about how GPs consult with postpartum patients and opportunities to improve care. They noted areas of professional development needs and discussed the system, professional and patient factors impacting care.</p><p><strong>Conclusions: </strong>We identified several areas for improving postpartum care, including routine antenatal contraception counselling, revisiting the timing of postpartum visits, improving GP education in IPIs and breastfeeding, and improving engagement in postpartum care services through patient education.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759581","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":"A day in the clinic: serving amidst chaos during the Gaza War.","authors":"Beesan Maraqa","doi":"10.1093/fampra/cmaf040","DOIUrl":"https://doi.org/10.1093/fampra/cmaf040","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283093","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":"Correction to: Expanding the primary care workforce by integrating genetic counselors in multidisciplinary care teams.","authors":"","doi":"10.1093/fampra/cmaf049","DOIUrl":"10.1093/fampra/cmaf049","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301472","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":"She shouldn't have died.","authors":"Fadya El Rayess","doi":"10.1093/fampra/cmaf042","DOIUrl":"https://doi.org/10.1093/fampra/cmaf042","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324906","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":"There but for the grace.","authors":"Andrew W Dixon","doi":"10.1093/fampra/cmaf045","DOIUrl":"https://doi.org/10.1093/fampra/cmaf045","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324907","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}