Family practice最新文献

{"title":"A survey on the implementation of family doctor contract services in China from the perspective of resident demand.","authors":"Yue-Ling Zhang, Yuan-Can Yang","doi":"10.1093/fampra/cmae075","DOIUrl":"10.1093/fampra/cmae075","url":null,"abstract":"<p><strong>Background: </strong>To understand the implementation of the family doctor contract service system in China from the perspective of resident demand.</p><p><strong>Methods: </strong>A stratified random sampling design was employed to survey 6380 residents across the eastern, central, and western regions of China. Data were processed using SPSS 22.0 and Python, and statistical methods such as chi-square and rank sum tests were applied. Multivariate logistic regression analysis was used to assess the impact of various factors.</p><p><strong>Results: </strong>(i) Overall implementation of the family doctor contract service system in China: (a) Nationwide awareness rate was 64.73%, with a contracting rate of 12.98%. (b) The overall satisfaction score for the implementation of contracted services was 3.78 out of 5, indicating general satisfaction. (ii) Regional implementation of the family doctor contract service system in the eastern, central, and western regions: (a) Awareness in the eastern region (67.76%) was higher than the national average (64.73%), while it was lower in the central region (60.44%). (b) The contracting rate in the eastern region (15.02%) was also above the national average, with the western region having the lowest rate (12.28%) but the highest willingness to contract.</p><p><strong>Conclusion: </strong>The current state of implementation of China's family doctor contract service system is far from the goals set out in the \"Guidance on Promoting High-Quality Development of Family Doctor Contract Services\". Inadequate promotion of the system and subpar service quality post-contract have led to low public trust and satisfaction. The construction of family doctor teams and the contract service guarantee mechanism remain underdeveloped.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064829","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":"Using an SMS to improve bowel cancer screening: the acceptability and feasibility of a multifaceted intervention.","authors":"Jennifer G McIntosh, Anna Wood, Mark Jenkins, Shakira Onwuka, Patty Chondros, Tina Campbell, Edweana Wenkart, Clare O'Reilly, Ian Dixon, Julie Toner, Javiera Martinez Gutierrez, Linda Govan, Jon D Emery","doi":"10.1093/fampra/cmae073","DOIUrl":"10.1093/fampra/cmae073","url":null,"abstract":"<p><strong>Background: </strong>The Australian National Bowel Cancer Screening Program sends an immunochemical faecal occult blood test to Australians aged 50-74 years to screen for bowel cancer, but uptake is low (40.9%). The SMARTscreen trial demonstrated that sending a short messaging services (SMS) prompt from the participant's general practitioner (GP) increased the proportion of kit returns by 16.5%. This research aimed to determine the acceptability and feasibility of implementing SMARTscreen.</p><p><strong>Method: </strong>SMARTscreen was a cluster randomized controlled trial set in 21 Australian general practices in regional Australia. Participants and general practice staff involved in the trial were included in this study. Acceptability and feasibility were measured quantitatively by calculating proportions of the SMS received, viewed, or opted out of, and qualitatively by interviewing people who sent and received the SMS.</p><p><strong>Results: </strong>Of 2914 SMS sent, 2645 SMS (91%) were received by participants, 1128 (43%) people opened the weblink, and 59 (2%) people opted out of receiving future SMS. Interviews with general practice staff (n = 17) and participants (n = 18) found that sending and receiving the SMS was acceptable and feasible. The SMS was considered a low-burden activity that easily integrated into the clinic's workflow without impacting clinicians' time. Participants reported an increased intention to participate in screening, but some people worried the weblink was spam, and some suggested sending it out of working hours.</p><p><strong>Conclusion: </strong>The SMS-based intervention was widely accepted by GP staff and participants. Future research should test the SMS with and without the weblink, and send the SMS at a more convenient time of the day/week.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871939","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":"Leaflet information by the local government on mental health during the coronavirus disease 2019 pandemic: a cross-sectional study in a rural area in Japan.","authors":"Ryu Fukase, Masayasu Murakami, Takaaki Ikeda","doi":"10.1093/fampra/cmad059","DOIUrl":"10.1093/fampra/cmad059","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic and associated infodemic increased depression and anxiety. Proper information can help combat the infodemic and promotes mental health; however, rural residents have more difficulties in getting correct information than urban residents.</p><p><strong>Objective: </strong>To examine whether the information on COVID-19 provided by the local government maintained the mental health of rural residents in Japan.</p><p><strong>Methods: </strong>A self-administered questionnaire survey of Okura Village (northern district of Japan) residents aged ≥16 years was conducted in October 2021. The main outcomes, depressive symptoms, psychological distress, and anxiety were measured using the Center for Epidemiologic Studies Depression Scale, Kessler Psychological Distress Scale, and Generalized Anxiety Disorder scale 7-item. Exposure was defined as whether the resident read the leaflet on COVID-19 distributed by the local government. The targeted maximum likelihood estimation was used to analyse the effect of leaflet reading on the main outcomes.</p><p><strong>Results: </strong>A total of 974 respondents were analysed. Reading the leaflet was significantly lower risk for depressive symptoms relative risk (95% confidence interval): 0.64 (0.43-0.95). Meanwhile, no clear effects of leaflet reading were observed on mental distress and anxiety.</p><p><strong>Conclusions: </strong>In rural areas with local governments, analogue information may be effective to prevent depression.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":"956-961"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9543632","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":"The role of social support as a moderator between resilience and levels of burden of multimorbidity management among general practitioners: a cross-sectional study in Portugal.","authors":"Filipe Prazeres, Luísa Castro, Andreia Teixeira","doi":"10.1093/fampra/cmad109","DOIUrl":"10.1093/fampra/cmad109","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity management poses significant challenges for general practitioners (GPs). The aim of this study is to analyse the role of resilience and social support on the burden experienced by GPs in managing patients with multiple health conditions in Portugal.</p><p><strong>Methods: </strong>Cross-sectional quantitative study conducted among GPs in Portugal using an online questionnaire that included validated measurement tools: Questionnaire of Evaluation of Burden of Management of Multimorbidity in General and Family Medicine (SoGeMM-MGF), European Portuguese Version of the Resilience Scale (ER14), and the Oslo Social Support Scale-3 (OSSS-3) in Portuguese. A multiple linear regression analysis was conducted to examine the factors influencing the burden of managing multimorbidity.</p><p><strong>Results: </strong>Two hundred and thirty-nine GPs were included, with 76.6% being female and a median age of 35 years. Most participants were specialists (66.9%) and had less than a decade of experience managing multimorbidity. Over 70% had not received specific training in multimorbidity. Female GPs and those with a higher proportion of multimorbid patients in the registries experienced higher burden levels. A multivariate regression model with moderation revealed that the effect of resilience on burden varied depending on the level of social support. Higher resilience was associated with higher burden in the \"Poor Social Support\" category, while it was associated with lower burden in the \"Moderate Social Support\" and \"Strong Social Support\" categories, although not statistically significant.</p><p><strong>Conclusions: </strong>The study highlights the importance of GPs' social support and resilience in managing the burden of multimorbidity, with poor social support potentially worsening the effects of high resilience.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":"909-915"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138433580","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":"Weight management in primary care: the call for a practical and evidence-informed approach.","authors":"Hilmi S Rathomi, Nahal Mavaddat, Judith Katzenellenbogen, Sandra C Thompson","doi":"10.1093/fampra/cmad101","DOIUrl":"10.1093/fampra/cmad101","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":"869-870"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71479875","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":"Rebuilding trust in the physician-patient relationship: addressing causes and implementing reforms in China.","authors":"Yu Xiao, Liang Liu, Ting-Ting Chen, Shao-Yi Zhu","doi":"10.1093/fampra/cmad104","DOIUrl":"10.1093/fampra/cmad104","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":"871-872"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520979","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":"Lay and general practitioner attitudes towards endometrial cancer prevention: a cross-sectional study.","authors":"Sarah J Kitson, Urwaa Khan, Emma J Crosbie","doi":"10.1093/fampra/cmad076","DOIUrl":"10.1093/fampra/cmad076","url":null,"abstract":"<p><strong>Background: </strong>Effective and targeted endometrial cancer prevention strategies could reduce diagnoses by 60%. Whether this approach is acceptable to individuals and general practitioners (GPs) is currently unknown. This study sought to determine attitudes towards the provision of personalised endometrial cancer risk assessments and the acceptability of potential prevention strategies.</p><p><strong>Methods: </strong>Specific online questionnaires were developed for individuals aged 45-60 years with a uterus and UK-practising GPs, with social media, charity websites, and email used to advertise the study. Individuals completed the questionnaires between February and April 2022.</p><p><strong>Results: </strong>Of 660 lay questionnaire respondents, 90.3% (n = 596) thought that undergoing an endometrial cancer risk assessment was a good or very good idea and 95.6% (n = 631) would be willing to undergo such an assessment. The commonest reasons for wanting to participate were \"to try and reduce my risk\" (n = 442, 67.0%), \"to be informed\" (n = 354, 53.6%), and \"it could save my life' (n = 315, 47.7%). Over 80% of respondents would make lifestyle changes to reduce their endometrial cancer risk (n = 550), with half accepting a pill, Mirena, or hysterectomy for primary prevention. GPs were similarly engaged, with 93.0% (n = 106) willing to offer an endometrial cancer risk assessment if a tool were available, potentially during a Well Woman screen.</p><p><strong>Conclusion: </strong>Personalised endometrial cancer risk assessments are acceptable to potentially eligible individuals and GPs and could be accommodated within routine practice. Clinical trials to determine the effectiveness of lifestyle modification and Mirena for endometrial protection are urgently required and should be targeted at those at greatest disease risk.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":"949-955"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888141","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":"Measurement of treatment burden in patients with multimorbidity in the Netherlands: translation and validation of the Multimorbidity Treatment Burden Questionnaire (NL-MTBQ).","authors":"Loes W S Engels, Tiny van Merode, Monique Heijmans, Juliane Menting, Polly Duncan, Jany Rademakers","doi":"10.1093/fampra/cmad100","DOIUrl":"10.1093/fampra/cmad100","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is a growing problem. The number and complexity of (non-)pharmaceutical treatments create a great burden for patients. Treatment burden refers to the perception of the weight of these treatments, and is associated with multimorbidity. Measurement of treatment burden is of great value for optimizing treatment and health-related outcomes.</p><p><strong>Objective: </strong>We aim to translate and validate the Multimorbidity Treatment Burden Questionnaire (MTBQ) for use in the Dutch population with multimorbidity and explore the level of treatment burden.</p><p><strong>Methods: </strong>Translating the MTBQ into Dutch included forward-backward translation, piloting, and cognitive interviewing (n = 8). Psychometric properties of the questionnaire were assessed in a cross-sectional study of patients with multimorbidity recruited from a panel in the Netherlands (n = 959). We examined item properties, dimensionality, internal consistency reliability, and construct validity. The level of treatment burden in the population was assessed.</p><p><strong>Results: </strong>The mean age among 959 participants with multimorbidity was 69.9 (17-96) years. Median global NL-MTBQ score was 3.85 (interquartile range 0-9.62), representing low treatment burden. Significant floor effects were found for all 13 items of the instrument. Factor analysis supported a single-factor structure. The NL-MTBQ had high internal consistency (α = 0.845), and provided good evidence on the construct validity of the scale.</p><p><strong>Conclusion: </strong>The Dutch version of the 13-item MTBQ is a single-structured, valid, and compact patient-reported outcome measure to assess treatment burden in primary care patients with multimorbidity. It could identify patients experiencing high treatment burden, with great potential to enhance shared decision-making and offer additional support.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":"901-908"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50161164","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":"Adoption, acceptance, and use of a decision support tool to promote timely investigations for cancer in primary care.","authors":"Sophie Chima, Barbara Hunter, Javiera Martinez-Gutierrez, Natalie Lumsden, Craig Nelson, Jo-Anne Manski-Nankervis, Jon Emery","doi":"10.1093/fampra/cmae046","DOIUrl":"10.1093/fampra/cmae046","url":null,"abstract":"<p><strong>Background: </strong>The complexities of diagnosing cancer in general practice has driven the development of quality improvement (QI) interventions, including clinical decision support (CDS) and auditing tools. Future Health Today (FHT) is a novel QI tool, consisting of CDS at the point-of-care, practice population-level auditing, recall, and the monitoring of QI activities.</p><p><strong>Objectives: </strong>Explore the acceptability and usability of the FHT cancer module, which flags patients with abnormal test results that may be indicative of undiagnosed cancer.</p><p><strong>Methods: </strong>Interviews were conducted with general practitioners (GPs) and general practice nurses (GPNs), from practices participating in a randomized trial evaluating the appropriate follow-up of patients. Clinical Performance Feedback Intervention Theory (CP-FIT) was used to analyse and interpret the data.</p><p><strong>Results: </strong>The majority of practices reported not using the auditing and QI components of the tool, only the CDS which was delivered at the point-of-care. The tool was used primarily by GPs; GPNs did not perceive the clinical recommendations to be within their role. For the CDS, facilitators for use included a good workflow fit, ease of use, low time cost, importance, and perceived knowledge gain. Barriers for use of the CDS included accuracy, competing priorities, and the patient population.</p><p><strong>Conclusions: </strong>The CDS aligned with the clinical workflow of GPs, was considered non-disruptive to the consultation and easy to implement into usual care. By applying the CP-FIT theory, we were able to demonstrate the key drivers for GPs using the tool, and what limited the use by GPNs.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":"1048-1057"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461443","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":"Financial barriers to primary health care in Aotearoa New Zealand.","authors":"Mona Jeffreys, Lis Ellison-Loschmann, Maite Irurzun-Lopez, Jacqueline Cumming, Fiona McKenzie","doi":"10.1093/fampra/cmad096","DOIUrl":"10.1093/fampra/cmad096","url":null,"abstract":"<p><strong>Background: </strong>In Aotearoa New Zealand, co-payments to see a general practitioner (GP, family doctor) or collect a prescription are payable by virtually all adults.</p><p><strong>Objective: </strong>To examine the extent to which these user co-payments are a barrier to accessing health care, focussing on inequities for indigenous Māori.</p><p><strong>Methods: </strong>Pooled data from sequential waves (years) of the New Zealand Health Survey, 2011/12 to 2018/19 were analysed. Outcomes were self-reported cost barriers to seeing a GP or collecting a prescription in the previous year. Logistic regression was used to estimate odds ratios (ORs) of barriers to care for Māori compared with non-Māori, sequentially adjusting for additional explanatory variables.</p><p><strong>Results: </strong>Pooled data included 107,231 people, 22,292 (21%) were Māori. Across all years, 22% of Māori (13% non-Māori) experienced a cost barrier to seeing a GP, and 14% of Māori (5% non-Māori) reported a cost barrier to collecting a prescription. The age- and wave-adjusted OR comparing Māori/non-Māori was 1.71 (95% confidence interval [CI]: 1.61, 1.81) for the cost barrier to primary care and 2.97 (95% CI: 2.75, 3.20) for the cost barrier to collecting prescriptions. Sociodemographics accounted for about half the inequity for both outcomes; in a fully adjusted model, age, sex, low income, and poorer underlying health were determinants of both outcomes, and deprivation was additionally associated with the cost barrier to collecting a prescription but not to seeing a GP.</p><p><strong>Conclusions: </strong>Māori experience considerable inequity in access to primary health care; evidence supports an urgent need for change to system funding to eliminate financial barriers to care.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":"995-1001"},"PeriodicalIF":2.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215537","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}