Journal of primary health care最新文献

Do antidepressants help people with low back pain?

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC25046

Vanessa Jordan

引用次数: 0

Nurses' and general practitioners' perspectives on oral health in primary care: a qualitative study.

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC23153

Moira B Smith, Elizabeth Hitchings, Lynn McBain

{"title":"Nurses' and general practitioners' perspectives on oral health in primary care: a qualitative study.","authors":"Moira B Smith, Elizabeth Hitchings, Lynn McBain","doi":"10.1071/HC23153","DOIUrl":"https://doi.org/10.1071/HC23153","url":null,"abstract":"Introduction Integrating oral health into primary health care (PHC) is recommended, thereby ensuring comprehensive patient care. Primary care teams are well placed to promote and protect patients' oral health, and frequently see oral health-related complaints, and so need to be sufficiently knowledgeable to manage such presentations. There is limited local evidence to inform acceptable and feasible ways of integrating oral health into PHC in Aotearoa New Zealand. Aim To explore the views of doctors and nurses on the place of oral health, and how to improve its inclusion, in PHC. Methods Focus groups with nurses and doctors from six practices were conducted. Data were analysed thematically. Results Several factors influenced the inclusion of oral health in PHC and management of oral health presentations, at individual, professional and system levels: low oral health knowledge, skill and confidence in managing presentations, and lack of communication with local dental services (individual level); considering oral health as out-of-scope of practice, competing priorities, time constraints and ethical considerations (professional level); and lack of affordable and timely definitive oral health care and referral pathways (systems level). Suggestions to facilitate integration of oral health in PHC included information sessions on oral health, developing relationships with local dental professionals, and health system changes. Discussion Primary care practitioners are open to incorporating oral health into their practice; however, several barriers exist to do so sustainably. For effective integration, a series of individual-, professional- and system-level changes are likely required.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"10-16"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rural Māori experiences of accessing heart health care: a Kaupapa Māori qualitative analysis.

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24111

Taria Tane, Vanessa Selak, Kyle Eggleton, Matire Harwood

{"title":"Rural Māori experiences of accessing heart health care: a Kaupapa Māori qualitative analysis.","authors":"Taria Tane, Vanessa Selak, Kyle Eggleton, Matire Harwood","doi":"10.1071/HC24111","DOIUrl":"https://doi.org/10.1071/HC24111","url":null,"abstract":"Introduction Rural Māori experience inequities in heart health outcomes compared to rural non-Māori and urban Māori. Access to health care is a significant contributor to these inequities. There is a wealth of literature that explores Māori access to health care; however, the voice of rural Māori within the literature is limited. Under Te Tiriti o Waitangi (The Treaty of Waitangi), Māori have legislative rights to access, engage, and participate in the health care system equitably. Aim This study aimed to investigate the barriers and facilitators of accessing heart health care for rural Māori. Methods The study was informed by Kaupapa Māori Theory, which centres on Māori worldviews and epistemologies. Rural Māori (n =11) with lived experience of (or who had supported their whānau (family) member with) acute coronary syndrome, heart failure or cardiovascular risk assessment were interviewed, and reflective thematic analysis of the data was undertaken. Results Three overarching themes were generated: rural Māori desires and expectations of heart health care; how the system engages with rural Māori; and knowing what is important to rural Māori when it comes to heart health. Discussion Participants experienced many barriers to accessing quality heart health care, some of which were unique to rural settings. Participants sought heart health care that was close to home, culturally responsive, included a representative Māori workforce, involved their whānau, and valued partnership. System-level action is needed to adequately address inequities in health care access and outcomes in rural Māori and to meet obligations under Te Tiriti o Waitangi.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"53-62"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interprofessional communication between general dental practitioners and general medical practitioners: a qualitative study.

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24071

Guangzhao Guan, Amanda Lim, HuiYee Sim, YeYan Khor, Li Mei

{"title":"Interprofessional communication between general dental practitioners and general medical practitioners: a qualitative study.","authors":"Guangzhao Guan, Amanda Lim, HuiYee Sim, YeYan Khor, Li Mei","doi":"10.1071/HC24071","DOIUrl":"https://doi.org/10.1071/HC24071","url":null,"abstract":"Introduction Interprofessional communication between health care professionals is crucial to deliver quality health outcomes and enhance patients' quality of life. Aim This study aimed to investigate the perspectives and contents of the interprofessional communication between general dental practitioners (GDPs) and general medical practitioners (GPs), and to explore the barriers and strategies that could bridge the gap between these health care professionals from their perspectives. Methods A qualitative study approach was undertaken, with semi-structured interviews conducted with GDPs and GPs from Dunedin and Auckland, New Zealand. Transcripts were analysed using a thematic approach to identify patterns and main themes. Results Three major themes emerged from the interviews with GDPs (n =10) and GPs (n =6): (1) experiences of communication, (2) the content of communication and (3) barriers and suggestions to improve communication. Most GDP and GP participants reported that there was a lack of communication between these two specialties. Complex medical conditions and polypharmacy were the topics perceived as essential for interprofessional communication between GDPs and GPs. The barriers of communication included time constraints, insufficient knowledge of the dental field among most GPs, inadequate understanding of referral among GDPs, and the absence of a common means of communication. Discussion Both GDPs and GPs reported a lack of efficient interprofessional communication. They suggested implementing interprofessional education, integrating health record systems, scheduling regular face-to-face meetings, and developing effective referral guidelines.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"30-36"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of a smartphone-based, non-mydriatic fundus camera for patients with red flag ophthalmic presentations in a rural general practice.

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24040

Scott Davidson, Waldir Rodrigues de Souza, Kyle Eggleton

{"title":"Use of a smartphone-based, non-mydriatic fundus camera for patients with red flag ophthalmic presentations in a rural general practice.","authors":"Scott Davidson, Waldir Rodrigues de Souza, Kyle Eggleton","doi":"10.1071/HC24040","DOIUrl":"https://doi.org/10.1071/HC24040","url":null,"abstract":"Introduction Fundus examination by direct ophthalmoscopy is widely used in general practice; however, it offers limited field of view, requires close approximation to the patient, has a steep learning curve and is a difficult skill to master and maintain. Non-mydriatic fundus photography (NMFP) offers an alternative with a wider field of view, ability for image analysis and transmission, and is able to be conducted by allied healthcare staff. Aim This study aimed to compare the use of direct ophthalmoscopy with smart-phone NMFP in a large rural general practice. It also aimed to analyse the number of adequate views and positive findings achieved with each instrument and the impact of NMFP on ophthalmology referral decisions. Methods Patients aged ≥16 years presenting to Dargaville Medical Centre (Dargaville, New Zealand) with visual disturbance, headache, hypertensive urgency (systolic blood pressure (BP) >200 mmHg or diastolic BP >120 mmHg), transient ischemic attack (TIA) or stroke were enrolled prospectively into an observational study of visualisation, diagnosis and management impact for a 1-year period (n = 152, 304 eyes). Direct ophthalmoscopy findings and management plans were documented by the attending general practitioner (GP), and then again following assessment of the NMFP. Results NMFP significantly improved visualisation of the fundal structures with an increase in adequate views achieved of both the optic disc and the retina. Inter-rater agreement between the referring GP and ophthalmologist was good. Discussion The use of NMFP in general practice might result in greater accuracy in diagnosing retina and optic disc disease. Routine transmission of NMFP images to specialist eye clinics as part of the referral might improve management and result in health system efficiencies.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"4-9"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Technology-enhanced, culturally-informed primary care results in sustained improvements in biomarkers for Indigenous patients with type 2 diabetes - a pilot study.

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24056

Lynne M Chepulis, Rebekah Crosswell, Suzanne Moorhouse, Helen Morton, Michael Oehley, Ryan Paul, Hamish Crocket

{"title":"Technology-enhanced, culturally-informed primary care results in sustained improvements in biomarkers for Indigenous patients with type 2 diabetes - a pilot study.","authors":"Lynne M Chepulis, Rebekah Crosswell, Suzanne Moorhouse, Helen Morton, Michael Oehley, Ryan Paul, Hamish Crocket","doi":"10.1071/HC24056","DOIUrl":"https://doi.org/10.1071/HC24056","url":null,"abstract":"Introduction Type 2 diabetes disproportionately affects Indigenous Māori in New Zealand. The reasons for this are multifactorial but include a history of colonialism, barriers to health care access and a lack of culturally appropriate interactions/relationships with health care providers. There is currently a need to develop models of health care delivery that are tailored to the needs of this population. Aim This pilot study evaluates the use of technology, education and culturally-informed wrap-around care (including medication optimisation) to improve type 2 diabetes biomarkers and self-management in a high-needs, majority Indigenous population. Methods Twenty-three participants with HbA1c >80mmol/L received 2-4weeks of continuous glucose monitor (CGM) wear at baseline and at 3months alongside culturally-informed type 2 diabetes education and clinical care. Clinical biomarkers and psychometric measures were recorded at 0, 3, 6 and 12months and 0 and 3months respectively. Medication changes were recorded throughout the study. Results Mean (± s.d.) HbA1c significantly decreased from 93.4±15.7mmol/mol at baseline to 76.5±14.8mmol/mol at 3months, with reductions maintained at 6 and 12months by approximately three-quarters of participants (all P Discussion CGM informed, culturally-appropriate care has the potential to lead to sustained improvements in glycaemia in high-risk, Indigenous populations managed in primary care.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"83-87"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to: Evaluating the impact of the Piki te Ora extended primary care team on clinical outcomes in type 2 diabetes patients: a retrospective study. 更正：评估 Piki te Ora 扩展初级保健团队对 2 型糖尿病患者临床疗效的影响：一项回顾性研究。

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24108_CO

Sara Mustafa, Claire Cannon, Rawiri Keenan, Martin Mikaere, Tammy Dehar, Suzanne Moorhouse, Janine Thompson, Lynne Chepulis

引用次数: 0

Exploration of family/whānau and general practitioner perspectives of paediatric grommet services: a mixed methods study.

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24083

Michelle A Pokorny, Elizabeth A-L Holt, Hannah Fuller, Peter R Thorne

{"title":"Exploration of family/whānau and general practitioner perspectives of paediatric grommet services: a mixed methods study.","authors":"Michelle A Pokorny, Elizabeth A-L Holt, Hannah Fuller, Peter R Thorne","doi":"10.1071/HC24083","DOIUrl":"https://doi.org/10.1071/HC24083","url":null,"abstract":"Introduction Traditionally, grommet post-surgical follow-up care has been undertaken by otorhinolaryngologists (ORLs), but in a large public outpatient ORL service in Auckland, New Zealand (Counties Manukau), this responsibility has been partially devolved to general practitioners (GPs). Aim The purpose of this study is to explore the perspectives and experiences of families/whānau and GPs regarding grommet services for children. Methods A mixed methods approach was used with family/whānau comprising semi-structured interviews and a GP survey. Recruitment of families/whānau reflected the local demographic and all participants were primary carers of a child who had received grommet surgery between 2020 and 2021. All GPs were practising in clinics within the ORL service catchment area. Results Twenty-eight family/whānau interviews were conducted, and 22 GPs responded to the survey. Five main themes were identified: (1) awareness of child development; (2) challenges accessing health care; (3) responses to health information; (4) importance of aftercare; and (5) preference for service provision. Most (16) GP respondents reported they should not be responsible for post-surgical follow-up after grommet insertion. Lack of capacity and funding were identified as key barriers to GP-led follow-up. Discussion Families/whānau highly valued follow-up services and hearing evaluations after grommet insertion, and had a strong preference for clinicians with perceived expertise in ear and hearing care (ORLs and audiologists). They reported multiple barriers to receiving the desired care. Māori and Pacific families/whānau experienced additional delays for referrals into specialist services. GPs showed low support for primary care-led grommet follow-up care, with most not providing routine grommet checks after surgery.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"45-52"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Envisaging better care for patients with complex multimorbidity in Aotearoa New Zealand.

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24082

Anna Askerud

{"title":"Envisaging better care for patients with complex multimorbidity in Aotearoa New Zealand.","authors":"Anna Askerud","doi":"10.1071/HC24082","DOIUrl":"https://doi.org/10.1071/HC24082","url":null,"abstract":"Introduction Client-Led Integrated Care (CLIC) was implemented in general practices between 2018 and 2022 in the Southern region of New Zealand. It was envisaged to be an equitable, holistic and patient-centred inter-disciplinary framework of care for those with multiple long-term conditions; usually called multimorbidity. Aim This process evaluation aimed to determine whether CLIC supported self-management ability and assessed its alignment with current priorities for multimorbidity management. Method Mixed methods were used across four purposively selected general practices. At each practice interviews were undertaken together with participant observation over 3years. This was followed by analysis of annual self-report surveys. Results CLIC worked well for those patients who were engaged, but the implementation provided minimal consideration of the resources required for everyone to receive culturally competent integrated care. Staff reported structural difficulties and wondered if the right patients were targeted. Discussion CLIC did not address the needs of all participants, nor did it target those with the most ability to benefit. In all practices, despite increasing rates of multimorbidity and social complexity during a pandemic, the organisation of general practice and how it connected with the health system remained unchanged. Transitioning to a general practice system for complex multimorbidity will require changes in funding, strong leadership and clear communication. It requires all areas of the health system to provide an integrated health and social care system that is culturally competent and engages those most vulnerable in our community.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"37-44"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Equitable access to primary health care: better availability of GP appointments is only one piece of the jigsaw. 公平获得初级保健服务：更好地提供全科医生预约服务只是拼图中的一块。

IF 1.1

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC25047

Tim Stokes, Felicity Goodyear-Smith

引用次数: 0