Journal of primary health care最新文献_第4页

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Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24183

E Lyn Lee, Jo Barnes

引用次数: 0

Expert patient and general practitioners' perspectives on the clinical attributes needed to deal with uncertainty: a qualitative study. 专家患者和全科医生对处理不确定性所需的临床属性的观点：一项定性研究。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC24055

Tania Ghosh, Erik Blair

{"title":"Expert patient and general practitioners' perspectives on the clinical attributes needed to deal with uncertainty: a qualitative study.","authors":"Tania Ghosh, Erik Blair","doi":"10.1071/HC24055","DOIUrl":"10.1071/HC24055","url":null,"abstract":"Introduction Clinical uncertainty is not uncommon; however, the current conception of the professional clinician has meant that discussion on uncertainty has focused on elimination rather than recognition. Uncertainty comes from an imbalance in knowledge, data, clinical experience, evidence-based guidelines, judgement, and decision-making. There is a strong argument for improving tolerance of clinical uncertainty, particularly in primary care where general practitioners might be especially vulnerable to uncertainty due to their exposure to undifferentiated illness. Aim This research aims to establish expert patient and general practitioners' perspectives on the clinical attributes needed to deal with uncertainty. Methods Two focus groups, consisting of three general practitioners and five expert patients, discussed uncertainty regarding restless legs syndrome. This topic was used as a rhetorical proxy to examine expert patient and general practitioner perspectives on the clinical attributes needed to deal with uncertainty. The qualitative data were then analysed to form overarching thematic areas. Results Four overarching professional attributes were identified: collaboration, compassion, insight, and unconventional thinking. These are all attributes that lie within a clinician's skillset, but the evidence here suggests that they need to be foregrounded in practice. Discussion In attempting to assess professional clinical practice in relation to uncertainty, this research recommends that clinicians work to adopt a holistic, patient-centred approach, where they explicitly share uncertainties, focus on a patient's emotional state during the diagnostic phases of treatment, and see the merits of challenging themselves to look beyond routine algorithms.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"23-29"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735922","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

Respiratory research with Māori and Pacific children living in Aotearoa, New Zealand: a systematic review and narrative synthesis. 居住在新西兰奥特罗阿的Māori和太平洋儿童的呼吸研究：系统回顾和叙事综合。

IF 0.9

Journal of primary health care Pub Date : 2025-03-01 DOI: 10.1071/HC23066

Amio Matenga-Ikihele, Jacinta Fa'alili-Fidow, Dantzel Tiakia, Dudley Gentles, John Natua, Gemma Malungahu, Bernadette Tatafu, Rudy Roodhouse-Hill, Ruby Tuesday, Maria Ngawati, Mataroria Lyndon

{"title":"Respiratory research with Māori and Pacific children living in Aotearoa, New Zealand: a systematic review and narrative synthesis.","authors":"Amio Matenga-Ikihele, Jacinta Fa'alili-Fidow, Dantzel Tiakia, Dudley Gentles, John Natua, Gemma Malungahu, Bernadette Tatafu, Rudy Roodhouse-Hill, Ruby Tuesday, Maria Ngawati, Mataroria Lyndon","doi":"10.1071/HC23066","DOIUrl":"10.1071/HC23066","url":null,"abstract":"Introduction Improving the respiratory health of Māori and Pacific children in Aotearoa, New Zealand is a priority. Respiratory studies over the past decade have continued to highlight the ongoing inequities among Māori and Pacific children. Aim This systematic review aimed to explore the characteristics of respiratory research with Māori and Pacific children (0-14 years) living in New Zealand. Research objectives were to evaluate the types of study designs used, summarise participant demographics including ethnicity and evaluate whether culturally relevant frameworks were incorporated. Methods Studies were located across four databases: Medline, EBSCOHost, Scopus and PubMed, from 2010 to 2022. To qualify, studies needed to include (1) Māori or (2) Pacific children aged (3) 0-14 years and (4) describe a respiratory research project conducted in New Zealand. A narrative synthesis of the studies meeting the inclusion criteria was performed. Results Of the 539 studies identified, 29 met the inclusion criteria. Most studies were retrospective cohort studies with respiratory conditions focused mainly on asthma, group A streptococcus and lower respiratory tract infections. Four studies were qualitative, and only 2 of the 29 studies reported using a Kaupapa Māori framework. Discussion Despite the increased attention to the respiratory health of Māori and Pacific children, there is a lack of research on the lived experiences of whānau and their children who endure these conditions. Few studies incorporated culturally relevant approaches. Further research that incorporates culturally responsive approaches is urgently needed to enhance ourunderstanding of Māori and Pacific child respiratory health and to advance health equity.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"17 1","pages":"63-82"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735944","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

Medicines use and polypharmacy in retirement village residents in Aotearoa New Zealand: a point prevalence observational study. 新西兰奥特罗阿退休村居民药物使用和综合用药：一项点流行观察研究。

IF 0.9

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24038

Joanna Hikaka, Zhenqiang Wu, Michal Boyd, Martin J Connolly, Joanna B Broad, Cheryl Calvert, Annie Tatton, Kathy Peri, Katherine Bloomfield

{"title":"Medicines use and polypharmacy in retirement village residents in Aotearoa New Zealand: a point prevalence observational study.","authors":"Joanna Hikaka, Zhenqiang Wu, Michal Boyd, Martin J Connolly, Joanna B Broad, Cheryl Calvert, Annie Tatton, Kathy Peri, Katherine Bloomfield","doi":"10.1071/HC24038","DOIUrl":"10.1071/HC24038","url":null,"abstract":"Introduction Polypharmacy increases the risk of medicines-related harm, including falls, in older adults. Falls have a significant impact on quality of life and health system resources. Little is known about medicine use in retirement village (RV) residents in Aotearoa New Zealand (NZ). Aim Our study aimed to describe medicine use and the point prevalence of polypharmacy among a cohort of RV residents in Auckland, NZ. Methods Data collection occurred from July 2016 to June 2018. Eligible participants (those residing permanently in a RV) were recruited from RVs in Auckland, New Zealand. Medicines use data were collected using an interRAI assessment tool. Descriptive statistics, t -tests and Chi-squared tests were used for analysis. Results A total of 578 residents were recruited from 33 RVs and the median age was 81.6 years. Participants took a mean of 4.8 regular medicines (standard deviation = 2.9) and 0.7 'as required' medicines. Anti-hypertensives (68.5%), lipid-lowering medicines (45.2%), antacids (39.4%) and antiplatelet agents (37.9%) were the most prescribed medicine classes. Polypharmacy (five-plus medicines; 51.8%) was common and hyperpolypharmacy (10-plus medicines; 5.7%) occurred infrequently. Discussion This study provides insight into medicines use by RV residents in Auckland, NZ. Medicines used for primary and secondary prevention of cardiovascular disease were used most commonly and polypharmacy was common. Active review of RV residents' medicines is warranted, based on these findings and increasing evidence regarding the use of medicines, including those for primary prevention of cardiovascular disease. Trial registration Australia and New Zealand Clinical Trials Registry: CTRN12616000685415. Registered 25.5.2016. Universal Trial Number (UTN): U111-1173-6083.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"407-411"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864711","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

Community pharmacy service provision to adults with palliative care needs in their last year of life: a scoping review. 社区药房服务提供与缓和护理需要的成年人在他们的生命的最后一年：范围审查。

IF 0.9

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24089

Sheng-Ting Chiu, Trudi Aspden, Shane Scahill

{"title":"Community pharmacy service provision to adults with palliative care needs in their last year of life: a scoping review.","authors":"Sheng-Ting Chiu, Trudi Aspden, Shane Scahill","doi":"10.1071/HC24089","DOIUrl":"10.1071/HC24089","url":null,"abstract":"Introduction The provision of palliative care is central to primary health care delivery. In this setting, community pharmacies often act in a medication supply role, yet their broader involvement in supporting people in the last year of life is less well understood. Aim This study aimed to review the literature on community pharmacies supporting adults with palliative care needs in their last year of life, emphasising challenges to optimising their role and improving equity and service accessibility. Methods A five-stage scoping review using a comprehensive literature search was conducted using MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, and grey literature up to 30 April 2024. Eligible articles were charted, descriptively analysed, and mapped to a bicultural and holistic health care model, Te Whare Tapa Whā Older Person's Palliative Care model. Results Twenty-five studies from seven countries were reviewed, revealing that community pharmacies provide a range of services to support people with palliative care needs. The main role of community pharmacies resides in Tinana, the physical health domain of Te Whare Tapa Whā Older Person's Palliative Care model. Challenges experienced by pharmacy staff include communication with palliative care service providers and users, integrating their role into palliative care provision, addressing their educational needs, and managing palliative medication stock. Discussion The role of community pharmacy in providing palliative care is not widely understood. If the challenges identified in these studies can be addressed, there is potential for community pharmacies to offer a more proactive palliative care approach to their communities.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"398-406"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864645","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}

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Does exercise benefit people with osteoarthritis of the knee? 运动对膝关节骨关节炎患者有益吗？

IF 0.9

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24182

Vanessa Jordan

引用次数: 0

Prescribing deprescribing for polypharmacy in Aotearoa New Zealand; experiences of a medication review activity in final year medical students on a general practice module. 新西兰奥特罗阿综合药房的处方解方医学生最后一年全科实践单元的药物回顾活动的经验。

IF 0.9

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC23169

Samantha A Murton, Lynn McBain, Caroline Morris, Estelle Jaine, Lesley Gray

{"title":"Prescribing deprescribing for polypharmacy in Aotearoa New Zealand; experiences of a medication review activity in final year medical students on a general practice module.","authors":"Samantha A Murton, Lynn McBain, Caroline Morris, Estelle Jaine, Lesley Gray","doi":"10.1071/HC23169","DOIUrl":"10.1071/HC23169","url":null,"abstract":"Introduction This study explored the experiences of students and their supervisors undertaking a medication review activity during a 6-week general practice module in their final year of medical school at University of Otago, Wellington, Aotearoa New Zealand. Aim The study sought the self-reported value of the activity in learning about prescribing, reflecting on polypharmacy, deprescribing, and changes to future practice for both student and supervisor. Methods All students in the final year general practice module were invited to complete a survey over a 12-month period, as were their supervisors. An abductive thematic analysis of survey results was performed. Results Fifty-eight percent (48/87) of students and 30% (10/33) of supervisors completed surveys. Five themes were identified in the analysis of qualitative data: value of the medication review, complexities of medicines, importance of monitoring, value of resources, and supervisor reflections on value to the student. Student and supervisor responses reflected on prescribing practice beyond what medication to give when. All responses described benefit to patients and the majority expressed thoughts on how it would change their future prescribing. Discussion The medication review activity in the final year general practice module provides learning opportunities for both student and general practitioner supervisor. This activity emphasises the risks of polypharmacy and how to deprescribe. This study underlines the value of medication reviews as intraprofessional communication activities, allowing reflection beyond what medication to prescribe and for what condition. The results underline the importance of reflecting on practice and aids quality improvement benefit to patients.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"357-363"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864728","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

Practice pharmacists in the primary healthcare team in Aotearoa New Zealand: a national survey. 实习药师在初级保健队在新西兰奥特罗阿：一项全国性调查。

IF 0.9

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24049

Janet McDonald, Caroline Morris, Tara N Officer, Jacqueline Cumming, Jonathan Kennedy, Lynne Russell, Eileen McKinlay, Mona Jeffreys

{"title":"Practice pharmacists in the primary healthcare team in Aotearoa New Zealand: a national survey.","authors":"Janet McDonald, Caroline Morris, Tara N Officer, Jacqueline Cumming, Jonathan Kennedy, Lynne Russell, Eileen McKinlay, Mona Jeffreys","doi":"10.1071/HC24049","DOIUrl":"10.1071/HC24049","url":null,"abstract":"Introduction The integration of pharmacists into general practice settings is increasingly common internationally. Within Aotearoa New Zealand, the role has evolved variably in different regions. Recent health policy and professional guidance support further development. Aim To describe the current status of pharmacists working in primary healthcare settings other than community pharmacy. Methods An online survey of all pharmacists in Aotearoa New Zealand primary healthcare settings was conducted in 2022, and covered employment, current services, patient consultations, relationships with other health professionals, and service costs and benefits. Descriptive statistical analyses were performed. Results Responses from 39 pharmacists (~35% response rate) working in primary healthcare practice roles are reported. Most were female (84%), New Zealand European (81%), and 45% had Discussion Practice pharmacists have both patient- and practice-facing roles. The proportion with a prescribing qualification has increased over time. There is some capacity for additional consultations, but this requires funding, space and time spent in a service/setting.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"332-340"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864717","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

Contribution of the community pharmacist workforce to primary care through the lens of medicines classification: comparison of Aotearoa New Zealand and Australia. 从药物分类的角度看社区药师队伍对初级保健的贡献：新西兰和澳大利亚的比较。

IF 0.9

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24050

Chloë Campbell, Caroline Morris, Bruce Sunderland, Lynn McBain, Petra Czarniak

{"title":"Contribution of the community pharmacist workforce to primary care through the lens of medicines classification: comparison of Aotearoa New Zealand and Australia.","authors":"Chloë Campbell, Caroline Morris, Bruce Sunderland, Lynn McBain, Petra Czarniak","doi":"10.1071/HC24050","DOIUrl":"10.1071/HC24050","url":null,"abstract":"Introduction Optimal use of the workforce in primary care is critical due to increasing complexity and demand resulting from multi-morbidity in ageing populations. Improving public access to medicines by making them available via a pharmacist without prescription can support self-care while ensuring oversight by a health professional. Aim The aim of this paper was to identify and explore key differences between New Zealand and Australia in medicines classified nationally for pharmacist-only non-prescription supply. Methods Medicines legally classified to allow sale by a pharmacist without a prescription were identified and compared between the two countries as of 1 February 2024. Based on consensus among the research team, notable differences were subjected to qualitative consideration about how medicines classification may be used to extend the role of pharmacists in primary care. Results Overall, New Zealand has a less restrictive approach to classification than Australia providing New Zealanders increased access to medicines via a pharmacist in two key therapeutic areas: sexual and reproductive health and infection. Oral contraceptives, sildenafil, antibiotics for urinary tract infection and two COVID-19 antivirals were classified for supply without prescription via pharmacists in New Zealand but not nationally in Australia, although some alternative legislative mechanisms are emerging at state level. Discussion Medicines classification has an ongoing role in enabling pharmacist contribution to primary care. Medicines classification needs to be considered alongside commissioning of services and other policy to facilitate integration of community pharmacy-provided care within the wider primary care environment. Digital tools supporting information sharing, collaboration and communication are key.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"372-381"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864658","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

Registered nurses' antimicrobial stewardship roles: a qualitative descriptive exploratory study. 注册护士抗菌药物管理角色：一项定性描述性探索性研究。

IF 0.9

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24080

Anecita Gigi Lim, Jennifer Woods, Brenda Waite

{"title":"Registered nurses' antimicrobial stewardship roles: a qualitative descriptive exploratory study.","authors":"Anecita Gigi Lim, Jennifer Woods, Brenda Waite","doi":"10.1071/HC24080","DOIUrl":"10.1071/HC24080","url":null,"abstract":"Introduction Antimicrobial stewardship (AMS) is a global initiative aimed at promoting the responsible use of antimicrobials to combat antimicrobial resistance (AMR), a critical global health threat. In New Zealand, over 95% of antibiotics are prescribed in the community, with estimates suggesting that half of these prescriptions are for self-limiting respiratory infections, contributing significantly to AMR. Registered nurses (RNs), especially nurse practitioners and designated nurse prescribers, are well-positioned to play a pivotal role in AMS efforts due to their accessibility and broad skill set. However, their potential remains underutilised in AMS programmes. Aim This study aimed to explore the role of New Zealand Māori and non-Māori registered nurses as antimicrobial stewards within the New Zealand health care system. Methods The current knowledge and involvement in activities that mitigate the risks of infectious diseases and AMR of registered nurses was assessed. The educational and organisational support needed to enhance their leadership and engagement in AMS initiatives were identified. Results Findings highlight the need for targeted AMS education, greater participation in stewardship activities, and clarity in RN roles in collaboration with other health care professionals. This research underscores the importance of empowering registered nurses through education and organisational support to strengthen AMS and mitigate the growing threat of AMR. Discussion This study provides key insights into the leadership potential of RNs in AMS and offers recommendations for future policy and education strategies to optimise their role in New Zealand's health care.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"382-389"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864734","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