Primary Health Care Research & Development最新文献

{"title":"‘Wads up, doc’ – trends in British newspapers’ reporting of general practitioners’ pay","authors":"F. Tanner, R. Foy, Wendy J Harrison","doi":"10.1017/S1463423610000290","DOIUrl":"https://doi.org/10.1017/S1463423610000290","url":null,"abstract":"Aim To analyse trends in newspaper reporting of British general practitioners’ (GPs’) pay before and after the introduction of the new General Medical Services (GMS) contract. Background The introduction of the new GMS contract for GPs in 2004 linked pay to performance. There may have been a range of wider consequences from this, including changes in how GPs are portrayed in the media. Methods We retrospectively analysed the internet archives of five British newspapers over 2001–2008. The search terms ‘doctor’ or ‘GP’ and ‘pay’ were used in a text search. After checking the relevance of full text articles, we randomly sampled included articles to achieve a quota of up to five articles per newspaper per year. We scored article content using criteria to determine whether GPs were depicted in a positive or negative manner. Summary scores for each article were plotted using locally weighted scatterplot smoothing (LOWESS). We used a grounded approach to identify key themes. Findings Newspaper coverage of GPs’ salaries became unfavourable following the introduction of the new contract. Initial recognition of GPs’ demanding working conditions and relatively poor rewards for public service transformed into concerns about unfairly excessive income and poor use of public money. Although public trust in GPs has remained fairly robust to media criticism, it cannot be taken for granted as continued negative newspaper coverage of their pay may start to erode public trust in the profession.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78154985","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}

{"title":"‘Doing Well’: description of a complex intervention to improve depression care","authors":"Michael Smith, L. Ackland, Sinéad O’Loughlin, D. Young, A. Pelosi, J. Morrison","doi":"10.1017/S1463423610000228","DOIUrl":"https://doi.org/10.1017/S1463423610000228","url":null,"abstract":"Aim To describe the service use and clinical outcomes associated with the implementation of a complex intervention designed to improve care for people with depression in a primary care setting. Background Health systems have limited capacity to provide appropriate psychological and pharmacological treatments for people with depression. Guidance on the treatment of depression in primary care in the United Kingdom was clarified by the National Institute for Clinical Excellence in 2004. However, there is little evidence so far of substantial changes in practice: antidepressant prescriptions continue to rise, there is limited access to psychological therapies and uncertainty persists about who should be treated for what and how. Although the welfare of staff is critical to their therapeutic engagement with patients, this is rarely an explicit focus of health systems design. Method An observational study examining the implementation of a complex intervention to improve depression care called ‘Doing Well’, based in 14 general practices in a mixed urban-rural area in Scotland, United Kingdom. A small team of clinicians implemented a programme for people with low mood, depression and adjustment disorder, based on primary care. This programme incorporated a number of changes in standard mental health care, including the following: no ‘severity threshold’ for referral to secondary care; routine use of an objective measure of depression severity with continuous outcome monitoring; prompt access to guided self-help; prompt ‘step-up’ care to more formal psychological therapy or medical care, if indicated; and careful attention to staff training and satisfaction. Findings There was good fidelity to the model of care designed by the programme. There was a high demand for the new service (1.8% of the catchment population each year) but the programme had the capacity to manage this adequately. Clinical outcomes were satisfactory, and antidepressant use adhered to the guidelines.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89195955","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}

{"title":"V.A. Crooks and G.J.A. Andrews (eds) 2009: Geographies of health. Primary health care: people, practice, place . Surrey: Ashgate Publishing. 280 pp, £60 hardback. ISBN: 978-0-7546-7247-0","authors":"C. Evans","doi":"10.1017/S146342361000023X","DOIUrl":"https://doi.org/10.1017/S146342361000023X","url":null,"abstract":"","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78450716","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}

{"title":"G. Thornbory 2009: Public health nursing: a textbook for health visitors, school nurses and occupational health nurses . Chichester, UK: Wiley-Blackwell. 265 pp, £26.99 paperback. ISBN: 9781405180078","authors":"R. Newland","doi":"10.1017/S1463423610000253","DOIUrl":"https://doi.org/10.1017/S1463423610000253","url":null,"abstract":"","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77889187","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}

{"title":"R. Appleton and A. Marson 2009: Epilepsy: the facts , third edition. Oxford, UK: Oxford University Press. 186 pp, £9.99 paperback. ISBN: 9780199233687","authors":"G. Rogers","doi":"10.1017/S1463423610000241","DOIUrl":"https://doi.org/10.1017/S1463423610000241","url":null,"abstract":"","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90938212","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}

{"title":"Effectiveness of treatment prescribed by GPs: patient assessment","authors":"S. Kukkola, M. Erhola, P. Arvio, T. Poussa, P. Kekki","doi":"10.1017/S1463423610000174","DOIUrl":"https://doi.org/10.1017/S1463423610000174","url":null,"abstract":"Aim We investigated patients’ impressions of the effectiveness of treatment provided by health centre physicians. Were the patients’ expectations met, and were the consultations considered effective? Which factors affected consultation success? Background The study was conducted in 16 municipalities in the Kanta-Häme region Finland in 2004. Primary healthcare services to these municipalities are provided by five health centres. The municipalities’ total population was 166 648 (31 December 2003). Methods The data were collected during telephone interviews, supplemented by a mail survey. The study population (2600) was drawn from the Finnish Population Information System by random sampling. A total of 1751 inhabitants participated in the study (response rate: 67%). The respondents were considered able to evaluate treatment effectiveness if they had visited a health centre physician because of an illness or an accident during the past 12 months. Seven hundred and twenty-nine respondents met these criteria. Findings Most respondents (73%) found that their treatment corresponded with their expectations. According to a logistic regression analysis, the factors that best explained whether the patient’s treatment expectations were met included the physician’s respect for the patient, the consultation duration and the reason for the visit. Of the respondents, 70% thought the consultation had been effective. Factors explaining consultation effectiveness included consultation duration, physician’s respect for the patient and whether the consultation was scheduled within three days. In conclusion, the physician–patient consultations seemed to be very good and clearly worth the effort. Notably, we observed that the same factors helped to explain whether the patient’s treatment expectations were met, and whether the patient found the consultation effective.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76748101","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}

{"title":"PHC volume 11 issue 3 Cover and Front matter","authors":"","doi":"10.1017/s1463423610000320","DOIUrl":"https://doi.org/10.1017/s1463423610000320","url":null,"abstract":"","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89842958","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}

{"title":"What can we learn from effective collaboration in primary care research? One success story","authors":"J. Beasley, B. Karsh","doi":"10.1017/S1463423610000265","DOIUrl":"https://doi.org/10.1017/S1463423610000265","url":null,"abstract":"Research in primary care has been developing slowly for a variety of reasons, most of which have been well documented. Specific impediments relate, among other factors, to a relative lack of expert researchers (due in part to problems in career pathways (Kendrick and Kendall, 2008), a lack of support in academic communities and the limited availability of funds both for projects and, more importantly, for infrastructure. The paucity of expert researchers (and especially research leaders) in primary care is being addressed by programs of fellowships for future researchers in both the United Kingdom and the United States, leading to masters, doctorate degree or post-doctoral awards. Wonca (the World Organization of Family Doctors) has sponsored the Brisbane Initiative for International Leadership, which holds yearly meetings at Oxford in the United Kingdom (Care, 2010). The issue of funding has been addressed to some extent in the United States by the concerns of our NIH that research results are not reaching the front lines of patient care and the development of a funding stream for translational research but serious problems in the ‘vertical’ nature of health care and the related research funding remain (De Maeseneer et al., 2008). One strategy that may help to address all of these issues together is collaboration with other disciplines – some of which are not even medical in their focus. Our success in developing such a collaboration at the University of Wisconsin provides one example of how this can work – and opportunities to replicate this at other institutions abound, although of course the specific collaborating schools and departments will vary according to interests and capacity. Fifteen years ago, through a chance meeting, one of the authors (JWB) was informed that other faculty at our own university in the Department of Industrial Engineering shared the family physicians’ interests in the quality of work life. Neither of us was aware of our common interests, living as we often do in our own silos. This led to a collaborative study between what was then our Wisconsin Research Network (WReN), the UW Department of Family Medicine and the UW Department of Industrial and Systems Engineering. One small grant got us started. As this work progressed, we realized that we had many common interests related not only to workforce satisfaction issues but also to the areas of patient safety, practice complexity and the role of electronic health records (EHRs) in all of these issues. As our collaboration matured, it became obvious that family physicians had knowledge of the relevant questions, project design opportunities and limitations as well as access to clinicians and their practices. The industrial engineering group had intimate knowledge of the background literature and expertise in methods. In addition, they had stable infrastructure resources including graduate students. Very importantly, they had superlative research grant writing skills and ","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87718099","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}

{"title":"PHC volume 11 issue 3 Cover and Back matter","authors":"","doi":"10.1017/s1463423610000332","DOIUrl":"https://doi.org/10.1017/s1463423610000332","url":null,"abstract":"","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88217939","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}

{"title":"N. Manning and N. Tikhonova (eds) 2009: Health and Health Care in the New Russia . Farnham, England: Ashgate Publishing Limited. 314 pp, £65 includes bibliographical reference and index. ISBN: 978-0-7546-7427-6 (hardcover).","authors":"D. Javakhishvili","doi":"10.1017/S1463423610000022","DOIUrl":"https://doi.org/10.1017/S1463423610000022","url":null,"abstract":"Health and Health Care in the New Russia is the third of a trilogy dedicated to the study of the impact of the dramatic changes in post-communist Russia on the wellbeing of its population. The first two companion volumes of the trilogy are focused on socio-economic aspects such as poverty, isolation, social exclusion, work and welfare and take a longitudinal quantitative perspective of these issues. This third volume combines qualitative and epidemiological approaches to provide a unique opportunity to explore wellbeing of householders in the situation of continuous social and economic instability and uncertainty. The book is in three sections and commences with a thoughtful overview of social policy and health crisis in the new Russia. The first section – Health Beliefs in the New Russia – considers the dynamics of health of the Russian population during the transition period and focuses on measuring and understanding health that is relevant to professionals and policy makers. The second section – Health and Social Structure – discusses the impact of social and economic problems such as social inequalities, poverty and unemployment on the health of the population, whereas the third section – Health and Social Action – focuses on access to healthcare, self-care and illness prevention, the influence of gender on health behavior and attitudes towards work and healthcare. The lived experiences of 10 Russian householders over a 10-year period provides a vivid account of their hopes and fears in a period of rapid change and inequalities. The content of this high-quality volume stimulates interest and provides many issues for reflection. The technical aspects of the book, for example, the layout, tables and figures, are userfriendly and informative. The findings show that health conditions of the Russian population decreased significantly in the post-Soviet period, a powerful indicator of which being a decrease in life expectancy of Russian men. The explanation is complex and involves multi-factorial issues impacting on health such as poverty, unemployment, disabilities, social inequalities and exclusion. The authors refer to other key factors such as socio-cultural issues and inertia of the authoritarian political system. To conclude, the volume reflects a very interesting type of research that gives the reader an opportunity to gain insight into health, politics and factors influencing health in the post-Soviet Russia.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75809971","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}