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General practitioners' barriers to cross-sectoral collaboration on pregnant women with vulnerabilities: a cross-sectional survey in Danish general practice.
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-08 DOI: 10.1080/02813432.2024.2432371
Louise Brygger Venø, Line Bjørnskov Pedersen, Jens Søndergaard, Ruth Kirk Ertmann, Dorte Ejg Jarbøl
{"title":"General practitioners' barriers to cross-sectoral collaboration on pregnant women with vulnerabilities: a cross-sectional survey in Danish general practice.","authors":"Louise Brygger Venø, Line Bjørnskov Pedersen, Jens Søndergaard, Ruth Kirk Ertmann, Dorte Ejg Jarbøl","doi":"10.1080/02813432.2024.2432371","DOIUrl":"https://doi.org/10.1080/02813432.2024.2432371","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy vulnerability contributes to poor perinatal mental health. Proper cross-sectoral collaboration may mitigate perinatal mental health problems. General practitioners (GPs) often face barriers when assessing pregnancy vulnerability, but little is known about GPs' perceived barriers to the cross-sectoral collaboration on vulnerable pregnant women.</p><p><strong>Objective: </strong>To explore GPs' barriers to cross-sectoral collaboration on pregnant women with vulnerabilities, and how barriers are associated with the organization of antenatal care (ANC) and general practice characteristics.</p><p><strong>Design, setting and subjects: </strong>A cross-sectional questionnaire study among Danish GPs (<i>n</i> = 3465).</p><p><strong>Main outcome measures: </strong>Descriptive statistics according to the Theoretical Domains Framework describes the barriers to collaboration. Analytical statistics with ordered logistic regression models demonstrate associations between selected barriers (the main outcome measures) and organization of ANC, GP and practice, characteristics.</p><p><strong>Results: </strong>A total of 760 GPs (22%) participated. Perceived GP barriers to collaboration were lacking knowledge of ANC levels relevant to vulnerable pregnant women, insufficient information on vulnerability indicators from collaborating parties, heavy workload and insufficient remuneration for collaborative meetings. Being young were associated with insufficient GP knowledge of ANC levels. Old age was associated with less likelihood of experiencing heavy workload as a barrier.</p><p><strong>Conclusions: </strong>Barriers to collaboration on vulnerable pregnant women were associated with some GP-organizational characteristics including low experience in collaborating with partners in ANC, and GP characteristics, such as age. Reducing general practice workload, e.g. by reorganizing priority areas, releasing more time to vulnerable patients, and improving cross-sectoral information sharing on vulnerability might improve collaboration on vulnerable pregnant women.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Care in the era of digital health: experiences from Norwegian general practitioners.
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-05 DOI: 10.1080/02813432.2024.2437417
Damoun Nassehi, Ellen Ramvi
{"title":"Care in the era of digital health: experiences from Norwegian general practitioners.","authors":"Damoun Nassehi, Ellen Ramvi","doi":"10.1080/02813432.2024.2437417","DOIUrl":"https://doi.org/10.1080/02813432.2024.2437417","url":null,"abstract":"<p><strong>Objective: </strong>This study explores the experiences of General Practitioners (GPs) in Norway, examining the role of care in their practice and the impact of digital health technologies on their caregiving approach.</p><p><strong>Design: </strong>A qualitative study employing semi-structured interviews. The data was analysed by systematic text condensation.</p><p><strong>Setting: </strong>Conducted in various general practice settings within an urban region in southwestern Norway.</p><p><strong>Subjects: </strong>Eleven GPs were interviewed, chosen to reflect a diverse mix of ages, genders, and professional experiences.</p><p><strong>Results: </strong>The findings reveal that care occupied a central and multifaceted role in GPs daily practice, and that the care aspect of their practice was experienced as a source of personal fulfilment. Technologies such as Secure Digital Messaging (SDM) and Electronic Health Records could enhance the efficiency of care delivery and facilitate better management of patient interactions, however these technologies also present challenges in maintaining the depth of personal engagement that is central to the care ethics that characterise their caring role. The GPs emphasized the necessity of integrating digital tools in a way that supports the relational and ethical foundations of their caregiving role.</p><p><strong>Conclusion: </strong>This study underscores the enduring importance of care in general practice, even as digital technologies become increasingly prevalent. GPs maintain their caregiving roles by navigating the complexities of digital tools, highlighting the need for a careful balance between leveraging digital advancements and preserving the core values of care. The findings suggest a need for ongoing evaluation of digital tools to align them with the ethical foundations of care in general practice.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study.
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-02 DOI: 10.1080/02813432.2024.2434123
Märit Löfgren, Karin Törnbom, Daniel Gyllenhammar, Lena Nordeman, Gun Rembeck, Cecilia Björkelund, Irene Svenningsson, Dominique Hange
{"title":"A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study.","authors":"Märit Löfgren, Karin Törnbom, Daniel Gyllenhammar, Lena Nordeman, Gun Rembeck, Cecilia Björkelund, Irene Svenningsson, Dominique Hange","doi":"10.1080/02813432.2024.2434123","DOIUrl":"https://doi.org/10.1080/02813432.2024.2434123","url":null,"abstract":"<p><strong>Background: </strong>Consensus on priorities to optimize the sick leave and rehabilitation process (SRP) is lacking.</p><p><strong>Objective: </strong>To explore perspectives of stakeholders in the SRP on bridging the gap between desired process scope, and actual practice, from a multi-professional, multi-organizational, and interdisciplinary approach.</p><p><strong>Design and setting: </strong>Focus group interviews were conducted with various SRP frontline professionals in Region Västra Götaland, Sweden, using purposive sampling to capture a range of experiences. Participants discussed their perceptions of critical changes and priorities needed to meet patients' SRP needs in a primary care context. All interviews were analyzed using systematic text condensation, as described by Malterud.</p><p><strong>Subjects: </strong>General practitioners (<i>n</i> = 6), rehabilitation coordinators and licensed healthcare professionals from primary healthcare (<i>n</i> = 13), administrators from the Social Insurance Agency, the Employment Agency and Social Services (<i>n</i> = 12).</p><p><strong>Results: </strong>Through data analysis, the following themes emerged: 1) The need for rules and regulations to enable coherent process governance 2) Challenges and opportunities in person-centered SRP: Professional collaboration, organizational priorities, and the need for enhanced leadership, and 3) Balancing resources and patient needs in the SRP: How to improve care quality and accessibility. In summary, participants mainly discussed how to improve process efficiency and quality of care while balancing available resources and a heavy workload. A main goal was to prevent negative spirals of suboptimal decision-making in individual cases, which could lead to increased work, unfortunate outcomes, and patient suffering.</p><p><strong>Conclusions: </strong>This qualitative study indicated that gaps between a desired process scope and actual practice might be bridged by enabling coherent cross-organizational process governance, prioritizing person-centered ways of working, and balancing available resources and workload. The above changes were believed to improve process quality and overall efficiency.</p><p><strong>Trial registration: </strong>The study project plan was pre-registered on September 21st, 2020, in the database FOU i VGR (researchweb.org), project number 274941.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the impact of mental and work-related stress on sick leave among middle-aged women: observations from the population study of women in Gothenburg, Sweden. 探索精神压力和工作压力对中年妇女病假的影响:瑞典哥德堡妇女人口研究观察。
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-01 Epub Date: 2024-07-29 DOI: 10.1080/02813432.2024.2380925
Kirsten Mehlig, Amanda von Below, Kristina Holmgren, Cecilia Björkelund, Lauren Lissner, Ingmarie Skoglund, Magnus Hakeberg, Dominique Hange
{"title":"Exploring the impact of mental and work-related stress on sick leave among middle-aged women: observations from the population study of women in Gothenburg, Sweden.","authors":"Kirsten Mehlig, Amanda von Below, Kristina Holmgren, Cecilia Björkelund, Lauren Lissner, Ingmarie Skoglund, Magnus Hakeberg, Dominique Hange","doi":"10.1080/02813432.2024.2380925","DOIUrl":"10.1080/02813432.2024.2380925","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women.</p><p><strong>Design: </strong>The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline.</p><p><strong>Subjects: </strong>A cohort of women aged 38 and 50 in 2016/17 (<i>n</i> = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave ± 2 weeks around baseline examination; 493 women had complete data on stress exposure.</p><p><strong>Methods: </strong>We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity.</p><p><strong>Results: </strong>Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2-6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3-4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3-3.6), and low decision latitude, OR = 1.7 (95% CI 1.0-2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment.</p><p><strong>Conclusion: </strong>Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"704-713"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary healthcare professionals' attitudes toward patients with current or previous drug use. 初级医疗保健专业人员对目前或曾经吸毒患者的态度。
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-01 Epub Date: 2024-05-09 DOI: 10.1080/02813432.2024.2349063
Lars Garpenhag, Disa Dahlman
{"title":"Primary healthcare professionals' attitudes toward patients with current or previous drug use.","authors":"Lars Garpenhag, Disa Dahlman","doi":"10.1080/02813432.2024.2349063","DOIUrl":"10.1080/02813432.2024.2349063","url":null,"abstract":"<p><strong>Objective: </strong>People with current or previous drug use (PCPDU) often lack long-term healthcare contacts in primary healthcare (PHC). While international research has shown negative attitudes toward PCPDU in healthcare, PHC professionals' attitudes toward PCPDU have not been assessed in Sweden. The aim of this study was to investigate PHC professionals' attitudes to PCPDU, and to compare attitudes toward people who actively use illicit drugs with those toward patients in opioid assisted treatment (OAT).</p><p><strong>Design: </strong>In this survey study, respondents were asked for background data, and their attitudes toward patients using illicit drugs, OAT patients and patients with depression were assessed by using an adapted version of the Medical Condition Regard Scale (MCRS).</p><p><strong>Setting and subjects: </strong>Nurses and physicians at primary healthcare centers (PHCCs) in Skåne, Sweden.</p><p><strong>Main outcome measures: </strong>Mean MCRS scores, dichotomized responses to MCRS items, and associations between MCRS score and background covariates (age, sex, profession and duration of professional experience).</p><p><strong>Results: </strong>Eighty-nine PHC professionals from 13 PHCCs responded (approximately 39% of relevant workforce). The median MCRS score was 44 for patients with illicit drug use and patients in OAT, and 51 for patients with depression. Drug use and OAT displayed similar minimum, maximum and interquartile range values as well, while scores regarding depression displayed a higher minimum value and smaller spread. No significant associations were found between background covariates and MCRS scores for either drug use or OAT.</p><p><strong>Conclusions: </strong>The results indicate widespread negative attitudes to PCPDU, with implications for health equity in the clinic. Further studies are needed to see if the results reflect attitudes in Swedish PHC in general.Key PointsPeople with current or previous drug use (PCPDU) often lack necessary primary healthcare (PHC) and are commonly subject to prejudice.Swedish PHC professionals held more negative attitudes toward PCPDU than toward patients with depression.Attitudes toward patients with active drug use and patients in opioid assisted treatment (OAT) were almost identical.Study findings have potential implications for the health of PCPDU as well as health equity in the clinic.Widespread negative attitudes to PCPDU in our sample indicate the need of larger-scale studies of attitudes toward PCPDU in Swedish PHC.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"525-531"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How do patients experience and use home blood pressure monitoring? A qualitative analysis with UTAUT 2. 患者如何体验和使用家庭血压监测?使用UTAUT 2进行定性分析。
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-01 Epub Date: 2024-06-20 DOI: 10.1080/02813432.2024.2368849
Peter Nymberg, Ida Bandel, Beata Borgström Bolmsjö, Moa Wolff, Susanna Calling, Ann-Chatrin Linqvist Leonardsen, Veronica MilosNymberg
{"title":"How do patients experience and use home blood pressure monitoring? A qualitative analysis with UTAUT 2.","authors":"Peter Nymberg, Ida Bandel, Beata Borgström Bolmsjö, Moa Wolff, Susanna Calling, Ann-Chatrin Linqvist Leonardsen, Veronica MilosNymberg","doi":"10.1080/02813432.2024.2368849","DOIUrl":"10.1080/02813432.2024.2368849","url":null,"abstract":"<p><p><i>Background:</i> Hypertension is an important cardiovascular risk factor with potentially harmful consequences. Home blood pressure monitoring is a promising method for following the effect of hypertension treatment. The use of technology-enabled care and increased patient involvement might contribute to more effective treatment methods. However, more knowledge is needed to explain the motivations and consequences of patients engaging in what has been called 'do-it-yourself healthcare'. <i>Aim:</i> This study aimed to investigate patients' experiences of home blood pressure monitoring through the theoretical frame of the Unified Theory of Acceptance and Use of Technology (UTAUT 2). <i>Methods:</i> The study had a qualitative design, with focus group interviews using the web-based platform Zoom. The data were analysed using qualitative deductive content analysis, inspired by Graneheim and Lundman. <i>Results:</i> The results are presented using the seven theoretical constructs of UTAUT 2: Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, Hedonistic Motivation, Price Value and Habit. We found one overarching theme ‒ 'It's all about the feeling of security'. The patients were influenced by relatives or healthcare personnel and experienced the home monitoring process as being easy to conduct. The patients emphasised that the quality of the blood pressure monitor was more important than the price. Patients reported home monitoring of blood pressure as a feasible method to follow-up care of their hypertension. <i>Discussion:</i> This study indicates that among motivated patients, home blood pressure measurement entails minimal effort, increases security, and leads to better communication about blood pressure between healthcare personnel and patients.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"593-601"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interpersonal contact and altered sensory conditions in video consultation - a qualitative interview study in Danish general practice. 视频咨询中的人际接触和感官条件改变--丹麦全科医生的定性访谈研究。
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-01 Epub Date: 2024-07-16 DOI: 10.1080/02813432.2024.2376744
Frida Greek Kofod, Elisabeth Assing Hvidt, Anne Beiter Arreskov, Ann Dorrit Guassora
{"title":"Interpersonal contact and altered sensory conditions in video consultation - a qualitative interview study in Danish general practice.","authors":"Frida Greek Kofod, Elisabeth Assing Hvidt, Anne Beiter Arreskov, Ann Dorrit Guassora","doi":"10.1080/02813432.2024.2376744","DOIUrl":"10.1080/02813432.2024.2376744","url":null,"abstract":"<p><strong>Objective: </strong>To explore possible challenges to General Practitioners' (GPs') interpersonal contact with patients in video consultations (VCs), and learn how they change their communication strategies to carry out medical work in a setting with altered sensory conditions.</p><p><strong>Design, setting, subjects: </strong>The study included 6 GPs from the Copenhagen area, with different levels of experience of VC. The data consist of 6 interviews with GPs, held in 2021-2022. The semi-structured interviews included playback of a recorded VC between each GP and a patient, inspired by the Video-Stimulated Interview technique. Interviews were transcribed and analyzed using Interpretative Phenomenological Analysis (IPA).</p><p><strong>Results: </strong>GPs experienced alterations in the sensation of their patients in VCs, and worried about missing something important, including assessing the patient. Generally, GPs felt that interpersonal contact was good enough for the purpose. GPs compensated for altered sensory conditions on video by asking more questions, repeating their advice, and meta-communicating. They used their senses of sight and hearing relatively more in VCs. Compensation also took the form of triage, so that consultations on sensitive topics or with new patients were not selected to take place on video.</p><p><strong>Conclusion and implications: </strong>By compensating for altered sensory conditions in VCs, GPs can carry out their medical work sufficiently well and sustain the best possible interpersonal contact. Our findings are useful for establishing ways to maintain good interpersonal contact between GPs and patients in VCs.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"650-658"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Parents of children with atopic diseases - experiences with care and the interaction with healthcare professionals over time. 特应性疾病患儿的父母--长期护理经验以及与医护人员的互动。
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-01 Epub Date: 2024-06-03 DOI: 10.1080/02813432.2024.2357794
Gitte Færk, Elisabeth Søndergaard, Lone Skov, Jacob Pontoppidan Thyssen, Kirsten Skamstrup Hansen, Susanne Reventlow
{"title":"Parents of children with atopic diseases - experiences with care and the interaction with healthcare professionals over time.","authors":"Gitte Færk, Elisabeth Søndergaard, Lone Skov, Jacob Pontoppidan Thyssen, Kirsten Skamstrup Hansen, Susanne Reventlow","doi":"10.1080/02813432.2024.2357794","DOIUrl":"10.1080/02813432.2024.2357794","url":null,"abstract":"<p><strong>Objective: </strong>To explore how the parents of children with atopic dermatitis and allergic diseases such as food allergy, allergic rhinoconjunctivitis, and asthma experience interactions with the Danish healthcare system over time.</p><p><strong>Design and methods: </strong>A qualitative design with individual in-depth interviews. The analysis was inspired by Systematic Text Condensation.</p><p><strong>Subjects: </strong>Eleven parents of children with atopic dermatitis and allergic diseases who received treatment at hospitals in the Capital Region of Denmark. The families had experiences of cross-sectoral patient care.</p><p><strong>Results: </strong>Despite having the same diseases, the children's care pathways were very different. Mapping demonstrated the intricacy of care pathways for this group of children. We identified three aspects that impacted interaction with healthcare: responsibility, tasks, and roles. The families experienced care when the distribution of tasks and responsibilities associated with treatment and system navigation were consistent with both their expectations and their actual experiences. At the same time, families frequently experienced limited collaboration between healthcare professionals resulting in perceived fragmented care and an extended role for parents as care coordinators. Families felt cared for when healthcare professionals knew both their biomedical and biographical circumstances, and adjusted the level of support and care in accordance with the families' particular needs, expectations, and evolving competences.</p><p><strong>Conclusion: </strong>We suggest that a possible pathway to improve care may be through a partnership approach as part of family-centered care, with general practitioners having a key role in helping to articulate the individual needs and expectations of each family.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"550-559"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient experiences and clinical outcomes of admissions to municipal acute wards versus a hospital: a multicentre randomised controlled trial in Norway. 入住市立急症病房与入住医院的患者体验和临床结果对比:挪威的一项多中心随机对照试验。
IF 16.4 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-01 Epub Date: 2024-07-15 DOI: 10.1080/02813432.2024.2377727
Vivian Nystrøm, Hilde Lurås, Tron Moger, Ann-Chatrin Linqvist Leonardsen
{"title":"Patient experiences and clinical outcomes of admissions to municipal acute wards versus a hospital: a multicentre randomised controlled trial in Norway.","authors":"Vivian Nystrøm, Hilde Lurås, Tron Moger, Ann-Chatrin Linqvist Leonardsen","doi":"10.1080/02813432.2024.2377727","DOIUrl":"10.1080/02813432.2024.2377727","url":null,"abstract":"<p><strong>Background: </strong>In Norway, municipal acute wards (MAWs) were implemented as alternatives to hospitalisation. Evaluations of the quality of MAW services are lacking. The primary objective of this study was to compare patient experiences after admission to a MAW versus to a hospital. The secondary objective was to compare 'readmissions', 'length of stay', 'self-assessed health-related quality of life' as measured by the EuroQol 5 items 5 level (EQ-5D-5L) index, and 'health status' measured by the RAND-12, in patients admitted to a MAW versus a hospital.</p><p><strong>Methods: </strong>A multicentre randomised controlled trial (RCT), randomising patients to either MAW or hospital.</p><p><strong>Results: </strong>In total, 164 patients were enrolled in the study; 115 were randomised to MAW and 49 to hospital. There were no significant differences between the MAW and hospital groups regarding patient experience, which was rated positively in both groups. Patients in the MAW group reported significantly better physical health status as measured by the RAND-12 four to six weeks after admittance than those randomised to hospital (physical component summary score, 31.7 versus 27.1, <i>p</i> = 0.04). The change in EQ-5D index score from baseline to four to six weeks after admittance was significantly greater among patients randomised to MAWs versus hospitals (0.20 versus 0.02, <i>p</i> = 0.03). There were no other significant differences between the MAW and hospital groups.</p><p><strong>Conclusions: </strong>In this study, patient experiences and readmissions were similar, whether patients were admitted to a MAW or a hospital. The significant differences in health status and quality of life favouring the MAWs suggest that these healthcare services may be better for elderly patients. However, unfortunately we did not reach the planned sample size due to challenges in the data collection posed by the Covid-19 pandemic.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"659-667"},"PeriodicalIF":16.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Healthcare seeking - who, when and why? 寻求医疗保健--谁、何时、为什么?
IF 1.9 3区 医学
Scandinavian Journal of Primary Health Care Pub Date : 2024-12-01 Epub Date: 2024-09-23 DOI: 10.1080/02813432.2024.2407878
Peter Haastrup, Linda Huibers
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