Scandinavian Journal of Primary Health Care最新文献

{"title":"Importance of continuity of care from a patient perspective - a cross-sectional study in Swedish health care.","authors":"Ebba Cohen, Ida Lindman","doi":"10.1080/02813432.2023.2299119","DOIUrl":"10.1080/02813432.2023.2299119","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this study was to evaluate the patients' view on continuity of care (CoC), including preference for a certain general practitioner (GP) and importance and access to a regular general practitioner (RGP).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Primary care center in Halland County, in the western part of Sweden.</p><p><strong>Subjects: </strong>Patients ≥18 years old and having at least one appointment at the primary care center during October-December 2022.</p><p><strong>Main outcome measures: </strong>Preference for a certain GP and importance of and accessibility for an RGP.</p><p><strong>Results: </strong>The study included 404 patients. Importance of having an RGP was considered by 86% of the patients. Preference for a certain GP was thought by 73% of the patients, and when asked as a bivariate question, 69% considered having an RGP. Both the importance of an RGP and preference for a certain GP were more often considered by patients ≥65 years (<i>p</i> < .0001). Regarding accessibility, 67% of the patients reported having access to their RGP 'always/most of the time or a lot of the time' and 62% reported seeing their RGP at last visit.</p><p><strong>Conclusions: </strong>In conclusion, this study showed that the majority of patients value CoC in terms of importance of having an RGP. Older patients were more likely to have a preference for a certain GP. Two-third of the patients succeeded in seeing their RGP always or a lot of the time. The results in this study provide evidence that CoC is important for most patients, regardless of age and gender.Key pointsPrevious studies have showed that continuity of care (CoC) is important regarding mortality and morbidity. In primary care, there is a current debate regarding CoC, accessibility and the strive for CoC. This study showed that the majority of patients, regardless of age and gender, value CoC and consider it being important. However, there was a statistically significant difference regarding age, where patients above 65 years old thought it was more important to have a regular general practitioner and more often had a preference for a certain GP.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378157","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}

{"title":"The burden of persistent symptom diagnoses in primary care patients: a cross-sectional study.","authors":"Asma Chaabouni, Juul Houwen, Georg Grewer, Martin Liebau, Reinier Akkermans, Kees van Boven, Iris Walraven, Henk Schers, Tim Olde Hartman","doi":"10.1080/02813432.2023.2293930","DOIUrl":"10.1080/02813432.2023.2293930","url":null,"abstract":"<p><strong>Introduction: </strong>The burden of symptoms is a subjective experience of distress. Little is known on the burden of feeling unwell in patients with persistent symptom diagnoses. The aim of this study was to assess the burden in primary care patients with persistent symptom diagnoses compared to other primary care patients.</p><p><strong>Methods: </strong>A cross-sectional study was performed in which an online survey was sent to random samples of 889 patients with persistent symptom diagnoses (>1 year) and 443 other primary care patients after a transactional identification in a Dutch primary care data registry. Validated questionnaires were used to assess the severity of symptoms (PHQ-15), Symptom Intensity and Symptom Interference questionnaires, depression (PHQ-9), anxiety (GAD-7), quality of life (SF-12 and EQ-5D-5L)) and social functioning (SPF-ILs).</p><p><strong>Results: </strong>Overall, 243 patients completed the survey: 178 (73.3%) patients in the persistent symptom diagnoses group and 65 (26.7%) patients in the control group. In the persistent group, 65 (36.5%) patients did not have persistent symptom(s) anymore according to the survey response. Patients who still had persistent symptom diagnoses (<i>n</i> = 113, 63.5%) reported significantly more severe somatic symptoms (mean difference = 3.6, [95% CI: 0.24, 4.41]), depression (mean difference = 3.0 [95% CI: 1.24, 3.61]) and anxiety (mean difference = 2.3 [95% CI: 0.28, 3.10]) and significantly lower physical functioning (mean difference = - 6.8 [95% CI: -8.96, -3.92]).</p><p><strong>Conclusion: </strong>Patients with persistent symptom diagnoses suffer from high levels of symptoms burden. The burden in patient with persistent symptoms should not be underestimated as awareness of this burden may enhance person-centered care.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378158","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}

{"title":"Psychiatric disorders and the cancer diagnostic process in general practice: a combined questionnaire and register study exploring the patients' experiences in Denmark.","authors":"Line Flytkjær Virgilsen, Henry Jensen, Alina Zalounina Falborg, Anders Prior, Anette Fischer Pedersen, Peter Vedsted","doi":"10.1080/02813432.2023.2296944","DOIUrl":"10.1080/02813432.2023.2296944","url":null,"abstract":"<p><strong>Objective: </strong>Patients with psychiatric disorders are at risk of experiencing suboptimal cancer diagnostics and treatment. This study investigates how this patient group perceives the cancer diagnostic process in general practice.</p><p><strong>Design: </strong>Cross-sectional study using questionnaire and register data.</p><p><strong>Setting: </strong>General practice in Denmark.</p><p><strong>Subjects: </strong>Patients diagnosed with cancer in late 2016 completed a questionnaire about their experiences with their general practitioner (GP) in the cancer diagnostic process (<i>n</i> = 3411). Information on pre-existing psychiatric disorders was obtained from register data on psychiatric hospital contacts and primary care treated psychiatric disorders through psychotropic medications. Logistic regression was used to analyse the association between psychiatric disorders and the patients' experiences.</p><p><strong>Main outcome measures: </strong>Patients' experiences, including cancer worry, feeling being taken seriously, and the perceived time between booking an appointment and the first GP consultation.[Box: see text].</p><p><strong>Results: </strong>A total of 13% of patients had an indication of a psychiatric disorder. This group more often perceived the time interval as too short between the first booking of a consultation and the first GP consultation. Patients with primary care treated psychiatric disorders were more likely to worry about cancer at the first presentation and to share this concern with their GP compared with patients without psychiatric disorders. We observed no statistically significant association between patients with psychiatric disorders and perceiving the waiting time to referral from general practice, being taken seriously, trust in the GP's abilities, and the patients' knowledge of the process following the GP referral.</p><p><strong>Conclusion: </strong>The patients' experiences with the cancer diagnostic process in general practice did not vary largely between patients with and without psychiatric disorders. Worrying about cancer may be a particular concern for patients with primary care treated psychiatric disorders.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040384","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}

{"title":"Heart failure patients without echocardiography are more commonly diagnosed in hospital care and are associated with higher mortality compared to primary care.","authors":"Viktor Samskog, Jason Davidge, Anders Halling, Björn Agvall","doi":"10.1080/02813432.2023.2283186","DOIUrl":"10.1080/02813432.2023.2283186","url":null,"abstract":"<p><strong>Objective: </strong>This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings.</p><p><strong>Design: </strong>We conducted a retrospective population-based study using data from the Region Halland healthcare database in Sweden covering 330,000 residents.</p><p><strong>Subjects: </strong>From 2013-2019, 3,903 patients received an incidental heart failure diagnosis without an echocardiogram and they were followed for one year.</p><p><strong>Main outcome measures: </strong>Using logistic and Cox regression analyses, we evaluated the prevalence, clinical characteristics, and all-cause mortality at intervals of 30, 100, and 365 days post-diagnosis.</p><p><strong>Results: </strong>In this Swedish cohort, the one-year all-cause mortality rate was markedly higher for patients diagnosed in hospitals (42%) compared to those in primary care (20%, <i>p</i> < 0.001). Patients diagnosed in primary care were older and had fewer comorbidities and lower NT-proBNP levels. Hospital-diagnosed patients faced a significantly higher mortality rate in the initial 30 days but saw similar rates to primary care patients thereafter.</p><p><strong>Conclusion: </strong>In a Swedish region, heart failure diagnoses without echocardiograms were more common in hospitals, and these patients initially faced worse prognoses. After the first month, however, the prognosis of hospital-diagnosed patients mirrored that of those diagnosed in primary care. These findings emphasize the need for improved diagnostic and treatment approaches in both care settings to enhance outcomes.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138295910","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}

{"title":"To reveal disease or to promote function - that is the question.","authors":"Eivind Meland, Stefan Hjörleifsson","doi":"10.1080/02813432.2023.2274336","DOIUrl":"10.1080/02813432.2023.2274336","url":null,"abstract":"<p><p>Medicine faces challenges that indicate that it may not be sustainable. A descriptive disease concept is apt to what philosopher of science Ian Hacking called \"looping effects\", which can explain why health care is faced with insatiable demands. Diseases are not only indifferent objects with an objective existence in the biology of individuals. They are often interactive identities that have attractive properties. We suggest a shift in medical practice where descriptive perspectives are complemented with functional perspectives to enable clinicians better to help people from merging with dysfunctional disease identities.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784263","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}

{"title":"How general practitioners used job crafting strategies during the COVID-19 pandemic in Sweden","authors":"Helena Månsson Sandberg, Åsa Tjulin, Emma Brulin, Bodil J. Landstad","doi":"10.1080/02813432.2024.2309633","DOIUrl":"https://doi.org/10.1080/02813432.2024.2309633","url":null,"abstract":"General practitioners (GPs) played a crucial role in limiting the impact of the COVID-19 pandemic, and many GPs experienced they did not have the prerequisites to provide adequate care. However, GP...","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139688996","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}

{"title":"Exploring expectations and readiness for healthy lifestyle promotion in Swedish primary health care: a qualitative analysis of managers, facilitators, and professionals","authors":"Emma Nilsing Strid, Lars Wallin, Ylva Nilsagård","doi":"10.1080/02813432.2023.2301556","DOIUrl":"https://doi.org/10.1080/02813432.2023.2301556","url":null,"abstract":"Prior to a multifaceted implementation strategy for a healthy lifestyle-promoting practice the expectations of primary health care managers, appointed internal facilitators and health care professi...","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139496181","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}

{"title":"Experiences of hospital rotation from family medicine residents’ points of view an empirical holistic study","authors":"Gun Rembeck, Cristina Arnell, Eva de Fine Licht, Roya Jalaly","doi":"10.1080/02813432.2023.2299115","DOIUrl":"https://doi.org/10.1080/02813432.2023.2299115","url":null,"abstract":"Trainees or medical residents’ experiences of hospital rotations and training have not been sufficiently studied. More empirical holistic studies of experiences of General Practice/Family Medicine ...","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139084221","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}

{"title":"Cultural competency of GP trainees and GP trainers: a cross-sectional survey study","authors":"Siham Bouchareb, Amber A.W.A van der Heijden, Josine A.Y van Diesen, Maria van den Muijsenbergh, Sylvia Mennink, Henrica C.W de Vet, Annette H. Blankenstein, Petra J.M Elders","doi":"10.1080/02813432.2023.2293927","DOIUrl":"https://doi.org/10.1080/02813432.2023.2293927","url":null,"abstract":"To assess the cultural competence (CC) of GP trainees and GP trainers.Design and setting: A cross-sectional survey study was conducted at the GP Training Institute of Amsterdam UMC.We included 92 G...","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138741454","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}

{"title":"Incidence of short-term community hospital stays and clinical profiles of patients: the Finnish Community Hospital Cohort Study","authors":"Henna Saari, Eija Lönnroos, Hannu Kautiainen, Simo Kokko, Olli-Pekka Ryynänen, Pekka Mäntyselkä","doi":"10.1080/02813432.2023.2291671","DOIUrl":"https://doi.org/10.1080/02813432.2023.2291671","url":null,"abstract":"A community hospital system covers the entire population of Finland. Yet there is little research on the system beyond routine statistics. More knowledge is needed on the incidence of hospital stay...","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138628433","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}