Scandinavian Journal of Primary Health Care最新文献

{"title":"Evaluating general practitioners' focused lung ultrasound competence and findings in patients with suspected community-acquired pneumonia in general practice.","authors":"Julie Jepsen Strøm, Camilla Aakjær Andersen, Martin Bach Jensen, Janus Laust Thomsen, Christian B Laursen, Søren Helbo Skaarup, Hans Henrik Lawaetz Schultz, Malene Plejdrup Hansen","doi":"10.1080/02813432.2024.2447083","DOIUrl":"10.1080/02813432.2024.2447083","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate general practitioners' (GPs') ability to perform focused lung ultrasound (FLUS) following a training program and assess FLUS feasibility in general practice. Also, to describe FLUS findings and evaluate GPs' ability to interpret these in adults with acute lower respiratory tract infection (LRTI) when pneumonia is suspected and assess GPs' perception of FLUS impact.</p><p><strong>Methods: </strong>Nine GPs, using point-of-care ultrasound, completed a FLUS training program. Adults (≥ 18 years) with acute cough (< 28 days) and at least one other symptom of acute LRTI, where the GP suspected pneumonia, were subsequently included. All patients received FLUS. The GPs reported FLUS findings, feasibility, and perception of FLUS impact. Recorded FLUS videos from all patients were reviewed by two specialists (Specialist Reference). The specialists assessed FLUS image quality. Agreements between the GPs and the Specialist Reference on FLUS findings were used to evaluate GPs' ability to interpret FLUS.</p><p><strong>Results: </strong>Of 91 patients included, FLUS image quality was acceptable or higher in 84 patients (92.4%). FLUS proved feasible with only two scans not completed. The GPs reported FLUS pathological findings in 51.7% of patients in 78% agreement with the Specialist Reference and Cohen's kappa 0.56. Focal B-lines represented the most frequent pathological findings. The GPs perceived that FLUS impacted change in tentative diagnosis and/or plans for treatment and/or visitation in 29 (32.0%) of patients.</p><p><strong>Conclusion: </strong>After the training, the GPs performed FLUS well. Interpretation of FLUS pathology presence was of moderate agreement. The GPs perceived that FLUS had impact on patient management.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov NCT04711031.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"359-369"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906964","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":"Health-related quality of life, lifestyle habits and chronic pain in individuals with knee pain - a 2-year follow-up study.","authors":"Charlotte Sylwander, Emma Haglund, Ingrid Larsson, Maria L E Andersson","doi":"10.1080/02813432.2025.2452916","DOIUrl":"10.1080/02813432.2025.2452916","url":null,"abstract":"<p><strong>Introduction: </strong>Knee pain increases the risk of developing chronic widespread pain (CWP) and knee osteoarthritis (KOA). The prevalence of CWP and KOA has increased, and there is a need for early prevention. Therefore, the aim was to examine the associations of health-related quality of life (HRQoL) and lifestyle habits with chronic pain at a two-year follow-up in individuals with knee pain.</p><p><strong>Methods: </strong>A two-year longitudinal cohort study including 251 individuals aged 30-60 years reporting knee pain at baseline. HRQoL was measured via the Short-Form General Health Survey (SF-36), and lifestyle habits included questions on overweight, physical activity, diet, alcohol and tobacco use. Pain was assessed with a pain mannequin. Differences in health status and lifestyle habits over time in groups with unchanged no chronic pain (NCP), transitioned to less and more pain, and unchanged CWP were analysed using Wilcoxon's, McNemar's and Friedman's tests. Multinominal regression analysis was performed to study associations with reporting chronic pain at follow-up.</p><p><strong>Results: </strong>Reporting better HRQoL across various SF-36 concepts and normal weight at baseline was associated with reporting NCP after two years. A few changes were made regarding HRQoL and lifestyle habits over the course of two years, but an increase in general health was associated with transitioning to less pain.</p><p><strong>Conclusions: </strong>During primary care visits for knee pain with a combination of overweight or lower HRQoL, individuals should receive comprehensive attention to prevent the development of CWP. Future studies should investigate the associations further.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"422-433"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010975","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":"'You would rather not fill your body with pills'-patient perspectives on polypharmacy and medication reviews by pharmacists in general practice.","authors":"Josefine Graabæk Als, Janus Laust Thomsen, Sabrina Storgaard Sørensen, Søren Paaske Johnsen, Camilla Hoffmann Merrild","doi":"10.1080/02813432.2025.2451660","DOIUrl":"10.1080/02813432.2025.2451660","url":null,"abstract":"<p><strong>Introduction: </strong>Polypharmacy is widespread. The demographic shift toward older patients receiving multiple medications increases risk and drug-related problems in these patients.</p><p><strong>Objective: </strong>To investigate patient perspectives on polypharmacy and the experienced effects of medication reviews by pharmacists in general practice.</p><p><strong>Methods: </strong>Twenty-two semi-structured interviews with patients with polypharmacy (>5 medications) from 6 different general practice clinics in the North Denmark region. The interviewees were from the intervention arm of a randomized clinical trial and had received a medication review with a pharmacist in addition to the usual annual check-up in general practice. Participants were interviewed at baseline (no later than 2 weeks after the medication review) and again at follow-up (6 months after the medication review). The interviews were transcribed verbatim and thematically analyzed with an inductive approach.</p><p><strong>Results: </strong>The patients' narratives show that they face many difficulties in their everyday lives, making it hard for them to live up to society's ideal of what it is to live a healthy life. The interviewees were generally positive toward the intervention and felt comfortable having a pharmacist conduct the medication review in their usual general practice clinic. Some interviewees gained more insight into their medication from the review.</p><p><strong>Conclusion: </strong>Patient narratives give a comprehensive understanding of the challenges of polypharmacy. Having pharmacists conduct medication reviews in general practice could ensure more time and focus on patients and their medication management. The combined knowledge of physicians, nurses, and pharmacists regarding thorough polypharmacy management is recommended.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"411-421"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971999","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":"Considerations and experiences with healthcare-seeking during the first COVID-19 lockdown in Denmark.","authors":"Isabella Raasthøj Holst, Lisa Maria Sele Sætre, Gitte Bruun Lauridsen, Kirubakaran Balasubramaniam, Peter Haastrup, Sonja Wehberg, Dorte Ejg Jarbøl","doi":"10.1080/02813432.2025.2452924","DOIUrl":"10.1080/02813432.2025.2452924","url":null,"abstract":"<p><strong>Aim: </strong>To (1) examine considerations before and experiences with GP contact during the first COronaVIrus Disease 2019 (COVID-19) lockdown among Danish citizens; (2) analyse the associations with sex, age, chronic disease, and socioeconomic factors; and (3) explore changes in healthcare-seeking behaviour post-pandemic.</p><p><strong>Method: </strong>A total of 100,000 Danes aged 20 years or older, randomly selected in the general population, were invited to participate in a survey examining considerations and experiences with healthcare seeking during the first COVID-19 lockdown. Data were collected in spring 2022 and linked to register data on socioeconomic factors. Descriptive statistics and multivariable logistic regression models were applied.</p><p><strong>Results: </strong>Of the 27,369 eligible individuals, 18% reported a need to contact their GP. Being worried about burdening the healthcare system was most frequently reported (45%), followed by being in doubt about acceptable contact reasons (33%), and concern about infection (24%). Although 44% of those who needed to contact their GP found the digital solutions advantageous, individuals frequently found it difficult to discuss symptoms by telehealth (29%) and that they were examined less thoroughly. Generally, women, younger people, and individuals with lower socioeconomic status were more likely to be worried and report difficulties with contact to general practice. Some 86% of the respondents reported no changes in healthcare-seeking behaviour post-pandemic.</p><p><strong>Conclusion: </strong>The results may assist in the organisation of healthcare in case of future lockdowns. Yet, the COVID-19 pandemic has only slightly affected the healthcare-seeking behaviour in the Danish general population.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"434-447"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010967","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":"Patients' experiences with GLP1-RAs - a systematic review.","authors":"Christoffer Kraul Ibsen, Marius Brostrøm Kousgaard, Sofie Olsen, Ann-Kathrin Lindahl Christiansen, Catharina Thiel Sandholdt, Rasmus Rørth, Gritt Overbeck","doi":"10.1080/02813432.2025.2477141","DOIUrl":"10.1080/02813432.2025.2477141","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a complex condition and a recognized public health challenge. Previous treatment options were associated with high failure rates, but recent trials have shown that significant weight loss can be achieved with GLP1-RAs. However, little is known about the patient's experiences with GLP1-RAs.</p><p><strong>Objectives: </strong>This paper systematically reviews research on patients' experience with GLP1-RAs.</p><p><strong>Methods: </strong>A literature search in PubMed, PsycINFO, Embase and Sociological Abstracts included studies on adults' experiences with GLP1-RAs, regardless of methodology. Exclusions of studies: mental illness, pregnancy, former bariatric surgery, PCOS. Study quality and transparency were assessed according to design, using thematic analysis for synthesis.</p><p><strong>Results: </strong>Nine studies, selected from 7,607 records, encompassed three qualitative studies (semi-structured interviews), three RCTs, two narrative reviews and one survey study. The analysis identified five key themes: (1) Patients are willing to accept adverse events, like gastrointestinal disorders, for successful weight loss, (2) Patients experience improved physical functioning, well-being, and active daily living as a result of weight loss, (3) Patients express diverse opinions and skills regarding the medication's usability, (4) Patients believe that the medication improves their ability to manage sweet cravings, (5) Gender seems to affect patients' experiences with the medication, with females reporting more benefits than males.</p><p><strong>Conclusion: </strong>Despite a huge demand and usage of GLP1-RAs, qualitative research on patients' experiences is scarce. Further studies are crucial for understanding short and long-term patient experiences.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"370-379"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606330","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":"Exploring participants' characteristics and self-assessed readiness to conduct clinical trials in general practice - baseline analysis of the RaPHaeL practice-based research network.","authors":"Alexander Bauer, Larissa Virnau, Eric Sven Kroeber, Heidrun Lingner, Markus Bleckwenn, Thomas Frese, Kathleen Denny, Annett Braesigk, Tobias Deutsch","doi":"10.1080/02813432.2024.2427272","DOIUrl":"10.1080/02813432.2024.2427272","url":null,"abstract":"<p><strong>Background: </strong>Primary care is integral to healthcare systems extending beyond traditional illness management to include preventive care, chronic disease management, and health promotion. Practice-based research networks (PBRNs) have emerged as essential infrastructures for conducting clinical research in primary care. This study explores the establishment of the 'Research-Practices Halle-Leipzig' (RaPHaeL) PBRN in Germany, evaluating the characteristics and research readiness of participating practices.</p><p><strong>Methods: </strong>A cross-sectional survey (MORNING II) was conducted among all general practitioners (GPs) joining the RaPHaeL PBRN, assessing socio-demographic characteristics, practice infrastructure, and research readiness. After a descriptive analysis, we compared data with a previous study (MORNING) to examine potential differences between PBRN participants and non-participants. We developed a research readiness score (RRS) to quantify practices' ability to perform clinical research subtasks.</p><p><strong>Results: </strong>The response rate was 97.1% and our participants were often male, involved in undergraduate education, generally interested in research or had previous research experiences. However, they differed widely in age and size, staff structure, and patient demographics of their practices. Initially, around two-thirds of the practices were not sufficiently prepared to conduct clinical trials (self-assessed feasibility of relevant subtasks). If further research and documentation tasks are required, patient recruitment estimations are lower than for patient identification and information.</p><p><strong>Conclusion: </strong>This study highlights the variability in research readiness among GP practices and shows the need for targeted training. By systematically assessing and enhancing research capabilities of participating GPs, PBRNs can facilitate high-quality clinical research in primary care to improve patient outcomes and healthcare delivery.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"270-280"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626334","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":"Validation of point-of-care tests used at in-home assessments among older adults in primary care.","authors":"Siri Aas Smedemark, Ditte Beck Jepsen, Karen Andersen-Ranberg, Mads Nybo","doi":"10.1080/02813432.2024.2426162","DOIUrl":"10.1080/02813432.2024.2426162","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing acute disease in older adults is challenged by vague and atypical symptoms. Point-of-care tests (POCTs) at home may improve diagnostics and clinical decision-making. We compared various POCT devices to routine testing in acutely ill older adults to assess their clinical reliability.</p><p><strong>Methods: </strong>We enrolled participants aged 65+ years requiring acute in-home assessment with signs of acute conditions. Venous and capillary blood samples were collected and analysed on-site using POCT, while identical samples were transported and analysed in a routine laboratory. Agreement between POCT and laboratory testing was assessed using scatter plots with linear regression, Pearson's correlation coefficient (PCC), limits of agreement, and Bland-Altman plots. Misclassification rates were calculated based on clinically meaningful cut-offs to assess POCT's clinical reliability.</p><p><strong>Results: </strong>We included 100 participants with a mean age of 81.6 (±8.4 SD) years. Strong correlation was found between POCT and routine measurements (PCC: 0.76-0.94 for capillary samples and 0.85-0.98 for venous samples). Venous samples showed higher PCC than capillary, except for neutrophils (0.93 for capillary, 0.89 for venous). Misclassification occurred in capillary samples for haemoglobin (10/62) and total WBC (6/50), while in venous samples, misclassification was observed for haemoglobin (4/54), total WBC (4/50), K⁺ (5/47), urea (5/47), and creatinine (3/42). No misclassification was observed for Na⁺.</p><p><strong>Conclusion: </strong>POCT provides acceptable, clinically reliable measurements in acutely ill older adults, potentially enhancing diagnostics and treatments during in-home assessment. Venous blood testing is preferable due to a lower misclassification rate, but capillary blood remains a pragmatic alternative, despite higher variation and inaccuracy.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"260-269"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626335","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":"Effects on HbA1c of referral of type 2 diabetes patients to secondary care.","authors":"Kjersti Nøkleby, Anne K Jenum, Esben Selmer Buhl, Tor Claudi, John G Cooper, Signe Flottorp, Karianne F Løvaas, Sverre Sandberg, Tore Julsrud Berg","doi":"10.1080/02813432.2024.2433107","DOIUrl":"10.1080/02813432.2024.2433107","url":null,"abstract":"<p><strong>Aim: </strong>To study trajectories of HbA1c in type 2 diabetes (T2D) patients referred to diabetes outpatient clinics (DOCs), and to explore characteristics of referrals and patient pathways in patients treated in DOCs.</p><p><strong>Methods: </strong>We retrospectively followed T2D patients from the Norwegian population-based ROSA 4 study to identify persons with T2D who were referred to a DOC. We used latent class trajectory modelling to identify subgroups of patients with similar patterns of HbA1c one year before to one year after the first consultation at a DOC. We performed multinomial regression analyses to identify baseline characteristics associated with group membership.</p><p><strong>Results: </strong>Four hundred and two of 6716 T2D patients started treatment at a DOC, constituting a yearly starting rate of 1.5%. We identified three classes of HbA1c trajectories: (1) stable moderate hyperglycaemia (75%); (2) severe hyperglycaemia with a decline in HbA1c around referral (14%) and (3) severe hyperglycaemia with a decline in HbA1c after starting treatment at the DOC (11%). HbA1c trajectories were associated with diabetes duration RRR 0.92, CI (0.87, 0.97) in class 2 vs. 1 and 0.93 (0.88, 0.98) in class 3 vs. 1. Some differences were found between clinics in rejection rate, processes of care, and duration of follow-up.</p><p><strong>Conclusions: </strong>Norwegian GPs handle most T2D patients themselves. Those with T2D and severe hyperglycaemia had a considerable benefit from being referred to a DOC, though with two separate trajectories: One where HbA1c improved around the time of referral, and another that improved after starting in a DOC.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"313-323"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771839","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":"A 'normal' life: a qualitative study exploring parents' experiences of everyday life with a child diagnosed with atopic dermatitis and atopic comorbidities.","authors":"Gitte Færk, Elisabeth Søndergaard, Lone Skov, Kirsten Skamstrup Hansen, Susanne Reventlow","doi":"10.1080/02813432.2024.2440777","DOIUrl":"10.1080/02813432.2024.2440777","url":null,"abstract":"<p><strong>Introduction: </strong>Atopic dermatitis (AD) and related atopic diseases are among the chronic health conditions that are becoming more common in children. Children with AD may develop atopic comorbidities, which makes it more difficult to manage treatment and necessitates more precautions in the child's everyday life. The parents of chronically ill children play a key role as the children's primary carers. This article explores the experiences of parents with the everyday tasks related to their children's illnesses.</p><p><strong>Methods: </strong>Face-to-face interviews in the Capital Region of Denmark, with eleven families with children, aged between one and five years, with AD and at least one atopic comorbidity (food allergy, allergic rhinoconjunctivitis or asthma).</p><p><strong>Results: </strong>We argue that, aside from the immediate tasks directly linked to the child's treatments, there are numerous other types of tasks, both inside and outside the home, that emerge when a family adjusts to living with a child with AD and atopic comorbidities. We present three major strategies that parents use to protect their child: risk avoidance, pursuing a normal childhood, and good parenting. These strategies are closely related to the parents' wish to give their child as normal a childhood as possible.</p><p><strong>Conclusion: </strong>Based on the findings, we suggest that healthcare professionals, beside the medical examination and treatment, are sensitive and attentive towards the large amounts of invisible work that parents of children with AD and atopic comorbidities accomplish and maintain awareness that parents may downplay the workload. Knowing the patients as persons can help facilitate and strength a trusting relationship.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"347-358"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878051","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":"Medical encounters with young unaccompanied refugees: a qualitative study among general practitioners and physicians in migrant health clinics in Norway and Denmark.","authors":"Gjertrud Moe, Bente Prytz Mjølstad, Linn Okkenhaug Getz, Morten Sodemann, Borgunn Ytterhus","doi":"10.1080/02813432.2024.2428364","DOIUrl":"10.1080/02813432.2024.2428364","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the experiences of clinical encounters with young unaccompanied refugees in Norway and Denmark among both general practitioners (GPs) and physicians in migrant health clinics (MHC physicians), and it identifies important aspects that should be taken into consideration for improving the quality of healthcare for these patients.</p><p><strong>Methodology: </strong>Ten individual in-depth interviews with physicians in Norway and Denmark were conducted and analysed using interpretative phenomenology. Axel Honneth's theory of recognition was our theoretical lens.</p><p><strong>Results: </strong>The physicians described these patients as vulnerable individuals. They adopted a variety of approaches in their encounters with young unaccompanied refugees spanning from a 'holistic' to an 'instrumental' approach. Those who described an instrumental approach focused on understanding and categorising symptoms from a biomedical perspective, while those describing a holistic approach considered 'the whole person' within their everyday context. Those with a more holistic approach also expressed the importance of interdisciplinary collaboration and defined work-divide. Relationships of trust between physicians and the young unaccompanied refugees were shown to be an important facilitator for adequate healthcare, but this required availability, continuity, and dialogue.</p><p><strong>Conclusion: </strong>Our results highlight how physicians' encounters with vulnerable young refugees actualize previously documented contrasts between holistic and instrumental approaches in clinical work. We argue that recognition in healthcare is conditional on physicians taking a holistic approach. This approach can help build relationships of trust and can support interdisciplinary collaboration. Moreover, such an approach can facilitate the essential components of Honneth's theory of recognition, namely social esteem and emotional support. Barriers to greater interdisciplinary collaboration in healthcare services need to be addressed at the system level.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"281-291"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682316","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}