Scandinavian Journal of Primary Health Care最新文献_第9页

Danish primary care: a focus on general practice in the Danish healthcare system. 丹麦初级保健：在丹麦医疗保健系统的一般做法的重点。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-22 DOI: 10.1080/02813432.2025.2508929

Peter Haastrup, Anne Møller, Jette Kolding Kristensen, Linda Huibers

引用次数: 0

Prerequisites for social prescribing in Swedish primary care - stakeholders' perspectives. 瑞典初级保健社会处方的先决条件-利益相关者的观点。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-20 DOI: 10.1080/02813432.2025.2507272

Frida Degerstedt, Emil Rapo, Emilia W E Viklund, Frida Jonsson, Anna Sofia Lundgren, Ingeborg Nilsson

{"title":"Prerequisites for social prescribing in Swedish primary care - stakeholders' perspectives.","authors":"Frida Degerstedt, Emil Rapo, Emilia W E Viklund, Frida Jonsson, Anna Sofia Lundgren, Ingeborg Nilsson","doi":"10.1080/02813432.2025.2507272","DOIUrl":"https://doi.org/10.1080/02813432.2025.2507272","url":null,"abstract":"Background and purpose: Loneliness is a complex public health issue that can lead to increased morbidity, with higher prevalence among older adults. Social prescribing may be one way to ease loneliness. This study aims to explore stakeholders' perceptions of prerequisites for implementing a social prescribing program in a Swedish context.Method: Reflexive thematic analysis was used to analyse individual semi-structured interviews with eleven stakeholders whose experience were considered relevant for implementing a social prescribing program in the Swedish context. They were selected to provide diverse perspectives related to organisation, position, and geography.Results: From the analysis three themes were constructed; Where to implement - Necessity to bridge organisational gaps, How to implement - Balancing professional expectations, and For whom to implement - Addressing those with 'real' needs. These themes highlight the perceived prerequisites, including barriers and facilitators, for successful implementation of social prescribing.Conclusions: The participants' perceptions are suggesting that Sweden has several practical advantages in place for implementing social prescribing, such as robust organisations responsible for citizens' health and well-being and a range of activities available. If organisations can collaborate by prioritizing patients' needs and overcoming organisational divisions and responsibilities, there is potential for successfully implementing social prescribing in Sweden in the future. Nevertheless, implementation may be hampered by limited resources within health care, and challenges to evaluate program effects.","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111690","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

Letter to the editor regarding 'How to support researchers in the primary care setting?' 给编辑的关于“如何在初级保健环境中支持研究人员？”

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-17 DOI: 10.1080/02813432.2025.2507270

Filipe Prazeres

引用次数: 0

What makes patients in primary care complex? A scoping review combined with a focus group analysis. 是什么让初级保健病人变得复杂？范围审查与焦点小组分析相结合。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-17 DOI: 10.1080/02813432.2025.2507278

Jozé Braspenning, Rachel van den Kieboom, Erik W M A Bischoff, Kirsten Hietland, Kris Vissers, Yvonne Schoon

{"title":"What makes patients in primary care complex? A scoping review combined with a focus group analysis.","authors":"Jozé Braspenning, Rachel van den Kieboom, Erik W M A Bischoff, Kirsten Hietland, Kris Vissers, Yvonne Schoon","doi":"10.1080/02813432.2025.2507278","DOIUrl":"https://doi.org/10.1080/02813432.2025.2507278","url":null,"abstract":"Background: Consultations can be challenging because of patient complexity, affecting care quality. Patient complexity involves factors related to the patient, healthcare professional, organization, and healthcare system. A comprehensive overview of these factors and their significance to healthcare providers is lacking. The aim of this study was to create a literature overview and to examine how the results relate to the experiences of primary care providers.Methods: The PubMed, Embase and Cochrane databases were searched (2018-2023) to conduct a scoping review. In addition, a focus group was organized with healthcare providers from general practices (a) to discuss the results of the review, and (b) to explore its meaning in daily consultation, based on the real-life patient cases they presented.Results: The review (171 unique studies) mainly revealed patient-related factors (medical, social and behavioural aspects). Complexity arises when multiple aspects are present and mutually interact. Factors related to the expertise of healthcare professionals, the organization (care coordination) and the system (availability of resources, navigation problems) were also identified. The focus group recognized the factors that influenced patient complexity and their interdependence. They noted a need for support in identifying and treating the patient population in question across disciplines.Conclusions: A comprehensive overview of factors influencing patient complexity at four different levels (patient, professional, organization, system) is provided. The primary care providers suggested disseminating these results to customize treatment to the needs of patients, which is likely to require coordination across disciplines and integrated care.","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094669","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

Promoting Nordic 'Green Care Practices'. 推广北欧“绿色护理实践”。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-16 DOI: 10.1080/02813432.2025.2503450

Nanna Holt Jessen, Stefan Hjørleifsson

{"title":"Promoting Nordic 'Green Care Practices'.","authors":"Nanna Holt Jessen, Stefan Hjørleifsson","doi":"10.1080/02813432.2025.2503450","DOIUrl":"https://doi.org/10.1080/02813432.2025.2503450","url":null,"abstract":"Climate change poses an urgent threat to human health, with thousands of deaths already attributed to extreme heat. In the Nordic countries, where per capita emissions are particularly high, healthcare accounts for 4.2-6.3% of emissions, highlighting the need for immediate action to reduce its climate impact. Evidence supporting sustainable climate solutions in healthcare is steadily growing. Greenhouse gas emissions in general practice can be broadly divided into those arising from clinical activities, such as patient examination, diagnosis, and treatment, and those from non-clinical activities, including clinic operations, energy use, and transportation by staff and patients. In this opinion paper, we discuss and advocate 'Green Care Practices' to minimize greenhouse gas emissions specifically related to clinical activities. We believe that Nordic general practitioners can adopt 'Green Care' to significantly reduce healthcare-related emissions while improving patient outcomes, enhancing efficiency, and promoting environmentally responsible healthcare. Strong primary healthcare, rooted in Nordic values, can support the United Nations Sustainable Development Goals by simultaneously mitigating climate change, reducing inequalities, fostering community stability, and promoting health and well-being. Thus, GPs can ensure sustainability for future generations.","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086508","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

Detection of heart failure in a general population not aware of having the disease. 在没有意识到自己患有心衰的一般人群中检测心衰。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-15 DOI: 10.1080/02813432.2025.2503447

Michelle Tuv Pettersen, Henrik Schirmer, Juan Carlos Aviles Solis, Mark Spigt, Hasse Melbye

{"title":"Detection of heart failure in a general population not aware of having the disease.","authors":"Michelle Tuv Pettersen, Henrik Schirmer, Juan Carlos Aviles Solis, Mark Spigt, Hasse Melbye","doi":"10.1080/02813432.2025.2503447","DOIUrl":"https://doi.org/10.1080/02813432.2025.2503447","url":null,"abstract":"Background: Heart failure (HF) is one of the most common causes of hospitalization and death worldwide. We aimed at identifying variables that can be helpful for early diagnosis of HF in primary care.Methods: In 2015-16, we included 2007 participants aged ≥ 40 years in the 7th Tromsø study. They underwent echocardiography and other examinations needed for establishing a diagnosis of HF according to European guidelines from 2016. We analyzed associations with HF among the 1863 participants who reported not to have HF. Variables significantly associated with HF were included in multivariable logistic regression analyses. Diagnostic models were further analyzed by ROC curves and areas under curve (AUC) were calculated, optimism corrected by bootstrapping.Results: The HF prevalence in the age groups 40-64 years, 65-74 years, and ≥ 75 years were 3.5%, 11.7% and 29.4%, respectively. A predictive model based on self-reported hypertension, myocardial infarction, atrial fibrillation, body-mass index and moderate to severe dyspnea had an AUC of 0.813 (95% CI 0.785-0.843). In a significantly stronger model, in which NT-proBNP was included and self-reported atrial fibrillation was replaced by atrial fibrillation on ECG, an AUC of 0.849 (95% CI 0.821-0.880) was reached.Conclusion: Easily available clinical information may be used both to rule out HF an to identify patients needing further examinations. A direct referral to echocardiography should be considered for elderly patients in primary care with a known cardiovascular disease and severe shortness of breath. With less abundant history and symptoms, ECG and NT-proBNP can guide further investigations.","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080075","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

Experiences of patients with complex needs at municipal emergency outpost satellites. 城市应急前哨卫星站复杂需求患者的经验。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-09 DOI: 10.1080/02813432.2025.2502095

Trude Østerbø, Gro Hovland, Siri Ytrehus, Dagrun Kyrkjebø, Erik Zakariassen, Ole T Kleiven

{"title":"Experiences of patients with complex needs at municipal emergency outpost satellites.","authors":"Trude Østerbø, Gro Hovland, Siri Ytrehus, Dagrun Kyrkjebø, Erik Zakariassen, Ole T Kleiven","doi":"10.1080/02813432.2025.2502095","DOIUrl":"https://doi.org/10.1080/02813432.2025.2502095","url":null,"abstract":"Background: In 2015, Norway introduced stricter requirements for organizing primary emergency care. These changes led to new solutions such as municipal emergency outpost satellites, providing inhabitants shorter access to care in resource-limited areas. This study explores patient experiences at emergency outpost satellites staffed by a nurse on site with a general practitioner (GP) available via video consultation.Methods: A qualitative study was conducted with seven patients, aged 62-82, with complex needs, from four small and medium-sized municipalities in Vestland County, Norway. Data were collected through individual semi-structured interviews, which took place within 6 months of an acute consultation at an emergency outpost satellite. The data were analysed using systematic text condensation (STC).Results: Patients had both positive and negative experiences with video consultations. They valued short travel distances and quick GP access via video link. Video consultations often replicated several aspects of in-person visits, with nurses playing a crucial role in organizing and ensuring that care was provided effectively. Nurses were key mediators, supporting patients before, during, and after the consultation. However, some patients were dissatisfied with the lack of a physical GP presence, technical issues, and communication challenges.Conclusions: The participants' experience of communication with the GP and nurse was crucial for the video consultation to be perceived as satisfactory. Participants felt that video consultations reduced travel burdens and provided quick clarification. Nurses played an important mediating role, but poor communication and technical issues made some participants feel unsafe using the emergency outpost satellites.","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033531","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

Improving access, mixed continuity: effects of multidisciplinary teams on primary health-care in Finland - a quasi-experimental study. 改善获取和混合连续性：多学科小组对芬兰初级保健的影响——一项准实验研究。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-08 DOI: 10.1080/02813432.2025.2502658

Elisa Jokelin, Laura Piirainen, Erja Mustonen, Paulus Torkki

{"title":"Improving access, mixed continuity: effects of multidisciplinary teams on primary health-care in Finland - a quasi-experimental study.","authors":"Elisa Jokelin, Laura Piirainen, Erja Mustonen, Paulus Torkki","doi":"10.1080/02813432.2025.2502658","DOIUrl":"https://doi.org/10.1080/02813432.2025.2502658","url":null,"abstract":"Objective: The multidisciplinary team (MDT) approach in primary care is a relatively recent innovation, developed over the past 15 years. There is limited data on MDTs' effects on Quadruple Aim (QA) goals. The object of this study is to evaluate the implementation of a novel MDT from 2021 to 2023 and its impact on access and continuity of care, compared to an established model. Future research will explore its effects on staff satisfaction, costs, and health outcomes.Design, setting and patients: This quasi-experimental study compares five intervention health centers with three control centers. It includes all primary care patients from 2021 to 2023, presenting data on access and continuity before and after the intervention.Intervention: Nurse-only consultations were replaced with a multidisciplinary nurse-physician model to address issues during initial contact more effectively. Nurses also took on the role of case managers, enhancing relational continuity. Lean daily visual management with continuous improvement, strategic goal setting, and coaching leadership style were implemented.Main outcome measures: Access was measured using the 'third available appointment' (T3) metric, and continuity with the COC-index, both for physicians only.Results: Access improved at all intervention centers, with T3 reduced from 90 to 1.125-4.75 days, while controls remained at 90 days. COC improved at three intervention centers but declined at two, with declines also observed at control centers.Conclusion: The novel MDT enhanced primary care access compared to the traditional model. However, relying solely on T3 may be insufficient for evaluating effectiveness. Mixed results in continuity underscore the need for further investigation.","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054252","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

Mapping the ideal job: insights into job resources of general practitioner trainees. 映射理想职业：全科实习生职业资源的洞察。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-05-07 DOI: 10.1080/02813432.2025.2501071

Outi Öhman, Nina Tusa, Tiina Ahonen, Taina Hintsa, Pekka Mäntyselkä

{"title":"Mapping the ideal job: insights into job resources of general practitioner trainees.","authors":"Outi Öhman, Nina Tusa, Tiina Ahonen, Taina Hintsa, Pekka Mäntyselkä","doi":"10.1080/02813432.2025.2501071","DOIUrl":"https://doi.org/10.1080/02813432.2025.2501071","url":null,"abstract":"Objective: Job resources are aspects of work that stimulate development, enhance work engagement and performance, help achieve goals and provide protection from the negative health effects of work demands. Identifying the job resources in GP trainees' work may provide ways to support their wellbeing and future careers in primary care. This study explores how GP trainees perceive their ideal job and identify job resources.Method: GP trainees attending an orientation course at the University of Eastern Finland were assigned to describe their ideal job. The descriptions were analyzed using abductive qualitative content analysis, where elements of job resources in the Job Demands-Resources (JD-R) model were applied as the theoretical framework.Results: Continuity of care, patient-centered care, community orientation, and comprehensiveness were key resources in the ideal job of a GP trainee. GP trainees aspired to work as GPs in well-managed clinics that offer opportunities for diverse skill utilization, professional development, collaborative practice, and autonomy in work management. They also prioritized achieving a healthy work-life balance and maintaining a manageable workload.Conclusion: GP trainees demonstrated a strong commitment to the core values and principles of general practice. This study suggests that it is essential to design jobs that align with these values and offer diverse work tasks, autonomy in work management, opportunities for continuous professional development, and balanced work-life integration. Prioritizing these elements in job design strategies could enhance GPs' occupational well-being and maintain their dedication to primary care throughout their careers.","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028187","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

Letter to the editor regarding 'does point-of-care ultrasound examination by the general practitioner lead to inappropriate care? A follow-up study'. 致编辑关于“全科医生的即时超声检查是否会导致不当护理？”一项后续研究。

IF 1.9 3区医学

Scandinavian Journal of Primary Health Care Pub Date : 2025-04-28 DOI: 10.1080/02813432.2025.2499172

Zachary Boivin

引用次数: 0