BJGP Open最新文献

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Role modelling to support careers in general practice: a realist review protocol. 支持全科医生职业生涯的角色模拟:现实主义审查协议。
BJGP Open Pub Date : 2024-05-24 DOI: 10.3399/BJGPO.2024.0109
Elizabeth Iris Lamb, Bryan Burford, Catherine Exley, Gillian Vance, Valerie Wass, Hugh Alberti
{"title":"Role modelling to support careers in general practice: a realist review protocol.","authors":"Elizabeth Iris Lamb, Bryan Burford, Catherine Exley, Gillian Vance, Valerie Wass, Hugh Alberti","doi":"10.3399/BJGPO.2024.0109","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0109","url":null,"abstract":"<p><strong>Background: </strong>Role models encountered during undergraduate training play an important part in shaping future doctors. They can act as powerful attractants towards, and deterrents away from a career in general practice. Many general practitioner (GP) educators who act as role models are burnt-out and wish to leave the profession which may limit their ability to influence students positively, with consequent detrimental impact on recruitment to the specialty.</p><p><strong>Aim: </strong>A realist review will be undertaken, aiming to explore how, why and for whom role modelling in undergraduate medical education can support medical students towards careers in general practice.</p><p><strong>Design & setting: </strong>The realist review will follow Pawson's five steps, including: locating existing theories, searching for evidence, article selection, data extraction, synthesising evidence and drawing conclusions and will explore literature published in English language between 2013 and 2024.</p><p><strong>Method: </strong>An initial explanatory framework (initial programme theory, IPT) will be developed guided by a stakeholder panel including medical undergraduates, GPs and patient/public representatives. Searches will be developed and conducted in electronic databases and grey literature. Studies will be included if they explore the relationship between GP role modelling and undergraduate career choice and relevant data will be extracted.</p><p><strong>Conclusion: </strong>Findings will refine the initial programme theory, unveiling key contexts, mechanisms and outcomes which influence role modelling in undergraduate GP medical education and support or deter students from careers in general practice. These findings will support recommendations and interventions to facilitate positive outcomes, including improved recruitment to general practice.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidence of hand and wrist disorders in primary care. 初级保健中手部和腕部疾病的发病率。
BJGP Open Pub Date : 2024-05-17 DOI: 10.3399/BJGPO.2023.0240
Patrick Krastman, Evelien It de Schepper, Patrick Je Bindels, Sita Ma Bierma-Zeinstra, Gerald Kraan, Jos Runhaar
{"title":"Incidence of hand and wrist disorders in primary care.","authors":"Patrick Krastman, Evelien It de Schepper, Patrick Je Bindels, Sita Ma Bierma-Zeinstra, Gerald Kraan, Jos Runhaar","doi":"10.3399/BJGPO.2023.0240","DOIUrl":"https://doi.org/10.3399/BJGPO.2023.0240","url":null,"abstract":"<p><strong>Background: </strong>The incidence of different types of hand and wrist disorders in primary care is unknown since there are no specific encodings for it.</p><p><strong>Aims: </strong>To determine the overall incidence and the incidence of specific types of hand and wrist disorders in primary care.</p><p><strong>Design & setting: </strong>A healthcare registration database from Dutch general practice, which contains medical records of over 200 000 patients and included approximately 25% of the population of the area of Rotterdam.</p><p><strong>Method: </strong>Patients aged ≥18 years with a new diagnosis of hand or wrist disorder from 1 January 2015 to 31 December 2019 were extracted using a search algorithm based on ICPC coding and search terms in free text.</p><p><strong>Results: </strong>The mean incidence over the study period of a hand disorder was 5.9 per 1,000 persons-years and of a wrist disorder 0.3 per 1,000 persons-years. The incidence of trigger finger/thumb, fracture hand/finger, tendon/ligament tendinopathy, mallet finger and ligament injury hand/finger were 3 (2.69-3.15), 1 (1.03-1.33), 1 (0.98-1.28), 0.6 (0.48-0.69) and 0.1 (0.06-0.14) per 1,000 persons-years, respectively. The incidence of a wrist fracture and ligament injury were 0.2 (0.13-0.25) and 0.1 (0.04-0.12) per 1,000 persons-years, respectively.</p><p><strong>Conclusions: </strong>There is a large difference between the number of patients presenting to the GP with hand and wrist complaints and the number of hand and wrist diagnosis reported in the medical files. Introducing specific ICPC codes for different types of hand and wrist disorders could (potentially) lead to a more accurate registration of a diagnosis and determination of the incidence figures.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interventions in ambulatory healthcare settings to reduce social isolation among adults aged 18-64: a systematic review. 在流动医疗机构中采取干预措施,减少 18-64 岁成年人的社会隔离:系统综述。
BJGP Open Pub Date : 2024-05-17 DOI: 10.3399/BJGPO.2023.0119
Kavya Anchuri, Liane Steiner, Roxana Rabet, Amy Craig-Neil, Ellah San Antonio, Segun Oluwasegun Ogundele, Melanie Seabrook, Ceinwen Pope, Serina Dai, Andree Schuler, Carolyn Ziegler, Andrew David Pinto
{"title":"Interventions in ambulatory healthcare settings to reduce social isolation among adults aged 18-64: a systematic review.","authors":"Kavya Anchuri, Liane Steiner, Roxana Rabet, Amy Craig-Neil, Ellah San Antonio, Segun Oluwasegun Ogundele, Melanie Seabrook, Ceinwen Pope, Serina Dai, Andree Schuler, Carolyn Ziegler, Andrew David Pinto","doi":"10.3399/BJGPO.2023.0119","DOIUrl":"https://doi.org/10.3399/BJGPO.2023.0119","url":null,"abstract":"<p><strong>Background: </strong>Social isolation is associated with increased all-cause and premature mortality, poor chronic disease management, and mental health concerns. Limited research exists on interventions addressing social isolation among individuals under 65 despite its increasing prevalence among young and middle-aged adults.</p><p><strong>Aim: </strong>To identify interventions from the extant literature that address social isolation and loneliness in ambulatory healthcare settings in adults aged 18-64, and to identify elements of successful studies for future intervention design.</p><p><strong>Design & setting: </strong>Systematic review of interventions targeting social isolation in community-dwelling adults aged 18-64 within ambulatory healthcare settings.</p><p><strong>Method: </strong>A search strategy was developed to identify relevant articles in the following databases: Ovid MEDLINE, Embase, EBM Reviews, Scopus, CINAHL and PsychInfo. Data were extracted on study design and setting, intervention type, outcome related to social isolation/loneliness and scale of measure used.</p><p><strong>Results: </strong>25,078 citations were identified and underwent title and abstract screening. 75 articles met our inclusion criteria and were synthesised, including an assessment of bias. Effective interventions were delivered in community health settings, incorporated a group component, and used digital technologies. They also addressed the association between mental health and social isolation using CBT approaches and enhanced self-management and coping strategies for chronic conditions through psycho-educational interventions.</p><p><strong>Conclusion: </strong>Future research should prioritise adults living in low- and middle-income countries, racialized individuals, as well as those with fewer educational opportunities. There is also a need to advance research in primary care settings, where longitudinal patient-provider relationships would facilitate the success of interventions.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
People's experiences of their involvement in nursing care: a systematic review protocol. 人们参与护理工作的经历:系统性综述方案。
BJGP Open Pub Date : 2024-05-17 DOI: 10.3399/BJGPO.2024.0048
Diana Santos, Eduardo Jf Santos, António F Amaral
{"title":"People's experiences of their involvement in nursing care: a systematic review protocol.","authors":"Diana Santos, Eduardo Jf Santos, António F Amaral","doi":"10.3399/BJGPO.2024.0048","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0048","url":null,"abstract":"<p><strong>Background: </strong>People's involvement and participation are the essential basis of nursing care. This phenomenon can be characterised as an approach based on the integration of the person's values, beliefs, and preferences during nursing care. This process contributes to improve the quality of care, satisfaction levels, and a better experience for people. To promote the person's participation in nursing care, it is necessary to better understand their experiences about this topic.</p><p><strong>Aim: </strong>To synthesise the available evidence on people's experiences of their involvement and participation in nursing care in a hospital setting.</p><p><strong>Design & setting: </strong>A systematic review that will be conducted according to the JBI methodology for systematic reviews of qualitative evidence.</p><p><strong>Method: </strong>The study selection, critical appraisal, and data extraction will be conducted by two independent reviewers. This review will consider studies with a qualitative approach, published and unpublished, in Portuguese, English and Spanish with no temporal limit, that include adults, aged 18 years or older, who have experienced an admission in a hospital; that explore people's experiences of their involvement and participation in nursing care in hospital wards settings. Findings will be presented using meta-aggregation approach and narrative format, and the final synthesised findings will be graded according to the ConQual approach.</p><p><strong>Conclusion: </strong>It is expected that this qualitative synthesis will inform people, health professionals and policymakers, allowing them to develop recommendations to promote the person's participation in nursing care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidence of hand and wrist disorders in primary care. 初级保健中手部和腕部疾病的发病率。
BJGP Open Pub Date : 2024-05-17 DOI: 10.3399/BJGPO.2023.0240
P. Krastman, E. D. de Schepper, P. Bindels, Sita Ma Bierma-Zeinstra, Gerald Kraan, Jos Runhaar
{"title":"Incidence of hand and wrist disorders in primary care.","authors":"P. Krastman, E. D. de Schepper, P. Bindels, Sita Ma Bierma-Zeinstra, Gerald Kraan, Jos Runhaar","doi":"10.3399/BJGPO.2023.0240","DOIUrl":"https://doi.org/10.3399/BJGPO.2023.0240","url":null,"abstract":"BACKGROUND\u0000The incidence of different types of hand and wrist disorders in primary care is unknown since there are no specific encodings for it.\u0000\u0000\u0000AIMS\u0000To determine the overall incidence and the incidence of specific types of hand and wrist disorders in primary care.\u0000\u0000\u0000DESIGN & SETTING\u0000A healthcare registration database from Dutch general practice, which contains medical records of over 200 000 patients and included approximately 25% of the population of the area of Rotterdam.\u0000\u0000\u0000METHOD\u0000Patients aged ≥18 years with a new diagnosis of hand or wrist disorder from 1 January 2015 to 31 December 2019 were extracted using a search algorithm based on ICPC coding and search terms in free text.\u0000\u0000\u0000RESULTS\u0000The mean incidence over the study period of a hand disorder was 5.9 per 1,000 persons-years and of a wrist disorder 0.3 per 1,000 persons-years. The incidence of trigger finger/thumb, fracture hand/finger, tendon/ligament tendinopathy, mallet finger and ligament injury hand/finger were 3 (2.69-3.15), 1 (1.03-1.33), 1 (0.98-1.28), 0.6 (0.48-0.69) and 0.1 (0.06-0.14) per 1,000 persons-years, respectively. The incidence of a wrist fracture and ligament injury were 0.2 (0.13-0.25) and 0.1 (0.04-0.12) per 1,000 persons-years, respectively.\u0000\u0000\u0000CONCLUSIONS\u0000There is a large difference between the number of patients presenting to the GP with hand and wrist complaints and the number of hand and wrist diagnosis reported in the medical files. Introducing specific ICPC codes for different types of hand and wrist disorders could (potentially) lead to a more accurate registration of a diagnosis and determination of the incidence figures.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140963647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interventions in ambulatory healthcare settings to reduce social isolation among adults aged 18-64: a systematic review. 在流动医疗机构中采取干预措施,减少 18-64 岁成年人的社会隔离:系统综述。
BJGP Open Pub Date : 2024-05-17 DOI: 10.3399/BJGPO.2023.0119
Kavya Anchuri, Liane Steiner, Roxana Rabet, A. Craig-Neil, Ellah San Antonio, Segun Oluwasegun Ogundele, Melanie Seabrook, Ceinwen Pope, Serina Dai, Andrée Schuler, Carolyn Ziegler, Andrew David Pinto
{"title":"Interventions in ambulatory healthcare settings to reduce social isolation among adults aged 18-64: a systematic review.","authors":"Kavya Anchuri, Liane Steiner, Roxana Rabet, A. Craig-Neil, Ellah San Antonio, Segun Oluwasegun Ogundele, Melanie Seabrook, Ceinwen Pope, Serina Dai, Andrée Schuler, Carolyn Ziegler, Andrew David Pinto","doi":"10.3399/BJGPO.2023.0119","DOIUrl":"https://doi.org/10.3399/BJGPO.2023.0119","url":null,"abstract":"BACKGROUND\u0000Social isolation is associated with increased all-cause and premature mortality, poor chronic disease management, and mental health concerns. Limited research exists on interventions addressing social isolation among individuals under 65 despite its increasing prevalence among young and middle-aged adults.\u0000\u0000\u0000AIM\u0000To identify interventions from the extant literature that address social isolation and loneliness in ambulatory healthcare settings in adults aged 18-64, and to identify elements of successful studies for future intervention design.\u0000\u0000\u0000DESIGN & SETTING\u0000Systematic review of interventions targeting social isolation in community-dwelling adults aged 18-64 within ambulatory healthcare settings.\u0000\u0000\u0000METHOD\u0000A search strategy was developed to identify relevant articles in the following databases: Ovid MEDLINE, Embase, EBM Reviews, Scopus, CINAHL and PsychInfo. Data were extracted on study design and setting, intervention type, outcome related to social isolation/loneliness and scale of measure used.\u0000\u0000\u0000RESULTS\u000025,078 citations were identified and underwent title and abstract screening. 75 articles met our inclusion criteria and were synthesised, including an assessment of bias. Effective interventions were delivered in community health settings, incorporated a group component, and used digital technologies. They also addressed the association between mental health and social isolation using CBT approaches and enhanced self-management and coping strategies for chronic conditions through psycho-educational interventions.\u0000\u0000\u0000CONCLUSION\u0000Future research should prioritise adults living in low- and middle-income countries, racialized individuals, as well as those with fewer educational opportunities. There is also a need to advance research in primary care settings, where longitudinal patient-provider relationships would facilitate the success of interventions.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140962453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From statistics to stories: understanding the complex landscape of missed medical appointments. 从统计数据到故事:了解错过就诊的复杂情况。
BJGP Open Pub Date : 2024-05-02 DOI: 10.3399/BJGPO.2024.0007
Lea Charton, Francis Gatier, Chloe Delacour, Camille Lépine
{"title":"From statistics to stories: understanding the complex landscape of missed medical appointments.","authors":"Lea Charton, Francis Gatier, Chloe Delacour, Camille Lépine","doi":"10.3399/BJGPO.2024.0007","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0007","url":null,"abstract":"<p><strong>Background: </strong>Research suggests that in both France and the UK, between 5 to 10% of appointments with General Practitioners (GPs) are unattended. A comprehensive Irish study linked missed appointments with an increased short-term risk of mortality, prompting further investigation into the reasons behind absenteeism.</p><p><strong>Aim: </strong>This study seeks to delve into the underlying causes of missed appointments, within the context of an urban health center.</p><p><strong>Design & setting: </strong>Using a mixed-method approach, this study combines qualitative telephone interviews with quantitative analysis of medical records. The research focuses on patients who failed to attend appointments at an urban health center over a 15-day period.</p><p><strong>Method: </strong>The interview guide collected data on circumstances leading to missed appointments and explored patients' social determinants of health. Additionally, patients' socio-economic backgrounds was undertaken of medical records.</p><p><strong>Results: </strong>Among 53 missed appointments (4.9% of all scheduled), 22 patients were interviewed. SHC beneficiaries (68% of the sample) cited socio-economic instability, including precarious work hours, social isolation, and multiple commitments, as reasons for non-attendance. For non-SHC beneficiaries, forgetfulness was the main cause. Remarkably, 36% disclosed a history of domestic violence. Retrospective analysis by physicians deemed over a quarter of these missed appointments as significant.</p><p><strong>Conclusion: </strong>The findings indicate that missed appointments can highlight social inequality, emphasising the need to align healthcare with patients' temporal realities. The identification of patients who have experienced violence and the use of missed appointments as triggers for follow-up calls seems to be promising strategies to enhance care and mitigate health inequalities.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advance care planning before and during COVID-19: evaluation of 73,675 patients' records. COVID-19 之前和期间的预先护理计划:对 73,675 份患者记录进行评估。
BJGP Open Pub Date : 2024-04-30 DOI: 10.3399/BJGPO.2023.0145
Philippa G McFarlane, Catey Bunce, Katherine E Sleeman, Martina Orlovic, Jonathan Koffman, John Rosling, Alastair Bearne, Margaret Powell, Julia Riley, Joanne Droney
{"title":"Advance care planning before and during COVID-19: evaluation of 73,675 patients' records.","authors":"Philippa G McFarlane, Catey Bunce, Katherine E Sleeman, Martina Orlovic, Jonathan Koffman, John Rosling, Alastair Bearne, Margaret Powell, Julia Riley, Joanne Droney","doi":"10.3399/BJGPO.2023.0145","DOIUrl":"https://doi.org/10.3399/BJGPO.2023.0145","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) was encouraged by policymakers throughout the COVID-19 pandemic. Little is known about use of ACP during this time.</p><p><strong>Aim: </strong>To compare use of ACP before and during the COVID-19 pandemic.</p><p><strong>Design & setting: </strong>Retrospective, observational cohort study, comparing the creation, use and content of Electronic Palliative Care Co-ordination System records in London. Individuals aged 18+ with a Coordinate My Care Record, created and published in the pre-pandemic period (01/01/2018-31/12/2019), Wave1 (W1) (20/03/2020-04/07/2020), and Wave2 (W2) (01/10/2020-05/03/2021).</p><p><strong>Method: </strong>Patient demographics and components of ACP were compared using descriptive and comparative statistics.</p><p><strong>Results: </strong>73,675 records were included; 35,108 pre-pandemic, 21,235 W1, 9,925 W2. Most records were created in primary care (56% pre-COVID, 76% in W1 and 48% in W2).Compared to the pre-pandemic period, the average weekly number of records created increased by 297% W1 (<i>P</i><0.005) and 29.1% W2 (<i>P</i><0.005). Patients with records created during the pandemic were younger (61% aged 80+ W1, 59% W2, 65% pre-pandemic (<i>P</i><0.005)). Patients with records created in W1 had longer estimated prognoses at record creation (73% had an estimated prognosis of 1 year+ W1 vs 53% pre-pandemic (<i>P</i><0.005)) and were more likely to be \"For Resuscitation\" (38% W1 vs 30% pre-pandemic (<i>P</i><0.005)).</p><p><strong>Conclusion: </strong>During the COVID-19 pandemic, increased ACP activity was observed, especially in primary care, and for younger people and those not imminently dying. Further research is needed to identify training and planning requirements as well as organisational and system changes to support sustained high-quality ACP within primary care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Managing patients with eating disorders: a qualitative study in primary care. 饮食失调症患者的管理:基层医疗机构的定性研究。
BJGP Open Pub Date : 2024-04-30 DOI: 10.3399/BJGPO.2024.0014
Carrie Ashby, Jane Ogden
{"title":"Managing patients with eating disorders: a qualitative study in primary care.","authors":"Carrie Ashby, Jane Ogden","doi":"10.3399/BJGPO.2024.0014","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0014","url":null,"abstract":"<p><strong>Background: </strong>General Practitioners (GPs) play a key role in the diagnosis and management of eating disorders (EDs).</p><p><strong>Aim: </strong>To explore GPs' experiences of managing patients with eating disorders (EDs).</p><p><strong>Design & setting: </strong>A qualitative study utilising remote semi-structured interviews.</p><p><strong>Method: </strong>Fourteen GPs were interviewed about their experiences of supporting patients with EDs. The interviews were recorded, transcribed and analysed using thematic analysis.</p><p><strong>Results: </strong>The analysis described four themes: i) 'Continuity of care' addressing the GPs relationship with patients and family, patients transitions across life stages and geographical areas and patient non-attendance; ii) 'The role of guidance' focusing on guidelines and protocols, referrals and specialist professionals as points of contact; iii) 'Structural barriers' including waiting times, lack of resources, referral criteria and relationships between services; iv) 'Confidence and skills' reflecting professional and personal experience in EDs, previous training and training needs. Transcending these themes was the notion of the 'Limits to the care' GPs can provide due to professional boundaries and the emotional impact of managing patients with EDs.</p><p><strong>Conclusion: </strong>This study found that whilst GPs want to help patients with EDs many limits remain to the care they can provide due to both internal and external factors. Funding is required for training and accessible specialist ED support and greater clarity is needed regarding referral processes if ED management in Primary Care is to be optimised.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patients' experience with German primary care practices during Covid-19: an interview study. Covid-19期间患者在德国初级保健实践中的经历:一项访谈研究
BJGP Open Pub Date : 2024-04-25 Print Date: 2024-04-01 DOI: 10.3399/BJGPO.2023.0129
Daniel Otto, Veronika van der Wardt
{"title":"Patients' experience with German primary care practices during Covid-19: an interview study.","authors":"Daniel Otto, Veronika van der Wardt","doi":"10.3399/BJGPO.2023.0129","DOIUrl":"10.3399/BJGPO.2023.0129","url":null,"abstract":"<p><strong>Background: </strong>Patient access to and communication with German primary care practices (PCPs) changed due to Covid-19. Patients had to comply with Covid-19 regulations, which included closed waiting rooms and appointment-based consultations. It is unclear how patients experienced these changes and how the pandemic impacted their primary care attendance.</p><p><strong>Aim: </strong>The aim of the study was to explore how patients, who frequently attended PCPs before the pandemic, perceived primary care during the initial phase of Covid-19 in Germany.</p><p><strong>Design & setting: </strong>Between January and June 2021, we completed 17 semi-structured interviews. Participants included primary care patients from two regions in Germany who frequently attended their physician before the start of the pandemic.</p><p><strong>Method: </strong>Data were analysed using content analysis.</p><p><strong>Results: </strong>Four interconnected themes emerged in the analysis: 'fear of COVID-19 infection', 'practice organisation', 'information about COVID-19', and 'telemedicine'. Participants were unconcerned about being infected in their practice and mostly agreed with COVID-19 regulations, although waiting outside for their appointment was uncomfortable for some. Participants consulted their primary care physician in relation to different vaccines but felt they were sufficiently informed regarding general information about COVID-19. Views on telemedicine, which was mostly understood as contact via telephone or video call, differed widely, with some participants being very accepting and interested, while others dismissed telemedicine categorically.</p><p><strong>Conclusion: </strong>Participants regarded the new COVID-19 regulations as sensible. Telemedicine using telephone or video call consultations should be further explored under the assumption that this would be acceptable for some but not all patients.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11169969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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