Family Medicine and Community Health最新文献

{"title":"Use of point-of-care resources for management of paediatric asthma: frequency, types and temporal trends in early-career general practitioners.","authors":"Nina Reid, Katie Fisher, Anna Ralston, Amanda Tapley, Elizabeth G Holliday, Ben Mitchell, Ian Charlton, Katherine Chen, Jason Dizon, Dominica Moad, Alison Fielding, Andrew Davey, Mieke van Driel, Lisa Clarke, Geoffrey Spurling, Parker Magin","doi":"10.1136/fmch-2025-003679","DOIUrl":"10.1136/fmch-2025-003679","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the frequency and temporal trends in Australian early-career general practitioners (registrars) accessing point-of-care resources (POCR) when managing paediatric asthma.</p><p><strong>Design: </strong>A longitudinal analysis (2010-2019) nested within the Registrar Clinical Encounters in Training project of registrars' in-consultation practice. The outcome factor in univariable and multivariable mixed effects logistic regression analyses was whether POCR was accessed for paediatric asthma problems, with year as the independent variable of interest. Further analyses compared trends (2010-2019) in asthma problem POCR use with non-asthma problem POCR use.</p><p><strong>Setting: </strong>Australian community training general practices.</p><p><strong>Participants: </strong>2834 Australian general practice registrars (trainees) (participation rate 92.2%).</p><p><strong>Result: </strong>POCR use was greater for asthma (15%) than for non-asthma problems (12.6%). The temporal increase in POCR use for paediatric asthma (OR for POCR use 1.15 per year (95% CI 1.07 to 1.24)) was greater than that for non-asthma problems (OR of 1.11 per year (95% CI 1.09 to 1.14)). This difference in rates of increase in POCR of paediatric asthma and non-asthma problems was not statistically significant.</p><p><strong>Conclusion: </strong>There are multiple possible reasons for the increasing use of POCR in paediatric asthma. This trend may reflect increasing focus on evidence-based asthma care and increasing access to high-quality asthma management online POCR available within Australia. Alternatively, paediatric asthma could represent an area of increasing clinical challenge and possible educational need for early-career general practitioners. Further research exploring the underlying reasons for the increasing POCR use in paediatric asthma is warranted.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677384","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":"Functional Independence Measure assessed early after admission predicts home discharge in older adults admitted to acute general medical wards: a retrospective cohort study.","authors":"Eiichi Kakehi, Yukako Matsumoto, Kyoichiro Namura, Kae Sugiyama, Yukinobu Akamatsu, Shigehisa Sakurai, Takafumi Nozaki, Keisuke Shoji, Seiji Adachi, Kazuhiko Kotani","doi":"10.1136/fmch-2025-003579","DOIUrl":"10.1136/fmch-2025-003579","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether Functional Independence Measure (FIM) scores assessed during the early phase of hospitalisation, before the initiation of rehabilitation, independently predict home discharge among older adults admitted to an acute general medical ward.</p><p><strong>Design: </strong>Retrospective observational cohort study.</p><p><strong>Setting: </strong>The General Medicine Department of a municipal general hospital in Japan.</p><p><strong>Participants: </strong>Of 1168 community-dwelling adults aged ≥65 years admitted from home, the study included 744 who received rehabilitation and underwent early-phase FIM assessment before rehabilitation.</p><p><strong>Main outcome measures: </strong>The primary outcome was the discharge destination (home vs facility). The predictive value of the total FIM score (FIM-T), motor score (FIM-M) and cognitive score (FIM-C) was evaluated using multivariable logistic regression and receiver operating characteristic (ROC) curve analyses.</p><p><strong>Results: </strong>Overall, 494 patients (66.4%) were discharged home, 175 were discharged to facilities, and 75 died in hospital. The admission FIM was measured during the early phase of hospitalisation, with a mean assessment time of 4 days after admission. Early-phase FIM scores were significantly higher in the home discharge group than the facility discharge group (FIM-T: 65.8 vs 44.8; FIM-M: 38.1 vs 23.1; FIM-C: 27.7 vs 21.8; all p<0.001). After adjustment for age, clinical variables and social factors, higher FIM-T, FIM-M and FIM-C scores remained independently associated with home discharge (adjusted OR per 1-point increase for FIM-T: 1.06). ROC analysis showed moderate discriminative ability (areas under the curve of 0.75 for FIM-T and FIM-M, and 0.71 for FIM-C).</p><p><strong>Conclusions: </strong>Early-phase FIM scores, including both motor and cognitive domains, independently predict home discharge among older adults in acute general medical wards and may support individualised discharge planning in routine practice. These findings may be most generalisable to acute care hospitals where early-phase functional assessments are performed at the initial rehabilitation evaluation, which, in our setting, occurred a mean of 4 days after admission.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616897","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":"Does the relationship between body mass index and health-related quality of life vary depending on early, middle and later adulthood?","authors":"Jieun Kim, Dong Jun Kim, Hooyeon Lee","doi":"10.1136/fmch-2025-003614","DOIUrl":"10.1136/fmch-2025-003614","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the association between body mass index (BMI) and health-related quality of life (HRQoL) in a Korean adult population using a nationwide population-based survey.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>This study analysed data from the 2021 Community Health Survey in South Korea.</p><p><strong>Participants: </strong>A total of 223 336 respondents were aged ≥19 years.</p><p><strong>Results: </strong>Underweight status was consistently associated with lower EuroQol HRQoL (EQ-5D) index scores across all age groups (early, middle and later adulthood), with the detrimental impact being most pronounced in men and the elderly (≥65 years). Specifically, underweight men aged 40-64 years exhibited the highest risk for problems in anxiety/depression (OR 2.48; 95% CI 1.86 to 3.30).The association between obesity and HRQoL showed different patterns depending on sex. In women, obesity was negatively associated with HRQoL across all life stages; notably, young women (19-39) with preobesity or obesity reported difficulties in all five EQ-5D dimensions. Conversely, in men aged ≥40 years, obesity was associated with better HRQoL outcomes and lower odds of anxiety/depression among those aged 40-64 years (OR 0.85; 95% CI 0.77 to 0.94) and those aged ≥65 years (OR 0.88; 95% CI 0.79 to 0.98).</p><p><strong>Conclusions: </strong>The association between BMI and HRQoL differs according to sex and age. Policy attention regarding HRQoL may benefit from considering the maintenance of proper weight and the promotion of nutritional health, tailored to sex and age.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610313","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":"Cultural health capital as a tool for health equity: the role of school-based health education in community and family medicine.","authors":"Samantha A Lee, Daniella D Maydan, Panagis Galiatsatos","doi":"10.1136/fmch-2026-003892","DOIUrl":"10.1136/fmch-2026-003892","url":null,"abstract":"<p><p>The role of primary care and family medicine in addressing social and structural determinants of health is well established, yet limited attention has been given to how young people acquire the skills needed to navigate healthcare systems. Cultural health capital-the repertoire of norms, communication styles and interactional competencies that shape patient-clinician encounters-represents an under-recognised determinant of access, engagement and equity across the life course. This article examines the potential of school-based health education and school-healthcare partnerships as strategic extensions of community-oriented primary care to strengthen cultural health capital among young people and their communities. Drawing on sociological theory, community-based practice examples, and evidence from existing K-12 school-based health initiatives, this article aims to argue that current health education programmes remain largely focused on information delivery, with limited emphasis on the practical skills required to navigate healthcare institutions. By integrating cultural health capital development into school curricula, particularly through partnerships with local family medicine and community health professionals, there is a scalable opportunity to enhance care navigation, trust and engagement while expanding avenues to healthcare professions. These reciprocal partnerships also provide clinicians with opportunities to deepen their understanding of local community contexts, communication norms and lived experiences. Framed within principles of community-oriented primary care, this article highlights the potential of school-healthcare partnerships to address upstream inequities and strengthen the capacity of both future patients and clinicians to engage more effectively with healthcare systems.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533430","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":"Transition time between long-term conditions among childbearing women in England: a nationwide observational analysis.","authors":"Sobia Ambreen, Adeniyi Fagbamigbe, Amanda Rodrigues Amorim Adegboye, Abiodun Adanikin","doi":"10.1136/fmch-2026-003904","DOIUrl":"10.1136/fmch-2026-003904","url":null,"abstract":"<p><strong>Objective: </strong>To examine transition times between long-term conditions (LTCs) and their associated determinants among childbearing women.</p><p><strong>Design: </strong>A population-based cohort study. We estimated median times to progress from 1 to 2, 2 to 3, 3 to 4 and 4 to ≥5 LTCs, stratified by ethnicity, socioeconomic status and region. 10-year risks of progression from first to second LTC were estimated by entry cohort (pre-2013 vs ≥2013) using Kaplan-Meier methods, with determinants assessed using Weibull survival models.</p><p><strong>Setting: </strong>English primary care records (CPRD Aurum and GOLD) and pregnancy registers.</p><p><strong>Participants: </strong>A total of 2 160 157 women with a first LTC diagnosis during reproductive years (ages 15-49) and at least one recorded pregnancy between 2003 and 2022.</p><p><strong>Results: </strong>Approximately 65% with one LTC progressed to develop two or more LTCs. The median time to develop additional LTCs decreased progressively: 5.58 years (from 1 to 2), 4.45 years (from 2 to 3), 3.89 years (from 3 to 4) and 3.68 years (from 4 to 5+). Women diagnosed with their first LTC from 2013 onwards transitioned to second LTC faster than those diagnosed before 2013 (χ² = 4260.55, p<0.001). Faster progression was observed among women from the most deprived backgrounds compared with the least deprived (TR 0.79, 95% CI 0.79 to 0.80). Compared with Southwest England, women in the Northwest, West Midlands and Southeast acquired additional LTCs more rapidly. Ethnic variations in the risk of progression were also observed in specific contexts. Furthermore, analysis of baseline condition-specific trajectories showed that women with an initial diagnosis of cardiomyopathy experienced the fastest transition to a subsequent LTC (median survival time (MST) 3.89 years; 95% CI 0.99 to 11.78). This was followed by women with coronary heart disease (MST 4.21 years; 95% CI 1.30 to 11.34), diabetes (MST 4.25 years; 95% CI 1.39 to 9.20) and anxiety (MST 4.29 years; 95% CI 1.46 to 10.12).</p><p><strong>Conclusion: </strong>LTC accumulation among childbearing women is driven by socioeconomic deprivation, ethnicity and regional disparities. Targeted interventions for high-risk groups, alongside efforts to address structural inequalities, may help slow this progression.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481987","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":"Adoption of the Reference Framework for Preventive Care for Older Adults: a study of primary care physicians.","authors":"Claire Chenwen Zhong, Mingtao Chen, Zehuan Yang, Zhaojun Li, Chung Yi Lo, William Cw Wong, Junjie Huang, Martin Cs Wong","doi":"10.1136/fmch-2025-003721","DOIUrl":"10.1136/fmch-2025-003721","url":null,"abstract":"<p><strong>Objective: </strong>The Reference Framework (RF) for Preventive Care for Older Adults in Primary Care provides evidence-based guidelines to enhance preventive care in Hong Kong. However, its adoption and feasibility among primary care physicians (PCPs) remain unclear. This study evaluates PCPs' awareness, adoption, and perceived barriers and enablers to RF implementation.</p><p><strong>Design: </strong>A cross-sectional survey conducted among PCPs in Hong Kong. Sociodemographics, adoption of RF and perceptions of implementation barriers and enablers were collected. Logistic regression was used to identify key factors influencing RF applicability, acceptability and feasibility.</p><p><strong>Setting: </strong>Both private and public primary care institutions in Hong Kong.</p><p><strong>Participant: </strong>A total of 485 PCPs who provide preventive care to older adults in primary care settings across both the private and public sectors in Hong Kong participated.</p><p><strong>Results: </strong>Among 485 physicians surveyed, most considered the RF applicable (71.3%), acceptable (78.1%) and feasible (65.6%), with significantly higher acceptability and feasibility reported by private physicians. Adoption of RF recommendations varied widely (17.5%-92.8%), with highest uptake for influenza vaccination and lowest for urinary incontinence screening. Private physicians more often viewed frequent RF updates as facilitators and market competition as a barrier, while public physicians more frequently reported incompatibility with clinical settings. Physicians seeing 30-59 patients per day were more likely to find the RF applicable (adjusted OR 2.123, 95% CI 1.201 to 3.753, p=0.010) compared with those who provided consultation for fewer than 30 patients per day.</p><p><strong>Conclusion: </strong>While most PCPs perceived the RF as applicable, acceptable and feasible, significant variation in adoption across recommendations and between practice settings highlights implementation challenges. Key enablers included high-quality evidence and local clinical information, while barriers like time constraints and patient adherence highlight the need for regular updates, ongoing education and tailored strategies for wider RF adoption.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436399","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":"Mapping competencies of family physicians in primary healthcare: a scoping review.","authors":"Laura Daniela Saza Salas, July Andrea Hernandez Rincon, Erwin Hernando Hernandez Rincon, Mauricio Fernando Ulloa Rodriguez, Diana Marcela Diaz Quijano, Claudia Liliana Jaimes Peñuela","doi":"10.1136/fmch-2025-003528","DOIUrl":"10.1136/fmch-2025-003528","url":null,"abstract":"<p><strong>Objective: </strong>To map the available evidence on the competencies of family physicians in primary healthcare (PHC).</p><p><strong>Design: </strong>A scoping review was conducted following the methodology of the Joanna Briggs Institute. The results were grouped into thematic categories and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.</p><p><strong>Eligibility criteria: </strong>Include documents published from 2010 to 2025 in English, Spanish and Portuguese that were available in full text and responded to the research question.</p><p><strong>Information sources: </strong>Using PubMed, LILACS and Scopus databases. The snowball methodology was employed to expand the search.</p><p><strong>Results: </strong>A total of 1754 studies were identified, and several competencies were grouped into eight categories: communication, knowledge management, health promotion, information and communications technology, clinical and administrative management, community-oriented and public health-oriented care, teaching and research, focused on PHC. A set of interrelated components enriches each category.</p><p><strong>Conclusions: </strong>Although the competency-based approach is not new, this review provides an updated and integrated framework that highlights eight interrelated competency domains essential for family physicians in PHC. The findings support its use in curriculum development, professional evaluation and future research aimed at strengthening primary care systems through a more strategic and people-centred workforce.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343669","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":"Long-term risk of bowel resection and mortality associated with sleep behaviours and sleep pattern in patients with inflammatory bowel disease: a large-scale prospective cohort study.","authors":"Qian Zhang, Fang Xu, Si Liu, Shengtao Zhu, Shutian Zhang, Shanshan Wu, Wei Li","doi":"10.1136/fmch-2025-003787","DOIUrl":"10.1136/fmch-2025-003787","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between sleep pattern, which integrates sleep duration, chronotype and quality, with risk of bowel resection and all-cause mortality in patients with inflammatory bowel disease (IBD) based on a long-term prospective cohort.</p><p><strong>Design: </strong>Prevalent patients with IBD were categorised into poor (0-2 score), intermediate (3 score) and healthy (4-5 score) based on sleep score. The score assigned 1 point for each of five low-risk sleep behaviours: sleep 7-8 hours per day, early chronotype, no snoring, never/rarely insomnia symptoms and no frequent daytime sleepiness. The primary outcome was all-cause death, with bowel resection as a secondary outcome. Multivariable Cox proportional hazards models were used to explore the association.</p><p><strong>Setting: </strong>This study used the data from the UK Biobank with participants recruited in 2006-2010.</p><p><strong>Participants: </strong>Among 502 411 participants recruited in UK biobank, 4262 cancer-free patients with IBD at baseline were finally included.</p><p><strong>Results: </strong>During a median of 14.6-year follow-up, 793 received bowel resection and 498 deaths developed. Compared with poor sleep pattern, both healthy (HR=0.75, 95% CI 0.59 to 0.94) and intermediate (HR=0.77, 95% CI 0.66 to 0.95) sleep groups had reduced mortality risk, with a dose-response relationship across sleep scores (HR=0.89, 95% CI 0.82 to 0.98). Specifically, appropriate sleep duration (HR=0.79, 95% CI 0.66 to 0.95) and early chronotype (HR=0.82, 95% CI 0.68 to 0.98) were associated with 21% and 18% lower mortality risk, respectively. Marginally significant lower risk of bowel resection was observed with healthy (HR=0.86, 95% CI 0.72 to 1.04) and intermediate (HR=0.87, 95% CI 0.73 to 1.03) sleep pattern, with 22% lower risk associated with never/rarely insomnia symptoms (HR=0.78, 95% CI 0.65 to 0.94).</p><p><strong>Conclusions: </strong>A healthy sleep pattern, particularly sleep duration and early chronotype, is associated with reduced all-cause mortality risk in patients with IBD, with probably beneficial effect on lowering risk of bowel resection, highlighting the importance of maintaining healthy sleep behaviours for long-term prognosis in IBD.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318494","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":"Time to care: the lived experience of receiving care from a primary care service for people with frequent hospital admissions.","authors":"Deirdre McGowan, Tania Winzenberg, Emily Hansen, Susan Henrys, Linda Richardson, Andrew J Palmer, Jan Radford, Kelly Shaw, Claire Morley","doi":"10.1136/fmch-2024-003234","DOIUrl":"10.1136/fmch-2024-003234","url":null,"abstract":"<p><strong>Objective: </strong>To explore the experiences and perceptions of health and healthcare of clients of a co-designed, community-based service for people with frequent hospital admissions.</p><p><strong>Design: </strong>This qualitative study used semi-structured interviews guided by a schedule that covered each participant's experience and perception of their health and healthcare and experience of receiving care from the service; what is important to them when receiving care; and what, if any, effect being a client of the service had on their health and well-being. Interviews took place in participants' homes, were audio-recorded, transcribed verbatim and checked for accuracy. Participants were able to amend their transcript. Using thematic analysis informed by grounded theory, data were independently and iteratively analysed by two investigators and data saturation was reached. The study was guided by principles of qualitative rigour.</p><p><strong>Setting: </strong>A nurse-led, multidisciplinary, community-based service comprising a nurse manager, GP, social worker, allied health assistant and administration assistant for people with frequent admissions at a public hospital in Tasmania, Australia.</p><p><strong>Participants: </strong>Any past or existing client was eligible to participate. Twenty were interviewed. Their median age was 78 years, 50% were female and 55% lived alone.</p><p><strong>Results: </strong>Three themes were identified: (i) the challenges of ageing, (ii) complex care needs require intensive multidisciplinary holistic care and (iii) relationships are central to care and healthcare delivery. The three themes together formed a central organising theme: time to care. Having 'time to care' enabled healthcare workers to provide biomedical and psychosocial care and support and help participants address their challenges of ageing. It also allowed the development of trusting and respectful relationships that were essential to participants when receiving care.</p><p><strong>Conclusion: </strong>To understand and support people with frequent admissions 'time to care' was essential. A range of healthcare workers were required to provide relational aspects of care, as well as individualised and time-intensive care that spanned medical, spiritual, mental and socio-economic dimensions across tertiary, social and community services. Diverse strategies may be needed to allow healthcare workers 'time to care'.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318462","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":"Development and psychometric properties of the 'Assessment of Burden of Chronic Conditions (ABCC) tool' for people with chronic heart failure (CHF): a mixed methods approach.","authors":"Lotte C E M Keijsers, Loraine H L Peters, Onno C P van Schayck, Jean W M Muris, Esther A Boudewijns, Danny Claessens, Robert T A Willemsen, Philippe L Salomé, Josiane J J Boyne, Hans-Peter Brunner-La Rocca, Petra E J van Pol, Tiny Jaarsma, Niels H Chavannes, Tobias N Bonten, Annerika H M Gidding-Slok","doi":"10.1136/fmch-2025-003781","DOIUrl":"10.1136/fmch-2025-003781","url":null,"abstract":"<p><strong>Objective: </strong>To develop a chronic heart failure (CHF) module for the Assessment of Burden of Chronic Conditions (ABCC) tool and evaluate its psychometric properties.</p><p><strong>Design: </strong>Mixed methods study.</p><p><strong>Setting: </strong>The study was conducted in the Netherlands.</p><p><strong>Participants: </strong>Healthcare providers (ie, general practitioners (GPs), practice nurses, cardiologists, heart failure nurse practitioners, heart failure specialist nurses) and patients with CHF were involved in the developmental phase. In the psychometric evaluation, patients with CHF were included.</p><p><strong>Results: </strong>The ABCC-CHF module comprised 26 items across CHF-specific domains, accompanied by associated advice. It demonstrated high convergent validity with the Kansas City Cardiomyopathy Questionnaire (KCCQ) (97%) and successfully differentiated most known-groups. Internal consistency yielded a Cronbach's α of 0.92 for the total scale, while test-retest reliability showed an intraclass correlation coefficient (ICC) of 0.97.</p><p><strong>Conclusion: </strong>The CHF-specific module is developed and validated. It aims to integrate disease burden into routine healthcare, supporting person-centred care for people with CHF and multimorbidity.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12933770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285545","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}