European Journal of General Practice最新文献

{"title":"The impact of professional characteristics and person-centred care on general practitioners' stress levels. Findings from the cross-sectional PACE GP/FP study in 24 European countries.","authors":"Katarzyna Nessler, Krzysztof Studzinski, Zalika Klemenc-Ketiš, Heather L Rogers, Torunn Bjerve Eide, Sara Ares Blanco, Heidrun Lingner, Sanda Kreitmayer, Jesús González-Lama, Esther Van Poel, Didem Kafadar, Kathryn Hoffmann, Thomas Frese, Radost Assenova, Mehmet Ungan, Gorka Vuletić, Erika Zelko, Rosa Megallón-Botaya, Marion Tomičić, Fatima Mendez Lopez, Zoi Tsimtsiou, Miguel J Mora, Vinita Mahtani, Ewa Wójtowicz, Adam Windak, Goranka Petriček","doi":"10.1080/13814788.2026.2652678","DOIUrl":"10.1080/13814788.2026.2652678","url":null,"abstract":"<p><strong>Background: </strong>General practitioners (GPs) face numerous challenges that can contribute to stress. Understanding these factors is crucial for developing interventions to support physician wellbeing and maintain high-quality care.</p><p><strong>Objectives: </strong>The study aims to explore the factors associated with perceived stress among European GPs, including attitudes towards person-centred care (PCC), demographics, and professional characteristics.</p><p><strong>Methods: </strong>The PACE GP/FP study is an online, cross-sectional, multi-centred survey conducted in 24 European countries between November 2022 and January 2024. The survey tool included the Perceived Stress Scale (PSS), the Patient-Practitioner Orientation Scale (PPOS), and questions on GPs' demographics and practice characteristics. Linear mixed models analysed the relationship between these variables and perceived stress.</p><p><strong>Results: </strong>In total, 3522 GPs were included in the analysis. The mean PSS score indicated moderate levels of stress. Female gender and younger age were associated with increased stress. Also, a higher number of daily patient contacts and a greater perceived responsibility for vulnerable patient populations (e.g. migrants, those with limited social support, or psychiatric vulnerabilities) were significantly associated with higher stress. A stronger patient-centred orientation was associated with lower perceived stress.</p><p><strong>Conclusion: </strong>The findings have implications for interventions to reduce GP stress, such as training programs promoting PCC, optimising patient contact rates, and providing targeted support for GPs caring for vulnerable patients. Further research is needed to explore these factors' complex interplay and impact on GP wellbeing.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2652678"},"PeriodicalIF":2.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare inequalities in general practice due to educational level: A retrospective cohort study analysing patients' presentation and GP response to requests.","authors":"Sjoerd Hulshof, Tim C Olde Hartman, Reinier Akkermans, Henk J Schers, Annemarie A Uijen","doi":"10.1080/13814788.2026.2649992","DOIUrl":"10.1080/13814788.2026.2649992","url":null,"abstract":"<p><strong>Background: </strong>Educational level is an important social determinant of health and may contribute to healthcare inequity by affecting how patients present health problems.</p><p><strong>Objectives: </strong>Explore the interaction between patients' educational level (1), their presentation of health problems to general practitioners (GPs) and (2) GP's responses to requested interventions.</p><p><strong>Design and setting: </strong>Retrospective cohort study within a Dutch primary care practice-based research network.</p><p><strong>Methods: </strong>All new episodes of care of patients' aged ≥25 years between 2014 and 2022 were included. Data were collected on the reason for encounter (RFE) at initial contact within each episode, and patients' educational level. Differences were analysed in incidence of RFE types (symptoms, intervention-requests, self-diagnoses) and GP's policies regarding requested diagnostic and therapeutic interventions among patients with low, medium and high educational levels.</p><p><strong>Results: </strong>Patients with lower educational levels more frequently presented symptoms (59.7% versus 56.5%) and were less likely to present with intervention requests (OR 0.88) or self-diagnosis (OR 0.83). They requested more urine tests (RR 1.28), but fewer blood tests (RR 0.90), diagnostic imaging (RR 0.75) and referrals to primary (RR 0.74) and secondary care (RR 0.87). GPs responded more often to urine test requests (RR 1.25), but less often to referral requests to primary (RR 0.68) and secondary care (RR 0.80) among patients with lower educational levels.</p><p><strong>Conclusion: </strong>This study emphasises GPs' need to understand how educational status affects patient's presentation and intervention preferences, which can improve communication, shared decision-making and enhance equitable healthcare delivery by addressing an important social determinant of health.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2649992"},"PeriodicalIF":2.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer screening in patients with severe psychiatric disorders in France: Towards a coordinated and inclusive approach.","authors":"Nadine Pellen, Bleuenn Gouzien, Manon Troënes, Sarah Khelifi, Gaëlle Ragot, Aziliz Le Glaz","doi":"10.1080/13814788.2026.2619260","DOIUrl":"10.1080/13814788.2026.2619260","url":null,"abstract":"<p><strong>Background: </strong>The close link between mental health and physical health is evident in patients with severe psychiatric disorders (SPD), such as schizophrenia and bipolar disorder. SPD is associated with a reduction in life expectancy, due to excess mortality from cardiovascular disease and cancer. In patients with SPD, reduced access to cancer screening programs, due to cognitive, organisational and social barriers, leads to late detection and worse prognosis.</p><p><strong>Objectives: </strong>The objective was to identify the barriers and facilitators to systematic cancer screening in patients with SPD, with a focus on the role of general practitioners (GPs) in improving access to preventive care.</p><p><strong>Method: </strong>This study was conducted in the Finistère department, France. A qualitative study based on semi-structured interviews with GPs, recorded, anonymised, transcribed verbatim, and analysed using a grounded theory approach.</p><p><strong>Results: </strong>From October 2023 to February 2024, 25 GPs were interviewed. The analysis highlighted 3 areas for improving access to cancer screening: logistic support, active involvement of the family and professional support networks and coordination among the healthcare providers. Barriers included the patients' lack of autonomy, difficulties in accessing transport, precariousness and complexity of the screening process, particularly for at-home screening tests. Family and friends play a key role, but remain vulnerable to caregiver burnout.</p><p><strong>Conclusion: </strong>These results confirm the importance of a multi-professional and integrative approach, with GPs playing a central role in addressing the specific vulnerabilities of this population. More research, involving patients, caregivers and psychiatric teams, is needed to co-construct appropriate, sustainable and ethically sound solutions.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2619260"},"PeriodicalIF":2.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing appropriate vestibular care: An interview study with general practitioners and patients.","authors":"Hà T N Ngo, Otto R Maarsingh, Pauline Slottje, Marco H Blanker, Jettie Bont, Vincent A van Vugt","doi":"10.1080/13814788.2025.2600144","DOIUrl":"10.1080/13814788.2025.2600144","url":null,"abstract":"<p><strong>Background: </strong>General practitioners (GPs) frequently prescribe anti-vertigo drugs (AVDs), even though there is limited evidence for their effectiveness. Meanwhile, they rarely apply vestibular rehabilitation, a treatment for various vestibular disorders with a strong evidence base.</p><p><strong>Objectives: </strong>This study aimed to identify barriers and facilitators to appropriate vestibular care in general practice.</p><p><strong>Methods: </strong>We conducted a qualitative study in Dutch general practice using semi-structured interviews with GPs and patients with vestibular symptoms. We used purposive sampling to select participants. Interviews were audio-recorded, transcribed verbatim, and thematically analysed following the Template Analysis approach using MAXQDA 2022 software.</p><p><strong>Results: </strong>We interviewed 11 GPs and 15 patients. We assessed barriers and facilitators to appropriate vestibular care for GPs (i.e. not prescribing AVDs, advising vestibular exercises) and patients (i.e. not using AVDs, doing vestibular exercises). We identified four themes: competence, mindset, relational determinants, and accessibility to care. Facilitators included adequate knowledge about vestibular disorders, GPs valuing delivering high-value care, positive experiences with physiotherapy, patients' coping skills, personal continuity, close collaboration between GP and colleagues, social support, and sufficient time and availability of providers. Barriers included diagnosis and treatment insecurity among GPs, patients doubting the GPs' competence, patients' desperation for treatment and GPs accommodating these wishes, positive experiences with AVDs, prescriptions by other providers, and insurance not covering physiotherapy.</p><p><strong>Conclusion: </strong>Multiple barriers and facilitators shape appropriate vestibular care in general practice. Interventions should strengthen GPs' and patients' knowledge of vestibular management. Internet-based vestibular rehabilitation may address key barriers, particularly logistic and financial ones.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"31 1","pages":"2600144"},"PeriodicalIF":2.5,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout among Catalan general practitioners. A repeated cross-sectional study, during and after the COVID-19 pandemic.","authors":"Maria Miñana- Castellanos, María Isabel Fernández-San-Martín, María Rodríguez-Barragán, Maria Teresa Santos E Silva Caldeira Marques, Antoni Sisó, Josep Basora, Enric Aragonès","doi":"10.1080/13814788.2025.2485073","DOIUrl":"https://doi.org/10.1080/13814788.2025.2485073","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 pandemic caused a significant impact on healthcare workers' mental health and burnout, which continues after the pandemic.</p><p><strong>Objectives: </strong>To assess the levels of burnout in general practitioners (GP) in Catalonia at three different times.</p><p><strong>Methods: </strong>Cross-sectional study involving members of the GPs' Catalan Society (<i>n</i> = 4700). A self-administered survey was sent via institutional email in June-July 2021 (T1), in March-April 2022 (T2), and in May-June 2023 (T3). Probable burnout was assessed through Maslach Burnout Inventory (MBI) test, with three independent dimensions: emotional exhaustion, depersonalisation, and personal achievement. A descriptive analysis was performed, as well as a comparison between T1, T2, and T3 results.</p><p><strong>Results: </strong>500 GPs responded in T1, 454 in T2, and 386 in T3. Samples were similar in demographic variables. Regarding burnout dimensions, the level of emotional exhaustion was 67.5% in T1, with a statistically significant decrease in T2 and T3 (56.4 and 58.1%, respectively, <i>p</i> = 0.001); levels of depersonalisation were 42.7% in T1, 37.0% in T2 and 36.7% in T3 (<i>p</i> = 0.091); levels of personal achievement were 29.9% in T1, 30.4% in T2 and 24.2% in T3 (<i>p</i> = 0.086).  Starting at high levels of emotional exhaustion and depersonalisation, the prevalence decreased significantly over time in two groups: women and GPs who worked <10 years at the same workplace.</p><p><strong>Conclusion: </strong>Catalan GPs experienced significant burnout during the COVID-19 pandemic with emotional exhaustion being particularly high. Although the prevalence of burnout decreased slightly over time, over half of the participants consistently reported high levels of emotional exhaustion.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"31 1","pages":"2485073"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/13814788.2025.2477962","DOIUrl":"10.1080/13814788.2025.2477962","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"31 1","pages":"2477962"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From trainee to general practitioner: A qualitative study of transition experiences of Flemish GP trainees.","authors":"Ellen Tisseghem, Joke Fleer, Melissa Horlait, Peter Pype, Emelien Lauwerier","doi":"10.1080/13814788.2024.2443603","DOIUrl":"10.1080/13814788.2024.2443603","url":null,"abstract":"<p><strong>Background: </strong>The transition from trainee to professional marks a key milestone in a family doctor's career, bringing both emotional and mental challenges. This critical period of specialisation shapes how young doctors adapt and influences their future career choices.</p><p><strong>Objectives: </strong>We explored trainees' experiences during their first year of advanced medical training in family medicine/general practice, including barriers and facilitators.</p><p><strong>Methods: </strong>Using qualitative methodology, we conducted ten focus group interviews with 111 trainees. These group interviews were held as part of small-group sessions integrated into a self-guided reflection course. All interviews were held between February 2021 and March 2021, conducted online via MS Teams, recorded, and transcribed verbatim for analysis.</p><p><strong>Findings: </strong>Our analysis uncovered two adaptational processes during this transition period: personal adaptation and professional socialisation. We interpreted this as a complex balancing act, with impact on mental health aspects such as energy, exhaustion, and self-confidence. Multiple elements at different levels influenced these processes, including the workplace (e.g. interactions with colleagues and patients), the educational program (e.g. assignments, courses), and societal expectations (e.g. role expectations, support).</p><p><strong>Conclusion: </strong>The findings highlight the importance of understanding both personal adaptation and professional socialisation to support trainees effectively during their transition into practice. Future studies should validate these findings and explore their evolution over time, particularly in relation to adaptation and career choices.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"31 1","pages":"2443603"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11722024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying opportunities for shared decision-making through patients' and physicians' perceptions on the diagnostic process: A qualitative analysis of malpractice claims in general practice.","authors":"Sofie Jacobse, Hanneke Rijkels-Otters, Manon Eikens-Jansen, Trudy van der Weijden, Glyn Elwyn, Walter van den Broek, Patrick Bindels, Laura Zwaan","doi":"10.1080/13814788.2025.2501302","DOIUrl":"10.1080/13814788.2025.2501302","url":null,"abstract":"<p><strong>Background: </strong>Shared decision-making (SDM) is considered the preferred communication model, yet its applicability in the diagnostic process is understudied.</p><p><strong>Objective: </strong>To identify clinical situations in the diagnostic process that could benefit from SDM.</p><p><strong>Methods: </strong>An observational study of closed malpractice claims against general practitioners (2012-2020) related to problems of diagnosis, obtained from a liability insurance company in the Netherlands. We established SDM-selection criteria, specified for the diagnostic process (i.e. diagnostic uncertainty, multiple options and clinical equipoise). Phase 1: We selected and categorised eligible cases, using summarised information from a claim database. Phase 2: We analysed 90 fully documented claims and extracted information from GPs and patients related to the diagnostic process. Using this data, we conducted an inductive thematic analysis.</p><p><strong>Results: </strong>Phase 1: 261 out of 1477 claims (18%) met the SDM-selection criteria. The main reason for complaints was (omitted) test-ordering (155 claims, 59.4%). The most frequent final diagnoses were: fracture (49%), malignancy (10%), infection (9%), tendon rupture (8%) and cardiovascular disease (4%). Phase 2: Six types of diagnostic considerations emerged from the data: diagnostic uncertainty, using time as a diagnostic tool, management consequences, information about test indication or procedure, indications for re-evaluation and individual patient context. Contradictory statements from GPs and patients demonstrated a lack of shared understanding.</p><p><strong>Conclusion: </strong>The diagnostic process could benefit from SDM in several areas, including discussing diagnostic options, test conditions (e.g. timing and procedure) and follow-up. SDM training programs should be tailored to encourage clinicians to apply SDM in diagnostic decisions.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"31 1","pages":"2501302"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing prevention: A clinician's perspective.","authors":"Paulo Santos","doi":"10.1080/13814788.2025.2549809","DOIUrl":"https://doi.org/10.1080/13814788.2025.2549809","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"31 1","pages":"2549809"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain and feasibility of capillary self-blood collection in general practice: A cross-sectional investigative study.","authors":"Christopher Schuchardt, Frank Müller, Angelika Hafke, Eva Hummers, Julie Schanz, Alexandra Dopfer-Jablonka, Georg M N Behrens, Dominik Schröder","doi":"10.1080/13814788.2025.2501309","DOIUrl":"10.1080/13814788.2025.2501309","url":null,"abstract":"<p><strong>Background: </strong>Capillary self-blood collection (SBC) with mailed samples enables remote laboratory monitoring without in-person healthcare visits. This approach may improve continuity of care for patients, especially with chronic conditions.</p><p><strong>Objectives: </strong>Compare pain perception between venous blood draws and capillary SBC and evaluate the usability and blood volume yield of SBC devices.</p><p><strong>Methods: </strong>In this cross-sectional study, general practice patients from mid of Germany, Germany performed SBC using the Tasso+^® upper-arm device and mailed samples to a laboratory. Pain, usability, SBC volume, and associated factors were analysed using bivariate and general linear models.</p><p><strong>Results: </strong>Of 106 patients, 57.5% performed SBC without assistance. Self-perceived pain was lower among SBC draws (0.13, SD = 0.42) versus venous draws (1.21, SD = 1.60) (<i>p</i> < .001). 59.4% self-collected ≥130 μL blood plasma. Patient characteristics were not associated with SBC volume in regression analysis. Overall, the mean System Usability Scale (SUS) score was 86.2, indicating high usability. Lower school education was associated with lower usability scores, while lower fear of blood and needles were associated with higher usability scores in regression analysis.</p><p><strong>Conclusions: </strong>Capillary SBC had high feasibility and usability and caused less pain than venous draws in the general practice setting. SBC shows promises for enabling remote laboratory monitoring.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"31 1","pages":"2501309"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}