BMC primary care最新文献

{"title":"Impact of a continuing medical education program on primary care providers - an analysis of a child psychiatry education program in Saskatchewan.","authors":"Malin Clark, Madhav Sarda, Mariam Alaverdashvili, Thuy Le, Adrian Teare, James Barton, Peter S Jensen, Anna Felstrom","doi":"10.1186/s12875-025-02872-4","DOIUrl":"https://doi.org/10.1186/s12875-025-02872-4","url":null,"abstract":"<p><strong>Background: </strong>Treating children and youth with mental health problems in the primary care setting is challenging for many reasons. One barrier to care is a lack of physician knowledge of child psychiatry. Saskatchewan has implemented a 6-month course developed by the non-profit REACH Institute and adapted to Canada (CanREACH), focused on teaching and implementing evidence-based child psychiatric diagnostic and treatment methods into primary care. Our study focused on determining this program's impact on primary care providers (PCPs) and patients.</p><p><strong>Methods: </strong>To determine the impact of CanREACH, we assessed the knowledge and skills gained by PCPs and determined whether these were retained over time. To evaluate systemic impact, we examined if the pre-training and post-training referrals to an outpatient child psychiatry clinic were impacted for PCPs who had taken the course.</p><p><strong>Results: </strong>PCPs developed significant skills and comfort in assessing, diagnosing and treating various mental illnesses and retained this knowledge over time. PCPs who had taken the course had a significant reduction in referrals (0.9 per PCP) made to child psychiatry, as compared to those who had not taken the course (1.3 per PCP) (p < 0.05). This long-term retention of skills provides reassurance about the effectiveness of the CanREACH program.</p><p><strong>Conclusions: </strong>Education improved the capacity of primary care providers to manage child and adolescent psychiatry cases, reducing the need to refer children to psychiatry subspecialists. This ultimately improved access to outpatient child psychiatry care for Saskatchewan residents.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"172"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087035","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}

{"title":"Can self-rated health be useful to primary care physicians as a diagnostic indicator of metabolic dysregulations amongst patients with type 2 diabetes? A population-based study.","authors":"K Umeh, S Adaji","doi":"10.1186/s12875-024-02671-3","DOIUrl":"https://doi.org/10.1186/s12875-024-02671-3","url":null,"abstract":"<p><strong>Background: </strong>Although most of the management of type 2 diabetes (T2DM) occurs in primary care, and physicians are tasked with using a 'whole person' approach, there is currently a lack of research on psychosocial diagnostic indicators for detecting metabolic abnormalities in T2DM patients. This study examined relations between SRH and metabolic abnormalities in patients with type 2 diabetes, adjusting for metabolic comorbidity.</p><p><strong>Method: </strong>A total of 583 adults with type 2 diabetes were identified from the 2019 HSE (Health Survey for England). Data on metabolic syndrome (MetS) was extracted, including lipids (high density lipoprotein cholesterol (HDL-C)), glycated haemoglobin (HbA1c), blood pressure (systolic/diastolic), and anthropometric measures (BMI, waist/hip ratio). Bootstrapped hierarchical regression and structural equation modelling (SEM) were used to analyse the data.</p><p><strong>Results: </strong>Adjusting for metabolic covariates attenuated significant associations between SRH and metabolic abnormalities (HDL-C, HbA1c), regardless of MetS status. Analysis by gender uncovered covariate-adjusted associations between SRH and both HDL-C (in men) and HbA1c (in women) (p's = 0.01), albeit these associations were no longer significant when evaluated against a Bonferroni-adjusted alpha value (p > 0.004). Sensitivity analysis indicated most findings were unaffected by the type of algorithm used to manage missing data. SEM revealed no indirect associations between SRH, metabolic abnormalities, and lifestyle factors.</p><p><strong>Conclusions: </strong>While poor SRH can help primary care physicians identify T2DM patients with metabolic dysfunction, it may not offer added diagnostic usefulness over clinical biomarkers.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"171"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087030","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}

{"title":"Assessing the implementation and impact of a social prescribing protocol in primary care.","authors":"Marina Pola-Garcia, Natalia Enríquez Martín, Alberto Turón Lanuza, Fátima Méndez-López, Ángel Gasch-Gallén, María Luz Lou Alcaine, Carmén Belén Benedé Azagra","doi":"10.1186/s12875-025-02862-6","DOIUrl":"https://doi.org/10.1186/s12875-025-02862-6","url":null,"abstract":"<p><strong>Background: </strong>Social prescribing allows clinicians to refer people to resources or activities in their community to improve their abilities and health. Implementation of social prescribing is growing. However, there is not enough evidence on several related issues. The aim of study was to analyse the implementation of the asset-based model in the primary care teams in Aragón and to describe the profile of people who benefit most and are most satisfied with social prescribing.</p><p><strong>Methods: </strong>It is an analytical observational study in the 123 primary healthcare teams of Aragon from September2018 to December2022. The data were obtained from Electronical Health Record, checked and cleaned. A descriptive analysis was performed for qualitative and mean and standard deviation for quantitative variables. To analyse the associations between attendance, satisfaction, and improvement with all variables, several analyses were conducted using different methods. Finally, a cluster analysis was developed with the most benefited and satisfied people.</p><p><strong>Results: </strong>During the study period, 2,735 asset recommendations were made to 2,578 different people and 1,050 follow-ups to 552. There was an increase in the use of the protocol over time, except during the COVID pandemic. Most recommendations were made to women (73.3%-2,006). The average age was 65. There were more referrals in the smallest places (3.11 referrals/1000inhabitants). The most frequent linked health issues were psychological problems (572 - 20.9%). Physical skills were the abilities that professionals most tried to promote (28.4-1,709). In the follow-ups, the 81.4%(373) reported attending to the asset regularly. There were differences according to age and health problems. The average of improvement was 3.87/5 with differences by age, municipality size and health problems. For satisfaction, the average was 4.57/5 with differences by age and health problems. The lowest level of improvement and satisfaction was found for social problems. The cluster analysis highlighted several groups. Three profiles were distinguished in terms of high improvement and four of high satisfaction. In both cases, the variables related to areas for enhancement primarily defined the profiles.</p><p><strong>Conclusions: </strong>It is necessary to continue research with strong methodological and complementary approaches. This manuscript is optimistic about the use and impact of the social prescription in primary health care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"169"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087027","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}

{"title":"The influence of professional identification and organizational incentives on turnover intentions: a hierarchical linear model in Beijing's family doctors.","authors":"Ziyan Zhai, Chengsen Cui, Kai Meng","doi":"10.1186/s12875-025-02859-1","DOIUrl":"https://doi.org/10.1186/s12875-025-02859-1","url":null,"abstract":"<p><strong>Background: </strong>The high turnover intentions among family doctos (FDs) in China have impacted the stability of teams and the quality of healthcare services in community health centers (CHCs). The factors influencing FDs' turnover intentions include not only individual characteristics but also organizational environmental factors within CHCs. This study aims to explore the mechanism of the impact of FDs' professional identification and organizational incentives on their turnover intentions.</p><p><strong>Methods: </strong>This study selected 3 397 FDs from 102 CHCs in six districts of Beijing as the research subjects. Multiple scales were used to quantify FDs' professional identity, turnover intention, and organizational incentives. A Hierarchical Linear Model (HLM) was employed to investigate the effects of organizational-level and individual-level factors on turnover intentions and to analyze the interaction between individuals and organizations.</p><p><strong>Results: </strong>The study found that FDs' professional identification has a significant negative impact on turnover intentions (Beta=-0.242, P < 0.001). The level of organizational incentives in CHCs had a significant negative impact on turnover intentions (Beta=-0.173, P < 0.001), and the level of organizational incentives played a significant negative moderating role in the process of individual professional identification influencing turnover intentions (Beta = 0.004, P < 0.05).</p><p><strong>Conclusions: </strong>Enhancing FDs' professional identity can lower their turnover intention, and the impact of personal identity on turnover intention diminishes in institutions with strong organizational incentives. During the training stage of FDs, it is essential to foster a strong personal professional identity value the role of organizational incentives, and optimize the overall organizational environment.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"170"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087039","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}

{"title":"Dementia care management in primary care practices: a descriptive study among nurse practitioners.","authors":"Lusine Poghosyan, Maura Dougherty, Grant R Martsolf, Kyle Featherston, Josh Porat-Dahlerbruch, Soo Borson, Tatiana Sadak, Siqing Wang, Monica O'Reilly-Jacob","doi":"10.1186/s12875-025-02855-5","DOIUrl":"https://doi.org/10.1186/s12875-025-02855-5","url":null,"abstract":"<p><strong>Background: </strong>More than 55 million people worldwide have dementia, and every year, 10 million new cases are diagnosed. In the United States (U.S.) alone, 6.9 million Americans ages 65 and older have dementia. Health systems are searching for innovative solutions to expand the primary care system's capacity to care for these patients. Advanced practice nurses such as nurse practitioners (NPs) are vital to increasing primary care capacity to meet the need, yet primary care NPs often face structural, organizational, and workforce challenges. More specifically, little is known about NPs who care for dementia patients in primary care settings. This study explored the practice structural capabilities, organizational context, and job outcomes (i.e., burnout, job dissatisfaction, and intent to leave the practice) among NPs providing care for patients with dementia in U.S. primary care practices.</p><p><strong>Methods: </strong>We conducted a national cross-sectional survey of NPs using modified Dillman methods. Between 2021 and 2023, NPs working in primary care practices who cared for patients with dementia received a mail and online survey. Additional survey mailings, emails, postcard reminders, and phone calls encouraged non-respondents to participate. In total, 968 NPs responded across 847 practices. We estimated a response rate of 16.4-36.4%.</p><p><strong>Results: </strong>NPs reported that the quality of dementia care in their practices is poorer than the overall care provided. About 45% of NPs indicated that dementia care in their practices is less than \"very good,\" while only 17% reported that the overall care delivered falls below that standard. Additionally, NPs reported significant deficits in practice structural capabilities for dementia care and challenges with administration within their organization. The findings show that over a third of NPs report burnout.</p><p><strong>Conclusions: </strong>Given the projected growth in the number of patients with dementia and the growing workforce of NPs worldwide, policy and practice efforts should be directed toward strengthening primary care practices to provide quality care for dementia patients. Bolstering NP workforce capacity and supporting NP roles in dementia care could improve organizational capacity to provide dementia care. However, widespread burnout among NPs found in our study could undermine their contribution to the dementia care workforce.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"164"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082501","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}

{"title":"How to improve support for people with (complex) multiple-problems through social prescribing in a vulnerable neighborhood; professionals', experts-by-experience' and clients' perspectives.","authors":"C Bos, S Vader, N van Vooren, K Jerković-Ćosić, B Keij","doi":"10.1186/s12875-025-02867-1","DOIUrl":"https://doi.org/10.1186/s12875-025-02867-1","url":null,"abstract":"<p><strong>Background: </strong>Comparative analysis of literature on social prescribing implementation suggests that strategies for implementing social prescribing for people with (complex) multiple-problems may differ significantly from those for people with mild-psychosocial issues. Similar findings have been observed in the Netherlands, where a SP program has been developed in 2018. This study examines the perspectives of health and care professionals, experts-by-experience, and clients regarding the design and implementation of social prescribing in vulnerable neighborhoods in order to better support people with (complex) multiple-problems.</p><p><strong>Methods: </strong>This study includes the first steps of the participatory action research methodology. During the research, 26 semi-structured interviews and observations were applied to gain insight among professionals, experts-by-experience and clients.</p><p><strong>Results: </strong>The findings indicate that support for people with (complex) multiple-problems requires more than a referral to already existing activities and services. Experts-by-experience and clients highlighted the necessity for a tailored based approach that considers clients' unique circumstances, e.g. the clients' living environment, particularly for those with (complex) multiple-problems and having a multicultural backgrounds. While all participants recognized the importance of addressing wider health needs, they also identified several challenges in doing so. Key themes for improving the support for individuals with (complex)multiple-problems are related to fragmentation due to insufficient collaboration, and to how wider health needs can best be addressed and by whom.</p><p><strong>Conclusion: </strong>While there is a clear willingness to enhance support for people with multiple-problems, findings reveal significant challenges faced by all parties involved. A key issue identified is the mismatch between what clients need and what professionals are able to provide. Ultimately, a tailored approach is essential for effectively addressing the complex and wider health needs of both individuals and populations, in order to improve their overall health and well-being outcomes. This approach may be feasible by providing clients with (complex) multiple-problem with a single case manager as first point of entry.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"165"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082505","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}

{"title":"Reasons for omitting anticoagulant treatment in patients with atrial fibrillation: an audit of patient records in general practice.","authors":"Ina Grønkjaer Laugesen, Anna Mygind, Erik Lerkevang Grove, Flemming Bro","doi":"10.1186/s12875-025-02852-8","DOIUrl":"https://doi.org/10.1186/s12875-025-02852-8","url":null,"abstract":"<p><strong>Background: </strong>Anticoagulant treatment is recommended for most patients with atrial fibrillation. Yet, register studies show a persisting treatment gap, which may lead to preventable strokes. This study aimed to explore the reasons for omitting anticoagulant treatment in patients with atrial fibrillation.</p><p><strong>Methods: </strong>We performed a comprehensive audit of electronic patient records in Danish general practice, including 12 clinics served by 39 general practitioners. All patients with atrial fibrillation, prevalent on 1 January 2023 and receiving no anticoagulant treatment, were identified using data from nationwide health registers. Patient records were reviewed retrospectively, covering the period 1 January 2001-1 January 2023. Information on care trajectories, follow-up patterns, decisions on anticoagulant treatment and reasons for omission were extracted and summarised using descriptive statistics.</p><p><strong>Results: </strong>In a representative sample of patients with atrial fibrillation receiving no anticoagulant treatment (n = 166), the absence of treatment was based on clinical decisions explicitly noted in the patient records in 93.4% of cases. In 34.3% of non-users, anticoagulants were deselected due to a low risk of stroke and no treatment indication, and 59.1% represented clinical decisions made in areas with no firm guideline recommendations. Reasons for anticoagulant treatment omission included minimal atrial fibrillation burden, left atrial appendage closure, palliative care, risk-benefit considerations and patient preference. However, in 6.6% of patients, the absence of treatment reflected unjustified or outdated decisions. For patients with atrial fibrillation receiving no anticoagulant treatment, care trajectories were characterised by contacts across healthcare sectors. For 64.4% of patients, the most recent contact for atrial fibrillation occurred in the hospital setting, while 30.7% had theirs in general practice. Most follow-up consultations were planned in general practice, but 59.0% had no follow-up plan. A decision on anticoagulant treatment was explicitly documented in the electronic patient record (at least once since diagnosis) for 94.6% of patients, with 22.3% revised in the past year.</p><p><strong>Conclusion: </strong>This study found that most anticoagulant treatment omissions in patients with atrial fibrillation were supported by documented clinical reasoning, suggesting that the extent of inappropriate undertreatment may be lower than expected. Nevertheless, optimising care pathways could facilitate timely anticoagulation for some patients with atrial fibrillation.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"166"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082533","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}

{"title":"Brief interventions for suicidal ideation in primary care: a systematic review.","authors":"Puya Younesi, Carolin Haas, Tobias Dreischulte, Andrea Schmitt, Jochen Gensichen, Karoline Lukaschek","doi":"10.1186/s12875-025-02848-4","DOIUrl":"https://doi.org/10.1186/s12875-025-02848-4","url":null,"abstract":"<p><strong>Background: </strong>General practitioners (GPs) play a crucial role in assessing and diagnosing suicidal ideation, often acting as the first person of contact for individuals with mental health concerns. Given the time constraints faced by primary care providers, interventions need to be brief and easily implemented. This systematic review seeks to identify, compare, and critically evaluate effective brief interventions for managing suicidality in primary care, offering a comprehensive overview and discussion of key findings.</p><p><strong>Methods: </strong>A systematic literature review was conducted using databases including MEDLINE, EMBASE, The Cochrane Library, PSYNDEX, and PsychINFO, supplemented by manual searches. Our search strategy focused on studies from 2000 to 2023. Risk of bias was assessed using the Cochrane RoB 2 Tool, and evidence quality was evaluated using GRADE, with adherence to the PRISMA-DTA checklist. A protocol was published in PROSPERO.</p><p><strong>Results: </strong>The search yielded 1248 publications. Of those, 44 were assessed for eligibility after screening, ultimately resulting in five included studies addressing four brief interventions for suicidality in primary care. Motivational interviews, safety planning, structured follow-ups, and collaborative care models were identified as key elements for future interventions to enhance the role of primary care in suicide prevention.</p><p><strong>Conclusion: </strong>This review highlights the need for further research to adapt brief interventions for primary care suicide prevention. Given their central role in patient care, GPs are well-positioned to identify and support individuals at risk. While initial promising approaches have emerged, further research in primary care suicide prevention is needed, and interventions tailored to the GP setting must be developed.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"167"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082495","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}

{"title":"Comparison of quit rates among exclusive cigarette smokers at Tobacco Control Center in Qatar: telephone versus face-to-face consultation.","authors":"Muslem M Aljaafar, Silva Kouyoumjian, Gafar Mahmoud, Ahmad AlMulla","doi":"10.1186/s12875-025-02858-2","DOIUrl":"https://doi.org/10.1186/s12875-025-02858-2","url":null,"abstract":"<p><strong>Background: </strong>During the coronavirus 2019 pandemic, smoking cessation services were delivered by telephone instead of routine face-to-face care. The objective of this study was to (1) determine if telephone care increases smoking quit rate compared to face-to-face intervention and (2) investigate factors associated with successful smoking cessation.</p><p><strong>Methods: </strong>A retrospective study design was utilized. Random selection of patients from two groups (face-to-face care and telephone care) that completed 3 follow-up sessions in Tobacco Control Center in Hamad Medical Corporation in Qatar was conducted from April 2020 to September 2021. Quit rates were compared at 4-week, 8-week and 12-week follow-up visits and a multivariable logistic regression analysis was conducted to obtain factors related to successful quitting at 12-week follow-up.</p><p><strong>Results: </strong>A total of 138 patients were included in this study (69 patients for each group). At 12-week follow-up, 31.9% of patients of telephone care (n = 22) succeeded in quitting smoking, while only 20.3% (n = 14) remained abstinent in the face-to-face care group. Telephone care compared with standard care increased the odds of success in stopping smoking (AOR = 3.279; 95% Cl: 1.191-9.026). Also, smokers with a previous quit attempt were significantly related to stopping smoking successfully (AOR = 4.724; 95% Cl: 1.131-19.727). Higher consumption of self-reported cigarette smoking was statistically associated with lower success rates in smoking cessation (AOR = 0.919; 95% Cl: 0.874-0.966).</p><p><strong>Conclusion: </strong>Our data suggests that providing telephone care seems more effective in smoking cessation treatment compared with routine face-to-face intervention. However, further formal assessment as randomized clinical trial needs to be conducted for more evaluation.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"168"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082499","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}

{"title":"Reflections of rural primary care physicians on the impact of the COVID-19 pandemic: a qualitative study.","authors":"Mary F Henningfield, Keelin McHugh, Sarina Schrager","doi":"10.1186/s12875-025-02868-0","DOIUrl":"https://doi.org/10.1186/s12875-025-02868-0","url":null,"abstract":"<p><strong>Background: </strong>Rural physicians tend to develop deep relationships with their patients and communities; however, few studies have evaluated the impact of the COVID-19 pandemic on relationships of physicians working in rural primary care clinics. We aimed to collect reflections of primary care physicians to understand their experiences during the pandemic and the impact on their relationships with patients, other physicians, clinic staff, and their communities.</p><p><strong>Methods: </strong>Interviews with primary care physicians practicing in rural Wisconsin used open-ended questions about experiences during the pandemic and the impact of the pandemic on their work and relationships, coping and well-being, and resources of their rural clinics. Interviews were recorded, transcribed, and de-identified for thematic qualitative analysis.</p><p><strong>Results: </strong>Twelve physicians were interviewed between October 3, 2022 and April 7, 2023. Experiences varied by the phase of the pandemic, especially changes in the work of physicians (e.g., working in the hospital), adapting to telemedicine, implementing mitigation strategies, and addressing vaccine hesitancy. These experiences impacted physicians' relationships with patients and their communities, especially when addressing vaccine hesitancy, mitigation strategies (e.g., masking), and misinformation. Some relationships were strengthened by shared experiences, such as clinic staff working together to meet challenges. Other relationships, however, were strained by social distancing and many physicians reported a loss of camaraderie with colleagues attributed to isolation and virtual meetings replacing in-person activities. Challenges for rural clinics included lack of resources (e.g., staff shortages), limited broadband access, and difficulties transferring patients to tertiary care centers.</p><p><strong>Conclusions: </strong>Physicians working in rural primary care clinics described a myriad of experiences during the pandemic. Difficulties in addressing vaccine hesitancy and misinformation about the pandemic were consistently identified as negatively affecting relationships with patients and some staff. Fewer in-person interactions with colleagues negatively impacted relationships, although the ability to connect with others through virtual methods was viewed positively. Future work could address the loss of collegiality and increasing isolation among clinicians attributed to continued use of virtual tools and increased remote work.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"160"},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082539","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}