BMC primary care最新文献

{"title":"Introducing colon capsule endoscopy as a new diagnostic modality for patients with bowel symptoms in general practice: a feasibility study.","authors":"Peter Haastrup, Jens Søndergaard, Thomas Bjørsum-Meyer, Benedicte Schelde-Olesen, Gunnar Baatrup","doi":"10.1186/s12875-025-02864-4","DOIUrl":"https://doi.org/10.1186/s12875-025-02864-4","url":null,"abstract":"<p><strong>Background: </strong>Bowel symptoms are common in general practice and though most often benign they can also indicate colorectal cancer where a colonoscopy often is required to rule out malignant disease. Colon capsule endoscopy (CCE) is suggested as a more patient-friendly alternative to colonoscopy but its application in symptomatic patients in general practice needs further investigation.</p><p><strong>Materials and methods: </strong>We present a feasibility study of integrating initial triage for CCE into general practice. The technical success of CCE, patient acceptance, and the experiences of general practitioners (GPs) are assessed through qualitative interviews with participating GPs.</p><p><strong>Results: </strong>We were able to recruit some general practices from the area of interest, but inclusion of patients was low. The participating GPs welcomed the concept of CCE as a more patient-friendly procedure and most patients invited by the GP accepted inclusion. Difficulties remembering the project in the diverse everyday of general practice, GP shortage and general time restraints were reported as barriers for patient recruitment by the GPs.</p><p><strong>Conclusion: </strong>Before conducting large-scale implementation studies of CCE, our investigation highlighted critical barriers that need addressing: (1) Time Constraints and GP Shortages: The design of task divisions between sectors should carefully consider time limitations and the scarcity of GPs. (2) Low reinvestigation rates: Minimizing reinvestigation rates is crucial to reduce strain on both patients and healthcare systems.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"159"},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082507","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":"A scoping review of the roles, challenges, and strategies for enhancing the performance of community health workers in the response against COVID-19 in low- and middle-income countries.","authors":"Joseph Mumba Zulu, Adam Silumbwe, Margarate Munakampe, Malizgani Paul Chavula, Chama Mulubwa, Nathanael Sirili, Wanga Zulu, Charles Michelo, Moses Tetui","doi":"10.1186/s12875-025-02853-7","DOIUrl":"10.1186/s12875-025-02853-7","url":null,"abstract":"<p><strong>Background: </strong>Global concerns regarding effective response strategies to the COVID-19 pandemic arose amid the swift spread of the virus to low- and middle-income country (LMIC) settings. Although LMICs instituted several measures to mitigate spread of the virus in low resource settings, including task shifting certain demand and supply functions to community actors such as community health workers (CHWs), there remains a lack of synthesized evidence on these experiences and lessons. This scoping review sought to synthesize evidence regarding the roles and challenges faced by CHWs during the fight against COVID-19, along with strategies to address these challenges.</p><p><strong>Methodology: </strong>We systematically searched several major electronic databases including PubMed, HINARI, Cochrane Library (Reviews and Trials), Science Direct and Google Scholar for relevant literature. The search strategy was designed to capture literature published in LMICs on CHWs roles during COVID-19 period spanning 2019-2023. Two researchers were responsible for retrieving these studies, and critically reviewed them in accordance with Arksey and O'Malley scoping review approach. In total, 22 articles were included and analysed using Clarke and Braun thematic analysis in NVivo 12 Pro Software.</p><p><strong>Results: </strong>Community health workers (CHWs) played a vital role during the COVID-19 pandemic. They engaged in health promotion and education, conducted surveillance and contact tracing, supported quarantine efforts, and maintained essential primary health services. They also facilitated referrals, advocated for clients and communities, and contributed to vaccination planning and coordination, including tracking and follow-up. However, CHWs faced significant challenges, including a lack of supplies, inadequate infection prevention and control measures, and stigma from community members. Additionally, they encountered limited supportive policies, insufficient remuneration and incentives. To enhance CHWs' performance, regular training on preventive measures is essential. Utilizing digital technology, such as mobile health, can be beneficial. Establishing collaborative groups through messaging platforms and prioritizing access to COVID-19 vaccines are important steps. Additionally, delivering wellness programs and providing quality protective equipment for CHWs are crucial for their effectiveness.</p><p><strong>Conclusion: </strong>The study found that CHWs are vital actors within the health system during global pandemics like COVID-19. This entails the need for increased support and investment to better integrate CHWs into health systems during such crises, which could ultimately contribute to sustaining the credibility of CHWs programs and foster more inclusive community health systems (CHSs).</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"163"},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082493","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":"Can you hear me? Physicians' attitudes and knowledge on the principles of communicating with hearing-impaired older adult.","authors":"Ela Sadan, Anastasia Bakal, Tamar Freud, Tali Samson, Yan Press","doi":"10.1186/s12875-025-02861-7","DOIUrl":"https://doi.org/10.1186/s12875-025-02861-7","url":null,"abstract":"<p><strong>Background: </strong>Hearing impairment is a prevalent barrier to communication that significantly affects older adults. This study explores family physicians' knowledge and attitudes towards communicating with hearing-impaired older patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among family physicians at Clalit Healthcare Services clinics in southern Israel. The study included a video illustrating 12 common errors made when communicating with hearing-impaired older patients.</p><p><strong>Results: </strong>Among the 101 participating family physicians, only 15.8% reported adequate training in medical school on treating these patients, and 17.8% during residency. On average, physicians identified 2.25 ± 1.35 errors of the 12 possible ones shown in the video. Ten physicians (9.9%) failed to identify any errors. Twenty-three (22.8%) identified one error, 25 (24.8%) found two, and 24 (23.8%) identified three, thirteen (11.9%) four, and 6 (5.9%) found five mistakes. No participant identified six or more mistakes. The only statistically significant variable for identifying more than three communication errors was the physician's perceived low or very low comfort level with communication skills during visits with hearing-impaired older adults (OR = 0.337, 95% CI: 0.126-0.900, p = 0.030).</p><p><strong>Conclusions: </strong>The findings highlight the importance of ongoing medical education programs to improve communication strategies for healthcare providers treating hearing-impaired older adults.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"162"},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082497","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":"Prescribing direct-acting antivirals for hepatitis C treatment: a scoping review of factors that influence primary care providers.","authors":"Jonathan Hallett, Tina Price, Corie Gray, Shoshana Rosenberg, Roanna Lobo, Gemma Crawford","doi":"10.1186/s12875-025-02865-3","DOIUrl":"10.1186/s12875-025-02865-3","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C is a significant public health challenge in Australia, particularly in diagnosis, treatment access, and ongoing care among people who inject drugs. Despite the availability of highly effective direct-acting antivirals and government subsidisation, treatment uptake has declined among this population in recent years, beyond what would be expected from the initial treatment of easier-to-reach patients.</p><p><strong>Objectives: </strong>This rapid scoping review aimed to identify barriers and enablers affecting primary care providers in prescribing direct-acting antivirals for hepatitis C treatment.</p><p><strong>Eligibility criteria: </strong>Studies were included if they: were published after 2014, focused on DAA treatment, included primary care provider perspectives, contained primary data, identified barriers/enablers to treatment, and were conducted in high-income countries.</p><p><strong>Sources of evidence: </strong>Two databases (Web of Science and Google Scholar) were searched for peer-reviewed articles. Primary care stakeholders were consulted through an online survey (n = 10) and telephone interviews (n = 7) to contextualise and validate findings.</p><p><strong>Charting methods: </strong>Data were charted using a standardised form capturing author, year, location, aim, participants, study details, and main findings. Analysis used a deductive approach to identify key themes.</p><p><strong>Results: </strong>Twenty-three articles, mostly quantitative studies, were included in the review. The analysis identified four key domains influencing direct-acting antiviral prescription: provider characteristics, healthcare systems and service delivery, models of care, and societal and structural issues.</p><p><strong>Conclusions: </strong>This review provides insights into contemporary challenges in hepatitis C care delivery models and highlights critical structural, sociocultural, and interpersonal factors affecting testing and treatment, particularly for people who inject drugs. These findings have implications for improving direct-acting antiviral prescription rates in primary care settings.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"157"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000473","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":"Promoting well-being in later life - a qualitative analysis of focus groups and individual interviews with older adults in Germany.","authors":"Evelyn Kleinert, Laura Mohacsi, Lena Stange, Daniel Broschmann, Lisa Nebel, Eva Hummers","doi":"10.1186/s12875-025-02767-4","DOIUrl":"10.1186/s12875-025-02767-4","url":null,"abstract":"<p><strong>Background: </strong>Medical decision-making for older adults is becoming increasingly complex due to chronic conditions, multimorbidity, and expanding medical options in old age. As the aging population grows, medical decision-making in old age will become an increasingly common issue. This study explores older adults' perspectives on well-being and medical decision-making to inform patient-centered care practices in family medicine.</p><p><strong>Methods: </strong>A qualitative study was conducted in Germany between August 2022 and August 2023, involving 35 participants aged 75 and older. Six focus group discussions and eight individual interviews were carried out. Focus groups were presented with two patient case histories involving medical decision dilemmas, while individual interviews used a guideline on personal history and experiences of medical care. Audio recordings were transcribed and analyzed using qualitative content analysis with MAXQDA software.</p><p><strong>Results: </strong>Three main categories emerged as central to well-being in late life: autonomy, physical and cognitive abilities, and social integration. Autonomy was identified as crucial, encompassing independent decision-making and adaptation to changing circumstances. Physical and cognitive abilities, particularly mobility, were considered essential for maintaining autonomy. Participants demonstrated different attitudes toward medical intervention, with some taking significant risks to maintain mobility and others taking a more adaptive approach to age-related limitations. Social integration emerged as a key to well-being, with participants emphasizing the importance of maintaining social connections and engaging in meaningful activities. Family practitioners were recognized as playing a vital role in providing holistic, patient-centered geriatric care.</p><p><strong>Conclusions: </strong>The study highlights the importance of understanding older adults' perspectives on well-being to inform medical decision-making. Family practitioners can support the evolving needs of older adults by addressing both medical and psychosocial issues, facilitating social engagement, and building long-term relationships with patients. This approach can contribute to improved well-being and more patient-centered care practices in geriatric medicine.</p><p><strong>German clinical trials register: </strong>DRKS00027076, 05/11/2021.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"158"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057936","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":"Arts on prescription intervention for primary healthcare patients with poor mental health or social isolation: a mixed-method study.","authors":"Anita Jensen, Anders Halling, Mirnabi Pirouzifard, Martin Lindström","doi":"10.1186/s12875-025-02866-2","DOIUrl":"https://doi.org/10.1186/s12875-025-02866-2","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare providers are increasingly challenged in supporting patients with psychosocial needs. Arts on Prescription (AoP) has been shown to improve primary healthcare patients' mental health wellbeing. The aim of the current study is to understand the psychosocial effect of participating in an Arts on Prescription programme.</p><p><strong>Methods: </strong>A total of 112 primary healthcare patients from 18 primary healthcare centres in Scania with mental health diagnoses depression and anxiety or social isolation participated in a 10-week group-based arts programme, twice a week for 2 h. A questionnaire with the Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), the Salutogenic Health Indicator Scale (SHIS) (for baseline and follow-up) and 14 sociodemographic and self-rated health covariates were collected as baseline. We also conducted 28 semi-structured interviews. We analysed data using paired t-test and a general linear regression model for change in SWEMWBS and SHIS. Qualitative data was analysed using a thematic approach.</p><p><strong>Results: </strong>The paired t-test showed highly significant results (p < 0.001) for increase in both SWEMWBS and SHIS. The general linear regression. models show that women and participants with poorer self-rated health (SRH), more contacts with the healthcare system, other referrals from the primary healthcare centre, and no previous arts and culture engagement displayed significantly stronger associations with increase in SWEMWBS but not SHIS. Qualitative results highlight use of other interventions and difficulties navigating the health system.</p><p><strong>Conclusions: </strong>Our findings support a proportionate universalism (scale and intensity proportionate to the degree of need) approach indicating that AoP programmes could be valuable additions to healthcare pathways enhancing wellbeing for vulnerable populations. Findings should be interpreted with caution due to small sample size.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"155"},"PeriodicalIF":2.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024548","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":"Correction: Translation, adaptation, and validation of person-centered primary care measures for patients in family doctor contract services within Mainland China.","authors":"Yang Wang, Dehua Yu, Hua Jin","doi":"10.1186/s12875-025-02857-3","DOIUrl":"10.1186/s12875-025-02857-3","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"153"},"PeriodicalIF":2.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063074","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":"Gender-stratified analyses of symptoms associated with life-threatening events in patients calling out-of-hours primary care for shortness of breath.","authors":"Michelle Spek, Dorien L Zwart, Gerardus J H M Reijers, Esther de Groot, Geert-Jan Geersing, Maarten van Smeden, Hester M den Ruijter, Anna S M Dobbe, Mathé Delissen, Frans H Rutten, Roderick P Venekamp","doi":"10.1186/s12875-025-02870-6","DOIUrl":"https://doi.org/10.1186/s12875-025-02870-6","url":null,"abstract":"<p><strong>Background: </strong>Women and men seem to perceive shortness of breath (SOB) differently. However, it is unknown whether symptom presentation varies between genders during a life-threatening event (LTE).</p><p><strong>Aim: </strong>To assess whether symptoms associated with an LTE vary between women and men with SOB calling out-of-hours primary care (OHS-PC).</p><p><strong>Methods: </strong>Cross-sectional study including data from patients contacting two large Dutch OHS-PC centres for SOB between 1 September 2020 and 31 August 2021. We compared symptoms mentioned during triage conversations between patients with and without LTEs (amongst others, acute coronary syndrome, pulmonary embolism, acute heart failure and severe pneumonia), stratified by gender.</p><p><strong>Results: </strong>We included 1,861 adults contacting OHS-PC for SOB (mean age 53.3 years, 55.3% women). The risk of an LTE was lower in women than in men (15.0% vs. 18.7%, RR 0.80; 95% CI 0.65-0.98). Patients with LTEs were older, more often had someone else calling for them, a history of cardiovascular disease, cardiovascular medication use and inability to speak full sentences compared to those without LTEs. Differences between women and men were only apparent for calling at night (women: 24.0% vs. 15.2%, p = 0.006, versus men: 18.7% vs. 22.5%, p = 0.300; p-value interaction term: 0.009) and participation of general practitioners during telephone triage (women: 49.4% vs. 49.5%, p = 0.975, versus men: 56.1% vs. 43.0%, p = 0.003; p-value interaction term: 0.033).</p><p><strong>Conclusions: </strong>Among patients contacting OHS-PC with SOB, about 1 in 6 had an LTE, more often men than women. We found no strong evidence of symptom differences between gender groups predictive of LTEs.</p><p><strong>Trial registration: </strong>The Netherlands Trial Register, number: NL9682, registration date: 20-08-2021.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"154"},"PeriodicalIF":2.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047407","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":"Integrating prevention into primary care organizations: a case study in France.","authors":"Estelle Clet, Anais Essilini, Céleste Cornet, Jean-Philippe Joseph, Christine Cohidon, François Alla","doi":"10.1186/s12875-025-02849-3","DOIUrl":"https://doi.org/10.1186/s12875-025-02849-3","url":null,"abstract":"<p><strong>Background: </strong>Although primary care providers have a major role to play in combating risk factors, preventive practices can still be improved. The development of coordinated practice is considered as an opportunity to integrate prevention into primary care. What are the conditions, obstacles and facilitators involved in such a process?</p><p><strong>Objectives: </strong>To explore and describe the conditions under which prevention is integrated into 'communautés professionnelles territoriales de santé' (CPTS = territorial professional health communities) in France, a new type of primary care organization being generalized in France.</p><p><strong>Method: </strong>A case study was conducted in two regions of France. We conducted interviews with: (i) healthcare professionals and coordinators, and (ii) local healthcare authorities and territorial officers for the CPTS. Data were collected through individual and semi-structured group interviews, observations and a documentary analysis. They were then coded by two investigators according to two coding trees depending on the population involved. A thematic analysis was then carried out.</p><p><strong>Results: </strong>This case study was composed of 18 interviews, two observations and three documents. They showed that healthcare professionals and healthcare authorities do not share the same vision, issues and expectations regarding prevention. For the former, prevention should be integrated into care as in preventive clinical practices, while the latter are more focused on the healthcare system with a vision based on prevention programs.</p><p><strong>Conclusion: </strong>This study identified the obstacles and facilitators to integrating prevention into coordinated practices in primary care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"152"},"PeriodicalIF":2.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036554","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":"Exploring the attitudes of healthcare professionals towards primary healthcare in northwest Syria.","authors":"Sara Basha, Aravinda Guntupalli, Diana Rayes, Abdulkader Mohammad, Mahmoud Hariri, Lena Basha, Safwan Alchalati, Yamama Bdaiwi, Aula Abbara","doi":"10.1186/s12875-025-02790-5","DOIUrl":"https://doi.org/10.1186/s12875-025-02790-5","url":null,"abstract":"<p><strong>Background: </strong>Though primary healthcare (PHC) is an essential component of a robust health system, it remains under-developed and under-resourced in many fragile and conflict affected settings. In Syria, even pre-conflict, the health system had more emphasis on specialist and secondary care with weaker emphasis on PHC. This is beginning to change with investment from donors, international and humanitarian organisations; however, its implementation remains challenging, in part due to negative attitudes towards PHC among both physicians and patients. Our aim is to explore attitudes towards PHC in northwest Syria among relevant stakeholders.</p><p><strong>Methods: </strong>A qualitative research design using a contextualist approach was used. Semi-structured interviews were conducted with stakeholders who had experience of the Syrian health system before and after the conflict. Purposive and subsequent snowball sampling were used for recruitment. A topic guide was developed with stakeholders and interviews were conducted using Microsoft Teams. Interviews were transcribed verbatim and translated where appropriate. Inductive thematic analysis was conducted using Nvivo V.12 software.</p><p><strong>Results: </strong>Fifteen in-depth interviews were conducted; 7 were female. The main emerging themes and subthemes were: 1. Governance of the health system (subthemes: inadequate communication and coordination; the power of donors; lack of monitoring systems; inadequate health information systems). 2. The observed attitudes of community and patients' towards primary healthcare (sub-themes: perceived patients' attitudes towards PHC; importance of building trust with the community; impact of cost on service use). 3. Healthcare workforce and primary healthcare (sub-themes: negative attitudes towards PHC as a specialty; numbers and capabilities of healthcare professionals; changing attitudes towards PHC as a system).</p><p><strong>Discussion: </strong>Though there was some evidence that attitudes were changing, there remain prevailing negative attitudes towards PHC, including a reluctance among undergraduates to choose it as a destination specialty. Without further understanding barriers, efforts by donors and humanitarian organisations to implement effective PHC in northwest Syria may flounder.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"151"},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014012","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}