BMC primary care最新文献

{"title":"Primary healthcare providers' perceived preparedness to respond to intimate partner violence in the public primary healthcare setting: a cross-sectional study.","authors":"Ying Ying Chan, Noran Naqiah Hairi, Wan Yuen Choo, Zamtira Seman, Mohd Azahadi Omar, Noor Raihan Khamal, Shazimah Abdul Samad, Azah Abdul Samad, Sajaratulnisah Othman","doi":"10.1186/s12875-025-02793-2","DOIUrl":"10.1186/s12875-025-02793-2","url":null,"abstract":"<p><strong>Background: </strong>Intimate partner violence (IPV) is the most prevalent form of violence against women globally, leading to various adverse health consequences. Primary healthcare providers (PHCPs) are often the first point of contact for identifying and managing IPV. However, research on PHCPs' responses to IPV in low- and middle-income countries, including Malaysia, remains limited. This study aimed to determine the perceived preparedness to respond to IPV and its associated factors among PHCPs in Malaysia.</p><p><strong>Methods: </strong>This cross-sectional study involved 1505 PHCPs selected through multistage stratified cluster random sampling from public primary healthcare clinics in Malaysia. Data were collected via self-administered online surveys using the validated Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS)-Malay tool. Complex sample analysis of descriptive data, general linear model (GLM) and logistic regression were performed. The GLM was used to determine knowledge and opinion score variables predicting the mean perceived preparedness score, whereas multivariable logistic regression identified factors associated with a good level of perceived preparedness to manage IPV. A p-value ≤ 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Most Malaysian PHCPs (81.0%) had not received any IPV training. Only 29.1% of the PHCPs reported a good level of perceived preparedness, 12.2% had good perceived knowledge, and a mere 8.6% had good actual knowledge. The perceived and actual knowledge, workplace/self-efficacy, and staff constraints scores were positively associated with the preparedness score, whereas the victim understanding score was negatively associated with the preparedness score. Multivariable logistic regression analysis revealed that longer work experience (≥ 10 years) (AOR = 1.70, 95% CI: 1.28-2.26), prior IPV training (AOR = 1.68, 95% CI: 1.12-2.51), previous experience with IPV inquiry (AOR = 1.55, 95% CI: 1.10-2.19), good perceived knowledge (AOR = 15.21, 95% CI: 11.15-20.74), and good actual knowledge (AOR = 1.79, 95% CI: 1.10-2.94) were significantly associated with a good level of perceived preparedness.</p><p><strong>Conclusions: </strong>A high percentage of Malaysian PHCPs have not received IPV training, and only a small proportion felt they are prepared to manage IPV, with even fewer possessing adequate knowledge about IPV. These findings highlight the urgent need to prioritize IPV training programs at the primary care level to better equip PHCPs with the knowledge and skills necessary to manage IPV effectively.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"92"},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756224","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":"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/s12875-025-02796-z","DOIUrl":"10.1186/s12875-025-02796-z","url":null,"abstract":"<p><strong>Background: </strong>In the context of China's health reforms aimed at strengthening primary care through the Family Doctor Contract Service Program, effectively measuring its functional features is paramount. This study seeks to translate, adapt, and validate the Person-Centered Primary Care Measure (PCPCM) for primary care patients enrolled in family doctor contract services in mainland China.</p><p><strong>Methods: </strong>Following the guidelines by Sousa and Rojjanasrirat, we translated and adapted the PCPCM into Simplified Chinese and evaluated its psychometric properties. A total of 583 patients enrolled in family doctor contract services from 10 primary care facilities in Shanghai, China, participated in the study. We assessed the structural validity, internal consistency, stability reliability, and criterion validity of the PCPCM-Simplified Chinese version in accordance with the practical guidelines developed by the Core Outcome Measures in Effectiveness Trials (COMET) initiative and the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) initiative.</p><p><strong>Results: </strong>The study led to the development of the PCPCM-Simplified Chinese version tailored for patients receiving family doctor contract services (PCPCM-SC-FDCS), specifically designed to address the needs of populations most closely aligned with the concept of \"primary care patients\" in mainland China. Initial pilot testing prompted refinements to enhance clarity and applicability, particularly for Item 5 (Relationship). Analyses of the refined PCPCM-SC-FDCS, based on a three-point Likert scale, revealed that structural validity, internal consistency, and criterion validity all met the criteria for good measurement properties outlined in the relevant guidelines. However, for test-retest reliability, the intraclass correlation coefficient (ICC) between the first and second surveys was 0.58, which fell short of the recommended threshold of ≥ 0.70.</p><p><strong>Conclusions: </strong>The PCPCM-SC-FDCS demonstrates satisfactory reliability and strong feasibility as a tool for evaluating the functional features of primary care among Family Doctor Contract Service Program patients in mainland China. Although further testing and refinement are necessary, this instrument offers a feasible and straightforward approach to evaluating service quality, supporting family doctor teams in enhancing primary care delivery.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"91"},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756226","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":"Engaging community health workers to promote oral health for people living with type 2 diabetes mellitus in Nepal: a qualitative study.","authors":"Yuriko Harada, Prapti Giri, Dilip Prajapati, Haruka Sakamoto, Tomohiko Sugishita, Lal Rawal","doi":"10.1186/s12875-025-02711-6","DOIUrl":"10.1186/s12875-025-02711-6","url":null,"abstract":"<p><strong>Background: </strong>People living with type 2 diabetes mellitus (T2DM) are likely to develop oral health problems, and vice versa. The burden of oral health and T2DM is increasing, especially in low- and middle-income countries. Access to oral health care remains a challenge in many countries, including Nepal. This study examined the challenges and opportunities for engaging community health workers (CHWs) in promoting oral health care among people with T2DM in Nepal.</p><p><strong>Methods: </strong>This study used a qualitative research design using key informant interviews (KIIs) and in-depth interviews (IDIs) responding to open ended questions. Data were collected from health facilities across two districts, Kavrepalanchowk and Kathmandu. The IDIs were conducted with CHWs, including health assistants (n = 7) and community medical assistants (n = 4) from rural and semi-urban areas, while the KIIs were conducted with policy makers and health managers at central level (n = 7). Data was analysed thematically.</p><p><strong>Results: </strong>The participants highlighted the importance and need for providing integrated oral health services at the primary care level. However, they pointed the challenges including (i) lack of policies, guidelines and provision of oral health care, especially for people with T2DM, (ii) lack of capacity on oral health among the CHWs, and (iv) inadequate resources and supplies at primary health care settings. These gaps presented opportunities to develop targeted policies and CHW training by ensuring continuous supervision and appropriate incentivisation, facilitating the integration of oral health care at primary health care level in Nepal.</p><p><strong>Conclusions: </strong>The findings of study highlight the potential for engaging CHWs to deliver oral health services for people with T2DM at the primary health care level in Nepal. Strengthening the health system and building capacity of CHWs, along with continued supervision, incentivisation and supply of adequate resources could facilitate the integration of oral health services into primary health care settings in Nepal.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"89"},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744567","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":"The impact of perinatal mental health training on knowledge and practice of primary care physicians: a systems strengthening initiative in Telangana, India.","authors":"Raveena Akkineni, Sundarnag Ganjekar, Veena Satyanarayana, Nithin Kondapuram, Khyati Tiwari, Sowjanya Medisetti, S Padmaja, R V Karnan, Prabha S Chandra","doi":"10.1186/s12875-025-02782-5","DOIUrl":"10.1186/s12875-025-02782-5","url":null,"abstract":"<p><strong>Background: </strong>In India, despite the high prevalence of perinatal mental health (PMH) conditions most primary care physicians (PCPs) have inadequate knowledge and skills to identify and provide appropriate interventions. The Health and Family Welfare Department of Telangana, India, partnered with the United Nations Children's Fund (UNICEF) and the Perinatal Mental Health service of the National Institute of Mental Health and Neurosciences to address this gap. The initial step in integrating PMH into the Maternal and child health (MCH) program involved training PCPs. This study aimed to outline the knowledge improvements regarding PMH among PCPs after the training.</p><p><strong>Methods: </strong>The training, conducted from June to January 2023-2024 across 30 districts, employed various interactive and reflective educational methods. Pre and post-training assessments evaluated knowledge enhancement and skill development, focusing on identifying perinatal anxiety and depression, assessing severity, recognizing risk factors, identifying the need for referrals, and rational psychopharmacology. This study aimed to assess the impact of training on improving knowledge and skills among PCPs which would influence perinatal mental health service delivery in Telangana.</p><p><strong>Results: </strong>Out of 863 PCPs in the 30 districts, 465 (53.8%) were able to complete the one-day training. Valid pre and post-training responses were available for 374 PCPs. A comparison of pre and post-training scores showed improvement in knowledge in a mean number of risk factors identified (pre: 3.05, post: 5.4; p < 0.001), ability to recognize depression (pre: 2.75, post: 4.33; p < 0.001) and anxiety symptoms (pre: 4.16, post: 6.08; p < 0.001), assess the severity of depression (pre: 0.46, post: 0.85; p < 0.001) and anxiety (pre: 0.57, post: 0.98, p < 0.001), safe medication use during pregnancy (pre: 0.89, post: 2.18;p < 0.001), and during breastfeeding (pre: 1.07, post: 2.13; p < 0.001) and identifying the need for referral to a psychiatrist (pre: 1.90, post: 3.13; p = 0.003).</p><p><strong>Conclusion: </strong>The one-day training for PCPs enhanced knowledge across various PMH domains. However, studies with follow-up data are necessary to assess the retention of this knowledge and skills related to case identification and referrals. Such studies will provide a more comprehensive evaluation of the effectiveness of the training program.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"88"},"PeriodicalIF":2.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743198","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":"General practitioners' attitudes and barriers to patient activation in cardiovascular disease prevention: insights from the DECADE study.","authors":"Willy Gräfe, Iris Tinsel, Maja Börger, Thomas Kloppe, Andy Maun, Henna Riemenschneider","doi":"10.1186/s12875-025-02798-x","DOIUrl":"10.1186/s12875-025-02798-x","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases (CVD) are the most common cause of death in Germany. General practitioners (GPs) have an important role in supporting patients in the prevention of CVD. The DECADE intervention was developed to encourage patients to improve self-management in order to prevent CVD, addressing both GPs and patients. This study focused on GPs attitudes towards patient activation and its relation to the level of activation on their patients, possible barriers according to lifestyle counselling and attitudes towards interprofessional consultations.</p><p><strong>Methods: </strong>Questionnaire-based cross-sectional analysis was conducted within the DECADE-cRCT. GPs attitudes to patient activation was measured by using seven items of the Clinician Support for Patient Activation Measure (CS-PAM). The degree of activation of the patients was measured by Patient Activation Measure (PAM13-D). The Barriers and attitudes towards responsibilities for lifestyle counselling were assessed using self-generated items on a 5-point Likert scale. Association between CS-PAM and PAM13-D was analysed using a linear mixed model.</p><p><strong>Results: </strong>79/82 GPs responded. Mean CS-PAM score of GPs at baseline was 23.00 (range 13-27, max. 28). GPs reported lack of time, funding and uncertainty of the impact as main barriers to the routine implementation of lifestyle counselling. GPs see themselves as primarily responsible for conducting lifestyle counselling, but they also emphasize the importance of interprofessional cooperation. No significant correlations between CS-PAM and PAM13-D were found.</p><p><strong>Conclusion: </strong>GPs perceive patient activation as important. Most GPs reported that they already provide lifestyle counselling as part of their routine practice. Overcoming the identified barriers in GPs lifestyle counselling is a prerequisite for effective and patient-centred consultation on cardiovascular risk factors. The interprofessional collaboration advocated by GPs could relieve the burden on GPs and thus reduce these barriers.</p><p><strong>Trial registrations: </strong>The DECADE-study is registered in the German Clinical Trials Register (DRKS-ID: DRKS00025401; Trial registration date: 2021/06/21) and in the International Clinical Trials Registry Platform (ICTRP): https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00025401 .</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"86"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744568","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":"Attributes of family physician encounters valued by older adults: a systematic review.","authors":"Rebecca H Correia, Darly Dash, Zain Pasat, Ryan P Strum, Komal Aryal, Humayun Kabir, Maya Potter, Elaine Swayze, Pat Beaudoin, Pat Ward, Henry Yu-Hin Siu","doi":"10.1186/s12875-025-02794-1","DOIUrl":"https://doi.org/10.1186/s12875-025-02794-1","url":null,"abstract":"<p><strong>Background: </strong>Older adults (aged ≥ 65) are frequent users of primary care services, often presenting with unique values, needs, expectations, and preferences for family physician encounters compared to patients of younger ages. This review identified and synthesized the attributes of family physician encounters that older patients prioritize, spanning the time of accessing primary care to post-visit.</p><p><strong>Methods: </strong>We conducted a systematic search of three electronic databases (MEDLINE, Ovid Embase, Web of Science) to identify peer-reviewed research articles of any design. Seven reviewers screened and extracted information using a standardized template. We narratively synthesized findings across the included studies. Older adult patient partners provided strategic input throughout the key phases of this review, including developing the research question, literature screening and synthesis, and interpreting the findings to enhance relevance and applicability.</p><p><strong>Results: </strong>We identified 28,461 articles for screening after duplicate removal. Title and abstract screening resulted in 463 retained articles, with 62 articles included for analysis after full-text screening. We identified six key attributes of family physician encounters that older adults value before, during, and after visits: trust in providers, feeling heard, effective information exchange, affective behaviours, continuity of care (longitudinal relationships), and foresight/future planning.</p><p><strong>Conclusions: </strong>Our findings synthesizing international evidence highlight which attributes matter most to older primary care patients as they age and increasingly access family physicians. These attributes can guide primary care planning, organization, and physician education/training to promote high-quality care for older adults.</p><p><strong>Registration: </strong>Our systematic review was prospectively registered with PROSPERO (CRD42024555970).</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"87"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744566","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: Developing a progress assessment model for age friendly primary health care initiatives.","authors":"Saber Azami-Aghdash, Maryam Biparva, Shahin Karami, Naser Derakhshani, Ramin Rezapour","doi":"10.1186/s12875-025-02795-0","DOIUrl":"10.1186/s12875-025-02795-0","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"85"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733441","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":"General practitioners' perceptions of interprofessional collaboration in Belgium: a qualitative study.","authors":"Hubert Jamart, Dionne Kringos, Dajana Tare, Aishwarya Chokshi, Anouk Tans, Isabelle Heymans, Ann Van den Bruel, Jean-Luc Belche","doi":"10.1186/s12875-025-02783-4","DOIUrl":"10.1186/s12875-025-02783-4","url":null,"abstract":"<p><strong>Background: </strong>Belgian primary care is facing significant challenges due to increasing healthcare demands and an overall decline in the workforce. Most general practitioners (GPs) work solo or in mono-disciplinary practices, leading to suboptimal outcomes in areas such as preventive care and health promotion. In response, the Ministry of Health introduced a \"New-Deal\" for GPs, which includes additional funding to support innovative practice organisation models. A think tank of GP representatives was established to guide the initiative, with input from practising GPs gathered for further insight. This study aims to identify the professionals needed to support GPs in daily practice, define their roles, and explore the conditions necessary for integrating them into the GP-centred model of care.</p><p><strong>Methods: </strong>Eleven focus groups were conducted with 122 GPs, ensuring geographical and linguistic diversity across Belgium. Participants were selected through purposive sampling to ensure a diverse range of organisational models across the country. A structured focus group guide was designed, incorporating three scenarios to examine tasks commonly encountered in GP practices. Data analysis was conducted using a codebook developed through an inductive approach.</p><p><strong>Results: </strong>GPs expressed a preference for relatively small-scale teams, generally consisting of nurses and receptionists. The role of a practice assistant was more ambiguously defined, positioned between clinical and administrative responsibilities. Key tools for effective team integration included co-location, well-defined protocols, a shared electronic health record, care coordination, and unified logistical management, all of which are critical to fostering multidisciplinary collaboration.</p><p><strong>Conclusions: </strong>This study explores Belgian GPs' preferences for integrating healthcare professionals into their practices, with team composition adjusted to workload and patient needs. However, the traditional autonomy of practice design may hinder change. Future research is needed to refine financial models and integration tools for collaborative care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"84"},"PeriodicalIF":2.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733446","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":"Understanding patients' perceptions of uncomplicated low back pain: a theory-informed qualitative study using the Common-Sense Self-Regulation Model.","authors":"Shannon M Ruzycki, Yamile Jasaui, Sameh Mortazhejri, Shawn Dowling, D'Arcy Duquette, Stefanie Linklater, Kelly Mrklas, Gloria Wilkinson, Jeremy M Grimshaw, Andrea M Patey","doi":"10.1186/s12875-025-02786-1","DOIUrl":"10.1186/s12875-025-02786-1","url":null,"abstract":"<p><strong>Background: </strong>Uncomplicated low-back pain (LBP), referring to LBP without symptoms that suggest an underlying medical or surgical cause, is a common and challenging problem for patients and primary healthcare providers. Multiple guidelines discourage the use of diagnostic imaging for uncomplicated LBP due to cost and lack of benefit; despite this, diagnostic imaging remains overused in this condition. Study of primary healthcare providers suggests that patient expectations contribute to imaging for uncomplicated LBP. Dedicated study of patient understanding and experiences of uncomplicated LBP is necessary to design interventions to reduce unnecessary diagnostic imaging.</p><p><strong>Methods: </strong>In this theory-guided qualitative study, people with uncomplicated LBP were recruited for a semi-structured interview. The Common Sense - Self-Regulation Model (CS-SRM), a framework that explores the relationship between a patient's perceptions, beliefs, and behaviors around their illness and the outcome of their illness, was selected to direct development of the interview guide and analysis. Higher-level themes were created to list patient-related drivers of unnecessary diagnostic imaging for uncomplicated LBP.</p><p><strong>Results: </strong>Thirteen participants (7 female) had experienced uncomplicated LBP for a median of 5 years (IQR 2-20 years; range 1 to 30 years). Framework analysis based on the CS-SRM suggested that most participants understood their uncomplicated LBP as a permanent part of their lives, though some felt that the pain could be controlled or prevented. Participants shared a range of coping mechanisms, including social support, medication, and exercises. For most participants, uncomplicated LBP negatively affected their lives emotional wellbeing characterized by a sense of loss from missing life events due to pain. Nearly all participants had visited their primary care physician (n = 11) and most underwent diagnostic imaging (n = 8); however, participants generally reported that they had not requested diagnostic imaging (n = 8). Several participants reported that they wanted validation and symptom-management advice from their physician rather than diagnostic tests.</p><p><strong>Conclusions: </strong>In contrast to other studies, we report that most patients with uncomplicated LBP in our setting did not request diagnostic imaging. Patient-facing interventions to address unnecessary diagnostic imaging for uncomplicated LBP may be more effective if they address illness conceptions identified in this study; for example, interventions should convey empathy by acknowledging patient worries, validating suffering, describing potential causes or triggers, addressing self-management strategies, and describing the natural history of uncomplicated LBP.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"83"},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712307","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":"Development of a patient decision aid for type 2 diabetes mellitus: a patient-centered approach.","authors":"Anna Tichler, Dorijn F L Hertroijs, Dirk Ruwaard, Martijn C G J Brouwers, Arianne M J Elissen","doi":"10.1186/s12875-025-02772-7","DOIUrl":"10.1186/s12875-025-02772-7","url":null,"abstract":"<p><strong>Background: </strong>Patient decision aids (PDAs) can effectively facilitate shared decision-making (SDM) between patients and healthcare professionals. The International Patient Decision Aid Standards (IPDAS) Collaboration created a model for the systematic development of PDAs. However, the absence of a solid evidence base limits practical recommendations for best practices. For example, uncertainties exist about the most appropriate method for identifying the needs and preferences of patients and healthcare professionals. This study aims to detail the development process for the development of a PDA for type 2 diabetes mellitus (T2DM), using the IPDAS model.</p><p><strong>Methods: </strong>From September 2020 to February 2023, we systematically developed the PDA for T2DM in the Netherlands. We adopted a patient-centered approach by researching patient considerations and actively collaborating with a multidisciplinary steering group, including patients with T2DM, patient organizations, and healthcare professionals. The PDA content and prototype development were determined by incorporating patients' needs and preferences, input from the steering group, and available evidence regarding T2DM treatment options. The research team and steering group iteratively reviewed the PDA prototype.</p><p><strong>Results: </strong>A web-based PDA was developed consisting of five sections: 1) information about T2DM and the available treatment options; 2) comparison of treatment options; 3) questions to assess patients' knowledge; 4) value-clarification exercise; and 5) summary of the patient's journey through the PDA. Before patients use the PDA, healthcare professionals can preselect the most relevant treatment options.</p><p><strong>Conclusions: </strong>Early and iterative involvement of relevant stakeholders in the development process of the PDA helped the alignment of the PDA with the needs and preferences of the diverse end-users. In a future study, we will investigate the effectiveness of the PDA in facilitating SDM in T2DM care.</p><p><strong>Trial registration: </strong>International Clinical Trials Registry Platform ID: NL8948, date of registration: 05-10-2020.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"81"},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694531","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}