BMC primary care最新文献

{"title":"Recurrent urinary tract infections in primary care: a qualitative study of women's experiences.","authors":"Caroline Skovsbo Clausen, Louise Bidstrup Jørgensen, Lars Bjerrum, Anne Holm, Mette Bech Risør","doi":"10.1186/s12875-026-03448-6","DOIUrl":"10.1186/s12875-026-03448-6","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are highly prevalent, affecting up to 50% of women during their lifetime. Among these, 20-30% develop recurrent UTIs (rUTIs), defined as ≥ 2 UTIs within 6 months or ≥ 3 UTIs within 12 months. In addition to physical symptoms, existing research describes how rUTIs affect women's quality of life, mental well-being, and intimate and social relationships. Few studies have investigated how women experience encounters with primary care and how rUTIs shape women's self-image and illness perceptions. The objective of this study was to explore how premenopausal women experience the impact of living with rUTIs, as well as how they experience the encounters with GPs in a Danish primary care setting.</p><p><strong>Methods: </strong>This qualitative study was based on semi-structured interviews with 12 premenopausal women. The data was analysed using thematic analysis.</p><p><strong>Results: </strong>Three themes were identified: (1) clashes between practice routines and women's perceptions, highlighting how standardised diagnostic and treatment practices were experienced as lacking, and that women expressed a need for clearer management pathways and a more patient-centred approach, (2) lack of validation from the GP, reflecting how women felt dismissed and insufficiently acknowledged in clinical encounters; and (3) gendered illness perceptions, illustrating how these experiences shaped women's understandings of their condition, leading to self-blame, normalisation, or feelings of injustice.</p><p><strong>Conclusion: </strong>rUTIs are highly distressing for women and the encounter with primary care often results in frustrations and unmet needs. Perceiving primary care routines as unclear can leave women feeling dismissed, compromise the patient-doctor relationship and affect the women's self‑image and illness perceptions. Improving rUTI management in primary care requires greater attention to women's lived experiences. GPs should recognize the broader impact of recurrent symptoms and ensure clear clinical routines that accommodate the recurrent condition rather than relying on repeated tests and prescriptions. Strengthening shared decision-making and aligning care with women's needs and understandings of health are essential for better support.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320888","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":"Sex differences in the secondary and primary prevention of cardiovascular diseases among 75-year-olds in Southwest Finland: a population-based study.","authors":"Marika Salminen, Maika Kummel, Jaana Koskenniemi, Tero Vahlberg, Matti Viitanen, Päivi Korhonen, Laura Viikari","doi":"10.1186/s12875-026-03440-0","DOIUrl":"https://doi.org/10.1186/s12875-026-03440-0","url":null,"abstract":"<p><strong>Background: </strong>The burden of cardiovascular diseases (CVDs) must be reduced through prevention. This study aimed to assess sex differences in the implementation of secondary and primary prevention of CVDs based on risk factor levels among 75-year-old community-dwelling Finns.</p><p><strong>Methods: </strong>The study included 75-year-old participants of the Turku Senior Health Clinic Study with CVD (n = 260) or with high or very high 5-year risk for CVD according to SCORE2-OP (n = 361). The achievement of low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG) levels, as well as the use of evidence-based medications recommended by disease-specific treatment guidelines, were assessed. Logistic regression analysis was used to explore sex differences in achieving national treatment targets.</p><p><strong>Results: </strong>In the secondary prevention of CVD, more men than women achieved the treatment target levels for LDL-C (38% vs. 25%, respectively) (OR 1.82, 95% CI 1.07-3.11), SBP (18% vs. 9%) (OR 2.24, 95% CI 1.05-4.79), and DBP (41% vs. 30%) (OR 1.69, 95% CI 1.01-2.82). Additionally, men were more likely than women to use lipid-lowering (82% vs. 70%) (OR 1.95, 95% CI 1.08-3.49) and diabetes (27% vs. 14%) (OR 2.16, 95% CI 1.15-4.05) medications. Among those using antihypertensives, men were more likely than women to meet the treatment target levels for SBP (19% vs. 9%) (OR 2.36, 95% CI 1.03-5.43) and DBP (43% vs. 30%) (OR 1.78, 95% CI 1.01-3.13). In the primary prevention of CVD, the only significant sex differences were observed in the use of antihypertensive medications: men were less likely than women to use agents acting on the renin-angiotensin system (45% vs. 62%) (OR 0.49, 95% CI 0.32-0.74) or any antihypertensive medications (57% vs. 74%) (OR 0.46, 95% CI 0.29-0.72).</p><p><strong>Conclusions: </strong>In primary care, there is a need for improvements in both secondary and primary prevention of CVDs in older adults, particularly in addressing elevated SBP and LDL-C levels. Moreover, the insufficient treatment of women in secondary prevention is a significant concern.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310712","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":"Complexity of medical needs and primary care attachment shape patient experiences with episodic virtual primary care: a mixed methods study in two Canadian provinces.","authors":"Rebecca H Correia, Emran Hasan, François Gallant, Shelley Doucet, Tara Kiran, Lauren Lapointe-Shaw, A Luke MacNeill, Rachel Thelen, Stephanie Welton, Julie Easley, Agnes Grudniewicz, Lindsay Hedden, M Ruth Lavergne","doi":"10.1186/s12875-026-03441-z","DOIUrl":"10.1186/s12875-026-03441-z","url":null,"abstract":"<p><strong>Background: </strong>Episodic virtual care (EVC) offers patients rapid access to virtual primary care services but lacks relational continuity with a primary care clinician or team. We investigated patients' experiences with EVC and examined differences based on access to a regular primary care clinician and self-reported complexity of medical needs.</p><p><strong>Methods: </strong>In this convergent parallel mixed methods study, we conducted a descriptive and exploratory survey of EVC users' health service access, self-reported medical needs, EVC use, and demographics. Participants included adults (aged ≥ 18) living in Nova Scotia or New Brunswick who self-reported using EVC in the past year. We used descriptive statistics to summarize numeric and ordinal data of patient experience and stratified findings by having a regular primary care clinician and medical complexity. We conducted inductive content analysis of free-text survey responses. We integrated quantitative and qualitative data at the interpretation phase.</p><p><strong>Results: </strong>We identified mixed experiences among EVC users, with quantitative data portraying virtual care experiences more favourably than free-text responses. Most users felt EVC met their health needs, although those without a regular primary care clinician and with greater medical complexity tended to rate experiences less favourably. In free-text responses, some participants expressed concerns with the technological aspects of virtual visits and voiced preferences for in-person care. Patients with a regular primary care clinician tended to access EVC for short-term health concerns, whereas those without a regular primary care clinician sought care for ongoing/chronic problems and prescription renewals.</p><p><strong>Conclusions: </strong>EVC is helping to address some gaps in access, particularly for patients without a regular primary care clinician, by providing care where there might otherwise be none. However, EVC often falls short of meeting ongoing and more comprehensive care needs, underscoring the importance of improving access to longitudinal primary care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320874","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":"Biopsychosocial factors associated with health-related quality of life in long COVID: a matched case-control study in primary care.","authors":"David Lerma-Irureta, Elsa Presa-Gutiérrez, Fátima Méndez-López, Carmen Vicente-García, Isabel Blasco-González, Rosa Magallón-Botaya","doi":"10.1186/s12875-026-03445-9","DOIUrl":"10.1186/s12875-026-03445-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Long COVID is associated with persistent symptoms, functional impairment, and reduced health-related quality of life (HRQoL), but the factors most strongly associated with poorer HRQoL remain incompletely characterized. This study compared adults with long COVID and recovered controls and identified variables independently associated with worse HRQoL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a case-control analysis of the ARALONGCOV 2022 dataset including 170 adults with prior COVID-19: 85 with long COVID and 85 recovered controls without persistent symptoms. HRQoL was assessed with the 12-item Short Form Health Survey (SF-12) total score. Additional measures included depressive symptoms (Patient Health Questionnaire-9, PHQ-9), fatigue severity (Fatigue Severity Scale, FSS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), pain catastrophizing, post-COVID functional status (PCFS), physical activity, and distance completed during the six-minute walk test (6MWT-D). Between-group comparisons used Mann-Whitney U tests for continuous variables and chi-squared or Fisher exact tests for categorical variables. Univariable and multivariable linear regression models were fitted within long COVID cases to identify factors independently associated with SF-12 total score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with recovered controls, participants with long COVID had markedly worse HRQoL (median SF-12 28.75 [IQR 21.25-39.17] vs 73.96 [62.81-77.50]; p &lt; 0.001), more depressive symptoms (PHQ-9: 12.00 [7.00-18.00] vs 2.00 [0.00-6.00]; p &lt; 0.001), greater fatigue (FSS: 57.00 [50.00-62.00] vs 13.00 [9.00-33.00]; p &lt; 0.001), worse sleep quality (PSQI: 14.00 [9.00-16.00] vs 6.00 [3.00-11.00]; p &lt; 0.001), and shorter 6MWT-D (481 [406-560] m vs 556 [491-609] m; p &lt; 0.001). Long COVID cases were also less frequently employed (38.8% vs 81.2%; p &lt; 0.001) and had more post-COVID comorbidity (88.2% vs 60.0%; p &lt; 0.001). In the multivariable model within long COVID cases (n = 85), active employment was independently associated with better HRQoL (B 5.315, 95% CI 0.610 to 10.021; p = 0.027), whereas depressive symptoms (B - 1.124, 95% CI - 1.500 to - 0.748; p &lt; 0.001) and post-COVID comorbidity count (B - 1.252, 95% CI - 2.484 to - 0.021; p = 0.046) were independently associated with worse HRQoL. Fatigue severity showed a borderline association in the same direction (B - 0.171, 95% CI - 0.343 to + 0.001; p = 0.051). The model explained 48.9% of the variance in SF-12 score within long COVID cases (R&lt;sup&gt;2&lt;/sup&gt; = 0.489; adjusted R&lt;sup&gt;2&lt;/sup&gt; = 0.463). Exploratory clustering did not identify discrete phenotypes; the burden distribution was more consistent with a continuous severity gradient. For descriptive purposes, a lower-burden stratum (33/78, 42.3%) and a higher-burden stratum (45/78, 57.7%) were operationalized and differed across symptom load, fatigue, mood, functional status, exercise capacity, and HRQoL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclus","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320915","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":"Paramedics in an emerging role; a reflexive thematic analysis of barriers and enablers to primary care innovation through a community of practice.","authors":"R Sharples, L Hemming, R Hardman, E Spelten, K Sutherland, G Agarwal, L Reynolds","doi":"10.1186/s12875-026-03426-y","DOIUrl":"10.1186/s12875-026-03426-y","url":null,"abstract":"<p><strong>Background: </strong>Community paramedicine is an emerging model of care that focuses on preventative and rehabilitative health and improves equitable access to primary care. Four community health services in rural and regional Victoria, Australia, implemented the evidence-based Canadian CP@clinic (Community Paramedicine at Clinic) program. The paramedic-led program delivers free drop-in clinics with chronic disease screening, onward referrals, care navigation and health education.</p><p><strong>Methods: </strong>We conducted a reflexive thematic analysis of de-identified monthly meeting records of 13 Community of Practice (CoP) meetings. Analysis specifically focussed on the barriers and enablers of program delivery and on how the CoP supported CP@clinic program administrators, researchers and community paramedics.</p><p><strong>Results: </strong>CP@clinic implementation in rural, regional and remote Australia was shaped by four interrelated themes: workforce development, community engagement, data collection and program sustainability. Barriers centred on role ambiguity and transition from emergency care, the time intensity of trust-building within communities and referral navigation, administrative burden compounded by digital infrastructure constraints and persistent funding and workforce instability. Within these dynamics the CoP emerged as a crucial implementation mechanism that enabled both individual practitioners and organisations to navigate uncertainties, build capacity and maintain program adherence.</p><p><strong>Conclusion: </strong>CP@clinic can take root in rural, regional and remote Australia but only if the conditions are right. The CoP acted as the engine room for implementation accelerating role transition, local adaptation and practical problem solving. Yet persistent barriers - role ambiguity, time-intensive trust building, heavy data demands in low-connectivity settings and funding instability - continue to stall momentum. To move from a promising pilot to durable system change, the CP@clinic program needs CoP-enabled learning along with structural investment in training, digital infrastructure, evaluation support and long-term funding.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310673","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":"Deprescription of proton pump inhibitors in the primary care setting in the Canary Islands. A randomized massive educational intervention.","authors":"Miguel Del-Pino, Emilio J Sanz","doi":"10.1186/s12875-026-03432-0","DOIUrl":"10.1186/s12875-026-03432-0","url":null,"abstract":"<p><strong>Background: </strong>It is estimated that between 20% and 80% of Proton Pump Inhibitor (PPI) prescriptions worldwide lack an appropriate clinical indication. Since their introduction in 1989, PPIs have proven highly effective for treating acid-related digestive disorders. However, over three decades of global use have revealed notable side effects, notwithstanding their overall safety profile. The chronic and indiscriminate use of PPIs by millions of people without proper indications represents a substantial public health issue and threatens the sustainability of health services worldwide.</p><p><strong>Objective: </strong>To evaluate the clinical and economic outcomes of deprescribing PPIs that are indefinitely and incorrectly prescribed in primary care centres across the Canary Islands after an educational intervention.</p><p><strong>Method: </strong>An online training course was developed to educate family physicians on deprescribing PPIs in accordance with internationally recognized guidelines. Indications for PPI prescriptions were assessed and compared among an intervention group and two control cohorts: physicians interested in but not participating in the training, and those who did not express any interest on it. Following an initial assessment at twelve weeks, the second interested group received the same training. Chronic prescribing practices were then evaluated for all three groups at twelve and twenty-four weeks post-study initiation.</p><p><strong>Results: </strong>Before the intervention the 8% of indefinite PPI prescriptions in the primary care setting met the appropriate criteria according to the guideline used. This percentage did not increase in the groups of trained physicians. However, PPI-related expenditures were significantly lower in the intervention group compared to both control groups at 24 weeks, with the intervention group showing a median reduction of €82 per physician, while the control and anonymous groups showed increases of €15 and €160 respectively (p = 0.020 for the initial to 12-week comparison).</p><p><strong>Conclusions: </strong>Given the high volume of use of these medicines, any strategy aimed at improving their management by physicians can have a significant beneficial effect on the health of the population, and an exponential impact on the consumption of public resources. Longer-term follow-up, improved documentation of indications, and increased longitudinal patient care may play a critical role in the impact of educational interventions.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297622","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":"Effect of a peer support group intervention on medication adherence, self- care practices, and diabetes knowledge among patients with diabetes in Northern Ethiopia: a randomized controlled trial.","authors":"Halefom Kahsay Haile, Bruck Messele Habte, Teferi Gedif Fenta","doi":"10.1186/s12875-026-03430-2","DOIUrl":"10.1186/s12875-026-03430-2","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is a chronic condition that requires consistent adherence to treatment, regular self-care, and adequate knowledge of the disease to prevent complications and improve quality of life. However, many patients struggle to maintain optimal adherence and integrate self-care into their daily routines. Nowadays, many diabetes self-management modalities have emerged as a promising approach to address these gaps. This randomized controlled study evaluated the effect of a structured peer support program on medication adherence, self-care practices, and diabetes-related knowledge among patients with diabetes who attended follow-up at a tertiary hospital.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted on 97 (intervention group = 48, control group = 49) adults with diabetes who were attending follow-up at Ayder Comprehensive Specialized Hospital (ACSH). Participants were randomly assigned to either a peer-support intervention group or a control group and followed for six months. The intervention comprised three structured peer-led sessions that focused on self-care, medication adherence, and diabetes knowledge. Outcomes were measured at baseline and follow-up using the Morisky Medication Adherence Scale (MMAS-8), adopted Diabetes self-care Activities (SDSCA) scale, and diabetes knowledge test (DKT). Data analysis was performed using chi-square tests, paired-sample t-tests, and independent-sample t-tests to compare baseline characteristics and evaluate intervention effects. Difference-in-differences (DiD) analysis was used to compare the intervention and control groups across outcome variables.</p><p><strong>Result: </strong>Compared with the control group, participants in the intervention group demonstrated significant improvements across all outcome measures. Medication adherence increased by a net difference-in-differences estimate of (DiD = + 1.5 points, p < 0.001) on the MMAS-8 scale. Self-care practices improved by (DiD = + 1.3 days per week of recommended behaviors, p < 0.001). Diabetes knowledge scores also showed substantial gains, among both the insulin users (DiD = + 4.9-point, p < 0.001) and non-insulin users (DiD = + 3.4-points, p < 0.001) of the intervention group compare to controls.</p><p><strong>Conclusion: </strong>Integrating structured peer-support interventions into routine diabetes care may provide a practical approach to improving patient outcomes while optimizing limited healthcare resources in low-resource settings. Future research should evaluate the sustainability, scalability, and cost-effectiveness of peer-support education model, together with their long-term impact on quality of life.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284904","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":"Identifying the facilitators and barriers of a healthy transition for adult children when an older parent is transferred to a nursing home: a narrative approach.","authors":"Maylen Reiersøl Dahl, Grethe Eilertsen, Siri Tønnessen, Truls Juritzen","doi":"10.1186/s12875-026-03419-x","DOIUrl":"10.1186/s12875-026-03419-x","url":null,"abstract":"<p><strong>Background: </strong>As the health of an older parent deteriorates, their transfer to a nursing home becomes inevitable to ensure that they receive safe and sufficient care, with the decision to transfer often being made and implemented within a matter of days. Family caregivers such as adult children remain actively involved in providing care after their parent's transfer to a nursing home, and are often described as an 'invisible workforce'. However, the impact of this situation on the health and well-being of adult children is rarely acknowledged. This study aimed to characterize the transition experiences of adult children during the weeks after their older parent's transfer to a nursing home, which is referred to as post-transition phase.</p><p><strong>Methods: </strong>This research study formed part of a larger qualitative project that had a narrative, longitudinal, prospective design. We conducted 22 narrative interviews with 8 adult children of older parents on 3 occasions in 2022. Narrative analysis was used to structure and systemize the generated data.</p><p><strong>Results: </strong>The findings are presented as two narratives of one daughter ('Susan') and one son ('Phillip') that exemplify common characteristics shared by all of the participants. They illustrate the facilitators and barriers of a healthy transition-defined as a positive and successful transition outcome-during the complex post-transition phase. Although sharing similar contextual circumstances, their narratives diverge with Phillip's account conveying a sense of calm and relief, while Susan's narrative reflects stress and tension. These exemplar narratives of adult children highlight how personal, organizational and social factors both facilitate and hinder a healthy transition.</p><p><strong>Conclusions: </strong>The transfer of an older parent to a nursing home is often emotionally challenging for adult children. Healthcare personnel can help reduce the burden during the transition by supporting role mastery, subjective well‑being and well-being of relationships. Promoting the well‑being of adult children may have positive implications for their older parents as well as the healthcare services and society as a whole.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280140","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":"Health literacy competencies among future healthcare providers: a cross-sectional study of preclinical medical students using TSOY-32.","authors":"Kemal Ozan Lüle","doi":"10.1186/s12875-026-03433-z","DOIUrl":"10.1186/s12875-026-03433-z","url":null,"abstract":"<p><strong>Background: </strong>Health literacy is essential for effective physician-patient communication and high-quality healthcare delivery. However, the extent to which future physicians possess these competencies during the early stages of medical training remains insufficiently understood. This study aimed to assess health literacy levels among preclinical medical students using the Turkish Health Literacy Scale-32 (TSOY-32) and to examine differences according to academic year.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among preclinical medical students (Year 1-3) at Gaziantep University Faculty of Medicine during the 2025-2026 academic year. Health literacy was assessed using the TSOY-32, which provides an overall health literacy index as well as domain- and competence-specific indices. Group comparisons were performed using one-way analysis of variance and chi-square tests. Pearson correlation analyses and multivariable linear regression analyses were performed to evaluate whether academic year was independently associated with overall health literacy after adjustment for sex and body mass index. Sensitivity analyses including age were conducted to assess the robustness of the findings.</p><p><strong>Results: </strong>A total of 305 students were included. According to the TSOY-32 Overall Health Literacy Index, 74.4% of participants were classified as having inadequate or problematic/limited health literacy. Mean overall health literacy scores differed between academic-year groups (Year 1: 28.51 ± 6.13; Year 2: 28.81 ± 5.82; Year 3: 30.74 ± 6.72; p = 0.036), with a small effect size (η² = 0.022). Between-group differences were most apparent for appraisal- and application-related indices. In multivariable analysis adjusted for sex and body mass index, third-year students scored 2.24 points higher than first-year students on the TSOY-32 index (95% CI: 0.47-4.01; p = 0.013); however, the model explained only a small proportion of score variability (adjusted R² = 0.022).</p><p><strong>Conclusions: </strong>A high proportion of students demonstrated suboptimal health literacy (inadequate or problematic/limited). Although third-year students had statistically higher health literacy scores than first-year students, the small effect size and low explained variance indicate that academic year had limited explanatory value. These findings should therefore be interpreted as modest between-group differences rather than evidence of longitudinal progression. As the present study did not directly assess curricular content or educational interventions, these findings are descriptive in nature; whether structured or competency-based educational approaches would improve health literacy in this population remains a hypothesis to be tested in future interventional research.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280166","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":"Changes in primary care provider behaviors after a brief educational intervention about opioid prescribing in older adults.","authors":"Alëna A Balasanova, Hongmei Wang, Jungyoon Kim, Jihyun Ma, Rebecca Hiebert, Mary Jo Spurgin, Jane Potter, Alfred L Fisher","doi":"10.1186/s12875-026-03438-8","DOIUrl":"10.1186/s12875-026-03438-8","url":null,"abstract":"<p><strong>Background: </strong>There is limited literature on educational interventions for primary care clinicians (PCC) addressing the unique considerations in opioid prescribing for older adult patients.</p><p><strong>Objective: </strong>We aimed to evaluate self-reported knowledge, confidence, and behavior change by PCC and the degree to which respondents followed through with their intentions to implement specific clinical strategies after receiving a brief educational intervention about opioid prescribing in older adults.</p><p><strong>Design: </strong>Analysis of pre-, post-, and one-month follow-up surveys of PCC.</p><p><strong>Participants: </strong>PCC working within our institution's 13 primary care clinics.</p><p><strong>Interventions: </strong>The brief educational training was conducted over 20 months and focused on limited benefits and unique harms of chronic opioid use in older adults, opioid use disorder screening, and harm reduction strategies.</p><p><strong>Main measures: </strong>The surveys assessed perceived knowledge and confidence in non-opioid medication options and opioid safety strategies before and after the intervention and potential use of strategies to address opioid use in their clinical practice. The one-month follow-up survey asked if participants had started implementing opioid safety strategies with patients. We also collected information on age, gender, race, ethnicity, and health professions discipline.</p><p><strong>Key results: </strong>Sixty-five PCC received the intervention and completed the immediate post-training survey. Of these, 24 also completed the one-month follow-up survey. We found increased perceived knowledge of the effectiveness of long-term opioids for chronic pain and increased confidence in suggesting non-opioid treatment options among all participants after the training. Post-training, all but one clinician planned to implement at least one of the taught opioid safety strategies. At one-month follow-up, depending on the strategy, between 10%-78% of participants had implemented their planned strategy.</p><p><strong>Conclusions: </strong>Our findings show that a brief opioid-focused educational intervention for practicing PCC is associated with increased perceived knowledge and confidence immediately after the intervention and a high likelihood of implementing some of the taught strategies one month later. These findings suggest that brief trainings may be impactful educational interventions for practicing PCC.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280158","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}