BMC primary care最新文献

{"title":"Investigating assumptions in motivational interviewing among general practitioners: a qualitative study.","authors":"Paul Aujoulat, Amélie Manac'h, Catherine Le Reste, Delphine Le Goff, Jean Yves Le Reste, Marie Barais","doi":"10.1186/s12875-025-02706-3","DOIUrl":"10.1186/s12875-025-02706-3","url":null,"abstract":"<p><strong>Background: </strong>Unhealthy behaviours contributing to cardiovascular issues, diabetes, strokes, and cancer, pose significant health risks. General practitioners (GPs) are pivotal in guiding behaviour change, with Motivational Interviewing (MI) showing promise. MI, developed by William Miller and Stephen Rollnick, aims to enhance motivation for change. Despite its efficacy in areas like smoking cessation and weight loss, its uptake among French GPs remains uncertain.</p><p><strong>Methods: </strong>This qualitative study was to explore GPs' understanding of MI, its perceived benefits and the obstacles to its implementation in western Brittany (Finistère). Semi-structured interviews, conducted by two female trainees, explored MI knowledge, benefits, and barriers with a thematic analysis.</p><p><strong>Results: </strong>Between November 2020 and May 2021, 11 semi-structured interviews were conducted with GPs. Participants had a limited understanding of MI, often confusing it with persuasion. MI was seen as a patient-centered tool fostering behavioural change, with reported benefits in cancer screening, chronic disease management, and vaccination. However, barriers such as time constraints, limited training availability, and systemic issues hinder its adoption. Participants emphasized MI's utility for challenging cases but noted it was unnecessary for engaged patients. MI could also enhance doctor-patient relationships and physician satisfaction. Overcoming barriers requires addressing logistical issues, integrating MI into training, and promoting its long-term efficiency to improve healthcare outcomes.</p><p><strong>Conclusion: </strong>This study highlighted GPs' limited knowledge of MI but recognized its value in promoting patient-centered care and behaviour change. GPs identified its potential in areas like cancer screening, chronic disease management, and vaccine hesitancy while noting barriers such as time constraints and insufficient training. Addressing these challenges through better integration into training and practice could enhance patient outcomes and provider satisfaction. Focused efforts are needed to translate MI's potential into routine clinical use.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"15"},"PeriodicalIF":2.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017292","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":"Factors associated with delayed referrals of patients with sepsis from primary to tertiary healthcare in Blantyre, Malawi: a qualitative study.","authors":"Sylvester Kaimba, Eric Umar","doi":"10.1186/s12875-025-02708-1","DOIUrl":"10.1186/s12875-025-02708-1","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is defined as invasion of pathogens into the blood stream together with the host response to this invasion. Thus, sepsis consists of the systemic inflammatory response syndrome (SIRS)caused by infection. It is a life-threatening condition that requires prompt detection and early definitive medical intervention. Globally, sepsis is common, with an estimated 31.5 million cases per year. Sepsis accounts for a significant in-hospital mortality rate of 17% in high-income countries, while in Malawi, it ranges from 17 to 50%. For Malawi, the trend can be reversed with improvements in patient referral system within the healthcare system. The study sets out to establish factors associate with delay referral of patients with sepsis from primary healthcare to tertiary hospitals and to understand healthcare workers and patients' perspectives on barriers associated with delayed referral of patients with sepsis from primary to tertiary healthcare.</p><p><strong>Methods: </strong>A qualitative descriptive study in six health centres within Blantyre District health office. In-depth interviews were conducted with 22 respondents: healthcare providers [n = 12]; patients [n = 10] using semi-structured interview guides. Purposive sampling techniques were used in selecting healthcare providers (health centre in charges) and patients.</p><p><strong>Results: </strong>The study demonstrating that the main referral pathways for patients with sepsis include community-to-facility and facility-to-facility referrals. Ambulances and personal transport are common transportation mode used during referrals. Primary care facilities face several challenges that delay referrals from primary to tertiary health facility of patients with sepsis, such as lack of referral transport, poor communication, poor road network, shortage of skilled healthcare workers, patient preferences, delayed treatment-seeking action, and ambulances prioritising maternal conditions.</p><p><strong>Conclusions: </strong>Patients' delay and failure to access prompt and timely referral services result from the healthcare system's lack of transport, communication problems, bad road networks and shortage of well-trained personnel. Referral delays have deleterious effects on patient-care outcomes.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"13"},"PeriodicalIF":2.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017281","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":"Patient perspectives on stress after ICU and a short primary care based psychological intervention - results from a qualitative sub‑study of the PICTURE trial.","authors":"Antina Beutel, Linda Sanftenberg, Chris M Friemel, Robert Philipp Kosilek, Maggie Schauer, Thomas Elbert, Ulf-Dietrich Reips, Tomke Schubert, Sabine Gehrke-Beck, Konrad Schmidt, Jochen Gensichen","doi":"10.1186/s12875-024-02698-6","DOIUrl":"10.1186/s12875-024-02698-6","url":null,"abstract":"<p><strong>Background: </strong>Approximately 20-25% of patients who survive medical treatment at an intensive care unit (ICU) develop post-traumatic stress symptoms. There is currently a gap in follow-up care for them. As part of the PICTURE study, general practitioners (GPs) carried out a brief interview-based intervention. The aim of this sub-study is to record the most distressing memories of ICU treatment from the patient's perspective and their evaluation of a GP-based brief psychological intervention.</p><p><strong>Methods: </strong>Participants were recruited from the intervention group of the main PICTURE study using selective sampling. All of them had experienced an ICU stay with mechanical ventilation and severe organ failure in the previous two years. They were interviewed about their experience of psychological stress during their ICU stay and their retrospective evaluation of the intervention. Semi-structured, guideline-based telephone interviews were conducted for this purpose, processed, and analyzed using the structuring qualitative content analysis based on Mayring.</p><p><strong>Findings: </strong>When asked N = 8 patients about the most stressful memory of their stay at ICU, the main themes were helplessness, pain, fixation, inability to communicate and sleep disturbances. The question of amnesia regarding the stay in the ICU was answered affirmatively by half of the interviewees but was not experienced as stressful. The brief trauma-focused intervention carried out by their GPs was well received by all respondents.</p><p><strong>Conclusions: </strong>The interviewees confirm that aversive traumatizing experiences are often associated with intensive care treatment and reinforce each other. These are due to the treatment setting but should be reduced wherever possible. In view of chronification and the lack of specific follow-up treatment options for these patients and the long waiting times for psychotherapy, the implementation of low-threshold treatment options by GPs appears to be ideally suited to closing this gap in care, particularly for patients with mild to moderate symptoms of a post-traumatic stress disorder.</p><p><strong>Trial registration: </strong>The main trial was registered at ClinTrials gov (NCT03315390) and at the German Register of Clinical Trials (DRKS, DRKS00012589) on 17/10/2017.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"12"},"PeriodicalIF":2.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017296","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":"Physicians' and patients' perceived risks of chronic pain medication and co-medications in Quebec, Canada: a cross-sectional study.","authors":"Gwenaëlle De Clifford-Faugère, Anaïs Lacasse, Hermine Lore Nguena Nguefack, Marimée Godbout-Parent, Aline Boulanger, Nancy Julien","doi":"10.1186/s12875-025-02704-5","DOIUrl":"10.1186/s12875-025-02704-5","url":null,"abstract":"<p><strong>Background: </strong>The risks associated with medications and co-medications for chronic pain (CP) can influence a physician's choice of drugs and dosages, as well as a patient's adherence to the medication. High-quality care requires patients to participate in medication decisions. This study aimed to compare perceived risks of medications and co-medications between physicians and persons living with CP.</p><p><strong>Methods: </strong>This cross-sectional survey conducted in Quebec, Canada, included 83 physicians (snowball sampling) and 141 persons living with CP (convenience sampling). Perceived risks of adverse drug reaction of pain medications and co-medications were assessed using 0-10 numerical scales (0 = no risk, 10 = very high risk). An arbitrary cutoff point of 2-points was used to ease the interpretation of our data. Physicians scored the 36 medication subclasses of the Medication Quantification Scale 4.0 (MQS 4.0) through an online survey, while CP patients scored the medication subclasses they had taken in the last three months through telephone interviews.</p><p><strong>Results: </strong>Persons living with CP consistently perceived lower risks of adverse drug reaction compared to physicians. For eight subclasses, the difference in the mean perceived risk score was > 2 points and statistically significant (p < 0.05): non-specific oral NSAIDs, acetaminophen in combination with an opioid, short-acting opioids, long-acting opioids, tricyclic antidepressants, antipsychotics, benzodiazepines, and medical cannabis.</p><p><strong>Conclusions: </strong>Divergent risk perceptions between physicians and patients underscore the necessity of facilitating a more extensive discussion on medications and co-medications risks to empower patients to make informed decisions and participate in shared decision-making regarding their treatments.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"8"},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985615","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":"Virtual primary care for people living with dementia in Canada: cross-sectional surveys of patients, care partners, and family physicians.","authors":"Vladimir Khanassov, Deniz Cetin-Sahin, Sid Feldman, Saskia Sivananthan, Allan Grill, Isabelle Vedel","doi":"10.1186/s12875-025-02710-7","DOIUrl":"10.1186/s12875-025-02710-7","url":null,"abstract":"<p><strong>Background: </strong>Virtual care (VC) for dementia in primary care settings is an important aspect of healthcare delivery in Canada. However, the evidence informing optimal and sustainable provision of VC for persons living with dementia (PLWD) and their care partners is scarce. The objectives of this study were to (1) describe the frequency of VC use, (2) identify characteristics of PLWD, care partners, and family physicians (FPs) that are associated with the use of VC, and (3) explore FPs' perceptions of barriers and facilitators to provide VC for PLWD and their care partners.</p><p><strong>Methods: </strong>The Alzheimer Society of Canada and College of Family Physicians of Canada conducted three nationwide cross-sectional surveys between October 2020 and April 2021: (1) One with PLWD, (2) one with care partners of PLWD, and (3) one with FPs. Virtual care was defined as two-way synchronous communication by telephone and/or a web camera. The prevalence of VC use among FPs, PLWD, and care partners was described. Logistic regression models were used to determine characteristics of participants (sociodemographic, urbanicity, frequency and availability of support for connecting with FPs, and FPs' practice characteristics) associated with any VC use (phone and/or video). Inductive thematic analysis of open-ended questions explored FPs' perceptions.</p><p><strong>Results: </strong>131 PLWD, 341 care partners, and 125 FPs participated. 61.2% of PLWD, 59.5% of care partners, and 77.4% of FPs reported using VC. The models for PLWD (included age and ethnicity) and care partners (included gender/sex, urbanicity, and receiving support from a family member/friend to connect with FP) were inconclusive. FPs with > 20 years in practice were less likely to provide VC (OR = 0.23, 95%CI: 0.08-0.62, p < 0.01). FPs perceived that preferences regarding virtual vs. in-person care, office/family support, technology and family presence, and remuneration for FPs influenced VC use.</p><p><strong>Conclusions: </strong>Virtual primary dementia care uptake in Canada is substantial and mainly performed via telephone. According to FPs, physician-patient-caregiver partnerships and infrastructure for VC play key roles in using VC. Virtual care could facilitate access to primary care and minimize potential disruptions to in-person care for PLWD. Outcomes of virtual primary care for dementia need further investigation.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"9"},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985598","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":"Social issues in general practice - a survey assessing the interprofessional perspective of general practitioners and social workers regarding frequency, challenges, and needs.","authors":"Tonia Gerber, Laura Diaz Hernandez, René Rüegg, Dunja Vetter, Andreas Zeller","doi":"10.1186/s12875-024-02702-z","DOIUrl":"10.1186/s12875-024-02702-z","url":null,"abstract":"<p><strong>Background: </strong>Health or illness and social issues cannot be viewed in isolation. Social problems can influence well-being and disease. General Practitioners (GPs) are requested to offer counselling opportunities to respond to the social issues of their patients adequately. Counselling on non-medical issues in general practice increases GPs' workload. The study aimed to analyse the occurrence of social problems as well as the strengths and weaknesses of existing working agreements between social services and GPs in primary care.</p><p><strong>Methods: </strong>We carried out a cross-sectional online survey between December 2022 and January 2023 among a sample of Swiss GPs from the Sentinella-Network, the uniham-bb-Network and social workers from the SAGES-Network.</p><p><strong>Results: </strong>Findings come from a sample of 143 GPs (mean age 54 years, 37.8% female) and 41 social workers (mean age 43 years, 75.6% female). GPs face a median of 3 patients with social problems per week (IQR 5.2). They reported encountering patients facing \"Finance\" issues most frequently, with 78.8% encountering such cases between \"more than 3 patients per week\" and \"1-3 patients per month\". \"Work\" (76.4%) and \"Loneliness\" (73.7%) were also among the most commonly encountered social problems. When suspecting the problem, GPs more often addressed the issue if it was about \"Addiction\" (83.2%), \"Loneliness\" (72.3%), or \"Protection\" (71.4%). More than half of GPs (56.0%) reported having contact with social workers less than once a month, while approximately half of the social workers reported having contact with GPs 1 to 3 times a month (48.7%). GPs (69.3%) and social workers (76.3%) would like more contact. The most frequently mentioned benefits of an increased collaboration from the GPs' perspective were \"improved quality of care (more time for medical issues)\" (64.8%) and \"improved mental health of patients\" (55.6%).</p><p><strong>Conclusions: </strong>Social problems in general practice are common, but the interprofessional cooperation between GPs and social workers is scarce. However, both parties appear to be in favour of closer interprofessional collaboration and seem to be willing to attempt to improve joint patient care in the future. The integration of social workers into general practice is promising for a comprehensive, interprofessional, and preventative patient approach to providing the best healthcare.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"11"},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985592","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":"Service delivery and the role of clinical pharmacists in UK primary care for older people, including people with dementia: a scoping review.","authors":"Alice Burnand, Abi Woodward, Vladimir Kolodin, Jill Manthorpe, Yogini Jani, Mine Orlu, Cini Bhanu, Kritika Samsi, Victoria Vickerstaff, Jane Wilcock, Jane Ward, Greta Rait, Nathan Davies","doi":"10.1186/s12875-024-02685-x","DOIUrl":"10.1186/s12875-024-02685-x","url":null,"abstract":"<p><strong>Objective: </strong>As populations age globally, there is increasing prevalence of multiple long-term conditions, such as dementia, leading to many challenges. The burden on health and care services, economic pressures, and the necessity for innovative policies to better support older people and people with dementia becomes paramount. This review explores how clinical pharmacists working in UK primary care support older people and people with dementia.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Method: </strong>This review was conducted following the framework for scoping reviews in accordance with the Joanna Briggs Institute (JBI) methodology. The search of Scopus, EMBASE, CINAHL, Web of Science, PsycINFO, and Cochrane was initially conducted in September 2022, and updated in August 2024. Searches included literature exploring the landscape of clinical pharmacy services for older people in the UK, focusing on roles and services delivered, perceptions, and experiences.</p><p><strong>Results: </strong>A total of 30 articles were included. These detail the multifaceted responsibilities of clinical pharmacists in primary care for older people. Stakeholder perspectives, including healthcare professionals and patients, emphasised the positive outcomes of clinical pharmacist involvement, from reducing other practitioners' workloads to improving patient safety. However, communication gaps, concerns about competence from other healthcare professionals, and the need for clear role definitions emerged as challenges. Research focused on the experiences of underserved groups, such as people with dementia or from minority ethnic backgrounds, is lacking.</p><p><strong>Conclusions and implications: </strong>The review enhances our understanding of the primary care clinical pharmacist service in the UK and identifies gaps in evidence, emphasising the need for empirical studies on the experiences of older people with cognitive impairment and those from minority ethnic backgrounds. It provides insights into what makes an effective clinical pharmacist service, such as training and communication, which may help to inform international policy and practice and improve service provision globally.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"10"},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985626","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":"Profiles of physician follow-up care, correlates and outcomes among patients affected by an incident mental disorder.","authors":"Marie-Josée Fleury, Louis Rochette, Zhirong Cao, Guy Grenier, Victoria Massamba, Alain Lesage","doi":"10.1186/s12875-024-02674-0","DOIUrl":"10.1186/s12875-024-02674-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study identified profiles of outpatient physician follow-up care and other practice features, mostly after detection of incident mental disorders (MD), and associated these profiles with patient characteristics and subsequent adverse outcomes.</p><p><strong>Methods: </strong>A cohort of 170,957 patients age 12 + with a new or recurrent MD detected in 2019-20 was investigated based on data from the Quebec Integrated Chronic Disease Surveillance System. Latent class analysis was performed to identify follow-up care profiles, mostly within one year of MD detection. Bivariate analyses tested associations between profiles and patient characteristics; logistic regressions examined relationships between profiles and adverse outcomes after one year.</p><p><strong>Results: </strong>Five profiles were identified: Profiles 2 and 5 (64%) offered low mental health (MH) outpatient follow-up care, while the others dispensed higher MH follow-up care. Profiles differed in patient characteristics and related outcomes. Labelled \"Follow-up care by usual psychiatrist\", Profile 1 (1% of sample) included younger patients with the most health and social issues. Profile 2 (50%), \"Low MH follow-up care but high prior consultations for physical reasons\", mostly integrated older patients with chronic physical illnesses. Profile 3 (11%), \"Follow-up care by general practitioners (GP) and psychiatrists\", referred to physicians other than the usual ones (e.g., walk-in practice) and encompassed patients with severe MD conditions. Profile 4 (23%), \"High follow-up care by usual GP and prior consultations for physical reasons\", showed the typical characteristics of patients treated in primary care (more common MD, women, less materially and socially deprived). Profile 5 (15%), \"Low MH follow-up care and prior consultations for physical reasons\", integrated more younger men, materially deprived patients, and with substance-related disorders (SRD) or co-occurring MD-SRD. More Profile 1 and 3 patients lived in university regions - those of Profile 4 were the least numerous in such regions. More Profile 5 patients lived in metropolitan and rural areas. Risk of death was higher in Profiles 5, 2, 3, and risk of frequent ED use and hospitalization higher in Profiles 1, 3, and 5 - patients with severe health and social issues.</p><p><strong>Conclusion: </strong>The study confirmed the need to improve prompt, adequate and continuous follow-up care for patients with incident MD.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"7"},"PeriodicalIF":2.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does the knowledge level of physicians and nurses working at primary health centers affect their preference for oral contraceptives in an inland Turkish province?","authors":"Gamze Dur, Ayşen Mert, Rıza Dur, Mine Kanat Pektas","doi":"10.1186/s12875-024-02700-1","DOIUrl":"https://doi.org/10.1186/s12875-024-02700-1","url":null,"abstract":"<p><strong>Background: </strong>Standardizing the knowledge of health care givers and eliminating their misconceptions would help to achieve optimal service for contraception. This study aims to evaluate the knowledge levels of physicians and nurses working at primary health care centers about the oral contraceptive pill (OCP) use.</p><p><strong>Methods: </strong>This is a cross-sectional review of 306 professional care givers (117 physicians and 189 nurses) who are working at primary health care centers.</p><p><strong>Results: </strong>Only 17.3% of health care givers recommend OCP as their first professional choice of contraception for their patients. Approximately 50.3% of these care givers do not feel qualified about the OCPs and 81.7% of them wish to have regular training about OCPs. There is a significantly higher number of male health care givers who claim that OCPs cause acne, sexual dysfunction, ectopic pregnancy, deep vein thrombosis, and liver cancer (respectively p = 0.040, p = 0.028, p = 0.001, p = 0.001, and p = 0.020). When compared to nurses, there is a significantly higher number of physicians who state that OCPs cause acne, depression, sexual dysfunction, ectopic pregnancy, deep vein thrombosis, breast cancer and liver cancer.</p><p><strong>Conclusion: </strong>Physicians and nurses working at primary health centers in an inland Turkish province have relatively lower rates of recommendation for OCP use. These lower recommendation rates become significantly more obvious in male physicians with ≥ 14 years' experience. The concern about probable adverse effects, the lack of standardization in formal education, the absence of post-graduate training and the shortage of time and resources for counseling might have led to the limitation in OCP use.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"6"},"PeriodicalIF":2.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959740","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":"Work-related stress and its associated factors among primary care doctors in Malaysia during the COVID-19 pandemic.","authors":"Muhammad Shah Shahrudin, Nik Munirah Nik-Nasir, Mohamed-Syarif Mohamed-Yassin","doi":"10.1186/s12875-024-02697-7","DOIUrl":"10.1186/s12875-024-02697-7","url":null,"abstract":"<p><strong>Background: </strong>In Malaysia, the recent COVID-19 pandemic had increased the workload of all health professionals, especially primary care doctors (PCDs). Hence, this study aimed to determine the level of work-related stress and factors associated with higher levels of work-related stress among PCDs in Malaysia during this pandemic.</p><p><strong>Methods: </strong>A cross-sectional study was conducted online using Google Forms™. Sociodemographic as well as work and workplace data were collected. The Job Demand Inventory, Physicians' Lack of Professional Autonomy, and Health Professions Stress Inventory questionnaires were used to assess the job demand score, job autonomy score, and the level of work-related stress, respectively. Multiple linear regression was performed to determine the significant factors associated with higher work-related stress.</p><p><strong>Results: </strong>A total of 301 PCDs participated in this study with the majority being female (76.1%), Malay (67.8%), married (73.1%), medical officers (68.8%), and worked in urban (70.4%) and public primary care clinics (83%). The mean (SD) score for work-related stress was 62.8 (18.4), (score range 0-120). PCDs who had any degree of worry about being alienated by friends and relatives because of close contact with COVID-19 patients had higher work-related stress levels compared to PCDs who did not have any worry [rarely (b = 10.23, 95% CI:5.57, 14.89), sometimes (b = 10.41, 95% CI:5.68, 15.13), often (b = 10.12, 95% CI:4.16, 16.08), and always (b = 14.65, 95% CI:7.43, 21.89)]. The other significant factor was higher job demand scores (b = 1.13, 95% CI:0.91, 1.35). In contrast, PCDs who always received support from supervisors at their workplace were found to have lower work-related stress levels compared to those who did not receive any support (b=-5.65, 95% CI:-10.38, -0.93).</p><p><strong>Conclusions: </strong>The level of work-related stress among Malaysian PCDs during the COVID-19 pandemic was higher compared to American PCDs and Malaysian physicians before the pandemic but lower compared to Australian emergency physicians during the pandemic. Urgent measures to address the above-mentioned associated factors should be implemented as another pandemic may be just around the corner.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"4"},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959744","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}