Primary health care research & development最新文献

{"title":"Investigating factors influencing recruitment and retention of adult community nurses: an exploratory qualitative study across NHS trusts in England.","authors":"Edwin Chamanga, Judith Dyson, Manuela Jarrett, Eamonn McKeown","doi":"10.1017/S1463423625100480","DOIUrl":"https://doi.org/10.1017/S1463423625100480","url":null,"abstract":"<p><strong>Aim: </strong>To investigate factors influencing the recruitment and retention of adult community nurses.</p><p><strong>Background: </strong>The recruitment and retention of community nurses is a growing global challenge, exacerbated by aging populations and increasing demand for primary and home-based care. Across Europe, nurse shortages threaten healthcare sustainability, with high attrition rates linked to workplace pressures, inadequate staffing, and emotional exhaustion. Despite efforts to strengthen retention, many European countries struggle to maintain adequate staffing levels, particularly in community nursing.</p><p><strong>Methods: </strong>An exploratory qualitative approach was used with semi-structured interviews. The interview schedule was shaped by the study's aims, a prior integrative literature review, and the 'causal model of turnover for nurses'. Questions explored participants' experiences of recruitment into community nursing and factors influencing retention. The study focused on registered nurses and service managers within adult community nursing organizations across diverse geographical areas.</p><p><strong>Findings: </strong>The study identified eight main themes influencing recruitment and retention: the perfect job, finding true self and fulfilment, alignment with organizational values, prior development and transitional experience, job dissatisfaction, shift in traditional practices, lack of compassionate leadership, and family commitments. Key factors included workplace flexibility, professional identity, job security, and organizational culture. However, challenges such as staffing shortages, lack of career progression, and increased administrative tasks were significant barriers to retention.</p><p><strong>Conclusion: </strong>This study highlights the multifaceted challenges surrounding community nurse recruitment and retention, emphasizing the need for targeted strategies that go beyond traditional hospital-focused approaches. While salary improvements remain crucial, broader systemic changes including workplace flexibility, compassionate leadership, and career development opportunities are essential to fostering a sustainable workforce. By addressing these factors through co-designed solutions and evidence-based policy adjustments, healthcare organizations can enhance job satisfaction, reduce attrition, and ultimately strengthen the future of community nursing.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e87"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253798","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":"PURE PRIME: Implementing pulmonary rehabilitation in primary care: a protocol for a randomized controlled feasibility trial - CORRIGENDUM.","authors":"Jessica A Walsh, Zoe J McKeough, Marita T Dale, Jennifer A Alison, Sarah M Dennis","doi":"10.1017/S1463423625100479","DOIUrl":"https://doi.org/10.1017/S1463423625100479","url":null,"abstract":"","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e86"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202463","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":"Measuring the strength of primary care: development of a new system of Structural Indicators for the Strength of Primary Care - SiSPC.","authors":"Wienke G W Boerma, Peter Groenewegen, Rob Timans, Sarah Burgmann, Rosa Suñol, Pili Illarramendi Charovsky, Jose M Valderas","doi":"10.1017/S1463423625100509","DOIUrl":"https://doi.org/10.1017/S1463423625100509","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to develop an up-to-date system of Structural Indicators for the Strength of Primary Care (SiSPC) to enable comparisons of primary care systems across countries.</p><p><strong>Background: </strong>Indicators are needed for international research into the development of primary care and to support countries in monitoring improvements in access, responsiveness and efficiency of their primary care services. International comparisons with use of identical indicators for the strength of primary care offer policymakers opportunities to learn lessons from abroad.</p><p><strong>Methods: </strong>Our point of departure was the Primary Health Care Activity Monitor Europe (PHAMEU), that effectively measured the strength of primary care at the beginning of this century. We went through the following steps: (1) Reduction, refining and tuning of the PHAMEU indicator system (2) comparison with the European Primary Health Care, Impact, Performance and Capacity Tool (PHC-IMPACT) (3) addition of topics from other frameworks (4) identification of topical issues from the literature. The resulting draft indicator system was discussed at meetings and received feedback from experts from 25 countries.</p><p><strong>Findings: </strong>SiSPC consists of three care-related domains: Structure of Primary Care, Systemic Aspects of Facility Management and Systemic Aspects of Care Delivery. SiSPC also contains a domain on the Context of Primary Care. Care processes that vary between care providers, were not included as a domain at the system level.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e85"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194086","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":"A study protocol for interprofessional collaborative, digital, and sustainability training in primary healthcare: the REALISE study.","authors":"Marlene Brunner, Eva Maria Propst, Melanie Roth, Christine Kern, Joachim Schulze, Johanna Bodenhofer, Gertie Janneke Oostingh, Daniela Huber","doi":"10.1017/S1463423625100455","DOIUrl":"https://doi.org/10.1017/S1463423625100455","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare units (PHCUs) in Austria play a crucial role in providing regionally tailored, high-quality care through interprofessional teams. Barriers, such as limited training and unclear roles, hinder effective interprofessional collaboration (IPC). Additionally, healthcare and social professionals (HCSPs) in primary healthcare (PHC) face a rise in patients with non-communicable diseases and increasing climate-related challenges, underscoring the need for education addressing IPC and sustainability to build resilient healthcare.</p><p><strong>Aim: </strong>This paper presents the protocol of the REALISE study, which aims to evaluate the effectiveness of a didactic concept integrating collaborative, digital, and sustainability skills within multimodal training modules (including simulations).</p><p><strong>Methods: </strong>In this prospective trial, HCSPs working in PHC and students in their final year of education in related professions are recruited to participate in interprofessional training modules, which take place on four days within a month in person and with additional e-learning elements between those days. The modules consist of didactic elements on IPC and sustainability, simulation scenarios with acting patients, and immersive virtual reality scenarios. The primary outcomes assess IPC by utilizing the Teamwork Assessment Scale, the Interprofessional Socialization and Valuing Scale (9a/9b), and the Interprofessional Collaborative Competency Attainment Survey. Secondary outcomes focus on sustainability and environmental awareness, as well as the organization and structure of the training modules.</p><p><strong>Discussion: </strong>The findings of this study will demonstrate the effect of proprietary training modules on IPC and will inform on the integration of respective modules into standard curricula and continuing educational programmes at the Salzburg University of Applied Sciences.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e83"},"PeriodicalIF":1.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194093","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":"Integrating nursing activities into general practices in Switzerland: a mixed-methods study.","authors":"Muriel Schütz Leuthold, Joëlle Schwarz, Fatima El Hakmaoui, Renzo Scuderi, Nicolas Senn, Christine Cohidon","doi":"10.1017/S146342362510039X","DOIUrl":"10.1017/S146342362510039X","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study is to describe the rollout of nursing activities during the pilot project's first 12 months (2019-2021), especially relating to what was initially planned in the nurses' job description.</p><p><strong>Background: </strong>To provide more comprehensive services and reinforce primary care, a pilot implementation study assessed the integration of nursing activities into eight general practitioners' (GPs') practices. The study evaluated how new types of activities were integrated and rolled out over the first year.</p><p><strong>Methods: </strong>A mixed-methods observational study collected quantitative data on nursing activities and duration and qualitative data via five interviews with nurses and patients and one focus group with six GPs. Investigators combined quantitative and qualitative data in discussions about their results.</p><p><strong>Results: </strong>New nursing activities were rolled out progressively, especially follow-up activities with chronically ill patients, with a median time dedicated/month of 21h58 (range: 9h25 to 64h50) at six months and 48h43 (range: 11h01 to 59h51) at 12 months. One-off clinical activities are more easily integrated: the median time dedicated/month was 40h01 (range: 13h44 to 74h53) at six months and 40h30 (range: 9h38 to 76h51) at 12 months. Three elements were crucial in the implementation of nursing activities. The nurse's previous professional experience influenced the scope of activities developed. GPs' willingness to refer patients to the nurses enabled the latter to carry out follow-up activities with care plan. Lastly, the implementation of nursing activities was also made possible by patients' acceptance of being cared for by nurse instead of a GP.</p><p><strong>Conclusion: </strong>Implementation of nursing activities increased progressively, although more slowly for activities with chronically ill patients and within care plans, principally due to the overall change faced by GPs and nurses.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e84"},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of ferrous oral iron used in the treatment of iron deficiency on weight gain and appetite in adults: a prospective study.","authors":"Cansu Alici Yilmaz, Duygu Ayhan Baser, Hilal Aksoy, M Merve Tengilimoglu-Metin","doi":"10.1017/S1463423625100443","DOIUrl":"https://doi.org/10.1017/S1463423625100443","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess the impact of oral Fe⁺² iron preparations on weight, body composition, metabolic, and appetite parameters in adults undergoing treatment for iron deficiency.</p><p><strong>Methods: </strong>In this observational prospective study, a total of 119 patients, aged 18-45, initiating Fe⁺² iron therapy for iron deficiency within the last month at Family Medicine Outpatient Clinic, were included. Data on sociodemographic variables, health, dietary habits, anthropometric measurements, metabolic parameters, and appetite scores were collected. The Power of Food (PFS), Visual Analogue Scale (VAS), and Three-Factor Eating Questionnaire (TFEQ) were utilized for appetite assessment.</p><p><strong>Findings: </strong>After three months of iron treatment, a statistically significant increase was found in the mean values of Hb, Hct, MCV, ferritin, iron, and transferrin saturation; anthropometric measurements displayed a significant reduction in body weight, body mass index (BMI), fat percentage, waist circumference, hip circumference, and waist/hip circumference ratios post-treatment. Notably, VAS scores for certain food items decreased, while carbonated drinks VAS score increased. Appetite-related factors, as per PFS, exhibited a significant decrease in PFS factor 1 (food available), PFS factor 2 (food present).</p><p><strong>Conclusions: </strong>In conclusion, our findings indicate that oral Fe⁺² iron preparations positively influence the treatment of iron deficiency anaemia by improving haematological parameters and concurrently leading to a significant reduction in body weight, BMI, and appetite scores related to specific food items. The study underscores the multifaceted impact of iron supplementation on both physiological and behavioural aspects, providing valuable insights for optimizing iron deficiency anaemia management.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e82"},"PeriodicalIF":1.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152262","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":"Factors that influence the use of direct access to allied health professionals in the Netherlands.","authors":"Laura J Damen, Willemijn M Meijer, Lilian H D Van Tuyl, Bart J Knottnerus, Judith D De Jong","doi":"10.1017/S1463423625100467","DOIUrl":"https://doi.org/10.1017/S1463423625100467","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare systems worldwide are under pressure due to increasing demand and rising costs. Simultaneously, there is a shortage of healthcare workers. This is leading to increased pressure on primary care, especially in countries where general practitioners (GPs) perform a gatekeeping function. One way to alleviate this pressure on GPs, and to reduce healthcare costs, is to introduce or expand, direct accessibility to allied health professionals. This study investigated the factors associated with this direct accessibility in the Netherlands.</p><p><strong>Method: </strong>We used data from electronic health records of physiotherapists, speech therapists, and dietitians, drawn from the 2022 Dutch Nivel Primary Care Database (Nivel's PCD). The data included information ranging from 15,470 to 776,690 patients, and for 62 to 593 practices, depending on the particular paramedic discipline. Multilevel logistic regressions were employed to identify patient and practice characteristics associated with direct access.</p><p><strong>Results: </strong>Patient characteristics significantly associated with direct access included younger age, higher socioeconomic status, and diagnosis. The patient's sex was also identified as a factor associated with the use of direct access in physiotherapy and dietetics, but not in speech therapy. Moreover, we observed significant variation between practices. We found that the dominant health insurer in an area was sometimes associated with direct access, as well as the number of therapists working in a practice.</p><p><strong>Conclusion: </strong>We observed significant associations between patient and practice characteristics and the direct access to allied health professionals in primary care. These findings suggest that the use of direct access to allied health professionals could be increased in order to enhance healthcare efficiency and thereby relieve pressure on GP care.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e80"},"PeriodicalIF":1.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126748","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":"Co-creating a person-centred approach in primary care for patients with low socioeconomic status and chronic conditions: <i>a participatory learning & action study</i>.","authors":"Hester E van Bommel, Maria E T C van den Muijsenbergh, Belle Bergsma, Jako S Burgers, Erik W M A Bischoff, Tessa van Loenen","doi":"10.1017/S1463423625100431","DOIUrl":"https://doi.org/10.1017/S1463423625100431","url":null,"abstract":"<p><strong>Aim: </strong>To tailor an existing Person-Centred Integrated Care (PC-IC) approach to the needs of patients with low socioeconomic status (LSES) and chronic conditions in primary care.</p><p><strong>Background: </strong>While Disease Management Programs (DMPs) have been introduced to reduce the burden of chronic diseases, their effectiveness for patients with LSES remains uncertain due to insufficient attention to the individual context. A PC-IC approach may enhance patient outcomes by addressing patients' cultural backgrounds, values, and health literacy needs, because these factors are particularly relevant for patients with LSES.</p><p><strong>Method: </strong>A qualitative study was conducted using three co-creation sessions with patients with LSES and chronic conditions, along with general practitioners and practice nurses, to adapt, develop, and test specific elements of the PC-IC approach. Participatory learning and action (PLA) techniques incorporating visual materials were employed to ensure meaningful engagement and input by all participants, including those with limited reading and language skills. Following these sessions, we conducted a validation check by patients on the draft materials.</p><p><strong>Findings: </strong>In the co-creation sessions, an existing PC-IC approach was tailored to the needs of LSES patients with chronic conditions in primary care. The adapted PC-IC approach emphasized key elements as trust, being seen as a person in the social context, shared decision-making, and access to clear and easily understandable information. Existing materials needed to be adapted, resulting in a visual conversation tool. This tool covers the physical, social, and mental health domains as well as daily life, each domain with six to eight topics. It helps to get better insight into the patient's daily life, wishes, and possibilities. It maps medical and psychosocial issues and supports the patient in gaining a better understanding. The adapted PC-IC approach with the conversation tool is being presented in a training for primary care professionals.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e79"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115224","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":"One template does not fit all: where next to improve hospital discharge communication to primary care?","authors":"Nicholas Boddy, Joanne Reeve, Rachel A Spencer, Anthony J Avery","doi":"10.1017/S1463423625100327","DOIUrl":"10.1017/S1463423625100327","url":null,"abstract":"<p><p>Led by national policy, standardisation has enhanced hospital discharge communication to primary care over recent decades. However, discharge summary content standards and their corresponding templates can be over-relied on by authors, risking the exclusion of important contextual and explanatory information for patients with more complex care.This information can be critical for GPs to deliver high quality, safe, and efficient post-discharge care, especially for this patient cohort which can be at higher risk of avoidable harm from suboptimal communication. Discharge summary authors can lack sufficient understanding of the recipient primary care perspective to mitigate this issue and communicate effectively through standardised letter templates. Strengthening this interprofessional understanding is an essential next step to improve discharge communication.In response to this challenge, we propose the basis of a new framework of interprofessional discharge communication that accounts for the different paradigms of specialism and generalism and supports summary authors to tailor their content to the patient's post-discharge care.We call for the co-development of this framework through a programme of applied research, alongside the exploration of primary-secondary care interface learning communities as a vehicle for interprofessional education. These initiatives can serve to augment the current strengths of standardised discharge summaries and mitigate their limitations, maximising the quality, safety, and efficiency of post-discharge care. Progress in this field can benefit wider cross-interface communications and practice and assist the NHS integration agenda.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e78"},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066762","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":"From acute to chronic: the PREVENT protocol for understanding pain progression after emergency department visits.","authors":"Michael Ray, Andrew C Meltzer, Timothy C McCall, Keith Meldrum","doi":"10.1017/S146342362510042X","DOIUrl":"10.1017/S146342362510042X","url":null,"abstract":"<p><strong>Aim: </strong>The Pain Recognition and Evaluation to Validate Effective Neck and back Treatment (PREVENT) study aims to identify cognitive, behavioral, and treatmentrelated predictors of chronic musculoskeletal pain (CMP) development following emergency department (ED) care for acute neck or back pain after trauma.</p><p><strong>Background: </strong>CMP is a leading cause of global disability, yet early risk factors for its development remain poorly characterized, particularly in ED settings. This prospective observational study will recruit 246 adult patients presenting with acute (≤ 4 weeks) neck or back pain after a recent trauma. Pain beliefs - measured using pain and attitude questionnaires - serve as the primary independent variable. Mediating variables include catastrophic thinking, fear-avoidance behaviors, low physical activity, poor recovery expectations, and low self-efficacy for pain management. Covariates include demographics, social determinants of health, mental health disorders, and high-risk substance use. The primary outcome is the presence of CMP at six months, defined as pain on most or every day for at least three months. Participants will complete follow-ups at 1, 3, and 6 months. Multivariable logistic regression, mediation analyses, and interaction testing will explore effects of pain beliefs on CMP development. As a secondary aim, a subset of participants will complete Think Aloud cognitive interviews to assess response process validity for the Neck Pain Attitudes Questionnaire (Neck-PAQ), a region-specific adaptation of the Back Pain Attitude Questionnaire, analyzed using a deductive content analysis framework.</p><p><strong>Discussion: </strong>This study is among the first to investigate the cognitive and behavioral predictors of pain chronification in the ED. Ethical approval has been obtained from The George Washington University Institutional Review Board. Findings will inform the design of targeted, ED-based screening and intervention strategies, including adaptation of a pain-specific Screening, Brief Intervention, and Referral to Treatment (SBIRT) model. Results will be disseminated through peer-reviewed publications, conferences, and stakeholder engagement.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e77"},"PeriodicalIF":1.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034868","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}