Primary health care research & development最新文献

{"title":"Decolonizing the exploration of perinatal mental health screening with Indigenous Australian parents in primary care.","authors":"Jayne Kotz, Corinne Reid, Melanie Robinson, Roz Walker, Tracy Reibel, Alison Bairnsfather-Scott, Rhonda Marriott","doi":"10.1017/S1463423624000665","DOIUrl":"10.1017/S1463423624000665","url":null,"abstract":"<p><strong>Background: </strong>Effective mental health primary prevention and early detection strategies targeting perinatal mental healthcare settings are vital. Poor maternal mental health places the developing foetus at risk of lasting cognitive, developmental, behavioural, physical, and mental health problems. Indigenous women endure unacceptably poor mental health compared to all other Australians and disproportionately poorer maternal and infant health outcomes. Mounting evidence demonstrates that screening practices with Indigenous women are neither effective nor acceptable. Improved understanding of their perinatal experiences is necessary for optimizing successful screening and early intervention. Achieving this depends on adopting culturally safe research methodologies.</p><p><strong>Methodology: </strong>Decolonizing translational research methodologies are described. Perspectives of Australian Indigenous peoples were centred on leadership in decision-making throughout the study. This included designing the research structure, actively participating throughout implementation, and devising solutions. Methods included community participatory action research, codesign, and yarning with data analysis applied through the cultural lenses of Indigenous investigators to inform culturally meaningful outcomes.</p><p><strong>Discussion: </strong>The Indigenous community leadership and control, maintained throughout this research, have been critical. Allowing time for extensive community collaboration, fostering mutual trust, establishing strong engagement with all stakeholders and genuine power sharing has been integral to successfully translating research outcomes into practice. The codesign process ensured that innovative strengths-based solutions addressed the identified screening barriers. This process resulted in culturally sound web-based perinatal mental health and well-being assessment with embedded potential for widespread cultural adaptability.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e66"},"PeriodicalIF":1.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746427","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":"Performance of community health volunteers during the COVID-19 pandemic: assessing the enablers and challenges in Machakos County, Kenya.","authors":"Ann Wanyaga Mwaniki, John Muge Nyaboga, Ezekiel Onyonka Mecha, Boniface Oyugi","doi":"10.1017/S1463423625100248","DOIUrl":"10.1017/S1463423625100248","url":null,"abstract":"<p><strong>Aim: </strong>This study explored the enablers and challenges influencing the performance of community health volunteers (CHVs) in Machakos County, Kenya, during the COVID-19 pandemic.</p><p><strong>Background: </strong>The COVID-19 pandemic disrupted healthcare systems globally, with particularly severe impacts in developing countries. Community health workers (CHWs) played a critical role in crisis communication, community engagement, case detection, referrals, and maintaining care continuity. However, limited evidence exists on the factors enabling and hindering their performance during the pandemic.</p><p><strong>Methods: </strong>This study employed a convergent mixed-methods design, integrating focus group discussions (FGDs), in-depth interviews (IDIs), and structured data extraction from the Kenya Health Information System (KHIS). Analysis of the data was guided by Agarwal et al.'s conceptual framework for measuring community health workforce performance with the quantitative data being analyzed using descriptive statistics, while qualitative data being analyzed through thematic analysis.</p><p><strong>Findings: </strong>CHVs effectively disseminated COVID-19 information, addressed vaccine hesitancy, and mobilized communities, supported by training, supervision, and community recognition. Their efforts led to significant improvements in healthcare services, including increased household visits, immunizations, and maternal health referrals. Despite their contributions, CHVs faced challenges such as delayed stipends, limited resources, and occasional community stigma, which hindered performance. Social support networks, community appreciation, and priority healthcare access emerged as key enablers, fostering resilience and motivation. Improved reporting mechanisms also highlighted CHVs' expanded roles during the pandemic.</p><p><strong>Conclusion: </strong>This study underscores the critical role of CHVs in sustaining healthcare services during the COVID-19 pandemic, despite facing financial, logistical, and social barriers. Their resilience and adaptability led to significant improvements in key health services, supported by effective supervision and training. Strengthening systemic support, integrating CHVs into long-term strategies, and enhancing community recognition are essential to maximize their impact in future health challenges.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e65"},"PeriodicalIF":1.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746428","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":"Evaluation and dynamic evolution of maternal and child health services in township health centers in ethnic minority areas of Guangxi, China.","authors":"Zhuanzhi Tang, Ranfeng Hang, Siyuan Wang, Jianying Liu, Wuxiang Shi","doi":"10.1017/S1463423625100224","DOIUrl":"10.1017/S1463423625100224","url":null,"abstract":"<p><strong>Aim: </strong>To achieve more efficient and comprehensive maternal and child health (MCH) care services in rural areas through optimizing resource allocation and enhancing service quality.</p><p><strong>Background: </strong>With the increasing awareness of health among rural residents and the growing demand for MCH care, township health centers, as a crucial component of primary medical services, have emerged as a key factor in ensuring the health of women and children in rural areas.</p><p><strong>Methods: </strong>Using a multi-stage stratified random sampling method, this study conducted on-site investigations on 49 township health centers across six districts and counties of Guilin, Guangxi. Descriptive statistics, entropy weight coefficient method, Data Envelopment Analysis (DEA) Banker-Charnes-Cooper (BCC) Model and Malmquist index were employed for dynamic analysis.</p><p><strong>Findings: </strong>The results indicate an upward trend in the incidence rates of birth defects and low birth weight in MCH services. Disparities in efficiency across regions are observed, which are associated with the economic status and capacity of MCH services in each area. Dynamic results from the Malmquist index show that the total factor productivity of MCH services experienced an upward trend from 2016 to 2021, with efficiency primarily influenced by scale efficiency. Updating management concepts is crucial for effectively addressing the relationship between scaling up and quality improvement.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e64"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683746","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":"Primary health care professionals' experiences of using the Tilburg Frailty Indicator: an interview study.","authors":"Amelie Mazya, Anne-Marie Boström, Christina Sandlund, Anne Wissendorff Ekdahl","doi":"10.1017/S1463423625100297","DOIUrl":"10.1017/S1463423625100297","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to explore primary health care professionals' (PHCP) experiences of frailty assessment with the Tilburg Frailty Indicator (TFI) with focus on feasibility aspects.</p><p><strong>Background: </strong>Primary health care (PHC) is often the first point of contact for older people and assessment of frailty is therefore often recommended in this setting. There is however a lack of awareness of frailty in PHC. The TFI has been proposed as a suitable instrument for frailty assessment in PHC. It consists of 25 questions, where ten questions aim to identify risk factors for frailty and 15 questions assess physical, psychological, and social frailty. There are no previous studies of feasibility aspects of TFI in PHC.</p><p><strong>Methods: </strong>A qualitative interview study with physicians, nurses, and physiotherapists that had used TFI in face-to-face interviews during a care visit. Interviews were transcribed and the text was thematically analyzed using qualitative content analysis.</p><p><strong>Findings: </strong>Nine interviews were performed. The PHCPs experiences were expressed in one theme: <i>TFI is useful and feasible but requires time and knowledge</i>. TFI was described as easy to use and providing a holistic assessment of the patient. Using the TFI was time-consuming but provided useful information for care planning. In conclusion, the TFI could be a clinically useful tool to assess frailty in PHC. The result indicates a need of educational efforts to increase knowledge about frailty and a need for primary health care to adjust to older people in order to allow care visits to include both assessment and management of frailty.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e61"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661208","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":"Risk factors for decompensation among multimorbid patients: analysis of a French Cohort with a 24-month follow-up.","authors":"Paul Aujoulat, Jean Yves Le Reste, Benoit Chiron, Lucas Beurton-Couraud, Marie Barais, Pierre Barraine, Morgane Guillou-Landreat, Delphine Le Goff","doi":"10.1017/S1463423625100157","DOIUrl":"10.1017/S1463423625100157","url":null,"abstract":"<p><strong>Aim: </strong>The European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. Identification of risk factors for decompensation would be an interesting challenge for family physicians (FPs) in the management of multimorbid patients. The aim was to assess which items from the EGPRN's definition of multimorbidity could identify outpatients at risk of decompensation at 24 months.</p><p><strong>Methods: </strong>A cohort study. About 120 multimorbid patients from Western Brittany, France, were included by general practitioners between 2014 and 2015. The status \"decompensation\" (hospitalization of at least 7 days or death) or \"nothing to report (NTR)\" was collected at 24 months of follow-up.</p><p><strong>Findings: </strong>At 24 months, there were 44 patients (36.6%) in the decompensation group. Two variables were significant risk factors for decompensation: the number of visits to the FP per year (HR = 1.06 [95% CI 1.03-1.10], <i>P</i> < 0.001) and the total number of diseases (HR = 1.12 [95% CI 1.013-1.33], <i>P</i> = 0.039).</p><p><strong>Conclusion: </strong>FPs should be warned that a high number of consultations and a high total number of diseases may predict death or hospitalization. These results need to be confirmed by large-scale cohorts in primary care.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e60"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661209","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":"Using media to enhance paediatric patient recruitment for research in primary care.","authors":"Ilse N Ganzevoort, Marjolein Y Berger, Marc A Benninga, Arine M Vlieger, Gea A Holtman","doi":"10.1017/S1463423625100315","DOIUrl":"10.1017/S1463423625100315","url":null,"abstract":"<p><p>Recruitment of participants for research is often difficult in primary care, especially children and adolescents. Poor recruitment often leads to extension or discontinuation of randomized controlled trials involving patients. This study describes the impact of media recruitment compared to recruitment via general practitioners (GPs) on characteristics of 152 children aged 7-17 years with functional abdominal pain (FAP) and irritable bowel syndrome. Demographics, clinical and psychosocial characteristics were compared. No clinically relevant differences were found, except for longer pain symptom duration and more diagnoses of FAP in children recruited via media compared to children recruited by their GP. Our results suggest that recruitment via media is effective to recruit children in primary care without inducing relevant baseline characteristic differences and this might decrease research recruitment load for GPs. Subgroup analyses on recruitment method are recommended because recruitment strategy might induce differences in unknown baseline characteristics between groups.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e62"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding primary care provider perspectives of the implementation of an integrated diabetes and mental health care solution.","authors":"Carly Whitmore, Janice Forsythe, Alegria Benzaquen, Michelle Domjancic, Osnat C Melamed, Peter Selby, Diana Sherifali","doi":"10.1017/S1463423625100236","DOIUrl":"10.1017/S1463423625100236","url":null,"abstract":"<p><strong>Aim: </strong>This research aimed to explore the perspectives of primary and community care providers on the challenges that hinder the delivery and uptake of personalized type 2 diabetes (T2D) care, with a focus on the integration of mental health support and care.</p><p><strong>Background: </strong>The day-to-day burden and demand of self-managing T2D can negatively impact quality of life and take a toll on mental health and psychological well-being. As a result, there is a need for personalized T2D self-management education and support that integrates mental health care. Despite the need for this personalized care, existing systems remain siloed, hindering access and uptake. In response, innovative, comprehensive, and collaborative models of care have been developed to address fragmentations in care. As individuals living with T2D often receive their care in primary care settings, linking mental health care to existing teams and networks in primary care settings is required. However, there is a need to understand how best to support access, adoption, and engagement with these models in these unique contexts.</p><p><strong>Methods: </strong>A cross-sectional survey was distributed to primary and community providers of an Ontario-based smoking cessation network. Survey data were analyzed descriptively with free text responses thematically reported.</p><p><strong>Findings: </strong>Survey respondents (n = 85) represented a broad mix of health professions across primary and community care settings. Addressing challenges to the delivery and uptake of personalized T2D care requires comprehensive strategies to address patient-, practice-, and system-level challenges. Findings from this survey identify the need to tailor these models of care to individual needs, clearly addressing mental health needs, and building strong partnership as means of enhancing accessibility and sustainability of integrated care delivery in primary care settings.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e63"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661210","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":"Barriers to accessing eye care in Pakistan: a mixed methods study.","authors":"Manal Malik, Niall Strang, Aiman Hafeez, Mujtaba Shabbir, Farah Iftikhar, Sven Jonuscheit","doi":"10.1017/S1463423625100261","DOIUrl":"10.1017/S1463423625100261","url":null,"abstract":"<p><strong>Aims: </strong>To support policymakers in enhancing access to eye care for the population aged 45 years and older in Pakistan, this study aims to identify and quantify the barriers that hinder effective eye care delivery to this group. Additionally, it seeks to explore patients' experiences with the Sehat Sahulat (health insurance) programme in the context of eye care services.</p><p><strong>Background: </strong>Accessible eye care services can reduce avoidable blindness by delivering timely, high-quality interventions. In Pakistan, the lack of primary eye care burdens overcrowded hospitals and combined with economic challenges, limits access for underprivileged populations. To address this, a nationwide health insurance scheme - the Sehat Sahulat programme (SSP) was introduced to reduce out-of-pocket (OOP) expenses and improve healthcare access for economically disadvantaged groups.</p><p><strong>Methods: </strong>Using an exploratory sequential mixed methods design, an initial qualitative phase explored participant experiences and identified specific barriers. The qualitative study provided the basis for the development of a customized survey tool. The survey tool was then used in a second phase to obtain quantitative data to capture the magnitude of barriers and costs associated with accessing eye care in Pakistan.</p><p><strong>Findings: </strong>Numerous considerable barriers were identified including illiteracy, long travel times, female gender, old age, mobility issues, and costs, all of which limited access to eye care in Pakistan. Awareness surrounding use of the SSP was poor, with the programme seldom used towards eye care costs. This study highlights patient experiences with eye care in urban and rural Pakistan, including enablers and barriers to accessing eye care. Improvements should focus on educating the public on eye health, increasing availability of eye care services in rural areas, improving accessibility within eye care facilities, addressing gender disparities, and reducing costs associated with eye care treatments, potentially through advancement of the SSP.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e58"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638877","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":"Implementation drivers scale: a new implementation measure to reduce mental health gaps.","authors":"Felipe Agudelo-Hernández, Marcela Guapacha-Montoya, Andrés Camilo Delgado-Reyes","doi":"10.1017/S146342362510025X","DOIUrl":"10.1017/S146342362510025X","url":null,"abstract":"<p><strong>Aim: </strong>The objectives of this study were to study the psychometric properties of the Implementation Drivers Scale (IDS), for the mhGAP programme, both clinical and community; to test its structural validity, and to propose an instrument to accompany the implementation of the mhGAP in similar contexts. For this purpose, a cross-sectional quantitative methodology study was conducted.</p><p><strong>Background: </strong>Mental health programmes proposed in low- and middle-income countries to address gaps in care have implementation problems.</p><p><strong>Methods: </strong>A cross-sectional quantitative methodology study was conducted. During 2022 and 2023, the instrument was administered to 204 individuals, including primary care professionals (50%), national administrative leaders (19.11%), and community strategy leaders. Three departments of Colombia participated, two with low levels of implementation in mental health programmes and one with high levels of implementation of programmes and services.</p><p><strong>Findings: </strong>The Kaiser-Meyer-Olkin factor analysis resulted in 0.861, which indicated the suitability of the data for a factor analysis. Bartlett's Test of Sphericity had a value of 2480.907 (153 degrees of freedom, p <.001). The exploratory factor analysis explained variance of 66.781%. The four factors proposed in the AIF model (System enablers for implementation, Accessibility of the strategy, Adaptability and acceptability, and Strategy training and supervision) were confirmed, with all items with loadings greater than 0.4. For the entire instrument, a Cronbach's alpha was 0.907. The IDS could contribute to the monitoring of some components of mhGAP implementation, both clinical and community-based, in low- and middle-income settings through appropriate validation processes.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e57"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638878","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":"Mental health of rural doctors and influencing factors in Hebei, China.","authors":"Yatian Liu, Hanling Di, Yunqing Xu, Ziwei Yang, Ye Zhang, Yuqi Yuan, Ning Zhang, Jiajun Li, Biao Zhao, Yu Wang, Yujie Niu, Longmei Tang","doi":"10.1017/S1463423625100200","DOIUrl":"10.1017/S1463423625100200","url":null,"abstract":"<p><strong>Aim: </strong>This study investigated the factors influencing the mental health of rural doctors in Hebei Province, to provide a basis for improving the mental health of rural doctors and enhancing the level of primary health care.</p><p><strong>Background: </strong>The aim of this study was to understand the mental health of rural doctors in Hebei Province, identify the factors that influence it, and propose ways to improve their psychological status and the level of medical service of rural doctors.</p><p><strong>Methods: </strong>Rural doctors from 11 cities in Hebei Province were randomly selected, and their basic characteristics and mental health status were surveyed via a structured questionnaire and the Symptom Checklist-90 (SCL-90). The differences between the SCL-90 scores of rural doctors in Hebei Province and the Chinese population norm, as well as the proportion of doctors with mental health problems, were compared. Logistic regression was used to analyse the factors that affect the mental health of rural doctors.</p><p><strong>Results: </strong>A total of 2593 valid questionnaires were received. The results of the study revealed several findings: the younger the rural doctors, the greater the incidence of mental health problems (OR = 0.792); female rural doctors were more likely to experience mental health issues than their male counterparts (OR = 0.789); rural doctors with disabilities and chronic diseases faced a significantly greater risk of mental health problems compared to healthy rural doctors (OR = 2.268); rural doctors with longer working hours have a greater incidence of mental health problems; and rural doctors with higher education backgrounds have a higher prevalence of somatization (OR = 1.203).</p><p><strong>Conclusion: </strong>Rural doctors who are younger, male, have been in medical service longer, have a chronic illness or disability, and have a high degree of education are at greater risk of developing mental health problems. Attention should be given to the mental health of the rural doctor population to improve primary health care services.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e55"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610559","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}