Primary health care research & development最新文献

{"title":"Co-location of services: an umbrella review to consider how primary care estates could be better used to support disadvantaged groups.","authors":"Helena Painter, Jatinder Hayre, Ananya Arora, Lucy Johnson, Anna Gkiouleka, Amy Dehn Lunn, Liam Loftus, Rebecca Rosen, John Ford","doi":"10.1017/S1463423626101728","DOIUrl":"10.1017/S1463423626101728","url":null,"abstract":"<p><strong>Aim: </strong>To examine how co-located community and health services in primary care could support disadvantaged groups.</p><p><strong>Background: </strong>Co-locating services is thought to improve access, collaboration, and patient outcomes. There are thousands of primary care premises across the UK. At a time of stagnating or widening health inequalities, they present an ideal opportunity to support communities, especially in disadvantaged areas.</p><p><strong>Method: </strong>We conducted a systematic umbrella review. Articles were retrieved from Ovid MEDLINE and Ovid Embase with supplementary snowball and grey literature searches. Reviews of co-located services supporting disadvantaged groups in primary care between 2010 and February 2024 were included. Quality and risk of bias were assessed using the Joanna Briggs Institute checklist. Two reviewers assessed eligibility, extracted data and assessed quality. Outcomes relating to health, welfare, healthcare utilization, and activity and processes were assessed. Data were narratively synthesized using a convergent integrated approach.</p><p><strong>Findings: </strong>2626 studies were screened, supplemented by snowball and grey literatures searches. Thirteen reviews were included for synthesis. One review included meta-analysis. Three models of care were identified; legal advice, welfare advice, and complementary health care. Data were synthesized according to themes: access and engagement, quality of care, efficiency, improved health, and improved social factors. We found co-located services can improve access to care, engagement in treatment, and quality of care for disadvantaged groups. Improvements to social determinants of health and mental health and well-being outcomes were reported. Findings were inconsistent when considering the impact of co-location on efficiency. We conclude that co-located services in primary care have the potential to improve identification of people most in need and improve their access to high quality health care and social support. Policy makers and practitioners should maximize the use of primary care estates to support disadvantaged groups and communities.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e97"},"PeriodicalIF":1.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901735","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":"Identifying components of a theory-informed complex intervention supporting primary care nurses to provide evidence-based dementia care in the general practice setting.","authors":"Caroline Gibson, Mark Yates, Dianne Goeman, Dimity Pond, Jill J Francis","doi":"10.1017/S1463423626101674","DOIUrl":"10.1017/S1463423626101674","url":null,"abstract":"<p><strong>Aim: </strong>To demonstrate the application of the Theoretical Domains Framework (TDF) and behaviour change theory to identify behaviour change techniques for a complex intervention targeting dementia care by general practice nurses (GPNs).</p><p><strong>Background: </strong>GPNs have an important role in dementia care but require support to translate evidence-based recommendations into routine practice. Theory-informed implementation strategies may help facilitate this change.</p><p><strong>Methods: </strong>The target behaviour was derived from a Delphi study identifying national dementia care recommendations relevant to GPNs. Barriers to operationalizing the target behaviour were identified from previous research and then coded independently by two authors using the TDF. Identified domains were then mapped to behaviour change techniques using the Theory and Techniques Tool.</p><p><strong>Findings: </strong>The specified behaviour was: 'the general practice nurse will use language that is accurate, respectful, inclusive, empowering and non-stigmatizing when communicating with people living with dementia within each patient encounter in general practice'. Seven TDF domains were identified, including 'knowledge', 'skills' and 'social influences', mapping to 22 behaviour change techniques, including 'instruction on how to perform the behaviour' and 'social support'. This theory-informed approach identifies practical techniques for developing interventions to improve GPN communication with people living with dementia and provides a method that could be applied to other dementia care behaviours in general practice.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e96"},"PeriodicalIF":1.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901439","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":"Dutch GPs' perceptions of post-pandemic changes in childhood infection management.","authors":"Frederike Vrouwenraets, Michiel A G E Bannier, Alma C van de Pol, Jochen W L Cals, Eefje G P M de Bont","doi":"10.1017/S1463423626101522","DOIUrl":"10.1017/S1463423626101522","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic significantly impacted primary care, including childhood infection management. Public health measures reduced respiratory infections, raising concerns about an 'immunity debt' in children. General practitioners (GPs) faced fewer in-person consultations, evolving diagnostic routines, and changing parental expectations. While hospital data are available, effects in general practice are less studied.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among Dutch GPs with experience before and after the pandemic. The 35-item questionnaire addressed infection patterns, management, parental behaviour, and communication.</p><p><strong>Results: </strong>Of 166 GPs, 32% noted changes in infection management and 44% observed altered seasonal trends. While consultation rates remained stable, diagnostic testing and antibiotic use increased. GPs reported longer consultations and rising parental demands, especially among those with lower health literacy or migrant backgrounds.</p><p><strong>Conclusion: </strong>GPs reported key shifts in managing childhood infections. Strengthening communication and further qualitative research may enhance care and equity.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e94"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889593","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 importance of small things and colleagues'. Enhancing the wellbeing of healthcare staff: Appreciative Inquiry in an integrated UK maternity service.","authors":"Rachel Arnold, Edwin van Teijlingen, Preeti Mahato","doi":"10.1017/S1463423626101479","DOIUrl":"10.1017/S1463423626101479","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to identify factors that enhanced staff wellbeing in an integrated UK maternity service.</p><p><strong>Background: </strong>Staff wellbeing affects the experience of patients, quality and safety of services, and staff retention. Global healthcare staff shortages mean we need to enable staff to thrive and remain in professional practice. High levels of stress, depression, burnout, attrition and staff shortages have been reported in maternity services. It is, therefore, critical to find ways to support the wellbeing of existing staff.</p><p><strong>Methods: </strong>Appreciative Inquiry interviews (n = 39) and group discussions (n = 4) were conducted with a cross-section of midwifery, medical and maternity support staff, working in community teams, the inpatient and midwife-led unit. Interviews explored best experiences, values and what made a difference to wellbeing. Data was co-analysed thematically by the research team, participants and midwifery staff.</p><p><strong>Findings: </strong>Despite workload and staffing pressures midwives, doctors, students and maternity support workers were highly motivated and passionate about their work. Five staff wellbeing themes were identified: Everything we need to do our work practically and psychologically; Meaning - in our work and relationships; Opportunities to learn and grow; Finding our niche; Agency - able to take care of ourselves. This study also revealed the important contribution that kindness, collegiality, feedback and psychological safety, made to staff wellbeing including professional confidence. Our findings suggest that every healthcare provider can make a difference to their colleagues wellbeing, contribute to the safety of the service and staff retention. An outline of practical recommendations for improving staff wellbeing is provided.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e93"},"PeriodicalIF":1.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842575","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":"Bridging the gap in young adult care: the educational value of implementing Student Health Centers in primary care training.","authors":"Tumay Sadikoglu, Duygu Altiparmak, Helen Shields","doi":"10.1017/S1463423626101637","DOIUrl":"10.1017/S1463423626101637","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to evaluate the feasibility and educational impact of utilizing SHCs as primary care training sites in undergraduate medical education, with the goal of enhancing clinical competencies in young adult healthcare.</p><p><strong>Background: </strong>Family Medicine (FM) is essential for integrating community-based health services into medical education. In Turkey, final-year medical students complete a one-month rotation at Family Health Centers (FHCs). However, young adults often utilize Student Health Centers (SHCs) on university campuses, resulting in a gap in students' experience with this age group. Addressing this, our programme initiated the inclusion of SHCs in the FM internship rotation for the 2024-2025 academic year.</p><p><strong>Methods: </strong>A mixed-methodology study was conducted in two phases. A retrospective analysis was performed on medical records of patients aged 18-25 who attended the SHC over a one-month period. A prospective 9-item online survey assessed the educational impact on final-year medical students following their FM internship, which included the SHC rotation. Descriptive and qualitative statistical analyses were performed to summarize the survey and clinical data.</p><p><strong>Findings: </strong>A total of 1228 patients were seen at the SHC, mirroring FHC trends. All 87 interns surveyed rated the FM programme initiative positively, with 94.1% highly satisfied and 85.9% reporting improved primary care skills. Qualitative feedback highlighted the value of practical experience and called for longer rotations.</p><p><strong>Conclusion: </strong>Integrating SHC rotations into undergraduate medical education is both feasible and beneficial, providing relevant primary care experience for medical students and enhancing training in the care of young adult populations.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e92"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714290","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":"Practice nurse management of hypertension in primary care: a scoping review.","authors":"Luke Heath, Ann Smith","doi":"10.1017/S1463423626101455","DOIUrl":"10.1017/S1463423626101455","url":null,"abstract":"<p><strong>Aim: </strong>To review the current diagnosis and treatment of hypertension (HTN) and explore alternative care management options.</p><p><strong>Background: </strong>HTN is underdiagnosed and poorly managed in the UK. With an increasing emphasis on teamwork in primary care (PC), what is the evidence base supporting the partial or complete management of HTN by practice nurses (PNs)?</p><p><strong>Methods: </strong>Using the PRISMA-Scr checklist as a framework, six database searches (BNI, CINAHL, Embase, Emcare, Medline, and PubMed) were conducted using Boolean Operators between December 2023 and February 2024, employing four search structures to find literature on independent or collaborative HTN management by PNs. Qualitative and quantitative research studies, reports, and articles were all considered.</p><p><strong>Findings: </strong>HTN is a significant risk factor for mortality and morbidity. Despite clear national guidelines on the diagnosis and management, many patients affected by this condition remain undiagnosed, with the majority of those diagnosed inadequately treated. PC is struggling to manage the workload due to an ageing population and reduced general practitioner (GP) numbers. The development of new roles to support GPs in their work is underway, but current roles remain vague and without nationally agreed remits or working practices. PNs currently manage most chronic non-communicable diseases, such as diabetes, asthma, and chronic obstructive pulmonary disease; however, HTN is not typically part of their remit. There is strong quantitative and qualitative evidence supporting PNs' involvement in HTN management as care coordinators. Such a move could improve patient outcomes and release GP time, but institutional barriers need to be addressed.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e89"},"PeriodicalIF":1.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708702","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 determination of the effect of music on pain, anxiety, and vital findings in cancer patients treated in palliative care centres: a cluster quasi-experimental study.","authors":"Gülsüm Kehribar, Pınar Tekinsoy Kartın","doi":"10.1017/S1463423626101625","DOIUrl":"10.1017/S1463423626101625","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to determine the effect of a single-session music intervention on pain intensity, state anxiety, and vital signs in cancer patients receiving palliative care.</p><p><strong>Background: </strong>While music therapy is recognized as a non-pharmacological complementary tool, its simultaneous effect on both physiological and psychological parameters requires robust methodological evaluation within specific palliative care settings.</p><p><strong>Methods: </strong>A cluster quasi-experimental pre-test/post-test control group design was conducted across two palliative care centres. The sample comprised 32 patients (Intervention: 16, Control: 16). To prevent treatment contamination, allocation was systematically performed at the room level rather than the individual level. The intervention group received a 30-minute session of instrumental Turkish classical music (Hicaz and Buselik maqams) via headphones, while the control group rested in bed. Data were collected using a Patient Description Form, Visual Analog Scale (VAS), State-Trait Anxiety Inventory (STAI), and a Physiological Parameter Monitoring Form. Linear Mixed Models (LMM) analyzed group × time interactions to account for clustering effects and baseline socio-demographic imbalances.</p><p><strong>Findings: </strong>Analysis revealed significant group × time interactions Post-intervention, the intervention group showed statistically significant reduction in pain intensity and state anxiety scores compared to the control group (<i>p</i> < 0.05). Vital signs (pulse rate, respiratory rate, and blood pressure) demonstrated significant stabilization, alongside a significant increase in oxygen saturation (SpO₂) in the intervention group. A 30-minute maqam-based instrumental music session shows potential as a stabilizing, non-pharmacological adjunct for acute symptom management in palliative cancer patients. Due to the small sample size and cluster-allocation, findings provide preliminary evidence.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e91"},"PeriodicalIF":1.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708714","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":"Family medicine residency students' competence in treatment planning for core diseases in the national core curriculum.","authors":"Berna Terzioğlu Bebitoğlu, Esra Akdeniz, Mehmet Ali Gülpınar","doi":"10.1017/S1463423626101613","DOIUrl":"10.1017/S1463423626101613","url":null,"abstract":"<p><strong>Purpose: </strong>It was aimed to determine the competencies of Family Medicine residency students regarding the treatment planning of diseases coded with diagnosis-treatment in the 'National Core Education Programme' (NCC) in Turkey. We aimed to identify areas where residents feel less competent, which can inform curriculum improvements to better address gaps in treatment planning skills for core diseases.</p><p><strong>Methods: </strong>The study was conducted with Family Medicine residency students from one medical school selected from each geographical region of Turkey. Students were asked to assess themselves at the time of graduation from medical school and currently during their residency training, in terms of 'appropriate drug selection', 'prescribing', 'non-drug treatment planning' and 'processing treatment management and giving information' competencies for 59 diseases in the NCC.</p><p><strong>Results: </strong>The rate of Family Medicine residency students who felt competent in treatment planning/management when they graduated from medical school was very low; although this rate increased to a certain extent with residency training, it could not reach an acceptable rate. Despite partial improvements after graduation, the results suggest potential gaps in achieving the desired competency levels, even after 1-3 year of residency training. The residency students' competency perceptions ranged from 10-30% to 60-80% across different diseases.</p><p><strong>Conclusion: </strong>It is important to review and reconstruct the six-year medical education and Family Medicine residency training programs, based on the framework drawn by NCC, focusing on rational treatment planning/management to reconceptualize treatment planning/management and decision-making.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e90"},"PeriodicalIF":1.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708709","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 lifestyle continuum: family physicians' attitudes toward lifestyle medicine and their health-promoting lifestyles.","authors":"Ozden Gökdemir, Halil Pak, Gazmend Bojaj, Miriam Rey Seoane, Marina Jotić Ivanović, Halime Seda Küçükerdem, Olgu Aygün, Maria Bakola, Angharad Kate Woolley","doi":"10.1017/S1463423626101558","DOIUrl":"10.1017/S1463423626101558","url":null,"abstract":"<p><p>This study investigates family physicians' attitudes toward lifestyle medicine, focusing on how these attitudes manifest in their health-promoting lifestyles and the moderating role of their healthcare sector attainment. Employing a quantitative, cross-sectional design, multicentric data were collected from 215 family physicians via an online survey accessed through professional networks. Data were collected using a study-specific demographic and healthcare sector information form, a custom questionnaire designed for attitudes toward lifestyle medicine, and The Health-Promoting Lifestyle Profile II. Findings revealed a positive association between health-promoting lifestyles and attitudes toward lifestyle medicine. The healthcare sector attainment significantly moderated this relationship, with private practice physicians showing a significant link between their health-promoting lifestyles (specifically, personal stress management, health responsibility, physical activity, and nutrition behaviours) and their attitudes toward lifestyle medicine. Conversely, this connection was not statistically significant in the public sector. The findings were discussed within the framework of social and organizational psychology theories and relevant literature. These results suggest that while physicians generally acknowledge lifestyle medicine, its embodiment through personal health behaviours is more pronounced in specific professional contexts. Our study underscores the need for sector-specific strategies to integrate lifestyle medicine more effectively into clinical practice. Policy initiatives should address structural barriers in the public sector that might hinder physicians' personal engagement with health-promoting behaviours, thereby impacting their professional advocacy for lifestyle medicine. Future research should explore the underlying mechanisms within different healthcare sectors and employ longitudinal designs to establish causality, ultimately aiming to enhance physician well-being and advance preventive care across all settings.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e87"},"PeriodicalIF":1.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687004","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":"Aligning values and behaviours in LGBTQIA+ affirming care: primary care providers' perspectives.","authors":"Arin Hectors, Lisa Nissen, Richard Violette, Cylie M Williams, Alex Ker, Nia Franks, Luke Otto, Corey Wakefield, Megan H Ross","doi":"10.1017/S1463423626101601","DOIUrl":"10.1017/S1463423626101601","url":null,"abstract":"<p><p>The lesbian, gay, bisexual, transgender, queer, intersex, asexual and other related communities (LGBTQIA+) possess rich and diverse lived experiences yet continue to face systemic barriers to safe and affirming healthcare. This study examined the key features of such care from the perspective of primary care providers who deliver affirming care to LGBTQIA+ people. Thirty-one clinicians across varied disciplines shared their insights through semi-structured interviews. These were analysed using reflexive thematic analysis informed by queer theory and a relativist epistemology. Two overarching concepts were identified across participants' experiences: their values (purpose, principles and qualities) that underpinned their practices (ways of providing affirming care) that were grounded in intentionality, reflection and relationality. Four key themes were generated that intersected with practices and values: 1) values-driven healthcare, 2) (un)learning biases, reflection, and sociocultural awareness, 3) mitigating the power imbalance in the patient-provider relationship, and 4) valuing lived experience. These themes describe key features of delivering safe and affirming healthcare for participants. The findings highlight the importance of addressing both the observable (behaviours and practices) and unobservable (values) when implementing interventions to improve healthcare provision for LGBTQIA+ people.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e88"},"PeriodicalIF":1.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687034","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}