Primary health care research & development最新文献

{"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}

{"title":"Spanish adaptation and validation of the Capability Cards for use in community primary health care.","authors":"Laia Llubes-Arrià, Gwendolijn Boonekamp, Annica Brummel, Joaquim Sol-Culleré, José Tomás Mateos, Sanna Salanterä","doi":"10.1017/S1463423626101583","DOIUrl":"10.1017/S1463423626101583","url":null,"abstract":"<p><strong>Aim: </strong>To translate, culturally adapt, and validate the Capability Cards into Spanish for use with adults living with multimorbidity in community health settings.</p><p><strong>Background: </strong>Adults with multimorbidity face complex self-management challenges arising from multiple conditions, clinical demands, and everyday priorities. Despite this complexity, tools to support meaningful dialogue and reflection on what individuals are able to do and be in daily life are scarce. Capability Cards support structured conversations on capabilities, well-being, and life goals, fostering empowerment, reflection, and shared decision-making. Cultural adaptation to the Spanish context is essential to ensure relevance and usability in community-based care.</p><p><strong>Methods: </strong>A methodological validation study was conducted in Lleida (Spain) following four phases: literature review to inform translation and cultural adaptation, development of instruments to assess content validity and usability, evaluation by expert and community health professional panels, and assessment with the target population. Participants included 12 experts, 19 community health professionals from nursing, physiotherapy, nutrition, and psychology, and 25 adults aged 62-81 years with multimorbidity. Content validity was evaluated using the Content Validity Index (CVI), and usability was assessed with the System Usability Scale (SUS).</p><p><strong>Findings: </strong>High content validity was observed across all groups, with CVI scores above the recommended threshold (experts: 0.88; professionals: 0.96; target population: 0.98). The SUS indicated excellent usability. The Spanish version of the Capability Cards demonstrated strong content validity, cultural appropriateness, and usability, supporting its suitability as a tool for facilitating structured, person-centred conversations, with potential to promote empowerment and participatory care in community primary health care for adults with multimorbidity.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e85"},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681042","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":"Midwives' experiences of care provision in refugee camps under the guidelines of the ORAMMA project: a qualitative study - ADDENDUM.","authors":"Eleni Triantafyllou, Maria Papadakaki, Elena Petelos, Antigoni Sarantaki, Anna Deltsidou, Victoria Vivilaki","doi":"10.1017/S1463423626101820","DOIUrl":"10.1017/S1463423626101820","url":null,"abstract":"","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e86"},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680708","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":"Investigating the persistence of infant mortality and the Matthew effect in post-Soviet countries: evidence from nonlinear and Fourier-based time-series methods.","authors":"Nijat Gasim, Shahriyar Mukhtarov, Ayse Nur Sahinler, Aytakin Afandiyeva, Narmin Alakbarova","doi":"10.1017/S1463423626101534","DOIUrl":"10.1017/S1463423626101534","url":null,"abstract":"<p><p>This study investigates long-term trends in infant mortality rates (IMRs) in the case of 15 post-Soviet countries, with the aim of testing the Matthew Effect hypothesis, which suggests that inequality in health outcomes tend to persist or even widen over time. To assess these trends comprehensively, we employed various unit root tests, including traditional augmented Dickey-Fuller (ADF), non-linear (KSS, Kruse, Sollis, and Hepsag), and Fourier-based approaches (Fourier KPSS, Fourier ADF, flexible Fourier ADF, flexible fractional Fourier ADF, Fourier KSS, Fourier Kruse, and Fourier Sollis) to the data period from 1982 to 2022. Additionally, the multi-criteria decision analysis (MCDA) methods, such as equal weighting, entropy weighting, and TOPSIS, were utilized for a robustness check. The findings demonstrated that stationarity is validated in Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan, thereby corroborating the Matthew Effect. Conversely, Belarus, Estonia, Moldova, and Russia exhibit non-stationary IMR series, indicating continued fluctuations or structural changes in their infant mortality patterns. The findings indicate that infant mortality has plateaued in several countries, pointing to stagnation in policy effectiveness. Conversely, some countries show dynamic change, possibly indicating responsive health systems. These insights provide important direction for country-specific health policy design to reduce IMR and health inequality more effectively.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e84"},"PeriodicalIF":1.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674860","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":"Self-care practices for puerperal sepsis prevention and their determinants among postpartum women: a community-based cross-sectional study in Halaba Town, Central Ethiopia.","authors":"Aberash Beyene Derribow, Mebratu Demissie Senbeta, Keyredin Nuriye Metebo, Melese Gabure Shukulo, Aynalem Belay, Berhanu Semra Mulat, Mangistu Abera","doi":"10.1017/S1463423626101571","DOIUrl":"10.1017/S1463423626101571","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess self-care practices for puerperal sepsis prevention and their determinants among postpartum women in Halaba Town, Central Ethiopia.</p><p><strong>Background: </strong>Self-care is the ability to maintain health, prevent disease, and manage illness with or without the support of healthcare personnel. Current evidence indicates a high burden of puerperal sepsis in East Africa, including Ethiopia. However, evidence on self-care practices for the prevention of puerperal sepsis and their determinants in the study setting remains limited.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted among postpartum women in Halaba Town from February 1 to March 30, 2025. Data were collected through face-to-face, interviewer-administered questionnaires. Bivariable and multivariable logistic regression analyses were performed to identify determinants of self-care practices; statistical significance was set at a p-value of less than 0.05.</p><p><strong>Findings: </strong>In the present study, 413 study participants were interviewed, resulting in a response rate of 98.3%. The prevalence of good self-care practice was 43.8% (95% CI: 39.1%-48.5%). Women's occupation (adjusted odds ratio (AOR) = 2.01; 95% CI: 1.23-3.57), educational attainment (AOR = 2.30; 95% CI: 1.46-7.93), antenatal care (ANC) contact (AOR = 2.73; 95% CI: 1.65-4.71), and women's knowledge (AOR = 3.30; 95% CI: 2.32-10.42) were determinants of self-care practices for puerperal sepsis prevention.</p><p><strong>Conclusion: </strong>The findings revealed that more than half of postpartum women had poor self-care practices for the prevention of puerperal sepsis. Hence, strengthening ANC contact, targeting women with low educational status and unemployed women, and improving women's knowledge may help to enhance awareness and prevention of puerperal sepsis.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e83"},"PeriodicalIF":1.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632943","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":"Dialogic Book-Sharing intervention in an Italian multicentre randomized controlled trial: effects on parental mood.","authors":"Loredana Cena, Alice Trainini, Mauro Belluardo, Chiara Buizza, Hal Cooper, Lynne Murray","doi":"10.1017/S1463423626101509","DOIUrl":"10.1017/S1463423626101509","url":null,"abstract":"<p><p>This randomized controlled trial (RCT) was conducted in 10 Italian health and maternal-child Centres to evaluate the effects of a Dialogic Book-Sharing (DBS) intervention on parental symptoms of anxiety and depression. Sixty-eight parents of 14-20-month-old infants were recruited. ANOVA analysis revealed a greater reduction in anxiety and depression symptoms in the intervention group (<i>N</i> = 36) compared to controls (<i>N</i> = 32). DBS is a simple, cost-effective programme that benefits parental mood, making it a valuable intervention for perinatal populations.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e82"},"PeriodicalIF":1.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632955","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":"Economic evaluation of diverting low-risk patients from the emergency department to adjacent out-of-hours primary care in Belgium.","authors":"Jane Phiri, Stefan Morreel, Diana De Graeve, Philippe Beutels, Anthony Pairon, Hilde Philips, Koen Monsieurs, Veronique Verhoeven, Lander Willem","doi":"10.1017/S146342362610142X","DOIUrl":"10.1017/S146342362610142X","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hours primary care (OOH-PC) has been introduced in many health systems to reduce non-urgent emergency department (ED) use. While prior studies suggest potential efficiency gains, economic evaluations rarely stratify outcomes by patient risk, limiting policy relevance. This study assesses the cost-effectiveness of diverting low-risk patients from ED to OOH-PC.</p><p><strong>Aim: </strong>Compare direct medical costs, time spent at the facility, and hospitalization probability across risk and care setting subgroups from a societal perspective.</p><p><strong>Methods: </strong>We analysed data from a cluster-randomized trial conducted in Belgium that examined a nurse-led triage system. Under the study trial's extended Manchester Triage System (eMTS) protocol, patients eligible for primary care were assigned to OOH-PC and are referred to in our study as low-risk, while those assigned to the ED are defined as high-risk. To complement previous work, we stratified costs and effects by risk group. Mixed-effects regression models estimated costs, time at the facility, and hospitalization, with bootstrap confidence intervals. We also calculated the incremental net monetary benefit (INMB).</p><p><strong>Results: </strong>Treating low-risk patients at the OOH-PC instead of at the ED reduced costs by €24 (€14-€39) per patient, shortened the time spent at the facility by 69 (52-94) minutes. From a societal perspective, the average INMB was €49.5 per low-risk patient. Aggregately, we estimated that the 37 intervention weekends in 2019 led to an average saving of €14,136 in direct medical costs and cumulative time savings of 28 days.</p><p><strong>Conclusion: </strong>Diverting low-risk patients from the ED to OOH-PC resulted in cost- and time-savings for low-risk patients at the study site. These findings highlight the potential to improve out-of-hours healthcare delivery to maximize benefits for patients and healthcare systems, although confirmation in other healthcare settings is required before wider implementation.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e81"},"PeriodicalIF":1.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623022","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":"Knowledge and perceptions of obesity care among general practice nurses in the Republic of Ireland.","authors":"Ciara Donaghue, Roisin Doogue, Suzanne Seery, Joanne Cecil, Francis M Finucane","doi":"10.1017/S1463423626101285","DOIUrl":"10.1017/S1463423626101285","url":null,"abstract":"<p><strong>Aims: </strong>We sought to explore the knowledge and perceptions of obesity care among general practice nurses in the Republic of Ireland.</p><p><strong>Background: </strong>Obesity is a complex condition driven by the interplay of social, cultural, environmental, genetic, biological and psychological factors. Despite its recognition as a chronic disease, it is underdiagnosed and undertreated in primary care. General practice nurses (GPNs) play a critical role in the monitoring of risk factors and treatment of chronic diseases, but their role in the management of obesity in primary care is less well described.</p><p><strong>Method: </strong>A cross-sectional cohort study was conducted. An anonymous online survey was disseminated asking a broad range of questions on levels of training, knowledge, perceptions and barriers to obesity care.</p><p><strong>Findings: </strong>Of 240 GPNs who completed the survey, 93% were aware that obesity aetiology is multifactorial. Identified causes which imply \"personal responsibility\" rated highly (73%). Most GPNs are comfortable having discussions about weight (74%). They reported discussing behavioural interventions more frequently than pharmacological treatments or bariatric surgery. Perceived lack of time in appointments (83%), lack of training (71%), shortage of specialist care (72%) and cost of treatments (67%) were the highest rated barriers to providing care. Lack of time in appointments (67%) and fear of causing offence (57%) were the highest rated barriers to initiating a discussion with patients about weight. GPNs felt their own BMI influenced how patients with obesity view their advice. Many GPNs (40%) reported they had no training in obesity care, while 54% had attended at least one obesity-themed webinar or conference.</p><p><strong>Conclusion: </strong>GPNs recognise their essential role in obesity care. We have identified the need for dedicated consultation time and further training for GPNs to enable discussion of treatment options and support appropriate care pathways, including access to specialist care.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e80"},"PeriodicalIF":1.7,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610814","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":"Assessing the job preferences of public health specialist doctors: a discrete choice experiment.","authors":"Buşra Tozduman, İrem Zengi","doi":"10.1017/S1463423626101510","DOIUrl":"10.1017/S1463423626101510","url":null,"abstract":"<p><strong>Background: </strong>Public health specialists (PHSs) are responsible for developing and implementing health promotion policies and can contribute to healthcare delivery at all levels. Discrete choice experiments (DCEs) can inform policy by identifying healthcare professionals' job preferences and the trade-offs they are willing to make between job attributes. This study aimed to investigate job preferences among PHSs, including trade-offs between job attributes and the probability of choosing specific job scenarios.</p><p><strong>Methods: </strong>This cross-sectional analytical study was conducted among 183 PHSs. Job attributes and levels were determined through a literature review and semistructured interviews with specialists. The questionnaire was administered online. A mixed logit model was used to estimate preferences for different attribute levels. Latent class analysis (LCA) was performed to identify subgroups with similar preference patterns. Simulations of job uptake probabilities were also conducted and willingness-to-pay (WTP) estimates were calculated.</p><p><strong>Results: </strong>Five of the six job attributes significantly influenced preferences, ranked as follows: proximity to family/friends, working environment, salary, developmental status of the workplace, and managerial position. LCA indicated that preference weights varied across subgroups defined by sociodemographic and professional characteristics.</p><p><strong>Conclusions: </strong>In addition to monetary incentives, ensuring proximity to family and providing a supportive working environment appear to be the most effective strategies for improving the employment of PHSs. Financial incentives are particularly important for managerial roles, especially among junior PHSs without prior managerial experience.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e78"},"PeriodicalIF":1.7,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610843","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}