Primary health care research & development最新文献

{"title":"Technology addiction as a predictor of visual problems in early adolescents: a multicentre case-control study.","authors":"Ecem Çiçek, Feyza Demir Bozkurt, Hilal Büyüktopaç Çakıcı","doi":"10.1017/S1463423626101546","DOIUrl":"10.1017/S1463423626101546","url":null,"abstract":"<p><p>Increasing screen exposure among early adolescents has raised concerns regarding technology addiction and its potential impact on visual health. Within the scope of primary health care, early identification of modifiable behavioural risk factors is essential for preventive intervention. This case-control study examined the association between technology addiction and visual problems among early adolescents and explored implications for primary health care and school health services. The study included 585 students in grades 5-8 from three randomly selected public middle schools. The case group comprised 47 students diagnosed with visual impairment or wearing corrective lenses, while the control group included 538 students without visual problems. Data were collected via face-to-face interviews using a Personal Information Form and the Technology Addiction Scale. Logistic regression analysis was conducted to determine predictors of visual problems. Students with visual problems demonstrated significantly higher total technology addiction scores and higher subdimension scores for social media use, instant messaging, online gaming, and website browsing (<i>p</i> < .001). Longer daily screen time and irregular sleep patterns were associated with increased addiction levels. Gender differences were observed: girls scored higher in instant messaging and website use, whereas boys scored higher in gaming addiction. Online gaming duration and total addiction scores were significant predictors of visual problems. Technology addiction, particularly excessive gaming exposure, appears to be a modifiable risk factor for visual problems in early adolescence. Integrating digital hygiene education, screen-time monitoring, and behavioural risk assessment into primary health care and school nursing practice may contribute to early prevention and health promotion strategies.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e79"},"PeriodicalIF":1.7,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610884","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.","authors":"Eleni Triantafyllou, Maria Papadakaki, Elena Petelos, Antigoni Sarantaki, Anna Deltsidou, Victoria Vivilaki","doi":"10.1017/S1463423626101492","DOIUrl":"10.1017/S1463423626101492","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore the experiences of midwives providing care in primary care walk-in clinics (PCWCs) within refugee camps, examining the challenges they encounter, and the relevance the ORAMMA framework.</p><p><strong>Background: </strong>Refugee camps present a complex environment for maternal care provision, due to limited resources, high population mobility, cultural and linguistic diversity, and increased psychosocial vulnerability among women. Midwives often being the primary providers of maternal care, must address both social and clinical needs. The ORAMMA framework was developed to support culturally sensitive and equitable maternity care for migrant and refugee populations. However, limited evidence exists regarding field experiences of ORAMMA-guided midwifery practice.</p><p><strong>Methods: </strong>A qualitative study design was employed to capture midwives' in-depth experiences. Data were collected from 22 ORAMMA-trained registered midwives working in refugee camp PCWCs. Data were collected using semi-structured individual interviews (<i>n</i> = 15) and two focus groups (<i>n</i> = 7). Data were thematically analysed to identify recurring patterns and key themes.</p><p><strong>Findings: </strong>Midwives reported persistent challenges, including inadequate infrastructure, shortages of essential medical supplies and disrupted care continuity. Language and cultural barriers limited effective communication, trust-building, and clinical decision-making. Despite these constraints, midwives demonstrated adaptability and professional resilience, through collaborative teamwork, creative problem-solving, and culturally sensitive care. ORAMMA training strengthened their confidence and awareness in providing care, although participants emphasised the need for enhanced material resources, interpreter services, and psychosocial support. Overall, findings highlight the value of ORAMMA-guided capacity-building to support midwives' resilience and commitment to quality care delivery.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e77"},"PeriodicalIF":1.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581541","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":"Navigating the national rollout: examining Primary Care Network link workers and the integration of local social prescribing models in Redbridge.","authors":"Ainul Nadhirah Hanafiah, Marcello Bertotti","doi":"10.1017/S1463423626101443","DOIUrl":"10.1017/S1463423626101443","url":null,"abstract":"<p><strong>Background: </strong>Social prescribing (SP) is increasingly recognised as a key component of primary care, implemented in at least 25 countries by 2023. In England, SP has been nationally rolled out through Primary Care Networks (PCNs), though many areas, including Redbridge in East London, had pre-existing VCSE-led models. How national and local approaches integrate in practice remains underexplored.</p><p><strong>Methods: </strong>This study used a two-step qualitative design. First, documentary analysis of service planning and evaluation documents mapped the SP referral pathway in Redbridge before and after the national rollout. Second, 16 semi-structured interviews were conducted with purposively sampled stakeholders from PCNs, RedbridgeCVS, the local authority, and the Clinical Commissioning Group, exploring service integration and delivery experiences. Data were analysed using the Framework Method, combining deductive coding against predefined themes with inductive identification of emergent categories.</p><p><strong>Results: </strong>RedbridgeCVS was widely valued for its expertise, especially in managing complex cases, training link workers, and facilitating access to local services. However, integration across PCNs was inconsistent. Participants reported variation in GP engagement, referral processes, and support structures. PCN link workers faced capacity pressures, unclear role boundaries, and limited access to clinical supervision, affecting the sustainability and coherence of service delivery.</p><p><strong>Conclusions: </strong>Integrating national and local SP models requires clearer leadership, standardized referral pathways, and consistent support for link workers. Without greater alignment across primary care and VCSE partners, the full potential of SP risks being undermined. Link workers must be recognized and supported as core members of the primary care team.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e76"},"PeriodicalIF":1.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537795","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":"Stakeholder's experience on financial incentive-based regulatory instruments for public-private partnership in developing countries: a study from Iran's primary health care delivery system.","authors":"Iman Keliddar, Amin Torabipour, SeyedMehdi EmamianFard","doi":"10.1017/S1463423626101431","DOIUrl":"10.1017/S1463423626101431","url":null,"abstract":"<p><strong>Background: </strong>Regulatory instruments are a key necessity to implement public-private partnership's strategy. This study aimed to explore the stakeholders' experience on financial incentive-based regulatory instruments for public-private partnership in Iran's primary health care (PHC) delivery system.</p><p><strong>Methods: </strong>This qualitative study was involved face-to-face interviews with 18 stakeholders in primary health care partnership projects including employers, experts, contractors, and executive managers of contracted companies operating as a private health sector participant in primary health care services. The data were analyzed using the framework analysis method.</p><p><strong>Results: </strong>Twenty-four codes were developed. Findings showed that the current state of financial incentive-based regulatory instruments in Iran's PHC delivery system faced some challenges despite existing capacities. These challenges include the lack of an independent trustee for access to capital, and a comprehensive regulatory program to facilitate private sector participants' access to capital, and partnership contracting mechanisms. Findings also showed main challenges of these instruments related to access to capital, tax incentives and subsidies, staff mobility control mechanisms, partnership contracting mechanisms, and provider payments.</p><p><strong>Conclusion: </strong>The presence of significant challenges in Iran's health care system can impact the private sector's motivation to participate in primary health care. By improvement the infrastructure, reforming legal processes, and providing financial incentives, the government can boost the private sector's motivation in primary health care and advance the health sector's goals.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e75"},"PeriodicalIF":1.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426626","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":"Changes in knowledge, skills, and confidence following a training program for primary care physiotherapists and exercise physiologists in pulmonary rehabilitation: a pre-post study.","authors":"Jessica A Walsh, Marita T Dale, Zoe J McKeough, Jennifer A Alison, Sarah M Dennis","doi":"10.1017/S146342362610139X","DOIUrl":"10.1017/S146342362610139X","url":null,"abstract":"<p><p>Pulmonary rehabilitation (PR) is recommended for people with chronic respiratory diseases, but access is limited. Delivering PR in primary care may overcome these barriers; however, physiotherapists and Accredited Exercise Physiologists (AEPs) report limited PR experience. Aim: to investigate the changes in knowledge, skills, and confidence following an education program for physiotherapists and AEPs in PR delivery in primary care. Primary care physiotherapists or AEPs undertook an education program of 6-8 hours online training and a half-day face-to-face workshop. 17 clinicians completed the training. Median (IQR) knowledge scores increased from 7 (6,8) at baseline to 10 (9,11) post-training (<i>p</i> < 0.001; Hedges' <i>g</i> = 1.52, 95% CI 0.81 to 2.21). Improvements in self-rated knowledge, skills, and confidence were observed across all domains and sustained at 3 months. In conclusion, a short education program improved PR knowledge, skills, and confidence in primary care clinicians. Educating primary care clinicians in PR is essential to build the workforce to provide PR in this setting and improve accessibility.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e74"},"PeriodicalIF":1.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392745","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":"Recall bias affects pain and depression assessment in multimorbidity: a pilot study.","authors":"Irina Mindlis, M Carrington Reid, Thomas L Rodebaugh","doi":"10.1017/S1463423626101406","DOIUrl":"10.1017/S1463423626101406","url":null,"abstract":"<p><strong>Objectives: </strong>Older adults with multimorbidity (OAMM) commonly receive depression and pain management through primary care, where symptoms are typically assessed through retrospective recall. Even with validated questionnaires, recall bias has been reported in younger populations for both depression and pain. However, recall bias for depression and pain has not been explored in OAMM. We examined discrepancies between prospectively measured and recalled symptoms of depression and pain among OAMM.</p><p><strong>Methods: </strong>We analysed data generated from a 14-day pilot feasibility trial of ecological momentary assessment (EMA) in OAMM (N = 18, age range 67-95). We examined discrepancies between retrospectively assessed depression and pain intensity over two weeks compared to follow-up, baseline characteristics correlated with discrepancies, and recency effects.</p><p><strong>Results: </strong>We found overreporting across most symptoms, with the largest discrepancies between prospectively recorded and recalled symptom scores for pain intensity and fatigue (d = .49). There was no association between recalled and EMA-measured items for appetite and trouble sleeping. Pain intensity at day 14 was associated with discrepancies in recalled pain (r = -.52, p =.029), and both day 14 mood and negative self-thoughts were associated with discrepancies in trouble concentrating recall (r = -.67, p =.002 and p = -.72, p <.001, respectively) - suggesting recency effects.</p><p><strong>Conclusions: </strong>We found preliminary evidence of recall bias among OAMM, including overreporting and recency effects of pain and depression symptoms. Given the reliance on recall during primary care visits, more research is needed.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e73"},"PeriodicalIF":1.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378425","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":"'But who's gonna listen?' A qualitative study of voicing experiences of healthcare in provincial correctional facilities in Ontario, Canada.","authors":"Katherine E McLeod, Lindsay Jennings, George Flowers, James Ruston, Fiona G Kouyoumdjian","doi":"10.1017/S1463423626101340","DOIUrl":"10.1017/S1463423626101340","url":null,"abstract":"<p><p>Experiences of healthcare services are an important indicator of quality and health system improvement. In correctional facilities, structural and contextual factors affect experiences of healthcare services and processes for voicing these experiences. This study explores barriers and opportunities for people in custody to voice their experiences of healthcare services in custody. We held four focus groups and one interview with people living in the community who had accessed, or tried to access, healthcare services while incarcerated in a provincial correctional facility in Ontario, Canada in the previous five years. Using template analysis, we developed four interacting themes related to expectations and experiences of healthcare, and of submitting complaints or asking for help: i) the system is not designed for healthcare, ii) gatekeeping and perceptions of 'deserving' healthcare, iii) impact of healthcare on other outcomes, and iv) calling the abyss. These factors affected perceptions of the potential efficacy of a patient feedback process, and how people in custody were likely to engage with it. Participants also identified five key features that should be components of any patient feedback processes. This study highlights challenges to patient-reported experiences of care in quality improvement work in restrictive environments and with incarcerated populations.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e72"},"PeriodicalIF":1.7,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347668","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":"The relationship between death distress and fertility intentions in married women after the earthquake.","authors":"Serap Bati, Sibel Kiyak","doi":"10.1017/S1463423626101315","DOIUrl":"10.1017/S1463423626101315","url":null,"abstract":"<p><strong>Objectives: </strong>Earthquake is a traumatic event with significant physiological and psychological effects, profoundly altering individuals' lives. This study aimed to determine the relationship between death distress and fertility intentions among women who experienced the Kahramanmaras earthquake in Türkiye on February 6, 2023.</p><p><strong>Methods: </strong>This descriptive, correlational study included 294 married women residing in an earthquake-affected region of Turkey. We collected data using the Participant Information Form and the Brief Death Distress Scale.</p><p><strong>Results: </strong>A total of 294 women participated in this study. The mean death distress score was 25.65 ± 7.46. The death depression dimension had the highest score among the subdimensions of the death distress scale (11.02 ± 3.61). Age, income level, pregnancy, number of children, extent of house damage during the earthquake, and experience of being trapped under debris were factors influencing death-related distress. Women who changed their fertility intentions had higher levels of death distress, anxiety, and obsession than those who did not change their fertility intentions.</p><p><strong>Conclusions: </strong>This study provides a new perspective for understanding post-earthquake changes in married women's mental health and fertility behavior. Death distress is a key factor that should be considered in planning post-disaster healthcare services for women.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e70"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297635","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":"'They're waiting for us to break before they listen': healthcare workers' perspectives on how to mitigate moral distress in British Columbia, Canada.","authors":"Muhammad Haaris Tiwana, Alice Murage, Jorges Andres Delgado-Ron, Rosemary Morgan, Julia Smith","doi":"10.1017/S1463423626101352","DOIUrl":"10.1017/S1463423626101352","url":null,"abstract":"<p><strong>Objectives: </strong>Moral distress among healthcare workers can have serious repercussions, including reduced morale, decreased quality of care, apathy, burnout, and workforce attrition. While much research has documented moral distress, few studies have considered how to effectively mitigate it. This study sought to enhance understanding of moral distress by exploring not only who is affected and why, but also examining strategies for addressing it.</p><p><strong>Methods: </strong>An online survey was conducted with primary care healthcare professionals in British Columbia, Canada, from October to December 2022, including physicians, nurses, homecare aides, and long-term care aides. The survey gathered sociodemographic data, documented experiences of moral distress, and explored methods used to mitigate it. We specifically analysed responses to two open-ended questions on how respondents addressed moral distress, categorizing responses by profession, gender, and racial identity.</p><p><strong>Results: </strong>Employing a socio-ecological framework, we organized mitigation strategies across four levels: individual, interpersonal, community/organizational, and societal/systemic. Strategies ranged from personal coping mechanisms - such as mindfulness and exercise - to more collective actions aimed at changing workplace culture and policies. At the organizational and systemic levels, participants offered recommendations for structural reforms to improve support for healthcare staff.</p><p><strong>Conclusion: </strong>This study highlights the multifactorial nature of moral distress, showing that it arises from a complex interplay of systemic, organizational, interpersonal, and individual factors. Our findings emphasize the importance of developing multi-level approaches to mitigate moral distress in healthcare, addressing both immediate individual needs and broader organizational and policy changes that promote a healthier work environment.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e68"},"PeriodicalIF":1.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and caregiver use of patient portal features in primary care: a cross-sectional survey study of Ontarians.","authors":"Alexis Aomreore, Simone Dahrouge, Kiran Saluja, Simon Lam, Rachelle Ashcroft","doi":"10.1017/S1463423626101376","DOIUrl":"10.1017/S1463423626101376","url":null,"abstract":"<p><strong>Background: </strong>Patient portals (PPs) are digital healthcare programs providing patients with access to their electronic health records with features aiding patients in managing their care. Although PPs are now widely used in primary care (PC), the desirability of its features is less known.</p><p><strong>Aim: </strong>This study aims to describe the current and anticipated use of PP features and the socio-demographic profile of PP users accessing these features.</p><p><strong>Methods: </strong>A cross-sectional survey of patient and caregiver experiences with virtual care in PC in Ontario, Canada, was conducted from December 2022 to March 2023. A survey section captured use/anticipated use of PP features: 'communicating with practice', 'viewing records', 'entering record information', 'receiving practice information', and 'scheduling appointments'. We report on respondents with/without PP access and their use/anticipated use of PP features, and analyzed associations between respondent socio-demographic data and the current use of a number of PP features using Pearson chi-square test.</p><p><strong>Findings: </strong>A total of 970 responses (743 patients (P) and 227 caregivers (C)) were obtained with respondents having PP access (P:57%; C:62%) and indicating using all (P: 43%; C:45%), some (P:55%; C:52%), or no (P: 2%; C:4%) PP features. For those with PP access, age (65+ years (14%) compared to <65 years (1%)), employment status (unemployed (6%) compared to employed (1%)), and language at home (non-English (9%) compared to English (1%)) were significantly associated with not using any PP features (percentages represent those not using any PP feature). Our findings provide insights into equity aspects to be considered for future PP implementation.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e69"},"PeriodicalIF":1.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280440","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}