International journal of family medicine最新文献_第3页

Corrigendum to "Development of a Tool to Identify Poverty in a Family Practice Setting: A Pilot Study". “开发在家庭实践环境中确定贫困的工具:一项试点研究”的勘误表。

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-09-21 DOI: 10.1155/2015/418125

Vanessa Brcic, Caroline Eberdt, Janusz Kaczorowski

引用次数: 9

Changes in identity after aphasic stroke: implications for primary care. 失语卒中后身份的改变:对初级保健的影响。

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-01-21 DOI: 10.1155/2015/970345

Benjamin Musser, Joanne Wilkinson, Thomas Gilbert, Barbara G Bokhour

{"title":"Changes in identity after aphasic stroke: implications for primary care.","authors":"Benjamin Musser, Joanne Wilkinson, Thomas Gilbert, Barbara G Bokhour","doi":"10.1155/2015/970345","DOIUrl":"10.1155/2015/970345","url":null,"abstract":"Background. Stroke survivors with aphasia experience difficulty associated with their communication disorder. While much has been written about aphasia's impacts on partners/family, we lack data regarding the psychosocial adjustment of aphasic stroke survivors, with a paucity of data from the patients themselves. Methods. Qualitative study of lived experiences of individuals with poststroke aphasia. Each of the stroke survivors with aphasia completed 3-4 semistructured interviews. In most cases, patients' partners jointly participated in interviews, which were transcribed and analyzed using techniques derived from grounded theory. Results. 12 patients were interviewed, with the total of 45 interviews over 18 months. Themes included poststroke changes in patients' relationships and identities, which were altered across several domains including occupational identity, relationship and family roles, and social identity. While all these domains were impacted by aphasia, the impact varied over time. Conclusion. Despite the challenges of interviewing individuals with aphasia, we explored aphasia's impacts on how individuals experience their identity and develop new identities months and years after stroke. This data has important implications for primary care of patients with aphasia, including the importance of the long-term primary care relationship in supporting psychosocial adjustment to life after aphasic stroke. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2015 ","pages":"970345"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33058133","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}

引用次数: 0

Are Cancer Patients' Socioeconomic and Cultural Factors Associated with Contact to General Practitioners in the Last Phase of Life? 癌症患者的社会经济和文化因素是否与生命最后阶段的全科医生联系有关?

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-08-27 DOI: 10.1155/2015/952314

M A Neergaard, F Olesen, J Sondergaard, P Vedsted, A B Jensen

{"title":"Are Cancer Patients' Socioeconomic and Cultural Factors Associated with Contact to General Practitioners in the Last Phase of Life?","authors":"M A Neergaard, F Olesen, J Sondergaard, P Vedsted, A B Jensen","doi":"10.1155/2015/952314","DOIUrl":"https://doi.org/10.1155/2015/952314","url":null,"abstract":"Introduction. General practitioners (GPs) play an important role in end of life care, which should be offered regardless of socioeconomic position and cultural factors. The aim was to analyse associations between GP contacts at the end of life and socioeconomic and cultural characteristics of Danish cancer patients. Method. Population-based study identifying 599 adults who died of cancer from March to November 2006, in Aarhus County, Denmark. Associations between health register-based data on \"total GP face-to-face contacts\" and \"GP home visits\" during the last 90 days of life and patients' socioeconomic and cultural characteristics were calculated. Results. Having low income (RR: 1.18 (95% CI: 1.03; 1.35)) and being immigrants or descendants of immigrants (RR: 1.17 (95% CI: 1.02; 1.35)) were associated with GP face-to-face contacts. However, patients living in large municipalities had lower likelihood of having both GP face-to-face contacts in general (RR: 0.85 (95% CI: 0.77;0.95)) and GP home visits (RR: 0.89 (95% CI: 0.80; 0.99)). Conclusion. This study indicates higher proportion of GP contacts to economically deprived patients and immigrants/descendants of immigrants. These subgroups were, however, small and results should be looked upon with caution. Furthermore, palliative needs were not included and together with urban/rural the underlying causes need further investigation. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2015 ","pages":"952314"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/952314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34109244","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}

引用次数: 6

Placebo-Controlled Discontinuation of Long-Term Acid-Suppressant Therapy: A Randomised Trial in General Practice. 长期抑酸治疗的安慰剂对照停药:一项普通实践中的随机试验。

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-07-12 DOI: 10.1155/2015/175436

Jon Eik Zwisler, Dorte Ejg Jarbøl, Annmarie Touborg Lassen, Jakob Kragstrup, Niels Thorsgaard, Ove B Schaffalitzky de Muckadell

{"title":"Placebo-Controlled Discontinuation of Long-Term Acid-Suppressant Therapy: A Randomised Trial in General Practice.","authors":"Jon Eik Zwisler, Dorte Ejg Jarbøl, Annmarie Touborg Lassen, Jakob Kragstrup, Niels Thorsgaard, Ove B Schaffalitzky de Muckadell","doi":"10.1155/2015/175436","DOIUrl":"https://doi.org/10.1155/2015/175436","url":null,"abstract":"Objective. To investigate whether patients on long-term antisecretory medication need to continue treatment to control symptoms. Methods. A double-blinded randomised placebo-controlled trial in general practices in Denmark. Patients aged 18-90 who were treated with antisecretory drugs on a long-term basis were randomized to esomeprazole 40 mg or identical placebo. Outcome measures were time to discontinuation with trial medication due to failed symptom control analysed as survival data. The proportion of patients stopping trial medication during the one-year follow-up was estimated. Results. A total of 171 patients were included with a median prior duration of antisecretory treatment of four years (range: 0.5 to 14.6 years). 86 patients received esomeprazole 40 mg and 85 patients received placebo. At 12 months, statistically significantly more patients in the placebo group had discontinued (73% (62/85)) compared with the esomeprazole group (21% (18/86); p < 0.001). Conclusions. Long-term users of antisecretory drugs showed a preference for the active drug compared to placebo. However, 27% of patients continued on placebo throughout the study and did not need to reinstitute usual treatment. One in five patients treated with esomeprazole discontinued trial medication due to unsatisfactory symptom control. Discontinuation of antisecretory treatment should be considered in long-term users of antisecretory drugs. This trial is registered with Trial registration ClinicalTrials.gov ID: NCT00120315. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2015 ","pages":"175436"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/175436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33899941","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}

引用次数: 24

The Role of Obesity Training in Medical School and Residency on Bariatric Surgery Knowledge in Primary Care Physicians. 医学院和住院医生肥胖症培训对基层医生减肥手术知识的影响。

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-08-03 DOI: 10.1155/2015/841249

Fatima Cody Stanford, Erica D Johnson, Mechelle D Claridy, Rebecca L Earle, Lee M Kaplan

{"title":"The Role of Obesity Training in Medical School and Residency on Bariatric Surgery Knowledge in Primary Care Physicians.","authors":"Fatima Cody Stanford, Erica D Johnson, Mechelle D Claridy, Rebecca L Earle, Lee M Kaplan","doi":"10.1155/2015/841249","DOIUrl":"10.1155/2015/841249","url":null,"abstract":"Objective. US primary care physicians are inadequately educated on how to provide obesity treatment. We sought to assess physician training in obesity and to characterize the perceptions, beliefs, knowledge, and treatment patterns of primary care physicians. Methods. We administered a cross-sectional web-based survey from July to October 2014 to adult primary care physicians in practices affiliated with the Massachusetts General Hospital (MGH). We evaluated survey respondent demographics, personal health habits, obesity training, knowledge of bariatric surgery care, perceptions, attitudes, and beliefs regarding the etiology of obesity and treatment strategies. Results. Younger primary care physicians (age 20-39) were more likely to have received some obesity training than those aged 40-49 (OR: 0.08, 95% CI: 0.008-0.822) or those 50+ (OR: 0.03, 95% CI: 0.004-0.321). Physicians who were young, had obesity, or received obesity education in medical school or postgraduate training were more likely to answer bariatric surgery knowledge questions correctly. Conclusions. There is a need for educational programs to improve physician knowledge and competency in treating patients with obesity. Obesity is a complex chronic disease, and it is important for clinicians to be equipped with the knowledge of the multiple treatment modalities that may be considered to help their patients achieve a healthy weight. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2015 ","pages":"841249"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34147814","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}

引用次数: 0

Management of Overweight during Childhood: A Focus Group Study on Health Professionals' Experiences in General Practice. 儿童期超重的管理:卫生专业人员全科实践经验的焦点小组研究。

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-07-06 DOI: 10.1155/2015/248985

Lone Marie Larsen, Loni Ledderer, Dorte Ejg Jarbøl

{"title":"Management of Overweight during Childhood: A Focus Group Study on Health Professionals' Experiences in General Practice.","authors":"Lone Marie Larsen, Loni Ledderer, Dorte Ejg Jarbøl","doi":"10.1155/2015/248985","DOIUrl":"https://doi.org/10.1155/2015/248985","url":null,"abstract":"Background. Because of the increasing prevalence of overweight and obesity in childhood in the Western world, focus on the management in general practice has also increased. Objective. To explore the experiences of general practitioners (GPs) and practice nurses participating in a randomised controlled trial (RCT) comparing two management programmes in general practice for children who are overweight or obese. Methods. Three focus groups with GPs and nurses participating in the RCT. Transcribed data were analysed using systematic text condensation followed by thematic analysis. Results. Health professionals considered it their responsibility to offer a management programme to overweight children. They recognised that management of overweight during childhood was a complex task that required an evidence-based strategy with the possibility of supervision. Health professionals experienced a barrier to addressing overweight in children. However, increasing awareness of obesity in childhood and its consequences in society was considered helpful to reach an understanding of the articulations concerning how best to address the issue. Conclusions. Health professionals in general practice recognised that they have a special obligation, capacity, and role in the management of obesity in childhood. Implementation of future management programmes must address existing barriers beyond an evidence-based standardised strategy. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2015 ","pages":"248985"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/248985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33890261","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}

引用次数: 4

An Algorithm Using Administrative Data to Identify Patient Attachment to a Family Physician. 一种使用管理数据识别患者对家庭医生依恋的算法。

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-08-27 DOI: 10.1155/2015/967230

Sylvie Provost, José Pérez, Raynald Pineault, Roxane Borgès Da Silva, Pierre Tousignant

{"title":"An Algorithm Using Administrative Data to Identify Patient Attachment to a Family Physician.","authors":"Sylvie Provost, José Pérez, Raynald Pineault, Roxane Borgès Da Silva, Pierre Tousignant","doi":"10.1155/2015/967230","DOIUrl":"https://doi.org/10.1155/2015/967230","url":null,"abstract":"Background. Commonly self-reported questions in population health surveys, such as \"do you have a family physician?\", represent one of the best-known sources of information about patients' attachment to family physicians. Is it possible to find a proxy for this information in administrative data? Objective. To identify the type of patient attachment to a family physician using administrative data. Methods. Using physician fee-for-service database and patients enrolment registries (Quebec, Canada, 2008-2010), we developed a step-by-step algorithm including three dimensions of the physician-patient relationship: patient enrolment with a physician, complete annual medical examinations (CME), and concentration of visits to a physician. Results. 68.1% of users were attached to a family physician; for 34.4% of them, attachment was defined by enrolment with a physician, for 31.5%, by CME without enrolment, and, for 34.1%, by concentration of visits to a physician without enrolment or CME. Eight types of patient attachment were described. Conclusion. When compared to findings with survey data, our measure comes out as a solid conceptual framework to identify patient attachment to a family physician in administrative databases. This measure could be of great value for physician/patient-based cohort development and impact assessment of different types of patient attachment on health services utilization. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2015 ","pages":"967230"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/967230","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34109245","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}

引用次数: 9

Does the Primary Care Experience Influence the Cancer Diagnostic Process? 初级保健经验是否会影响癌症诊断过程？

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-10-04 DOI: 10.1155/2015/176812

Sylvie Provost, Raynald Pineault, Pierre Tousignant, Danièle Roberge, Dominique Tremblay, Mylaine Breton, Lynda Benhadj, Mamadou Diop, Michel Fournier, Astrid Brousselle

{"title":"Does the Primary Care Experience Influence the Cancer Diagnostic Process?","authors":"Sylvie Provost, Raynald Pineault, Pierre Tousignant, Danièle Roberge, Dominique Tremblay, Mylaine Breton, Lynda Benhadj, Mamadou Diop, Michel Fournier, Astrid Brousselle","doi":"10.1155/2015/176812","DOIUrl":"10.1155/2015/176812","url":null,"abstract":"Objective. To analyze the impact of patients' experience of care at their usual source of primary care on their choice of point of entry into cancer investigation process, time to diagnosis, and presence of metastatic cancer at time of diagnosis. Method. A questionnaire was administered to 438 patients with cancer (breast, lung, and colorectal) between 2011 and 2013 in four oncology clinics of Quebec (Canada). Multiple regression analyses (logistic and Cox models) were conducted. Results. Among patients with symptoms leading to investigation of cancer (n = 307), 47% used their usual source of primary care as the point of entry for investigation. Greater comprehensiveness of care was associated with the decision to use this source as point of entry (OR = 1.25; CI 90% = 1.06-1.46), as well as with shorter times between first symptoms and investigation (HR = 1.11; p = 0.05), while greater accessibility was associated with shorter times between investigation and diagnosis (HR = 1.13; p < 0.01). Conclusion. Experience of care at the usual source of primary care has a slight influence on the choice of point of entry for cancer investigation and on time to diagnosis. This influence appears to be more related to patients' perceptions of the accessibility and comprehensiveness of their usual source of primary care. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2015 ","pages":"176812"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34120522","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}

引用次数: 0

Improving preclinic preparation for patients with chronic conditions in quito, ecuador: a randomized controlled trial. 改善基多慢性病患者的临床前准备:一项随机对照试验。

International journal of family medicine Pub Date : 2015-01-01 Epub Date: 2015-03-25 DOI: 10.1155/2015/724245

K Rodriguez, E Kaselitz, J Wong, S Ligard, D Peck, V Hugo Mena, F Gordillo, D Serlin, M Heisler

{"title":"Improving preclinic preparation for patients with chronic conditions in quito, ecuador: a randomized controlled trial.","authors":"K Rodriguez, E Kaselitz, J Wong, S Ligard, D Peck, V Hugo Mena, F Gordillo, D Serlin, M Heisler","doi":"10.1155/2015/724245","DOIUrl":"https://doi.org/10.1155/2015/724245","url":null,"abstract":"Objectives. As in many settings, patients in community health centers in Ecuador do not complete previsit forms or receive assistance to identify questions and concerns they would like to address in brief clinic visits with physicians. We examined the comparative effectiveness of providing (1) a previsit form to complete; (2) a previsit form along with assistance in completing the form; and (3) usual care. Methods. Parallel, three-arm randomized controlled trial in two health centers serving indigent to low-income communities in Quito, Ecuador, among 199 adult patients who took medications for at least one chronic condition. Outcome measures were self-reported satisfaction with the visit, confidence in asking questions, and extent to which patients' objectives were met. Results. Patients who received assistance in completing a previsit form were more than twice as likely as participants in usual care to report achieving everything they wanted during their visit (AOR 2.2, P = 0.039). There were no differences in any outcomes between the groups who received the previsit form with no assistance and usual care. Conclusions. For high-quality patient-centered primary care, it is important to develop and test innovative and scalable interventions for patients and physicians to make the best use of limited clinic time. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2015 ","pages":"724245"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/724245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33227537","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}

引用次数: 1

A Change in Students' Perceptions of Peer and Faculty Attitudes to Rural Medicine following the Introduction of a Rural Health Rotation. 引入农村卫生轮转后，学生对同行和教师对农村医学态度的看法发生了变化。

International journal of family medicine Pub Date : 2014-01-01 Epub Date: 2014-08-27 DOI: 10.1155/2014/124708

Martyn Williamson

{"title":"A Change in Students' Perceptions of Peer and Faculty Attitudes to Rural Medicine following the Introduction of a Rural Health Rotation.","authors":"Martyn Williamson","doi":"10.1155/2014/124708","DOIUrl":"https://doi.org/10.1155/2014/124708","url":null,"abstract":"Introduction. In 2000, the Dunedin School of Medicine (one of Otago Medical School's 3 clinical schools) introduced 7-week rural placement. A survey of students conducted before attending the placement showed that most students did not perceive faculty to have a positive view of rural health. In 2007, we explored whether students' perceptions had changed. Method. All 5th year medical students at Otago Medical School were surveyed using items from the original study. The perceptions of students in Dunedin were compared with those of students in the other clinical schools (no rural rotation) and with those of students in the original study. Results. In 2007, there was a significantly increased likelihood of students from Dunedin reporting perceptions of positive faculty attitudes towards rural health compared with students from the other two clinical schools and with Dunedin students from the original survey. Conclusion. The results suggest that student perceptions of faculty attitudes in the school towards rural health may be changed following the introduction of a general practice rural placement to its curriculum.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2014 ","pages":"124708"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/124708","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32685785","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}

引用次数: 1