Australian journal of primary health最新文献_第5页

Building workforce capacity to address substance use in primary health care: preliminary results from a mixed-methods pilot program. 在初级医疗保健中培养解决药物使用问题的劳动力能力：一项混合方法试点计划的初步成果。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23148

Matthew W R Stevens, Rowena Ivers, Joanne Telenta, Robert L Ali

{"title":"Building workforce capacity to address substance use in primary health care: preliminary results from a mixed-methods pilot program.","authors":"Matthew W R Stevens, Rowena Ivers, Joanne Telenta, Robert L Ali","doi":"10.1071/PY23148","DOIUrl":"10.1071/PY23148","url":null,"abstract":"Background: Primary health care is critical to the prevention of alcohol, tobacco and other drug-related harms. Scaling-up screening, brief intervention and referral to treatment (SBIRT) within primary health care can reduce the burden of substance-related diseases, and improve downstream healthcare services. Building knowledge, skills and confidence among general practitioners (GPs), particularly in rural, regional and remote areas, to deliver SBIRT is an essential step. Therefore, this study aimed to pilot test a skills-based training program for GPs designed to build capacity for SBIRT delivery.Methods: This pilot study investigated the acceptability of a structured, educational skills-based training program among GPs, as well as its preliminary effectiveness in inducing changes in confidence to deliver SBIRT, and in increasing knowledge about low-risk alcohol guidance. The training package was designed by experts in addiction medicine and public health, and involved a series of online webinars and in-person workshops at four locations across the South Eastern NSW Primary Healthcare Network catchment.Results: A total of 18 GPs registered for the training, with six completing the final webinar. The GPs who completed all sessions demonstrated increases in confidence to deliver SBIRT and alcohol guidance knowledge from baseline. Qualitative feedback found the program acceptable, and GPs were able to successfully implement learnings into practice, and promote to colleagues.Conclusions: The results indicated the potential of this program at a national level, but highlighted the need for a range of additional incentives to encourage uptake and ongoing implementation.","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":"NULL"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833493","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}

引用次数: 0

Reducing antibiotic prescribing in general practice in Australia: a cluster randomised controlled trial of a multimodal intervention. 减少澳大利亚全科医学中的抗生素处方：一项多模式干预的集群随机对照试验。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23024

Minyon L Avent, Lisa Hall, Mieke van Driel, Annette Dobson, Laura Deckx, Mahmoud Galal, Malene Plejdrup Hansen, Charles Gilks

{"title":"Reducing antibiotic prescribing in general practice in Australia: a cluster randomised controlled trial of a multimodal intervention.","authors":"Minyon L Avent, Lisa Hall, Mieke van Driel, Annette Dobson, Laura Deckx, Mahmoud Galal, Malene Plejdrup Hansen, Charles Gilks","doi":"10.1071/PY23024","DOIUrl":"10.1071/PY23024","url":null,"abstract":"Background: The health and economic burden of antimicrobial resistance (in Australia is significant. Interventions that help guide and improve appropriate prescribing for acute respiratory tract infections in the community represent an opportunity to slow the spread of resistant bacteria. Clinicians who work in primary care are potentially the most influential health care professionals to address the problem of antimicrobial resistance, because this is where most antibiotics are prescribed.Methods: A cluster randomised trial was conducted comparing two parallel groups of 27 urban general practices in Queensland, Australia: 13 intervention and 14 control practices, with 56 and 54 general practitioners (GPs), respectively. This study evaluated an integrated, multifaceted evidence-based package of interventions implemented over a 6-month period. The evaluation included quantitative and qualitative components, and an economic analysis.Results: A multimodal package of interventions resulted in a reduction of 3.81 prescriptions per GP per month. This equates to 1280.16 prescriptions for the 56GPs in the intervention practices over the 6-month period. The cost per prescription avoided was A$148. The qualitative feedback showed that the interventions were well received by the GPs and did not impact on consultation time. Providing GPs with a choice of tools might enhance their uptake and support for antimicrobial stewardship in the community.Conclusions: A multimodal package of interventions to enhance rational prescribing of antibiotics is effective, feasible and acceptable in general practice. Investment in antimicrobial stewardship strategies in primary care may ultimately provide the important returns for public health into the future.","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":"NULL"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242101","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}

引用次数: 0

Corrigendum to: Older adults' experiences of a community wellness program (Connect 60+) that focused on physical activity and social connections: a qualitative exploratory study. 更正：老年人对社区健康计划（Connect 60+）的体验，该计划侧重于体育锻炼和社会联系：一项定性探索性研究。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY22153_CO

Tammy Weselman, Chiara Naseri, Sharmila Vaz, Janet Beilby, Luke Garswood, Hilary O'Connell, Anne-Marie Hill

引用次数: 0

Postpartum contraception in Australia: opportunities for increasing access in the primary care setting. 澳大利亚的产后避孕：在初级保健环境中增加避孕机会。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23101

Rhea Singh, Jessica R Botfield

引用次数: 0

'A sense of self, empowerment and purposefulness': professional diversification and wellbeing in Australian general practitioners. “自我意识、赋权意识和目标感”：澳大利亚全科医生的职业多元化和幸福感。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23090

Jill Benson, Shaun Prentice, Penny Need, Michelle Pitot, Taryn Elliott

{"title":"'A sense of self, empowerment and purposefulness': professional diversification and wellbeing in Australian general practitioners.","authors":"Jill Benson, Shaun Prentice, Penny Need, Michelle Pitot, Taryn Elliott","doi":"10.1071/PY23090","DOIUrl":"10.1071/PY23090","url":null,"abstract":"Background: Burnout and workforce shortages comprise a vicious cycle in medicine, particularly for Australian general practitioners (GPs). Professional diversification, whereby individuals work multiple roles across their week, may help address this problem, but this strategy is under-studied.Methods: We surveyed 1157 Australian GPs using qualitative and quantitative questions examining professional diversification, values, autonomy, and wellbeing. Quantitative data were analysed using inferential statistics, whilst qualitative data were analysed using inductive thematic analysis. We triangulated the data by using the qualitative findings to inform further quantitative testing.Results: Approximately 40% of the sample had diversified. Although diversifying was not significantly associated with wellbeing, the qualitative data indicated that diversification supported GPs' wellbeing by enhancing career sustainability, accomplished through various pathways (e.g. value fulfilment, autonomy, variety). Subsequent quantitative analyses provided evidence that these pathways mediated the relationship between diversification and wellbeing. To diversify, GPs needed particular personal qualities, external supports, flexibility, and serendipity. Barriers to diversifying mirrored these factors, spanning individual (e.g. skillset) and situational levels (e.g. autonomy, location).Conclusions: Diversification can support GPs' wellbeing if it meets their needs. Organisations should focus on publicising opportunities and accommodating requests to diversify.","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":"NULL"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523834","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}

引用次数: 0

The client and family experience of attending a nurse-led clinic for chronic wounds. 客户和家人在护士主导的慢性伤口诊所就诊的经历。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23081

Anusuya Dhar, Judith Needham, Michelle Gibb, Elisabeth Coyne

{"title":"The client and family experience of attending a nurse-led clinic for chronic wounds.","authors":"Anusuya Dhar, Judith Needham, Michelle Gibb, Elisabeth Coyne","doi":"10.1071/PY23081","DOIUrl":"10.1071/PY23081","url":null,"abstract":"Background: The quality of life for individuals with chronic wounds is diminished due to poor health-related outcomes and the financial burden of wound care. The literature has shown nurse-led wound care to have a positive impact on wound healing and psychosocial wellbeing. However, there is minimal research investigating the lived experience of attending a nurse-led clinic for chronic wounds. The purpose of this study was to explore the client and family experience of attending a nurse-led clinic for chronic wounds.Methods: Qualitative descriptive study. Semi-structured telephone interviews were transcribed verbatim and thematic analysis was undertaken.Results: Twelve clients and two family members participated, and the average length of interviews was 20min. Three main themes emerged: (1) expecting and managing pain; (2) receiving expert advice and reflecting on previous care; and (3) managing the cost of care. There was an emphasis on the impact of chronic wounds on pain and the ability to complete the activities of daily living. Expert advice, client satisfaction and physical accessibility were highlighted as benefits of the clinic. Cost and minimal client education were identified as challenges of the clinic.Conclusions: The findings demonstrated that chronic wounds have a significant impact on the client and family attending the nurse-led clinic. Comprehensive pain assessment, improved social support, better client education and cost-effective care is required to optimise the experience for people attending the nurse-led clinic.","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":"NULL"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489885","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}

引用次数: 0

GP perspectives on a psychiatry phone line in Western Australia's Great Southern region: implications for addressing rural GP workload. 全科医生对西澳大利亚大南部地区精神病学电话线的看法：对解决农村全科医生工作量的影响。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23039

Beatriz Cuesta-Briand, Daniel Rock, Layale Tayba, James Hoimes, Hanh Ngo, Michael Taran, Mathew Coleman

{"title":"GP perspectives on a psychiatry phone line in Western Australia's Great Southern region: implications for addressing rural GP workload.","authors":"Beatriz Cuesta-Briand, Daniel Rock, Layale Tayba, James Hoimes, Hanh Ngo, Michael Taran, Mathew Coleman","doi":"10.1071/PY23039","DOIUrl":"10.1071/PY23039","url":null,"abstract":"Background: Mental illness is a public health challenge disproportionately affecting rural Australians. GPs provide most of the mental health care, and they report increasing levels of burnout and unsustainable workload in the context of increased patient complexity. This may be more salient in rural settings characterised by resource constraints. In this paper, we use evaluation data from a GP psychiatry phone line established in Western Australia's Great Southern region in 2021 to describe GPs' perspectives on the service and reflect on how it may help alleviate rural GP workload.Methods: The sample was recruited among GPs practicing in the region. Data were collected through an online survey and semistructured interviews. Descriptive statistics were used to analyse the survey data. Interview data were subjected to thematic analysis; qualitative survey data were used for triangulation.Results: A total of 45GPs completed the survey and 14 were interviewed. Interview data yielded three themes: the criticality of timeliness; the building blocks of confidence; and trust. GPs were highly satisfied with the service, and timeliness and trust were the characteristics underpinning its effectiveness. The service built GPs' confidence in managing mental health and alcohol and other drug use issues through strengthening knowledge and providing reassurance.Conclusions: Our results suggest that a telephone line operated by trusted, local psychiatrists with knowledge of the local mental health ecosystem of support can reduce rural GP workload through building confidence and strengthening personal agency, helping GPs navigate the ethical and clinical labyrinth of managing patient complexity in rural settings.","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":"NULL"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41157828","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}

引用次数: 0

Lessons from the Netherlands for Australia: cross-country comparison of trends in antidepressant dispensing 2013-2021 and contextual factors influencing prescribing. 荷兰给澳大利亚的经验教训:2013-2021年抗抑郁药配药趋势的跨国比较以及影响处方的背景因素

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23168

Katharine A Wallis, Pieter J S Dikken, Piumika Sooriyaarachchi, Arthur M Bohnen, Maria Donald

{"title":"Lessons from the Netherlands for Australia: cross-country comparison of trends in antidepressant dispensing 2013-2021 and contextual factors influencing prescribing.","authors":"Katharine A Wallis, Pieter J S Dikken, Piumika Sooriyaarachchi, Arthur M Bohnen, Maria Donald","doi":"10.1071/PY23168","DOIUrl":"10.1071/PY23168","url":null,"abstract":"Background: There is concern internationally about increasing antidepressant use. Most antidepressants are prescribed in general practice. The aim of this study was to compare trends in antidepressant dispensing in Australia and the Netherlands over the 9years from 2013 to 2021, and to explore reasons for differences.Methods: A convergent mixed methods study including analysis of publicly available antidepressant dispensing data obtained from Australia's Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme and the Dutch Foundation for Pharmaceutical Statistics and a search of relevant literature to compare contextual factors influencing prescribing were undertaken.Results: In 2013, antidepressant dispensing rates in Australia were nearly twice as high as those in the Netherlands (82.5 versus 44.3DDD/1000/day) and increased to be more than twice as high by 2021 (115.6 versus 48.8DDD/1000/day). Antidepressant dispensing increased by 40% in Australia over the nine study years, but by only 10% in the Netherlands. Our scan of the literature confirms that while population factors, health system structure, and clinical guideline recommendations are largely consistent across the two countries, a multifaceted approach in the Netherlands involving improved access to non-pharmacological alternatives, initiatives targeting safer antidepressant prescribing, and tight regulation of pharmaceutical industry influence on prescribers, has successfully curtailed increasing antidepressant use.Conclusions: Australia may learn from the Netherlands' approach to redress increasing antidepressant use.","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":"NULL"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500494","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}

引用次数: 0

Quantitative analysis on dental utilisation in culturally and linguistically diverse mothers. 不同文化和语言的母亲牙科使用的定量分析。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23136

Kanchan Marcus, Madhan Balasubramanian, Stephanie D Short, Woosung Sohn

{"title":"Quantitative analysis on dental utilisation in culturally and linguistically diverse mothers.","authors":"Kanchan Marcus, Madhan Balasubramanian, Stephanie D Short, Woosung Sohn","doi":"10.1071/PY23136","DOIUrl":"10.1071/PY23136","url":null,"abstract":"Background: Culturally and linguistically diverse (CALD) mothers are influential in children's behaviours, yet little is known about this population. Furthermore, insufficient quantitative and context-based studies are available with CALD mothers and their access to oral health care. To address this gap, the study investigates oral health behaviours, psychological factors and remoteness area with dental utilisation in CALD mothers, within the NSW context.Methods: Informed by middle-range theory and a CALD-specific rainbow model, the 2013 and 2015 NSW Adult Population Health Survey was analysed. Variables for CALD mothers included household structure, age and language spoken. Multivariable analysis was conducted with oral health behaviours, psychological and remoteness variables, with dental utilisation as the outcome.Results: The sample was weighted (n =190,283). In total, 39.8% did not have a dental visit, and older mothers (aged 36-55 years) sought more dental services than younger mothers (aged 18-35 years). Higher odds for treatment dental care (aOR 2.21, 95% CI 1.12-4.37) than prevention-oriented care were found. Mothers experiencing moderate levels of psychological distress (aOR 0.49, 95% CI 0.31-0.77), or residing in outer regional and remote regions (aOR 0.19, 95% CI 0.04-0.85) were less likely to utilise dental care.Conclusion: Findings underline geographical issues in dental care utilisationand the need for integrated care for CALD mothers experiencing psychological distress, and to encourage uptake of preventive oral health care. Addressing cost barriers necessitates for universal health coverage. Multidisciplinary integration of healthcare services with improved primary sector collaboration between governments and healthcare providers, and the expansion to regional services are required for equity in CALD communities.","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":"NULL"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500495","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}

引用次数: 0

A content analysis of the interventions for low back pain promoted on the websites of Australian pain clinics. 对澳大利亚疼痛诊所网站上宣传的腰背痛干预措施进行内容分析。

Australian journal of primary health Pub Date : 2024-02-01 DOI: 10.1071/PY23164

Chris G Maher, Christopher S Han, Stephen E Gilbert, Michael K Nicholas

{"title":"A content analysis of the interventions for low back pain promoted on the websites of Australian pain clinics.","authors":"Chris G Maher, Christopher S Han, Stephen E Gilbert, Michael K Nicholas","doi":"10.1071/PY23164","DOIUrl":"10.1071/PY23164","url":null,"abstract":"Background: The Internet is a widely used source of health information, yet the accuracy of online information can be low. This is the case for low back pain (LBP), where much of the information about LBP treatment is poor.Methods: This research conducted a content analysis to explore what pain treatments for LBP are presented to the public on websites of Australian pain clinics listed in the PainAustralia National Pain Services Directory. Websites providing information relevant to the treatment of LBP were included. Details of the treatments for LBP offered by each pain service were extracted.Results: In total, 173 pain services were included, with these services linking to 100 unique websites. Services were predominantly under private ownership and located in urban areas, with limited services in non-urban locations. Websites provided detail on a median of six (IQR 3-8) treatments, with detail on a higher number of treatments provided by services in the private sector. Physical, psychological and educational treatments were offered by the majority of pain services, whereas surgical and workplace-focused treatments were offered by relatively few services. Most services provided details on multidisciplinary care; however, interdisciplinary, coordinated care characterised by case-conferencing was infrequently mentioned.Conclusions: Most websites provided details on treatments that were largely in-line with recommended care for LBP, but some were not, especially in private clinics. However, whether the information provided online is a true reflection of the services offered in clinics remains to be investigated.","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907128","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}

引用次数: 0