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BMC Family Practice

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https://www.readbyqxmd.com/read/28330457/exercising-alcohol-patients-don-t-lack-motivation-but-struggle-with-structures-emotions-and-social-context-a-qualitative-dropout-study
#1
Sengül Sari, Ashley Elizabeth Muller, Kirsten K Roessler
BACKGROUND: Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Furthermore, this study aims to propose possibilities for a better practice of future intervention studies based on the participants' experiences and suggestions...
March 23, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28330453/a-systematic-review-of-primary-care-models-for-non-communicable-disease-interventions-in-sub-saharan-africa
#2
Jennifer Kane, Megan Landes, Christopher Carroll, Amy Nolen, Sumeet Sodhi
BACKGROUND: Chronic diseases, primarily cardiovascular disease, respiratory disease, diabetes and cancer, are the leading cause of death and disability worldwide. In sub-Saharan Africa (SSA), where communicable disease prevalence still outweighs that of non-communicable disease (NCDs), rates of NCDs are rapidly rising and evidence for primary healthcare approaches for these emerging NCDs is needed. METHODS: A systematic review and evidence synthesis of primary care approaches for chronic disease in SSA...
March 23, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28327100/impact-of-a-continuing-medical-education-meeting-on-the-use-and-timing-of-urgent-cancer-referrals-among-general-practitioners-a-before-after-study
#3
Berit Skjødeberg Toftegaard, Flemming Bro, Alina Zalounina Falborg, Peter Vedsted
BACKGROUND: Detection of cancer in general practice is challenging because symptoms are diverse. Even so-called alarm symptoms have low positive predictive values of cancer. Nevertheless, appropriate referral is crucial. As 85% of cancer patients initiate their cancer diagnostic pathway in general practice, a Continuing Medical Education meeting (CME-M) in early cancer diagnosis was launched in Denmark in 2012. We aimed to investigate the effect of the CME-M on the primary care interval, patient contacts with general practice and use of urgent cancer referrals...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28327096/exploring-why-a-complex-intervention-piloted-in-general-practices-did-not-result-in-an-increase-in-chlamydia-screening-and-diagnosis-a-qualitative-evaluation-using-the-fidelity-of-implementation-model
#4
R Allison, D M Lecky, K Town, C Rugman, E J Ricketts, N Ockendon-Powell, K A Folkard, J K Dunbar, C A M McNulty
BACKGROUND: Chlamydia trachomatis (chlamydia) is the most commonly diagnosed sexually transmitted infection (STI) in England; approximately 70% of diagnoses are in sexually active young adults aged under 25. To facilitate opportunistic chlamydia screening in general practice, a complex intervention, based on a previously successful Chlamydia Intervention Randomised Trial (CIRT), was piloted in England. The modified intervention (3Cs and HIV) aimed to encourage general practice staff to routinely offer chlamydia testing to all 15-24 year olds regardless of the type of consultation...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28327082/out-of-hours-care-in-germany-high-utilization-by-adult-patients-with-minor-ailments
#5
R Leutgeb, P Engeser, S Berger, J Szecsenyi, G Laux
BACKGROUND: Family practitioners (FPs) who work in Out-Of-Hours Care (OOHC) - especially in rural areas - complain about high workload related to low urgency and potentially unnecessary patient presentations with minor ailments. The aim of this study was to describe Reasons for Encounter (RFEs) in primary OOHC taken into account the doctor's perspective in the context of high workload without knowing patients' motives for visiting an OOHC-centre. METHODS: Within this descriptive study, OOHC data from 2012 were evaluated from a German statutory health insurance company in the federal state of Baden-Wuerttemberg...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28320337/barriers-and-facilitators-to-use-of-non-pharmacological-treatments-in-chronic-pain
#6
William C Becker, Lindsey Dorflinger, Sara N Edmond, Leila Islam, Alicia A Heapy, Liana Fraenkel
BACKGROUND: Consensus guidelines recommend multi-modal chronic pain treatment with increased uptake of non-pharmacological pain treatment modalities (NPMs). We aimed to identify the barriers and facilitators to uptake of evidence-based NPMs from the perspectives of patients, nurses and primary care providers (PCPs). METHODS: We convened eight separate groups and engaged each in a Nominal Group Technique (NGT) in which participants: (1) created an individual list of barriers (and, in a subsequent round, facilitators) to uptake of NPMs; (2) compiled a group list from the individual lists; and (3) anonymously voted on the top three most important barriers and facilitators...
March 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28320330/self-monitoring-of-health-data-by-patients-with-a-chronic-disease-does-disease-controllability-matter
#7
Martine W J Huygens, Ilse C S Swinkels, Judith D de Jong, Monique J W M Heijmans, Roland D Friele, Onno C P van Schayck, Luc P de Witte
BACKGROUND: There is a growing emphasis on self-monitoring applications that allow patients to measure their own physical health parameters. A prerequisite for achieving positive effects is patients' willingness to self-monitor. The controllability of disease types, patients' perceived self-efficacy and health problems could play an essential role in this. The purpose of this study is to investigate the relationship between patients' willingness to self-monitor and a range of disease and patient specific variables including controllability of disease type, patients' perceived self-efficacy and health problems...
March 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28320325/-was-that-a-success-or-not-a-success-a-qualitative-study-of-health-professionals-perspectives-on-support-for-people-with-long-term-conditions
#8
John Owens, Vikki A Entwistle, Alan Cribb, Zoë C Skea, Simon Christmas, Heather Morgan, Ian S Watt
BACKGROUND: Support for self-management (SSM) is a prominent strand of health policy internationally, particularly for primary care. It is often discussed and evaluated in terms of patients' knowledge, skills and confidence, health-related behaviours, disease control or risk reduction, and service use and costs. However, these goals are limited, both as guides to professional practice and as indicators of its quality. In order to better understand what it means to support self-management well, we examined health professionals' views of success in their work with people with long-term conditions...
March 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28302060/heart-failure-labelled-patients-with-missing-ejection-fraction-in-primary-care-prognosis-and-determinants
#9
Miguel-Angel Muñoz, Xavier Mundet-Tuduri, Jordi Real, José-Luis Del Val, Mar Domingo, Ernest Vinyoles, Ester Calero, Caterina Checa, Nuria Soldevila-Bacardit, José-María Verdú-Rotellar
BACKGROUND: It is common to find a high variability in the accuracy of heart failure (HF) diagnosis in electronic primary care medical records (EMR). Our aims were to ascertain (i) whether the prognosis of HF labelled patients whose ejection fraction (EF) was missing in their EMR differed from those that had it registered, and (ii) the causes contributing to the differences in the availability of EF in EMR. METHODS: Retrospective cohort analyses based on clinical records of HF and attended at 52 primary healthcare centres of Barcelona (Spain)...
March 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28302056/antibiotic-overuse-for-acute-respiratory-tract-infections-in-sri-lanka-a-qualitative-study-of-outpatients-and-their-physicians
#10
L Gayani Tillekeratne, Champica K Bodinayake, Thushani Dabrera, Ajith Nagahawatte, Wasantha Kodikara Arachchi, Anoji Sooriyaarachchi, Kearsley Stewart, Melissa Watt, Truls Østbye, Christopher W Woods
BACKGROUND: Acute respiratory tract infections (ARTIs) are a common reason for antibiotic overuse worldwide. We previously showed that over 80% of outpatients presenting to a tertiary care hospital in Sri Lanka with influenza-like illness received antibiotic prescriptions, although almost half were later confirmed to have influenza. The purpose of this qualitative study was to assess Sri Lankan patients' and physicians' attitudes towards ARTI diagnosis and treatment. METHODS: Semi-structured interviews were conducted with 50 outpatients with ARTIs and five physicians in the Outpatient Department (OPD) at a large, public tertiary care hospital in southern Sri Lanka...
March 16, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28298197/what-do-young-australian-women-want-when-talking-to-doctors-about-contraception
#11
Denisa L Goldhammer, Catriona Fraser, Britta Wigginton, Melissa L Harris, Deborah Bateson, Deborah Loxton, Mary Stewart, Jacqueline Coombe, Jayne C Lucke
BACKGROUND: Access to most contraceptives in Australia requires a prescription from a doctor, and it has been shown that doctors can influence women's decision-making with respect to contraception. However, little research has documented how women experience their interactions with doctors within the context of a contraceptive consultation. Understanding such experiences may contribute to our knowledge of factors that may influence women's contraceptive decisions more broadly. METHODS: We report on findings from the Contraceptive Use, Pregnancy Intentions and Decisions (CUPID) survey of young Australian women, a large-scale longitudinal study of 3,795 women aged 18-23 years...
March 15, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28298185/general-practitioners-perceptions-of-population-based-bowel-screening-and-their-influence-on-practice-a-qualitative-study
#12
Greer Dawson, Melanie Crane, Claudine Lyons, Anna Burnham, Tara Bowman, Donna Perez, Joanne Travaglia
BACKGROUND: Although largely preventable, Australia has one of the highest rates of bowel cancer in the world. General Practitioners (GPs) have an important role to play in prevention and early detection of bowel cancer, however in Australia this is yet to be optimised and participation remains low. This study sought to understand how GPs' perceptions of bowel screening influence their attitudes to, and promotion of the faecal occult blood test (FOBT), to identify opportunities to enhance their role...
March 15, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28292257/medical-appropriateness-of-adult-calls-to-danish-out-of-hours-primary-care-a-questionnaire-based-survey
#13
Karen Busk Nørøxe, Linda Huibers, Grete Moth, Peter Vedsted
BACKGROUND: Optimal utilisation of the out-of-hours primary care (OOH-PC) services remains a concern in public health policy. We need more knowledge on potentially avoidable contacts. This study examines the frequency of medically assessed inappropriate OOH-PC calls from adults, explores factors associated with such assessment, and examines the relation to patient-assessed severity of health problem and fulfilment of expectations. METHODS: We performed secondary analyses of data from a large cross-sectional survey on contacts to Danish OOH-PC...
March 14, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28259143/training-on-domestic-violence-and-child-safeguarding-in-general-practice-a-mixed-method-evaluation-of-a-pilot-intervention
#14
Natalia V Lewis, Cath Larkins, Nicky Stanley, Eszter Szilassy, William Turner, Jessica Drinkwater, Gene S Feder
BACKGROUND: Children's exposure to domestic violence is a type of child maltreatment, yet many general practice clinicians remain uncertain of their child safeguarding responsibilities in the context of domestic violence. We developed an evidence-based pilot training on domestic violence and child safeguarding for general practice teams. The aim of this study was to test and evaluate its feasibility, acceptability and the direction of change in short-term outcome measures. METHODS: We used a mixed method design which included a pre-post questionnaire survey, qualitative analysis of free-text comments, training observations, and post-training interviews with trainers and participants...
March 4, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28249606/immigrant-parents-experience-with-the-swedish-child-health-care-system-a-qualitative-study
#15
Elisabeth Mangrio, Karin Persson
BACKGROUND: Immigration, particularly when it is involuntary, is known to be an emotional stressor, regardless of the reason behind it. It is always a challenge to be removed from the habitual and cultural action pattern of the person or family. This can make children more vulnerable, because they often arrive with an increased risk of poor physical health. Because of that, it is crucial that immigrant children have access to ongoing health care. The aim of this study is to shed light on the experience of non-European immigrants with Sweden's Child Health Care system...
March 1, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28241802/criteria-in-diagnosing-nocturnal-leg-cramps-a-systematic-review
#16
Joannes Hallegraeff, Mathieu de Greef, Wim Krijnen, Cees van der Schans
BACKGROUND: Up to 33% of the general population over 50 years of age are affected by nocturnal leg cramps. Currently there are no generally accepted clinical characteristics, which identify nocturnal leg cramps. This study aims to identify these clinical characteristics and to differentiate between them and the characteristics of restless leg syndrome and periodic limb disorder. METHOD: A systematic literature study was executed from December 2015 to May 2016. This study comprised of a systematic literature review of randomized clinical trials, observational studies on nocturnal and rest cramps of legs and other muscles, and other systematic and narrative reviews...
February 28, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28241789/nurses-and-pharmacists-learning-experiences-from-participating-in-interprofessional-medication-reviews-for-elderly-in-primary-health-care-a-qualitative-study
#17
H T Bell, A G Granas, I Enmarker, R Omli, A Steinsbekk
BACKGROUND: Traditionally, drug prescription and follow up have been the sole responsibility of physicians. However, interprofessional medication reviews (IMRs) have been developed to prevent drug discrepancies and patient harm especially for elderly patients with polypharmacy and multimorbidity. What participating nurses and pharmacists learn from each other during IMR is poorly studied. The aim of this study was to investigate nurses' and pharmacists' perceived learning experience after participating in IMRs in primary health care for up to two years...
February 28, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28241787/using-self-reported-data-on-the-social-determinants-of-health-in-primary-care-to-identify-cancer-screening-disparities-opportunities-and-challenges
#18
A K Lofters, A Schuler, M Slater, N N Baxter, N Persaud, A D Pinto, E Kucharski, S Davie, R Nisenbaum, T Kiran
BACKGROUND: Data on the social determinants of health can help primary care practices target improvement efforts, yet relevant data are rarely available. Our family practice located in Toronto, Ontario routinely collects patient-level sociodemographic data via a pilot-tested survey developed by a multi-organizational steering committee. We sought to use these data to assess the relationship between the social determinants and colorectal, cervical and breast cancer screening, and to describe the opportunities and challenges of using data on social determinants from a self-administered patient survey...
February 28, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28235400/implementation-of-cardiovascular-disease-prevention-in-primary-health-care-enhancing-understanding-using-normalisation-process-theory
#19
Nerida Volker, Lauren T Williams, Rachel C Davey, Thomas Cochrane, Tanya Clancy
BACKGROUND: The reorientation of primary health care towards prevention is fundamental to addressing the rising burden of chronic disease. However, in Australia, cardiovascular disease prevention practice in primary health care is not generally consistent with existing guidelines. The Model for Prevention study was a whole-of-system cardiovascular disease prevention intervention, with one component being enhanced lifestyle modification support and addition of a health coaching service in the general practice setting...
February 24, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28231847/process-evaluation-of-a-stepped-care-program-to-prevent-depression-in-primary-care-patients-and-practice-nurses-experiences
#20
Alide D Pols, Karen Schipper, Debbie Overkamp, Susan E van Dijk, Judith E Bosmans, Harm W J van Marwijk, Marcel C Adriaanse, Maurits W van Tulder
BACKGROUND: Depression is common in patients with diabetes type 2 (DM2) and/or coronary heart disease (CHD), with high personal and societal burden and may even be preventable. Recently, a cluster randomized trial of stepped care to prevent depression among patients with DM2 and/or CHD and subthreshold depression in Dutch primary care (Step-Dep) versus usual care showed no effectiveness. This paper presents its process evaluation, exploring in-depth experiences from a patient and practice nurse perspective to further understand the results...
February 23, 2017: BMC Family Practice
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