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Qualitative research primary care

Maria Noonan, Owen Doody, Andrew O'Regan, Julie Jomeen, Rose Galvin
BACKGROUND: Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, her baby, family and wider society. General practitioners (GPs) play a central role in identifying and supporting women and this study aimed to explore GPs' experiences of caring for women with perinatal mental health problems in primary care. The results of this study may provide guidance to inform policy, practice, research and development of curriculum and continuous professional development resources...
December 13, 2018: BMC Family Practice
Rosalie Schultz, Tammy Abbott, Jessica Yamaguchi, Sheree Cairney
BACKGROUND: For Indigenous Australians, health transcends the absence of disease, and includes the health and wellbeing of their community and Country: their whole physical, cultural and spiritual environment. Stronger relationships with Country and greater involvement in cultural practices enhance the wellbeing of Indigenous Australians, and those in more remote regions have greater access to their Country and higher levels of wellbeing. However this does not translate into improvements in clinical indicators, and Indigenous Australians in more remote regions suffer higher levels of morbidity and mortality than Indigenous people in non-remote areas, and other Australians...
December 12, 2018: BMC Health Services Research
Regina Cavalcante Agonigi, Simone Mendes Carvalho, Mary Ann Menezes Freire, Lucas Fernandes Gonçalves
OBJECTIVE: To identify the factors interfering in the production of care in the daily work of health professionals from the Primary Health Care. METHOD: Qualitative research carried out with Family Health Strategy (FHS) teams, in the health units of Rocinha (Rocinha is a favela located in the South Zone of the city of Rio de Janeiro, Brazil). To analyze the data, the thematic network proposed by Attride-Stirling was used. RESULTS: The routine of Teams in the Production of Care was the denomination of the network formed by the following themes: scales of services of the teams; structural problems of Family Health Units; standardization of protocols; challenges for the production of care; and collections of micro and macro management...
2018: Revista Brasileira de Enfermagem
Nichole B Thorne, Taylor K Soderborg, Jacqueline J Glover, Lilian Hoffecker, Maryam Guiahi
OBJECTIVE: Given the rise in Catholic ownership of U.S. health care facilities, we aimed to examine reproductive health care provision and patient outcomes. We performed a scoping review, which maps the literature and considers inclusion of studies that are not specifically quantitative. DATA SOURCES: We searched five databases (MEDLINE, EMBASE, Web of Science and Cochrane Library, from inception through August 2018 using terms related to reproductive health care and religion...
December 4, 2018: Obstetrics and Gynecology
Véronique de Goumoëns, Laura Marques Rio, Cécile Jaques, Anne-Sylvie Ramelet
OBJECTIVE: This scoping review sought to describe the literature on the different types of interventions to support families of patients with acquired brain injuries (ABIs) and their outcomes. INTRODUCTION: Acquired brain injuries are among the leading causes of disability in adults worldwide and have physical, cognitive or/and behavioral consequences not only for the patient, but also for the family. Several support interventions have been proposed in different contexts at different phases of recovery with various levels of evidence, yet no synthesis is available to date...
December 2018: JBI Database of Systematic Reviews and Implementation Reports
Salaha Zaheer, Vanessa Garofalo, David Rodie, Athina Perivolaris, Jenny Chum, Allison Crawford, Rose Geist, Andrea Levinson, Brian Mitchell, David Oslin, Nadiya Sunderji, Benoit H Mulsant
BACKGROUND: Depression, anxiety, and at-risk drinking are highly prevalent in primary care settings. Many jurisdictions experience geographical barriers to accessing mental health services, necessitating the development and validation of alternative models of care delivery. Existing evidence supports the acceptability and effectiveness of providing mental health care by telephone. OBJECTIVE: This analysis assesses patient's acceptability of computer-aided telephone support delivered by lay providers to primary care patients with depression, anxiety, or at-risk drinking...
December 10, 2018: JMIR Mental Health
Matthew Horrocks, Maria Michail, Aimee Aubeeluck, Nicola Wright, Richard Morriss
BACKGROUND: Suicide is a global public health concern, but it is preventable. Increased contact with primary care before the suicide or attempted suicide raises opportunities for intervention and prevention. However, suicide assessment and management are areas that many general practitioners (GPs) find particularly challenging. Previous research has indicated significant variability in how GPs understand, operationalize, and assess suicide risk, which subsequently has an impact on clinical decision making...
December 7, 2018: JMIR Research Protocols
Danielle M Nash, Amit X Garg, K Scott Brimble, Maureen Markle-Reid
BACKGROUND: Patients should receive follow-up serum creatinine tests after an initial abnormal result to diagnose chronic kidney disease. However, half of the time this fails to occur in primary care. We interviewed primary care providers to better understand their perceptions of enablers and barriers to following this guideline-recommended care. METHODS: We performed a qualitative descriptive study guided by the Theoretical Domains Framework (TDF), a framework for behavioural change...
December 10, 2018: BMC Family Practice
Claire Kendall, Michael Fitzgerald, Rachel Seoyeon Kang, Sabrina T Wong, Alan Katz, Martin Fortin, Emilie Dionne, Kerry Kuluski, Mary Ann O'Brien, Jenny Ploeg, Lois Crowe, Clare Liddy
Plain English summary: Increasingly, health researchers are conducting their research in partnership with non-researchers such as patients and caregivers, advocacy groups, clinicians, and policymakers. The idea behind this partnership is to make research more relevant and appropriate. However, so far there is not much evidence about how this partnership or engagement actually affects research. We conducted an online survey of 12 teams in Canada that have engaged patients and other stakeholders in community based health research, partly as a requirement to obtain funding...
2018: Research Involvement and Engagement
Bente Martinsen, Anne Sofie Mortensen, Annelise Norlyk
The pressure on homecare nursing in the Nordic countries has increased in recent years because of a reorganisation of healthcare systems that has put a focus on very early discharge from hospital as well as demographic changes. This article details an analysis of the findings of 13 published qualitative research reports about Nordic homecare nurses' experiences of their work. Using a process of meta-ethnography, the authors identify five themes within the primary research: home care as a professional practice on foreign ground; home care as a massive time constraint; home care as fair rationing; home care as relationships with relatives as fellow players or opponents; and home care as latent paternalism...
December 2, 2018: British Journal of Community Nursing
Meredith L Greene, Judy Y Tan, Sheri D Weiser, Katerina Christopoulos, Mary Shiels, Allison O'Hollaren, Eva Mureithi, Loren Meissner, Diane Havlir, Monica Gandhi
OBJECTIVE: People living with HIV (PLWH) are living longer and developing comorbidities and aging-related syndromes. New care models are needed to address the combined burden and complexity of HIV and its comorbidities in this group. The goal of this study is to describe qualitative data from patients and providers that informed the development of a comprehensive care model for older PLWH. METHODS: Patient and provider perspectives on the clinical care and service needs of patients living and aging with HIV were explored via surveys and focus groups at a safety net HIV clinic in San Francisco...
2018: PloS One
Davoud Pourmarzi, Lisa Hall, Julie Hepworth, Andrew Smirnov, Tony Rahman, Gerrard FitzGerald
Several community-based models for treating Hepatitis C Virus (HCV) infection have been implemented to improve treatment accessibility and health outcomes. However, there is a lack of knowledge regarding how well these models achieve the desired goals. We conducted a mixed-method systematic review of quantitative and qualitative evidence about clinical effectiveness, cost effectiveness and acceptability of community-based HCV treatment models. Seventeen databases were researched for published and unpublished studies...
December 5, 2018: Journal of Viral Hepatitis
N Jincharadze, N Kazakhashvili, I Sakvarelidze
The purpose of the above work is to study the trends of mothers' health condition according to the implementation of antenatal monitoring of primary healthcare programs in 1996 - 2016 in Georgia. The methodology basis of the research is the qualitative investigation, so called Desk Research: collecting statistical data, description, systematization, comparison, analyses and interpretation. Data about mothers' health indicators were derived from National Center for Disease Control and Social Health and National Service of Georgian Statistics...
October 2018: Georgian Medical News
Claire Bamford, Richard Lee, Emma McLellan, Marie Poole, Karen Harrison-Dening, Julian Hughes, Louise Robinson, Catherine Exley
BACKGROUND: People with advanced dementia often experience suboptimal end of life care (EoLC) with inadequate pain control, increased hospitalisation, and fewer palliative care interventions compared to those with cancer. Existing policy, guidance and recommendations are based largely on expert opinion because of a shortage of high quality, empirical research. Previous studies have tended to consider the views and experience of particular groups. Whilst providing important evidence, they do not take into account the diversity of perspectives of different stakeholders...
December 4, 2018: BMC Geriatrics
Ann-Helen Patomella, Gustav Mickols, Eric Asaba, Gunnar Nilsson, Cecilia Fridén, Anders Kottorp, Bo Christer Bertilson, Kerstin Tham
BACKGROUND: By screening and modifying risk factors, stroke incidence can be reduced. Clinical guidelines states that primary prevention of stroke is a responsibility and task of primary health care, but research shows that this not always the case. The aim of the study was to explore and describe what characterizes GPs' reasoning around risk screening and primary prevention among persons at risk for stroke in primary health care. METHODS: A qualitative design based in a grounded theory approach was chosen in order to investigate this unexplored research area...
December 4, 2018: BMC Family Practice
Alison Avenell, Clare Robertson, Zoë Skea, Elisabet Jacobsen, Dwayne Boyers, David Cooper, Magaly Aceves-Martins, Lise Retat, Cynthia Fraser, Paul Aveyard, Fiona Stewart, Graeme MacLennan, Laura Webber, Emily Corbould, Benshuai Xu, Abbygail Jaccard, Bonnie Boyle, Eilidh Duncan, Michal Shimonovich, Marijn de Bruin
BACKGROUND: Adults with severe obesity [body mass index (BMI) of ≥ 35 kg/m2 ] have an increased risk of comorbidities and psychological, social and economic consequences. OBJECTIVES: Systematically review bariatric surgery, weight-management programmes (WMPs) and orlistat pharmacotherapy for adults with severe obesity, and evaluate the feasibility, acceptability, clinical effectiveness and cost-effectiveness of treatment. DATA SOURCES: Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials and the NHS Economic Evaluation Database were searched (last searched in May 2017)...
November 2018: Health Technology Assessment: HTA
Richard Ig Holt, Daniel Hind, Rebecca Gossage-Worrall, Michael J Bradburn, David Saxon, Paul McCrone, Tiyi A Morris, Angela Etherington, David Shiers, Katharine Barnard, Lizzie Swaby, Charlotte Edwardson, Marian E Carey, Melanie J Davies, Christopher M Dickens, Yvonne Doherty, Paul French, Kathryn E Greenwood, Sridevi Kalidindi, Kamlesh Khunti, Richard Laugharne, John Pendlebury, Shanaya Rathod, Najma Siddiqi, Stephen Wright, Glenn Waller, Fiona Gaughran, Janette Barnett, Alison Northern
BACKGROUND: Obesity is twice as common in people with schizophrenia as in the general population. The National Institute for Health and Care Excellence guidance recommends that people with psychosis or schizophrenia, especially those taking antipsychotics, be offered a healthy eating and physical activity programme by their mental health care provider. There is insufficient evidence to inform how these lifestyle services should be commissioned. OBJECTIVES: To develop a lifestyle intervention for people with first episode psychosis or schizophrenia and to evaluate its clinical effectiveness, cost-effectiveness, delivery and acceptability...
November 2018: Health Technology Assessment: HTA
Liza Yurie Teruya Uchimura, Andréa Tenório Correia da Silva, Ana Luiza d'Ávila Viana
Introduction: Characteristics of primary health care and emergency services may hamper their integration and, therefore, reduce the quality of care and the effectiveness of health systems. This study aims to identify and analyse policy, structural and organizational aspects of healthcare services that may affect the integration between primary health and emergency care networks. Theory and Methods: We conducted a qualitative research study based on grounded theory that included: (1) interviews with 30 health care leaders; and (2) documental analysis of the summaries of Regional Interagency Committee meetings from two regions in the state of Sao Paulo, Brazil...
November 15, 2018: International Journal of Integrated Care
Mette Sagbakken, Ragnhild Storstein Spilker, T Rune Nielsen
BACKGROUND: Along with the ageing of the general population, Europe's migrant populations are also ageing, thus posing new challenges for dementia care services, particularly if the services are to be adjusted to persons with different linguistic and cultural backgrounds. From the perspective of health professionals, this study aims to explore challenges involved in identifying, assessing and diagnosing people with cognitive impairment/dementia who have different linguistic and cultural backgrounds...
November 29, 2018: BMC Health Services Research
Elizabeth A Claydon, Danielle M Davidov, Keith J Zullig, Christa L Lilly, Lesley Cottrell, Stephanie C Zerwas
BACKGROUND: Women with eating disorders are more likely to negatively react to finding out they are pregnant, although this difference in attitudes between women with eating disorders and controls disappears at 18-weeks' gestation. Those with anorexia also are twice as likely to have an unplanned pregnancy and those with bulimia have a 30-fold increased chance compared with healthy controls. Therefore, due to these considerations, pregnancy and the transition to motherhood can be an extremely challenging time for these women both psychologically and physically...
November 29, 2018: BMC Pregnancy and Childbirth
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