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Qualitative research primary care

Christina Malatzky, Kristen Glenister
As many patients' sole point of contact with the health care system, primary health care physicians (general practitioners [GPs] in Australia) are often positioned as key players in responding to rates of overweight and obesity in dominant public discourse. However, research from Western industrialised countries suggests that GPs may not be prepared for, or confident in, having conversations about overweight and obesity with patients. Little attention has been given to this topic in Australia, particularly in the context of rural health...
October 11, 2018: Health & Social Care in the Community
Peter Damiano, Julie Reynolds, Jill Boylston Herndon, Susan McKernan, Raymond Kuthy
OBJECTIVE: To develop the first standardized definition of the patient-centered dental home (PCDH). DATA SOURCES/STUDY SETTING: Primary data from a 55-member national expert panel and public comments. STUDY DESIGN: We used a modified Delphi process with three rounds of surveys to collect panelists' ratings of PCDH characteristics and open-ended comments. The process was supplemented with a 1-month public comment period. DATA COLLECTION/EXTRACTION METHODS: We calculated median ratings, analyzed consensus using the interpercentile range adjusted for symmetry, and qualitatively evaluated comments...
October 10, 2018: Health Services Research
Molly A Martin, Helen H Lee, Jazmin Landa, Mark Minier, David Avenetti, Anna Sandoval
Background: The COordinated Oral health Promotion (CO-OP) Chicago trial will test the efficacy of a community health worker (CHW) intervention to improve oral health behaviors for children at high risk for early childhood caries. Before implementing the cluster-randomized controlled trial, we conducted a formative assessment to determine the final design. We used qualitative methods to assess the feasibility and acceptability of the proposed recruitment, data collection, and intervention plan...
2018: Pilot and Feasibility Studies
Nicholas Rubashkin, Ruby Warnock, Nadia Diamond-Smith
INTRODUCTION: We conducted a systematic review to summarize the global evidence on person-centered care (PCC) interventions in delivery facilities in order to: (1) map the PCC objectives of past interventions (2) to explore the impact of PCC objectives on PCC and clinical outcomes. METHODS: We developed a search strategy based on a current definition of PCC. We searched for English-language, peer-reviewed and original research articles in multiple databases from 1990 to 2016 and conducted hand searches of the Cochrane library and gray literature...
October 10, 2018: Reproductive Health
Reem Kayyali, Shereen Nabhani Gebara, Iman Hesso, Gill Funnell, Minal Naik, Thuy Mason, Mohammed Ahsan Uddin, Noor Al-Yaseri, Umar Khayyam, Teebah Al-Haddad, Roshan Siva, John Chang
BACKGROUND: Medication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision making (SDM), and the availability of rapid access clinics in primary care. This study aimed to investigate the experience of patients with LTCs about SDM including medication counselling and their awareness of community pharmacy medication review services...
October 10, 2018: BMC Health Services Research
Carolina Kahl, Kamylla Santos da Cunha, Gabriela Marcellino de Melo Lanzoni, Giovana Dorneles Callegaro Higashi, Alacoque Lorenzini Erdmann, Maria Aparecida Baggio
OBJECTIVE: to understand how repercussions of the referral and counter-referral of patients with indication/submitted to Coronary Artery Bypass Graft Surgery in the context of Primary Health Care. METHOD: qualitative research with a theoretical-methodological contribution anchored in the Grounded Theory. Theoretical sampling was performed with 41 participants, divided into three sample groups (patients, health professionals and managers) in the Metropolitan Region and Western Region of Santa Catarina State...
September 2018: Revista Brasileira de Enfermagem
Darren David Chadwick, Tracey Platt
Background: Humor, both producing and appreciating, underpins positive social interactions. It acts as a facilitator of communication. There are clear links to wellbeing that go along with this form of social engagement. However, humor appears to be a seldom studied, cross-disciplinary area of investigation when applied to people with an intellectual disability. This review collates the current state of knowledge regarding the role of humor behavior in the social interactions of people with intellectual disabilities and their carers...
2018: Frontiers in Psychology
Elisa Longinetti, Amanda Regodón Wallin, Kristin Samuelsson, Rayomand Press, Anne Zachau, Lars-Olof Ronnevi, Marie Kierkegaard, Peter M Andersen, Jan Hillert, Fang Fang, Caroline Ingre
OBJECTIVE: We set up the Swedish Motor Neuron Disease (MND) Quality Registry to assure early diagnosis and high-quality health care for all MND patients (mainly amyotrophic lateral sclerosis, ALS), and to create a research base by prospectively following the entire MND population in Sweden. METHODS: Since 2015, the MND Quality Registry continuously collects information about a wide range of clinical measures, biological samples, and quality of life outcomes from all MND patients recruited at the time of MND diagnosis in Sweden and followed at each clinic visit approximately every 12 weeks...
October 9, 2018: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Kranti S Vora, Shahin L Saiyed, Dileep V Mavalankar
Background: Government of Gujarat introduced a public-private partnership scheme called the Chiranjeevi Yojana (CY) in 2005, to improve access to delivery care for poor women. Till date, more than 1 million deliveries have been conducted under CY. Although CY has been evaluated, this is the only study using primary data to evaluate the quality of care. Objective: The objective of this study was to (i) determine the quality of free delivery care and (ii) examine the differences in the quality of care between public sector facilities and accredited private sector facilities...
July 2018: Indian Journal of Community Medicine
Katrina M Turner, John Percival, David Kessler, Jenny L Donovan
Qualitative researchers are increasingly reanalyzing and synthesizing data sets from different studies, and this method has now been used across trials to inform trial methodology and delivery. Despite this work, however, limited guidance exists about how this method should be employed. This article details an example in which interview data collected during three primary care depression trials were brought together to explore trial participants' study and treatment journeys. It details the process involved and the decisions made...
October 8, 2018: Qualitative Health Research
Nicola S Pocock, Long Hoang Nguyen, Don Eliseo Lucero-Prisno Iii, Cathy Zimmerman, Siân Oram
Background: Little is known about the health of GMS commercial fishers and seafarers, many of whom are migrants and some trafficked. This systematic review summarizes evidence on occupational, physical, sexual and mental health and violence among GMS commercial fishers/seafarers. Methods: We searched 5 electronic databases and purposively searched grey literature. Quantitative or qualitative studies reporting prevalence or risk of relevant outcomes were included...
2018: Global Health Research and Policy
Katherine Morton, Sarah Voss, Joy Adamson, Helen Baxter, Karen Bloor, Janet Brandling, Sean Cowlishaw, Tim Doran, Andrew Gibson, Nils Gutacker, Dan Liu, Sarah Purdy, Paul Roy, Christopher Salisbury, Arabella Scantlebury, Anu Vaittinen, Rose Watson, Jonathan Richard Benger
INTRODUCTION: Pressure continues to grow on emergency departments in the UK and throughout the world, with declining performance and adverse effects on patient outcome, safety and experience. One proposed solution is to locate general practitioners to work in or alongside the emergency department (GPED). Several GPED models have been introduced, however, evidence of effectiveness is weak. This study aims to evaluate the impact of GPED on patient care, the primary care and acute hospital team and the wider urgent care system...
October 3, 2018: BMJ Open
James P Sheppard, Jenni Burt, Mark Lown, Eleanor Temple, John Benson, Gary A Ford, Carl Heneghan, F D Richard Hobbs, Sue Jowett, Paul Little, Jonathan Mant, Jill Mollison, Alecia Nickless, Emma Ogburn, Rupert Payne, Marney Williams, Ly-Mee Yu, Richard J McManus
INTRODUCTION: Recent evidence suggests that larger blood pressure reductions and multiple antihypertensive drugs may be harmful in older people, particularly frail individuals with polypharmacy and multimorbidity. However, there is a lack of evidence to support deprescribing of antihypertensives, which limits the practice of medication reduction in routine clinical care. The aim of this trial is to examine whether antihypertensive medication reduction is possible in older patients without significant changes in blood pressure control at follow-up...
October 4, 2018: BMJ Open
Stephen Maluka, Dereck Chitama, Esther Dungumaro, Crecensia Masawe, Krishna Rao, Zubin Shroff
BACKGROUND: Governments increasingly recognize the need to engage non-state providers (NSPs) in health systems in order to move successfully towards Universal Health Coverage (UHC). One common approach to engaging NSPs is to contract-out the delivery of primary health care services. Research on contracting arrangements has typically focused on their impact on health service delivery; less is known about the actual processes underlying the development and implementation of interventions and the contextual factors that influence these...
October 5, 2018: International Journal for Equity in Health
Laura O Wray, Mona J Ritchie, David W Oslin, Gregory P Beehler
BACKGROUND: Mental health care lags behind other forms of medical care in its reliance on subjective clinician assessment. Although routine use of standardized patient-reported outcome measures, measurement-based care (MBC), can improve patient outcomes and engagement, clinician efficiency, and, collaboration across care team members, full implementation of this complex practice change can be challenging. This study seeks to understand whether and how an intensive facilitation strategy can be effective in supporting the implementation of MBC...
October 3, 2018: BMC Health Services Research
Marta Qualizza, Valentina Bressan, Antonio Rizzuto, Simone Stevanin, Giampiera Bulfone, Lucia Cadorin, Luca Ghirotto
The aim was to conduct a systematic review and a meta-synthesis of primary qualitative studies exploring experiences of head and neck cancer patients (HNC) undergoing radio and/or chemotherapy, in order to provide a better understanding of this phenomenon and supply new directions for care and clinical practice. Six databases were systematically searched, and 13 studies were included. The meta-synthesis methodology was adopted to conceptualise the way in which patients lived their cancer journey and the impact of treatments on their daily life...
October 4, 2018: European Journal of Cancer Care
Maryam Sadat Hashemi, Alireza Irajpour, Parvaneh Abazari
Introduction: Hemodialysis is currently the most common alternative treatment in patients with renal failure in the world. Today, despite the support provided by healthcare providers for these patients, they still express dissatisfaction with the quality of care and find it inadequate. However, there have been few studies investigating the needs of in-patients receiving hemodialysis care in Iran. Thus this research was undertaken to study the needs and demands of such patients. Methods: This qualitative research was conducted from June to November 2016 to investigate the view points of the patients, their families and health care providers about improving quality of care in dialysis unit...
September 2018: Journal of Caring Sciences
Bonnie M Vest, Jessica A Kulak, Gregory G Homish
Background: Non-VA health care providers in the USA have been called upon to screen patients for veteran status as a means to better identify military-related health sequelae. Despite this recognized need, many service members are still not being asked about veteran status. Objective: The purpose of this research was to qualitatively assess, from non-VA primary care providers' point-of-view, barriers to providing care to veterans, the training providers perceive as most useful and the tools and translational processes they think would be most valuable in increasing military cultural competency...
October 3, 2018: Family Practice
Sandipan Bhattacharjee, Anita C Murcko, Miranda K Fair, Terri L Warholak
BACKGROUND: The prior authorization (PA) process for medications used by community providers requires modernization. Therefore, a deeper understanding of current state of PA from the community provider perspective is imperative to inform and modernize this managed care tool. OBJECTIVES: Objectives of this study were to identify, analyze and categorize the issues associated with the medication PA process from provider practice perspective. METHODS: A prospective non-experimental, cross sectional, observational study was performed using semi-structured interviews and direct observation at a convenience sample of eight primary care and medicine subspecialty group practices in Tucson, Arizona, USA...
September 26, 2018: Research in Social & Administrative Pharmacy: RSAP
Tom van Gils, Talha G Senler, Henriëtte E van der Horst, Chris J J Mulder, Gerd Bouma, Henk de Vries
BACKGROUND: General practitioners (GPs) play a crucial role in diagnosing coeliac disease (CD). However, data on GP management of (suspected) CD patients is sparse. OBJECTIVES: To provide insights into the daily practice of diagnosis, treatment, and follow-up of CD by GPs. METHODS: A qualitative study using topic list-based semi-structured in-depth interviews with Dutch GPs with more than five years' experience carried out between January and March 2017...
December 2018: European Journal of General Practice
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