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Qualitative research primary care

Katriona Brooksbank, Joanne O'Donnell, Vicky Corbett, Sarah Shield, Rachel Ainsworth, Ross Shearer, Susan Montgomery, Andrew Gallagher, Hannah Duncan, Lorna Hamilton, Valerie Laszlo, Rhonda Noone, Anna Baxendale, David Blane, Jennifer Logue
BACKGROUND: Guidelines for the management of type 2 diabetes universally recommend that adults with type 2 diabetes and obesity be offered individualized interventions to encourage weight loss. Yet despite the existing recommendations, provision of weight management services is currently patchy around the United Kingdom and where services are available, high attrition rates are often reported. In addition, individuals often fail to take up services, that is, after discussion with a general practitioner or practice nurse, individuals are referred to the service but do not attend for an appointment...
February 15, 2019: JMIR Research Protocols
Christopher R McParland, Mark A Cooper, Bridget Johnston
BACKGROUND: Differential Diagnosis Decision Support Systems (DDDSS) and other forms of clinical decision support systems may have a role in supporting clinicians and the public in making decisions about differential diagnosis and accessing health care services. The aim of this qualitative, focus group study was to explore the needs of out-of-hours and primary care clinicians, and members of the public in relation to DDDSS. METHODS: Twenty-nine participants (comprising 13 advanced nurse practitioners [ANPs], 7 general practitioners [GPs], 2 allied health professional advanced practitioners [AAPs], and 7 members of the public) took part in 1 of 6 focus groups...
January 2019: Journal of Primary Care & Community Health
Dee Mangin, Jenna Parascandalo, Olga Khudoyarova, Gina Agarwal, Verdah Bismah, Sherrie Orr
OBJECTIVE: There is increasing awareness of the burden of medical care experienced by those with multimorbidity. There is also increasing interest and activity in engaging patients with chronic disease in technology-based health-related activities ('eHealth') in family practice. Little is known about patients' access to, and interest in eHealth, in particular those with a higher burden of care associated with multimorbidity. We examined access and attitudes towards eHealth among patients attending family medicine clinics with a focus on older adults and those with polypharmacy as a marker for multimorbidity...
February 12, 2019: BMJ Open
Stephen Barclay, Emily Moran, Sue Boase, Margaret Johnson, Roberta Lovick, Jonathan Graffy, Patrick L White, Brenda Deboys, Katy Harrison, Brooke Swash
INTRODUCTION: Primary care has a central role in palliative and end of life care: 45.6% of deaths in England and Wales occur under the care of primary care teams at home or in care homes. The Community Care Pathways at the End of Life (CAPE) study investigated primary care provided for patients in the final 6 months of life. This paper highlights the opportunities and challenges associated with primary palliative care research in the UK, describing the methodological, ethical, logistical and gatekeeping challenges encountered in the CAPE study and how these were addressed...
February 12, 2019: BMJ Supportive & Palliative Care
Cara Kang, Louise Tomkow, Rebecca Farrington
BACKGROUND: Asylum seekers and refugees (ASR) face difficulty accessing health care in host countries. In 2017, NHS charges for overseas visitors were extended to include some community care for refused asylum seekers. There is growing concern that this will increase access difficulties, but no recent research has documented the lived experiences of ASR accessing UK primary health care. AIM: To examine ASR experiences accessing primary health care in the UK in 2018...
February 11, 2019: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Ali M K Hindi, Ellen I Schafheutle, Sally Jacobs
BACKGROUND: This study aimed to use marketing theory to examine the views of patients, pharmacists and general practitioners (GPs) on how community pharmacies are currently used and to identify how community pharmacy services may be better integrated within the primary care pathway for people with long-term conditions (LTCs). METHODS: A qualitative research design was used. Two focus groups were conducted with respiratory patients (n = 6, 5) and two with type 2 diabetes patients (both n = 5)...
February 8, 2019: BMC Family Practice
Mary Ann Meeker, Jacqueline M Mcginley, Mary Ann Jezewski
AIM: To describe and explain the process of transition from cure-focused to comfort-focused healthcare as perceived and reported by patients, family members and healthcare providers. BACKGROUND: Moving into the last phase of life due to advanced illness constitutes a developmental transition with increased vulnerability for patient and family. DESIGN: Qualitative metasynthesis. DATA SOURCES: Medline, CINAHL and PsycInfo databases, searched from inception through March 2016...
February 7, 2019: Journal of Advanced Nursing
J M Valderas, J Gangannagaripalli, E Nolte, C Boyd, M Roland, A Sarria-Santamera, E Jones, M Rijken
Multimorbidity, the simultaneous presence of multiple health conditions in an individual, is an increasingly common phenomenon globally. The systematic assessment of the quality of care delivered to people with multimorbidity will be key to informing the organisation of services for meeting their complex needs. Yet, current assessments tend to focus on single conditions and do not capture the complex processes that are required for providing care for people with multimorbidity. We conducted a scoping review on quality of care and multimorbidity in selected databases in June 2018 and identified 87 documents as eligible for review, predominantly original research and reviews from North America, and Europe, and Australasia and mostly frequently related to primary care settings...
February 5, 2019: Journal of Internal Medicine
Sophie Opsomer, Sofie Joossens, Claudia De Wit, Emelien Lauwerier, Peter Pype
PURPOSE: Nutrition-related problems are common in patients with advanced cancer. They can disrupt daily life and routines. This study aimed to explore how couples cope with this source of distress. METHODS: A qualitative descriptive study design was adopted using semi-structured interviews. Seven couples, each consisting of an advanced cancer patient and his or her co-habiting life partner, participated. The Qualitative Analysis Guide of Leuven (QUAGOL) was used as a guide to facilitate the analysis process...
February 2019: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Stephen Parker, Gordon Hopkins, Dan Siskind, Meredith Harris, Gemma McKeon, Frances Dark, Harvey Whiteford
BACKGROUND: Clinically operated community-based residential rehabilitation units (Community Rehabilitation Units) are resource intensive services supporting a small proportion of the people with severe and persisting mental illness who experience difficulties living in the community. Most consumers who engage with these services will be diagnosed with schizophrenia or a related disorder. This review seeks to: generate a typology of service models, describe the characteristics of the consumers accessing these services, and synthesise available evidence about consumers' service experiences and outcomes...
February 4, 2019: BMC Psychiatry
Randall C Gale, Justina Wu, Taryn Erhardt, Mark Bounthavong, Caitlin M Reardon, Laura J Damschroder, Amanda M Midboe
BACKGROUND: It is challenging to conduct and quickly disseminate findings from in-depth qualitative analyses, which can impede timely implementation of interventions because of its time-consuming methods. To better understand tradeoffs between the need for actionable results and scientific rigor, we present our method for conducting a framework-guided rapid analysis (RA) and a comparison of these findings to an in-depth analysis of interview transcripts. METHODS: Set within the context of an evaluation of a successful academic detailing (AD) program for opioid prescribing in the Veterans Health Administration, we developed interview guides informed by the Consolidated Framework for Implementation Research (CFIR) and interviewed 10 academic detailers (clinical pharmacists) and 20 primary care providers to elicit detail about successful features of the program...
February 1, 2019: Implementation Science: IS
Mark D Williams, Gladys B Asiedu, Dawn Finnie, Claire Neely, Jason Egginton, Lila J Finney Rutten, Robert M Jacobson
BACKGROUND: Care coordination has been a common tool for practices seeking to manage complex patients, yet there remains confusion about the most effective and sustainable model. Research exists on opinions of providers of care coordination but there is limited information on perspectives of those in the insurance industry about key elements. We sought to gather opinions from primary care providers and administrators in Minnesota who were involved in a CMS (Center for Medicare and Medicaid Services) transformational grant implementing COMPASS (Care Of Mental, Physical And Substance-use Syndromes), an evidence-based model of care coordination for depressed patients comorbid with diabetes and/or cardiovascular disease...
February 1, 2019: BMC Health Services Research
Pascal Djiadeu, Joseph Nguemo, Chantal Mukandoli, Apondi J Odhiambo, David Lightfoot, Lawrence Mbuagbaw, LaRon E Nelson
INTRODUCTION: Language is a social determinant of health. Addressing social determinants of health is paramount to successful progression along the HIV-care continuum. Canada is a bilingual country with French and English as official languages. There are few studies to date that have focused on the impact of being a French-speaking linguistic minority on the HIV-care continuum. The primary objective of this scoping, systematic review of literature is to evaluate existing gaps in access to HIV- care among French-speaking people living with HIV in Canada...
January 30, 2019: BMJ Open
Angela C Martin, Peter O'Meara
INTRODUCTION: Community paramedicine is one emerging model filling gaps in rural healthcare delivery. It can expand the reach of primary care and public health service provision in underserviced rural communities through proactive engagement of paramedics in preventative care and chronic disease management. This study addressed key research priorities identified at the National Agenda for Community Paramedicine Research conference in Atlanta, USA in 2012. The motivations, job satisfaction and challenges from the perspectives of community paramedics and their managers pioneering two independent programs in rural North America were identified...
February 2019: Rural and Remote Health
Susan Dierickx, Julie Balen, Chia Longman, Ladan Rahbari, Ed Clarke, Bintou Jarju, Gily Coene
INTRODUCTION: In many Sub-Saharan African countries, women with infertility search relentlessly for treatment. Guided by the Partners for Applied Social Sciences model for health seeking behaviour and access to care research, this study aims to understand the health seeking behaviour of women with infertility in the West Coast region of The Gambia and the influence of aetiological beliefs on health seeking paths. METHODOLOGY: A qualitative approach was used to generate both primary and secondary data for thematic analysis...
2019: PloS One
Anubha Agarwal, Ehete Bahiru, Sang Gune Kyle Yoo, Mark A Berendsen, Sivadasanpillai Harikrishnan, Adrian F Hernandez, Dorairaj Prabhakaran, Mark D Huffman
OBJECTIVE: To estimate the direction and magnitude of effect and quality of evidence for hospital-based heart failure (HF) quality improvement interventions on process of care measures and clinical outcomes among patients with acute HF. REVIEW METHODS: We performed a structured search to identify relevant randomised trials evaluating the effect of in-hospital quality improvement interventions for patients hospitalised with HF through February 2017. Studies were independently reviewed in duplicate for key characteristics, outcomes were summarised and a qualitative synthesis was performed due to substantial heterogeneity...
January 30, 2019: Heart: Official Journal of the British Cardiac Society
Marco Warth, Friederike Koehler, Martin Weber, Hubert J Bardenheuer, Beate Ditzen, Jens Kessler
BACKGROUND: Although patients in palliative care commonly report high emotional and spiritual needs, effective psychosocial treatments based on high quality studies are rare. First research provides evidence for benefits of psychosocial interventions in advanced cancer care. To specifically address end-of-life care requirements, life review techniques and creative-arts based therapies offer a promising potential. Therefore, the present study protocol presents a randomized controlled trial on the effectiveness of a newly developed music therapy technique that is based on a biographically meaningful song ("Song of Life"; SOL)...
January 30, 2019: BMC Palliative Care
Louise Moeldrup Nielsen, Lisa Gregersen Østergaard, Thomas Maribo, Hans Kirkegaard, Kirsten Schultz Petersen
INTRODUCTION: Elderly patients often receive care and rehabilitation from different providers across healthcare settings. Collaboration between hospital and primary care providers is therefore essential to ensure that the discharge and transition of rehabilitation is coherent. However, research that focuses on elderly patients' experiences of the discharge, and their everyday lives after, has attracted little attention. PURPOSE: This study explores elderly patients' experiences of being discharged and returning to everyday lives after discharge from a short-stay unit at the Emergency Department...
2019: International Journal of Qualitative Studies on Health and Well-being
Debbie Cavers, Liset Habets, Sarah Cunningham-Burley, Eila Watson, Elspeth Banks, Christine Campbell
PURPOSE: To identify the qualitative evidence on the experience of cancer and comorbid illness from the perspective of patients, carers and health care professionals to identify psycho-social support needs, experience of health care, and to highlight areas where more research is needed. METHODS: A qualitative systematic review following PRISMA guidance. Relevant research databases were searched using an exhaustive list of search terms. Two reviewers independently screened titles and abstracts and discussed variations...
January 26, 2019: Journal of Cancer Survivorship: Research and Practice
Regina Poss-Doering, Aline Kunz, Sabrina Pohlmann, Helene Hofmann, Marion Kiel, Eva C Winkler, Dominik Ose, Joachim Szecsenyi
BACKGROUND: Personal electronic health records (PHR) are considered instrumental in improving health care quality and efficiency, enhancing communication between all parties involved and strengthening the patient's role. Technical architectures, data privacy, and applicability issues have been discussed for many years. Nevertheless, nationwide implementation of a PHR is still pending in Germany despite legal regulations provided by the eHealth Act passed in 2015. Within the information technology for patient-oriented care project funded by the Federal Ministry of Education and Research (2012-2017), a Web-based personal electronic health record prototype (PEPA) was developed enabling patient-controlled information exchange across different care settings...
August 3, 2018: JMIR formative research
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