family practice in Canada

BACKGROUND: Many studies have reported interventions for women with vasa praevia to improve perinatal outcomes. However, which outcomes are important for women remains unclear. AIM: To explore what outcomes are important for women with lived experience of vasa praevia and why, in order to inform the development of a core outcome set for studies on vasa praevia. METHODS: An international qualitative study was conducted with women and clinicians...

BACKGROUND: Medical Assistance in Dying (MAiD) was legalized in Canada in 2016 and amended in 2021. At the time that this study was conducted, the federal government was considering expanding the eligibility criteria to include patients whose death was not reasonably foreseeable. The purpose of this study was to better understand rural healthcare professionals' experiences with assisted dying set against the backdrop of legislative expansion. METHODS: A qualitative exploratory study was undertaken with general rural practice physicians, nurse practitioners, registered nurses, ethicists, patients, and patient families in rural Southern Alberta, Canada...

This article analyzes how couples made up of two mothers redefine their roles when they break up as well as how legal professionals frame the custodial arrangements of these former same-sex couples. To do so, we focus on the case of Quebec, Canada, where parentage equality between mothers was attained as early as in 2002. We rely on individual semi-structured interviews with mothers' ( N  = 17) and legal professionals' accounts ( N  = 23) as well as on court records regarding physical custody arrangements...

INTRODUCTION: Children and youth with disabilities and special healthcare needs, and their families, have been uniquely affected by the COVID-19 pandemic. However, the voices of children themselves are still not well represented in the existing literature. METHODS: This qualitative descriptive study used a combination of visual methods and interviews to learn about the experiences of Canadian children with disabilities (n=18) and their parents (n=14) during the COVID pandemic and into the post-pandemic period...

OBJECTIVES: Indigenous public health theory and the voices of Canadian Indigenous communities remain under-represented in the literature despite the Canadian Truth and Reconciliation Calls to Action, and the perspectives of Inuit are further under-represented in this literature. The goal of this paper is to explore the perspectives of Iqalungmiut (people of Iqaluit), frontline staff, and decision-makers on the management of the COVID-19 outbreak in Iqaluit in April to June 2021 and to identify lessons learned and contributions to public health policy and practice specific to Inuit populations in Canada...

BACKGROUND AND OBJECTIVES: We compared experiences of patients who reported usually being seen by a resident with those usually seen by a staff physician. METHODS: We analyzed responses to a patient experience survey distributed at 13 family medicine teaching practices affiliated with the University of Toronto between May and June 2020. We analyzed responses to seven questions pertaining to timely access, continuity, and patient-centeredness. We compared responses between two types of usual primary care clinicians and calculated odds ratios before and after adjustment for patient characteristics...

African immigrants are moving to high-income nations such as Canada in greater numbers in search of a better life. These immigrants frequently struggle with several issues, including limited social support, shifts in gender roles/status, cultural conflicts with their children, and language barriers. We used participatory action research (PAR) to gather data about Sub-Saharan African immigrants residing in Alberta, Canada, with a focus on their viewpoints, difficulties, and experiences of parenting children in Canada...

BACKGROUND: Primary care professionals encounter difficulties coordinating the continuum of care between primary care providers and second-line specialists and adhere to practice guidelines pertaining to diabetic foot ulcers management. Family medicine groups are providing primary care services aimed to improve access, interdisciplinary care, coordination and quality of health services, and reduce emergency department visits. Most professionals working in family medicine groups are primary care physicians and registered nurses...

BACKGROUND: Many patients present to their family medicine clinic with more than one health concern, placing an increased demand on family physicians. Research into the average number of concerns per regular family medicine visit is limited. Recognition of the frequency that family physicians address more than one concern per visit and adapting practices accordingly is important for improving patient care. OBJECTIVE: To examine whether family physicians routinely address multiple different patient concerns during a single visit and if this is influenced by patient demographics...

BACKGROUND: With the rapid aging of the global population, the prevalence of mild cognitive impairment (MCI) and dementia is anticipated to surge worldwide. MCI serves as an intermediary stage between normal aging and dementia, necessitating more sensitive and effective screening tools for early identification and intervention. The BrainFx SCREEN is a novel digital tool designed to assess cognitive impairment. This study evaluated its efficacy as a screening tool for MCI in primary care settings, particularly in the context of an aging population and the growing integration of digital health solutions...

BACKGROUND: The practice of continuous palliative sedation until death is the subject of much medical and ethical debate, which is reflected in the inconsistency that persists in the literature regarding the definition and indications of palliative sedation. AIM: This study aims to gain a better understanding of palliative care clinicians' experiences with continuous palliative sedation. DESIGN: We conducted a qualitative study based on focus group discussions...

BACKGROUND: Higher numbers of family physicians (FPs) stopped practicing or retired during the COVID-19 pandemic, worsening the family doctor shortage in Canada. Our study objective was to determine which factors were associated with FPs' plans to retire earlier during the COVID-19 pandemic. METHODS: We administered two cross-sectional online surveys to Ontario FPs asking whether they were "planning to retire earlier" as a result of the pandemic during the first and third COVID-19 pandemic waves (Apr-Jun 2020 and Mar-Jul 2021)...

OBJECTIVE: To explore perceptions of early-career family physicians on the personal, educational, organizational, community, and system factors that had influenced their scope-of-practice decisions and to compare the similarities and differences among these factors across all 13 Canadian jurisdictions. DESIGN: Qualitative descriptive study. SETTING: Canada. PARTICIPANTS: Fifty-nine early-career family physicians who were 2 to 5 years into independent practice...

Being the 'mother' of most clinical specialties, general practice is as old as medicine itself. However, as a recognized academic discipline within medical schools, general practice has a relatively short life span. A decisive step forward was taken in 1956 when the University of Edinburgh established its Department of General Practice, and appointed the world's inaugural professor in the field in 1963. During the 1960s, the pioneering move in Edinburgh was followed by universities in the Netherlands (University of Utrecht), Canada (Western University, Ontario), and Norway (University of Oslo), marking the beginning of global academic recognition for general practice/family medicine...

BACKGROUND: A key role of nurses working in long-term care homes (LTCHs) is to promote the involvement of care partners in end-of-life (EOL) care. However, studies on the involvement of care partners in EOL care in LTCHs have focused on care planning and decision-making. While care partners can participate in other ways, it's unclear how they are currently involved in EOL care by staff. PURPOSE: We aimed to explore the involvement of care partners in the EOL care of an older adult living in a LTCH...

UNLABELLED: Critically ill patients in rural areas at times require an interhospital transfer from their local hospital to an urban tertiary care centre for advanced critical care services not available locally. Family members have described this transfer window as a communication blackout and one of the most stressful times of their relative's critical illness event. OBJECTIVE: To explore what communication process would be most acceptable between family members and transfer team members (consisting of critical care nurses, paramedics, and physicians) during interhospital transfers of critically ill patients...

BACKGROUND: The devastating impact of the COVID-19 pandemic on long-term care (LTC) homes underscores the importance of effective pandemic preparedness and response. This mixed-methods, implementation science study investigated how a virtual-based quality improvement (QI) collaborative approach can improve uptake of pandemic-related promising practices and shared learning across six LTC homes in British Columbia, Canada in 2021 during the COVID-19 pandemic health emergency. METHODS: QI teams consisting of residents, family/informal caregivers, care providers and leadership in LTC homes are supported by QI facilitation and shared learning through virtual communication platforms...

BACKGROUND: Variations in primary care practices may explain some differences in health outcomes during the COVID-19 pandemic. We sought to evaluate the characteristics of primary care practices by the proportion of patients unvaccinated against SARS-CoV-2. METHODS: We conducted a population-based, cross-sectional cohort study using linked administrative data sets in Ontario, Canada. We calculated the percentage of patients unvaccinated against SARS-CoV-2 enrolled with each comprehensive-care family physician, ranked physicians according to the proportion of patients unvaccinated, and identified physicians in the top 10% (v...

Interest in using cannabis products for a medical purpose in children under the age of 18 years is increasing. There are many medical cannabis products available that can include cannabidiol (CBD) or delta-9-tetrahydrocannabinol (THC), or both. Despite many therapeutic claims, there are few rigorous studies to inform the dosing, safety, and efficacy of medical cannabis in paediatric clinical practice. This statement reviews the current evidence and provides recommendations for using medical cannabis in children...

BACKGROUND: Delayed discharge is problematic. It is financially costly and can create barriers to delivering best patient care, by preventing return to usual functioning and delaying admissions of others in need. This systematic review aimed to collate existing evidence on delayed discharge in psychiatric inpatient settings and to develop understanding of factors and outcomes of delays in these services. METHODS: A search of relevant literature published between 2002 and 2022 was conducted on Pubmed, PsycInfo and Embase...