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Journal of the Advanced Practitioner in... Jan 2022
PubMed: 35186400
DOI: 10.6004/jadpro.2022.13.1.9 -
Psychiatria Danubina Sep 2019We wanted to investigate the patient's expectations on the general practitioner's (GP) responsibilities in screening and follow up of disturbed eating behaviour. Then,...
OBJECTIVES
We wanted to investigate the patient's expectations on the general practitioner's (GP) responsibilities in screening and follow up of disturbed eating behaviour. Then, we looked for remediation for some of the mentioned shortcomings in family medicine. We also examined if online aid (offered by the non-profit organisation "Eetexpert.be") is already known and used.
SUBJECTS AND METHODS
Anonymous patient questionnaires were gathered at 4 treatment centres for eating disorders or were collected with help of the Flemish patients organisation for eating disorders (Vlaamse Vereniging Anorexia Nervosa en Boulimia Nervosa). Later, online enquiries were sent to Flemish GPs.
RESULTS
Out of 123 patients responding to the questionnaire, 44 found their GP to have had an important supportive role in their healing process. Active listening and targeted referral were among the most appreciated interventions by those patients. 71 GPs replied the online enquiry. Only 1 out of 5 knew about the free online assistance of "Eetexpert.be". Responders suggested several additional barriers to care.
CONCLUSIONS
In Flanders there is a contrast between expectations and needs of patients on one hand compared to the services provided by GPs on the other. Reassuringly, all responding physicians were open to more education and support regarding eating disorder treatment.
Topics: Attitude of Health Personnel; Belgium; Feeding and Eating Disorders; General Practitioners; Humans; Patient Preference; Patients; Referral and Consultation; Surveys and Questionnaires
PubMed: 31488763
DOI: No ID Found -
Diabetes Therapy : Research, Treatment... Jul 2024Despite insulin being a lifesaving medication, insulin distress, insulin hesitancy, and insulin inertia remain oft-repeated themes in diabetes discourse. The current...
Despite insulin being a lifesaving medication, insulin distress, insulin hesitancy, and insulin inertia remain oft-repeated themes in diabetes discourse. The current model lists three issues: temperament, troublesomeness, and technicality, which contribute to insulin perceptions. Therapeutic patienteducation (TPE), value-added therapy (VAT), and medication counseling are concepts that assist in optimizing insulin perceptions. Insulin icodec is a basal insulin with a half-life of 196 h and a once-weekly or circaseptan frequency of administration. Insulin icodec reduces the frequency of basal insulin administration to one-seventh, which along with the lower requirement of glucose monitoring, reduces the burden of plastic and ancillary supply disposal. Because of its unique frequency of injection, insulin icodec usage requires appropriate counseling and education. This reader-friendly counseling guide helps practitioners offer VAT, as well as TPE while prescribing icodec and other insulins.
PubMed: 38743307
DOI: 10.1007/s13300-024-01600-y -
BMC Pediatrics Jan 2023Practitioner's knowledge and parental perspectives on dental general anaesthesia (GA) have been surveyed separately in the past. But in daily routine both need to...
BACKGROUND
Practitioner's knowledge and parental perspectives on dental general anaesthesia (GA) have been surveyed separately in the past. But in daily routine both need to collaborate for the benefit of the child. The aim of this paper was to compare parental and practitioner's acceptance of GA with special focus on identifying factors which influence their differences in decision making.
METHODS
Questionnaires were conducted among 142 participants in a specialized paediatric dental clinic in Germany from February 2020 to February 2021. 51 German practitioners from private practices and clinics participated. Data collection included: age, gender, experience with GA, fear of GA, risk evaluation and indications for GA.
RESULTS
There were no gender related differences in decision making. Emotional factors are present in parents of younger children. Parents are more likely to express fear and uncertainty regarding GA than dentists. Prior experience with GA significantly decreases fears in GA for parents. Both agree that extent of the treatment and low compliance are a suitable indication for GA. Dentists are more likely to accept GA due to a mental disability than parents. Parents were more likely to accept GA than dentists when multiple extractions were needed (regardless of compliance) or acute pain was present.
CONCLUSIONS
A significant divergence in risk evaluation, acceptance and decision-making could be found in parents compared to dentists. Influencing factors are previous experience, younger age of the child, lack of knowledge and indication for GA.
Topics: Child; Humans; Parents; Anesthesia, General; Surveys and Questionnaires; Emotions; Dental Care
PubMed: 36707845
DOI: 10.1186/s12887-022-03805-1 -
JAMA Network Open Mar 2023Human papillomavirus vaccination coverage rates lie below desired thresholds in Switzerland. Because general practitioners are the main contact for the relatively rare...
IMPORTANCE
Human papillomavirus vaccination coverage rates lie below desired thresholds in Switzerland. Because general practitioners are the main contact for the relatively rare health issues of many Swiss young adults, primary care offers an important opportunity to provide catch-up human papillomavirus vaccination.
OBJECTIVE
To examine the knowledge, experiences, and attitudes of Swiss university students in the context of receiving human papillomavirus vaccination during primary care visits.
DESIGN, SETTING, AND PARTICIPANTS
This self-administered, cross-sectional, web-based survey study was conducted among students of 3 universities and 1 educational institution for health professions in the Swiss Canton of Zurich. Specific questions about human papillomavirus vaccination experience were directed to respondents who had received at least 1 dose administered by a general practitioner. Responses were collected during 12-week intervals between November 11, 2020, and April 7, 2021, and data were analyzed from August 3 to August 30, 2022.
MAIN OUTCOMES AND MEASURES
The primary outcome was whether human papillomavirus vaccination had been administered on the patient's or the general practitioner's initiative.
RESULTS
The responses of 5524 participants (median [IQR] age, 23 [21-25] years; 3878 women [70.2%]) were analyzed. The survey completion rate was 90.9% (5524 of 6076 students who consented to participate). A total of 2029 respondents (1792 women [46.2%] and 237 men [14.6%]) reported having received at least 1 human papillomavirus vaccination dose, of whom 740 (36.5%) had received at least 1 dose administered by a general practitioner. Among these, 190 respondents (25.7%) reported that vaccine administration had occurred on their request rather than on their general practitioner's initiative. Among all respondents, 4778 (86.5%) wanted to obtain more information about human papillomavirus vaccination at a general practitioner's office, and 2569 (55.3%) rated acute consultations in general practice as inappropriate for addressing human papillomavirus vaccination.
CONCLUSIONS AND RELEVANCE
The findings of this survey study of Swiss university students suggest that primary care shows a high potential for increasing human papillomavirus vaccination coverage rates in Switzerland. However, there was room for improvement in the proactivity of general practitioners, especially with men, and in the attitudes of students toward the appropriateness of acute consultations in general practice for addressing human papillomavirus vaccination.
Topics: Male; Young Adult; Humans; Female; Adult; Universities; Human Papillomavirus Viruses; Papillomavirus Infections; Cross-Sectional Studies; Switzerland; Uterine Cervical Neoplasms; Papillomavirus Vaccines; Health Knowledge, Attitudes, Practice; Vaccination; Students; Primary Health Care
PubMed: 36943263
DOI: 10.1001/jamanetworkopen.2023.3949 -
BMC Medical Ethics Mar 2020This paper considers ethical dilemmas arising where a patient asks their General Practitioner for advice and their personal opinion regarding whether or not to have an...
BACKGROUND
This paper considers ethical dilemmas arising where a patient asks their General Practitioner for advice and their personal opinion regarding whether or not to have an abortion. Patients often seek their General Practitioner's advice regarding treatments and procedures, which may occasionally lead to the General Practitioner facing a difficult dilemma of whether to share their personal opinion with their patient. As General Practitioners are more accessible as the first point of contact for patients and often have a closer relationship with them, they may be particularly exposed to such situations. Additionally, the significance of abortion as a sensitive topic and the fact the General Practitioner may have their own personal viewpoint on its morality may make it particularly difficult for them to know how to respond to such a request.
MAIN TEXT
This paper explores the difficulties arising in such a situation and considers whether it could ever be ethically justifiable for General Practitioners to express their opinions on such a matter. We consider the duties of a doctor, and highlight the need for clearer guidance for healthcare professionals on managing tensions in their professional boundaries between their personal moral views and their professional responsibilities. A range of ethical viewpoints are considered to explore how a doctor might ap, in particular the principle of autonomy, virtue ethics, and consequentialism.
CONCLUSIONS
This article recognises that a General Practitioner in a situation such as this faces many ethical challenges. We propose that offering their opinion to the patient where specifically requested may be morally justifiable. A virtue ethics approach in particular requires that the General Practitioner applies practical wisdom to make this decision, and where they do disclose their opinion ensure this is done so in such a manner that it does not harm the patient and promotes flourishing. We encourage GPs and other healthcare professionals to consider their own moral perspectives on sensitive issues such as abortion, and reflect on how their moral viewpoints have the potential to influence their practice. In doing so, we hope clinicians can be better should they be faced with a situation such as this.
Topics: Abortion, Induced; Ethical Theory; Female; General Practitioners; Humans; Morals; Pregnancy; Virtues
PubMed: 32164682
DOI: 10.1186/s12910-020-0464-9 -
Acta Ortopedica Brasileira 2022Evaluate the scapular movement of Crossfit® practitioners and identify whether they present an increased incidence of scapular dyskinesis (SD) compared to...
OBJECTIVE
Evaluate the scapular movement of Crossfit® practitioners and identify whether they present an increased incidence of scapular dyskinesis (SD) compared to non-practitioners.
METHOD
A transversal study was evaluated quantitatively and dynamically, using retro-reflective spherical markers, the scapular movements of ten volunteers composing the control group, and 11 Crossfit® practitioners. The control group's results were used as a normality parameter and compared to those of the Crossfit® practitioner's group.
RESULTS
It was identified that the superior scapular rotation in the ascending phase is inferior in the group of Crossfit® practitioners (p = 0.02).
CONCLUSION
The regular practice of Crossfit® causes scapular dyskinesis (SD), with alteration in the scapular superior rotation movement. .
PubMed: 36506859
DOI: 10.1590/1413-785220223002e251074 -
Emergency Nurse : the Journal of the... Mar 2022Breaking the news of potentially serious and new diagnoses to patients in the emergency department (ED) is a common but challenging aspect of the autonomous...
Breaking the news of potentially serious and new diagnoses to patients in the emergency department (ED) is a common but challenging aspect of the autonomous practitioner's role. It is a complex process, requiring expertise and skill. If the news is delivered appropriately there is evidence to suggest a beneficial effect on the patient's ability to cope, yet there is little formal training available and literature focused on the ED setting is limited. This article aims to guide and prepare autonomous practitioners in the ED to break bad news to patients, including during remote consultations introduced due to the coronavirus disease 2019 pandemic. It identifies the importance of preparation; different approaches to breaking bad news, namely the six-stage SPIKES framework and a case study exploring its application in practice; the range of potential patient reactions and how these can be managed, including the provision of support; and how to involve and communicate with other members of the multidisciplinary team. Suggestions for further training are outlined.
Topics: COVID-19; Communication; Emergency Service, Hospital; Humans; Physician-Patient Relations; Truth Disclosure
PubMed: 34643342
DOI: 10.7748/en.2021.e2108 -
The South African Journal of... 2023One in three women in South Africa suffer from urinary incontinence. Effective management is influenced by patients help-seeking behaviour and services offered by...
BACKGROUND
One in three women in South Africa suffer from urinary incontinence. Effective management is influenced by patients help-seeking behaviour and services offered by healthcare professionals within the healthcare system. Current practice towards urinary incontinence management in South Africa is unknown.
OBJECTIVES
Our study aimed to describe and compare urinary incontinence practice and knowledge of nurses and physicians (practitioners) working in primary healthcare settings, measured against the NICE 2013 guideline and explore attitudes and beliefs towards urinary incontinence management.
METHOD
Cross-sectional study using a self-designed online questionnaire. All primary healthcare practitioners in the Western Cape were eligible for the study. Stratified random and snowball sampling was used. Data was analysed in consultation with a statistician using SPSS.
RESULTS
Fifty-six completed questionnaires were analysed. Practitioners had an overall knowledge score of 66.7% and practice score of 68.9% compared to NICE 2013 guidelines. A lack of knowledge regarding urinary incontinence screening, following up on patients and conducting bladder diaries were noted. Pelvic floor muscle training and bladder training education was recognised as initial management but only 14.8% of practitioners referred patients to physiotherapy. Half of the sample reported being uncomfortable with urinary incontinence, although the majority wanted to learn more about urinary incontinence.
CONCLUSION
The knowledge and practices of practitioners working at a primary healthcare level in the Western Cape are not congruent with NICE 2013 guidelines.
CLINICAL IMPLICATIONS
Data can be used to inform intervention planning to address urinary incontinence management at a primary healthcare level in the Western Cape.
PubMed: 37415853
DOI: 10.4102/sajp.v79i1.1860 -
Hospital Topics May 2023The increase in the number of people developing dementia, the growing number of geriatric patients suffering and dying from serious chronic diseases, and the rising...
The increase in the number of people developing dementia, the growing number of geriatric patients suffering and dying from serious chronic diseases, and the rising costs of health care as a result of an aging population have centered attention on advance care planning. Advance care planning is the recurrent conversation between competent patients, their families, and the health care provider about end of life care. Although vital, advance care planning discussions between providers and patients are not occurring regularly, and completion rates of advance directives are low. Barriers to health care providers discussing advance directives include lack of time, knowledge, and confidence. The purpose of this project was to evaluate the effectiveness of an educational program regarding advance directives on nurse practitioner's competency and confidence to start advance care planning discussions. Wilcoxon signed rank test indicated that post-education, confidence improved significantly for all items (average rank of 4.5 vs average rank of 10.65). The study showed that most of the nurse practitioners were knowledgeable about advance directives and the educational program increased their level of confidence about initiating advance directive discussions.
PubMed: 37129933
DOI: 10.1080/00185868.2023.2201693