-
BMC Primary Care Jul 2022The potential for data collected in general practice to be linked and used to address health system challenges of maintaining quality care, accessibility and safety,...
OBJECTIVE
The potential for data collected in general practice to be linked and used to address health system challenges of maintaining quality care, accessibility and safety, including pandemic support, has led to an increased interest in public acceptability of data sharing, however practitioners have rarely been asked to share their opinions on the topic. This paper attempts to gain an understanding of general practitioner's perceptions on sharing routinely collected data for the purposes of healthcare planning and research. It also compares findings with data sharing perceptions in an international context. MATERIALS AND METHODS: A mixed methods approach combining an initial online survey followed by face-to-face interviews (before and during COVID-19), designed to identify the barriers and facilitators to sharing data, were conducted on a cross sectional convenience sample of general practitioners across Western Australia (WA).
RESULTS
Eighty online surveys and ten face-to-face interviews with general practitioners were conducted from November 2020 - May 2021. Although respondents overwhelmingly identified the importance of population health research, their willingness to participate in data sharing programs was determined by a perception of trust associated with the organisation collecting and analysing shared data; a clearly defined purpose and process of collected data; including a governance structure providing confidence in the data sharing initiative simultaneously enabling a process of data sovereignty and autonomy.
DISCUSSION
Results indicate strong agreement around the importance of sharing patient's medical data for population and health research and planning. Concerns pertaining to lack of trust, governance and secondary use of data continue to be a setback to data sharing with implications for primary care business models being raised.
CONCLUSION
To further increase general practitioner's confidence in sharing their clinical data, efforts should be directed towards implementing a robust data governance structure with an emphasis on transparency and representative stakeholder inclusion as well as identifying the role of government and government funded organisations, as well as building trust with the entities collecting and analysing the data.
Topics: Australia; COVID-19; Cross-Sectional Studies; General Practitioners; Humans; Information Dissemination
PubMed: 35773626
DOI: 10.1186/s12875-022-01759-y -
London Journal of Primary Care 2016Outlining an educational initiative for those who work in the National Health Service (NHS), this article argues that literary reflection has been too easily seen as a...
Outlining an educational initiative for those who work in the National Health Service (NHS), this article argues that literary reflection has been too easily seen as a simple tool which may improve the practitioner's empathic skills and benefit patient-centred care. Using anecdotal feedback, the author reports ways in which a series of literary workshops held for professionals in the NHS have added to practitioners' general sense of well-being. Feedback shows that participants perceived literature in the workshop setting as being more than an enabler of 'empathy'. They reported that reflecting on literature in a group setting is an opportunity to think about their own autonomy, pleasure and creativity. The article concludes with a reflection about priorities in regulatory culture, its relationship to burnout, and ideas for future work.
PubMed: 28250831
DOI: 10.1080/17571472.2016.1163950 -
Journal of Autism and Developmental... Jan 2024Lockdown drill practice is part of the "new normal" in schools for young children with autism spectrum disorder (ASD) and educational practitioners in K-12 schools...
Lockdown drill practice is part of the "new normal" in schools for young children with autism spectrum disorder (ASD) and educational practitioners in K-12 schools across the United States. These drills place a tremendous amount of responsibility on practitioners (i.e., teachers, paraprofessionals) that is beyond the scope of their training and typical requirements of their position in the classroom. Lockdown drills also require young children with ASD to engage in actions that are inherently hard for most young children but could be especially difficult for children with ASD who need individualized support to develop the executive function and self-regulation skills to participate in drills successfully. This study investigates practitioners' training experiences and perceptions of perceived confidence in teaching young children with ASD lockdown drills. Practitioner's self-efficacy was measured through survey analysis and their perceptions and experiences were investigated through individual interviews. Results indicated low rates of confidence to teach lockdown drills to young children with ASD and higher rates of confidence were correlated with more drill practice. Themes gleaned from interview data revealed varied training and practice experiences for children and practitioners, general characteristics of ASD that help or hinder children's participation, connections between these characteristics and aspects of lockdown drills that make them difficult to teach, and identification of practitioner responsibilities beyond following protocols.
PubMed: 38175330
DOI: 10.1007/s10803-023-06201-5 -
International Urogynecology Journal Mar 2021Urinary incontinence affects women of all ages, influencing 8.5% of the world's population in 2018. Effective management of urinary incontinence is influenced by... (Review)
Review
INTRODUCTION AND HYPOTHESIS
Urinary incontinence affects women of all ages, influencing 8.5% of the world's population in 2018. Effective management of urinary incontinence is influenced by patients help-seeking behaviour and services offered by healthcare professionals within the healthcare system. To facilitate behavioural change, it is important to understand the knowledge(Knowledge: "the comprehension and understanding of acquired facts or information about UI in adults"), attitudes (Attitude: "a predisposed perspective which influences nurses' thoughts, feelings, perceptions and behaviours towards care of adults with UI") and beliefs (Beliefs: "a theoretically conceptualized conviction or expectation regarding UI in general") of healthcare practitioners towards urinary incontinence management. The aim of this review is thus to systematically map the existing literature, reporting on how knowledge, attitude, belief and practices towards urinary incontinence management have been explored.
METHODS
Six databases were systematically searched. Included studies were published between January 2013 to January 2020 in English, investigating urinary incontinence management in women.
RESULTS
The search yielded 39 studies, with data emanating from 16 counties. Quantitative, Qualitative and mixed methodologies were used to explore the four concepts of knowledge, attitudes, beliefs and practices. A wide range of healthcare practitioners were questioned and management was explored in five healthcare settings. All factors explored related to the four concepts are reported and factors reaching consensus in included literature were highlighted.
CONCLUSION
The summarized factors can assist further investigations into the four concepts to change healthcare practitioner's behaviour towards urinary incontinence management.
Topics: Adult; Female; Health Knowledge, Attitudes, Practice; Humans; Urinary Incontinence
PubMed: 33404801
DOI: 10.1007/s00192-020-04628-3 -
Palliative Medicine Apr 2018General practitioners have overall responsibility for community care, including towards end of life. Current policy places generalists at the centre of palliative care...
BACKGROUND
General practitioners have overall responsibility for community care, including towards end of life. Current policy places generalists at the centre of palliative care provision. However, little is known about how patients and carers understand the general practitioner's role.
AIMS
To explore patient and carer perspectives of (1) the role of the general practitioner in providing palliative care to adult patients and (2) the facilitators and barriers to the general practitioner's capacity to fulfil this perceived role.
DESIGN
Systematic literature review and narrative synthesis.
DATA SOURCES
Seven electronic databases (MEDLINE, Embase, PsycINFO, BNI, CINAHL, Cochrane and HMIC) were searched from inception to May 2017. Two reviewers independently screened papers at title, abstract and full-text stages. Grey literature, guideline, hand searches of five journals and reference list/citation searches of included papers were undertaken. Data were extracted, tabulated and synthesised using narrative, thematic analysis.
RESULTS
A total of 25 studies were included: 14 employed qualitative methods, 8 quantitative survey methods and 3 mixed-methods. Five key themes were identified: continuity of care, communication between primary and secondary care, contact and accessibility, communication between general practitioner and patient, and knowledge and competence.
CONCLUSION
Although the terminology and context of general practice vary internationally, themes relating to the perceived role of general practitioners were consistent. General practitioners are considered well placed to provide palliative care due to their breadth of clinical responsibility, ongoing relationships with patients and families, and duty to visit patients at home and coordinate healthcare resources. These factors, valued by service users, should influence future practice and policy development.
Topics: Caregivers; General Practice; Health Knowledge, Attitudes, Practice; Humans; Palliative Care; Patients; Physician's Role
PubMed: 29343169
DOI: 10.1177/0269216317748862 -
Journal of Law and Medicine Mar 2021During a pandemic such as COVID-19 fear, anxiety and paranoia can become prevalent within the community. Agnotology has taught us that in such times science denialism...
During a pandemic such as COVID-19 fear, anxiety and paranoia can become prevalent within the community. Agnotology has taught us that in such times science denialism and vaccination scepticism can gain a foothold and discourage the undiscerning and the uninformed from receiving the treatment and prophylactic public health measures that are essential to community health and safety. When health practitioners endorse such attitudes they pose a serious risk to not only their patients but the whole community. This requires a robust response from health practitioner regulators, disciplinary tribunals and courts. This column identifies such a sensible and proportionate response from the Irish High Court in Medical Council v Waters [2021] IEHC 252 when a general practitioner's registration to practise was suspended for promoting such views. The decision, along with a comparable decision by the Victorian Civil and Administrative Tribunal in 2020 constitute potent international examples of a robust and commonsense regulatory endorsement of science during a time of public health crisis.
Topics: COVID-19; Humans; Pandemics; Public Health; SARS-CoV-2; Vaccines
PubMed: 34369118
DOI: No ID Found -
Health Services Insights 2023Many people in developing countries are struggling with chronic diseases yet traditional health services remain under-utilized in the quest for universal health care....
BACKGROUND
Many people in developing countries are struggling with chronic diseases yet traditional health services remain under-utilized in the quest for universal health care. Thousands patronize these outlets for care yet little is known about provider's competence and how these competencies inform palliative care decisions and practices. The study documented traditional health practitioners (THPs) competencies and practices for traditional palliative cancer care service delivery in Kenya.
METHODS
This study utilized mixed-methods design and was undertaken in major towns across Kenya. A total of 201 Traditional health practitioners were purposely sampled, and interviewed. Five in-depth interviews and 6 focus group discussions were conducted. Quantitative data were analyzed using SPSSv22 while thematic and discourse analysis was carried out for qualitative data.
RESULTS
Majority (92.7%) of the THPs provided general traditional health services. Nearly half of the respondents (47.7%, n = 92) stated that they had received their knowledge and abilities through divine gifting, 71 (36.8%) lineage, 61 (31.6%) apprenticeship, and 39 (20.2%) formal study. Palliative care was determined by patient state and followed consultation with caregivers for 165 (85.5%) of respondents. For 160 respondents (83%), management practices involved a mix of patient examination, conventional medical tests, herbal medicine administration, follow-up or referral. Positive feedback consisted of symptom reduction and function recovery.
CONCLUSION
Core competencies identified include: knowledge acquisition and specialization, assessment, diagnosis and disclosure, decision making, treatment, follow-up, and referral. Traditional palliative care providers share common health-related beliefs, practices and abilities that influence how they approach and make decisions regarding the health management of their patients, despite marked ethnic diversity. The shared pathways offer a chance to develop a cogent traditional palliative care service delivery model and health policy framework to promote its integration within the health workforce. The leading unmet requirements are knowledge of intellectual property rights, disclosure frameworks, and ethical regulation principles.
PubMed: 38028116
DOI: 10.1177/11786329231211780 -
Therapeutische Umschau. Revue... 2018Nephrological diagnostics with the general practitioner's toolbox Abstract. Kidney diseases are often asymptomatic or present nonspecifically and are frequently... (Review)
Review
Nephrological diagnostics with the general practitioner's toolbox Abstract. Kidney diseases are often asymptomatic or present nonspecifically and are frequently diagnosed by chance as part of a laboratory check up. In newly diagnosed renal failure, the physician should determine the dynamics (acute versus chronic) and identify the cause of the renal dysfunction based on history and additional tests. This is crucial to identify treatable kidney diseases and to provide patients with the adequate therapy. The identification of the underlying disease and determination of its severity are necessary to estimate the renal and cardiovascular prognosis. Finally, the degree of renal insufficiency is important for dose adjustment of renally eliminated drugs and assessment of possible complications of renal failure. Most general practitioners have the necessary diagnostic tools at their disposal to carry out the above assessments and decide when a specialist nephrological referral is advisable. To diagnose and stage renal failure, serum creatinine must be measured and the glomerular filtration rate (GFR) estimated. The second pillar is the examination of urine (proteinuria, albuminuria, urine sediment). Depending on the findings, further laboratory tests may be useful. Renal ultrasound is the primary imaging method in patients with acute and chronic renal failure. In this article, the above mentioned methods are described in more detail and their potential pitfalls are discussed.
Topics: Albuminuria; Creatinine; General Practitioners; Glomerular Filtration Rate; Humans; Kidney Diseases; Kidney Function Tests
PubMed: 30880620
DOI: 10.1024/0040-5930/a001006 -
International Nursing Review Jun 2015By describing the practice of a Japanese nurse practitioner, this descriptive case study discusses role development and outcomes before and after the intervention.
AIM
By describing the practice of a Japanese nurse practitioner, this descriptive case study discusses role development and outcomes before and after the intervention.
BACKGROUND
One of the first Japanese nurse practitioners intervened at a nursing home during the government-designated trial period for nurse practitioner practice.
CONCLUSION
Because of the nurse practitioner's meticulous observation and timely care provision to the residents in collaboration with the physician and the other staff in the facility, comparative data showed improvement in daily health status management of every resident and decreased deterioration of residents' health conditions requiring ambulance transfer and hospitalization.
Topics: Aged, 80 and over; Female; Geriatric Nursing; Humans; Japan; Male; Nurse Practitioners; Nurse's Role; Nursing Homes; Outcome Assessment, Health Care
PubMed: 25495863
DOI: 10.1111/inr.12158 -
Journal of Clinical Nursing Jul 2023The aim of this research was to evaluate a nurse practitioner's clinical practicum module designed with a capability education framework. The objectives were to...
AIMS AND OBJECTIVES
The aim of this research was to evaluate a nurse practitioner's clinical practicum module designed with a capability education framework. The objectives were to determine if the module prepared students adequately for their role and to determine if the Mini-CEX assessment tool was suitable for use with nurse practitioners.
BACKGROUND
Capability is a necessary part of expertise, where a capable person takes responsibility to develop their own education, knowledge and skills. The capability learning framework offers nurse practitioners flexible learning pathways between the student, the university and clinical practice. This capability learning framework focuses on the wider complexities of nurse practitioner practice as opposed to a point-in-time assessment.
DESIGN
A case study design was used.
METHODS
Mixed methods including, document review, focus group and field notes were used in the case study evaluation adhering to the standards for the reporting of organisational case studies.
RESULTS
A layered incremental approach to learning and assessments were applied. Students and assessors were satisfied with using the Mini-CEX assessment tool in the module. The Mini-CEX tool was familiar to clinical mentors, who compared students demonstrating competency in a similar manner to medicine. The feedback component of the tool provided deep and meaningful engagement for students. The module provided mentors with insight and understanding of the nurse practitioner role. Students identified the transitioning process from competent to capable practitioners. The module learning and assessments were mapped to regulatory nurse practitioner standards and requirements.
CONCLUSIONS
The module provided comprehensive preparation for students to develop their nurse practitioner role. The Mini-CEX assessment tool is a fitting assessment for nurse practitioner students, particularly when supplemented with a corresponding reflective exercise. The assessments and feedback provided the students with opportunities to focus on agreed learning outcomes in their specialist area of practice.
RELEVANCE TO CLINICAL PRACTICE
Nurse practitioners are required to practice autonomously and independently at a level of capability in clinical practice. The education preparation of nurse practitioner students must be directed appropriately.
Topics: Humans; Preceptorship; Clinical Competence; Students; Education, Nursing, Baccalaureate; Nurse Practitioners
PubMed: 36658779
DOI: 10.1111/jocn.16626