In a controlled trial training general practitioners and occupational physicians to collaborate did not influence sickleave of patients with low back pain

NARCIS (Netherlands)

Faber, E.; Bierma-Zeinstra, S. M. A.; Burdorf, A.; Nauta, A. P.; Hulshof, C. T. J.; Overzier, P. M.; Miedema, H. S.; Koes, B. W.

2005-01-01

The objective of this study was to determine the effectiveness of a training to increase collaboration between general practitioners and occupational health physicians in the treatment of patients with low back pain (LBP) because more collaboration might improve a patient's recovery and shorten sick

Identifying current training provision and future training needs in allergy available for UK general practice trainees: national cross-sectional survey of General Practitioner Specialist Training programme directors.

Science.gov (United States)

Ellis, Jayne; Rafi, Imran; Smith, Helen; Sheikh, Aziz

2013-03-01

There are ongoing concerns about the quality of care provision for allergy in primary care. To identify current training provision in allergy to GP trainees and to understand how this could be enhanced. A cross-sectional survey of GP Speciality Training (GPST) programme directors was undertaken. Programme directors of the 174 GPST schemes were sent an online questionnaire which was informed by the content of the Royal College of General Practitioners curriculum. Quantitative data were descriptively analysed and a thematic analysis was undertaken of free text responses. We obtained responses from 146 directors representing 106 training programmes. Responses indicated that two-thirds (62%, 95% CI 53.1 to 71.5) of programmes were providing at least some allergy training, with the remaining third stating that they either provided no training or were unsure. Overall, one-third (33%, 95% CI 22.7 to 42.2) of programme directors believed that all the relevant allergy-related curriculum requirements were being met. Where provided, this training was believed to be best for organ-specific allergic disorders but was thought to be poorer for systemic allergic disorders, particularly food allergy where 67% (95% CI 57.5 to 76.5) of respondents indicated that training was poor. There was considerable interest in increasing the allergy training provided, preferably through eLearning modules and problem-based learning materials supported by those with relevant specialist knowledge. This UK-wide survey has identified important gaps in the training of GP trainees in relation to allergy care. Addressing these gaps, particularly in the management of systemic allergic disorders, should help to improve delivery of primary care-based allergy care.

Are general practitioners well informed about fibromyalgia?

Science.gov (United States)

Kianmehr, Nahid; Haghighi, Anousheh; Bidari, Ali; Sharafian Ardekani, Yaser; Karimi, Mohammad Ali

2017-12-01

Fibromyalgia syndrome (FMS) is a common rheumatologic disorder characterized by easy fatigability, widespread musculoskeletal pain and sleep disorder. In spite of its high prevalence, general practitioners, as primary care providers, seem to have inadequate knowledge about FMS. This study aimed to assess Iranian general practitioners' knowledge about FMS and its treatment. A detailed questionnaire (including items on signs and symptoms, diagnostic criteria and treatment) was completed by 190 general practitioners (54.7% male; mean age: 41 years). Data analysis was performed with SPSS for Windows 15.0 and awareness about all aspects of FMS was reported as percentages. About one-third (30%) of the participants had seen at least one case of FMS during their practice. Most subjects (62.7%) claimed to know 1-6 tender points. Only 3.2% knew 16-18 points. The common proposed symptoms of FMS were widespread pain (72.6%), excessive fatigue (72.6%), weakness (60.5%), sleep disorder (36.3%), anxiety (34.7%) and depression (34.2%). Wrong symptoms including elevated erythrocyte sedimentation rate and C-reactive protein, arthritis, joint swelling, weight loss and abnormal radiologic findings were selected by 27.9%, 18.9%, 14.7%, 12.6% and 2.1% of the physicians, respectively. Moreover, selective serotonin reuptake inhibitors, tricyclic antidepressant and pregabalin were identified as treatment options for FMS by, respectively, 45.8%, 22.1% and 15.3% of the participants. Finally, 52.1% and 23.7% of the subjects incorrectly considered nonsteroidal anti-inflammatory drugs and corticosteroids as treatment modalities for FMS. Iranian general practitioners are not well informed about FMS. Therefore, FMS should be specifically integrated in continuing medical education programs and undergraduate medical training curriculum. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Preventing burnout among general practitioners: is there a possible route?

DEFF Research Database (Denmark)

Nielsen, Helena G.; Tulinius, C.

2009-01-01

Stress and burnout among general practitioners (GPs) is a serious problem. Some authors suggest supervision groups or Balint groups as a means of preventing burnout and others address how to treat the condition. This paper reports a case study of a supervision group for Danish GPs which, as well...... as training reflective practice, focuses specifically on the prevention of burnout. The concept of compassion fatigue is extended to cover the circumstances reported by some practitioners in supervision Udgivelsesdato: 2009/9...

An endodontic practice profile amongst general dental practitioners in Kathmandu: A questionnaire survey

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D Shrestha

2014-04-01

Full Text Available Objective To investigate the endodontic practice profile of general dental practitioners. To explore the materials and methods employed by them in Kathmandu valley. To compare these findings with well acknowledged international academic standards. Methods Questionnaires with 18 closed-ended questions were distributed among randomly chosen 120 general dental practitioners of Kathmandu, working in various government or private hospital or clinics.The data were collected and descriptive statistical analysis was done. Results Out of 120 questionnaires, only 110 that were completely filled were included in the study .Most general dental practitioners (97% regularly did multi-rooted root canal treatments and followed multivisit root canal treatment.. Radiograph with instrument in canal was used by 80% of general dental practitioners to determine the working length while only 36% used electronic apex locator which is considered to be more reliable. Half of them (57% used nickel-titanium files for cleaning and shaping but only 23% used crown down technique. Sodium hypochlorite and calcium hydroxide was the most popular irrigation solution and intra-canal medicament respectively. Majority of general dental practitioners (91% used lateral compaction technique for root canal obturation. Sixty three percent used zinc oxide eugenol as root canal sealer and 46% used endomethasone. They seem to overuse antibiotics in cases requiring endodontic therapy. Only 48% used autoclave for sterilization of endodontic files while 86% never used rubber dam. Eight three percent of them felt the need of further endodontic training and 42% of them preferred post-graduate dental program. Conclusion This study shows that the standard guidelines and new technologies for endodontic treatments are not implemented by many general dental practitioners of Kathmandu and require further endodontic trainings. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 40-50 DOI

The impact of information on clinical decision making by General Medical Practitioners

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Frances Wood

1996-01-01

Full Text Available Summarises some of the principal findings of a recent study investigation of information usage by general medical practitioners (GPs. The work was based on previous studies of the value and impact of information, these studies being undertaken in the corporate sector in Canada, the USA and the UK. The study used a critical incident technique similar to that employed in the Canadian and USA studies. Twenty seven in-depth interviews were conducted with general practitioners (GPs in the Trent Health Region (only one from each practice. The sample, selected from two health districts, included large, medium and small practices, fund-holding and non-fund-holding practices, and training and non-training practices, with some representation of those located in deprived and non-deprived (socio-economic areas.

General practitioners' use of sickness certificates.

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Roope, Richard; Parker, Gordon; Turner, Susan

2009-12-01

At present, sickness certification is largely undertaken by general practitioners (GPs). Guidance from the Department of Work and Pensions (DWP) is available to help with this task; however, there has been little formal evaluation of the DWP's guidance in relation to day-to-day general practice. To assess GPs' training, knowledge and application of the DWP's sickness certification guidelines. A structured questionnaire was sent to GPs within a (former) primary care trust (PCT). It probed demographics, training and knowledge of sickness certification guidelines. Case histories and structured questions were used to assess current practice. In this group of 113 GPs, there was a low awareness and use of the DWP's guidelines and Website relating to sickness certification. The majority of the GPs (63%) had received no training in sickness certification, and the mean length of time for those who had received training was 4.1 h. Most GPs also felt that patients and GPs have equal influence on the duration of sickness certification. This evidence of variable practice indicates that GPs should have more guidance and education in sickness certification. Closer sickness certification monitoring through existing GP computer systems may facilitate an improvement in practice that benefits patients and employers. The DWP, medical educators and PCTs may all have an additional role in further improving sickness certification practice.

[A competency model of rural general practitioners: theory construction and empirical study].

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Yang, Xiu-Mu; Qi, Yu-Long; Shne, Zheng-Fu; Han, Bu-Xin; Meng, Bei

2015-04-01

To perform theory construction and empirical study of the competency model of rural general practitioners. Through literature study, job analysis, interviews, and expert team discussion, the questionnaire of rural general practitioners competency was constructed. A total of 1458 rural general practitioners were surveyed by the questionnaire in 6 central provinces. The common factors were constructed using the principal component method of exploratory factor analysis and confirmatory factor analysis. The influence of the competency characteristics on the working performance was analyzed using regression equation analysis. The Cronbach 's alpha coefficient of the questionnaire was 0.974. The model consisted of 9 dimensions and 59 items. The 9 competency dimensions included basic public health service ability, basic clinical skills, system analysis capability, information management capability, communication and cooperation ability, occupational moral ability, non-medical professional knowledge, personal traits and psychological adaptability. The rate of explained cumulative total variance was 76.855%. The model fitting index were Χ(2)/df 1.88, GFI=0.94, NFI=0.96, NNFI=0.98, PNFI=0.91, RMSEA=0.068, CFI=0.97, IFI=0.97, RFI=0.96, suggesting good model fitting. Regression analysis showed that the competency characteristics had a significant effect on job performance. The rural general practitioners competency model provides reference for rural doctor training, rural order directional cultivation of medical students, and competency performance management of the rural general practitioners.

General Practice On-the-Job Training in Chinese Urban Community: A Qualitative Study on Needs and Challenges

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Wang, Bo; Wu, Tao; Huang, Yafang; Guo, Aimin

2014-01-01

Background On-the-job training is an important strategy for general practitioners to deliver appropriately community health services in China. The development of basic professional competence for general practitioners is the main goal of on-the-job training program. The aim of this study was to explore the needs of and the challenges to on-the-job training for general practitioners, and to provide advices for policy-makers to carry out this program more effectively. Methods We conducted 3 nominal group techniques, 17 in-depth interviews and 3 focus groups to identify the status of, needs of and challenges to on-the-job training for general practitioners in Liaoning, Ningxia, and Fujian provinces from September 2011 until December 2011. Audiotapes and transcripts were analyzed to identify major themes. Content analysis of the data was completed from January 2012 to March 2012. Results Basic theoretical knowledge and clinical skills were the main needs for general practitioners during on-the-job training. The challenges during training included the time contradiction between work and training, deficiencies of qualified preceptors, and lack of training funds. Participants gave recommendations how to resolve the above problems. Conclusions In order to improve the outcomes of general practice on-the-job training, it is necessary for government officials to resolve the contradiction between work and training, train preceptors continuously, and increase financial support in the training program. PMID:24728399

General practice on-the-job training in Chinese urban community: a qualitative study on needs and challenges.

Science.gov (United States)

Zhao, Yali; Chen, Rui; Wang, Bo; Wu, Tao; Huang, Yafang; Guo, Aimin

2014-01-01

On-the-job training is an important strategy for general practitioners to deliver appropriately community health services in China. The development of basic professional competence for general practitioners is the main goal of on-the-job training program. The aim of this study was to explore the needs of and the challenges to on-the-job training for general practitioners, and to provide advices for policy-makers to carry out this program more effectively. We conducted 3 nominal group techniques, 17 in-depth interviews and 3 focus groups to identify the status of, needs of and challenges to on-the-job training for general practitioners in Liaoning, Ningxia, and Fujian provinces from September 2011 until December 2011. Audiotapes and transcripts were analyzed to identify major themes. Content analysis of the data was completed from January 2012 to March 2012. Basic theoretical knowledge and clinical skills were the main needs for general practitioners during on-the-job training. The challenges during training included the time contradiction between work and training, deficiencies of qualified preceptors, and lack of training funds. Participants gave recommendations how to resolve the above problems. In order to improve the outcomes of general practice on-the-job training, it is necessary for government officials to resolve the contradiction between work and training, train preceptors continuously, and increase financial support in the training program.

Views of general practitioners and pharmacists on the role of the ...

African Journals Online (AJOL)

The successful implementation of this operational plan requires many healthcare providers trained in aspects of HIV. This study aimed to establish and compare the views of general practitioners and pharmacists on the role of the pharmacist in HIV/Aids management and to elucidate an appropriate role for pharmacists.

General dental practitioner's views on dental general anaesthesia services.

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Threlfall, A G; King, D; Milsom, K M; Blinkhom, A S; Tickle, M

2007-06-01

Policy has recently changed on provision of dental general anaesthetic services in England. The aim of this study was to investigate general dental practitioners' views about dental general anaesthetics, the reduction in its availability and the impact on care of children with toothache. Qualitative study using semi-structured interviews and clinical case scenarios. General dental practitioners providing NHS services in the North West of England. 93 general dental practitioners were interviewed and 91 answered a clinical case scenario about the care they would provide for a 7-year-old child with multiple decayed teeth presenting with toothache. Scenario responses showed variation; 8% would immediately refer for general anaesthesia, 25% would initially prescribe antibiotics, but the majority would attempt to either restore or extract the tooth causing pain. Interview responses also demonstrated variation in care, however most dentists agree general anaesthesia has a role for nervous children but only refer as a last resort. The responses indicated an increase in inequalities, and that access to services did not match population needs, leaving some children waiting in pain. Most general dental practitioners support moving dental general anaesthesia into hospitals but some believe that it has widened health inequalities and there is also a problem associated with variation in treatment provision. Additional general anaesthetic services in some areas with high levels of tooth decay are needed and evidence based guidelines about caring for children with toothache are required.

General practitioners' approach to malingering in basic military training centres.

Science.gov (United States)

Kokcu, Alper Tunga; Kurt, E

2017-04-01

Malingering can be defined as the abuse of the right to benefit from the health services. In this study, the frequency of the malingering cases in Basic Military Training Centres (BMTCs) and the behaviours and the attitudes of the military physicians towards the recruits who are suspected malingerers were described. A total of 17 general practitioners in nine different BMTCs in different regions of Turkey constitute the universe of this descriptive study. In the questionnaire, there were a total of 30 questions about the descriptive characteristics of the participants and their attitudes and behaviours towards malingering. Informed consent form and a questionnaire were applied through the intranet via participants' emails. In the study, 15 physicians were reached with a response rate of 88.2%. All of the physicians suspected malingering in some of the soldiers who were examined. A total of 80% of the physicians (n=12) suspected malingering in at least 10% of the patients they examined. Only 13.3% of the physicians (n=2) had officially diagnosed a case of malingering in the last training period. All of the participants stated that they did not report the official decision for every soldier suspected of malingering. Instead of reporting official decision for malingering, the military physicians apply alternative procedures for suspected malingerers. In countries where the military service is compulsory, prevalence of malingering is estimated to be higher (approximately 5-25%). The problem of malingering is often underestimated due to the fact it is usually overlooked. Malingering remains a problem for the entire military healthcare system, due to the difficulties in exact diagnosis. Therefore, it can be useful to take some practical administrative measures for the soldiers who are prone to malingering, in order to discourage the behaviour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

General practice on-the-job training in Chinese urban community: a qualitative study on needs and challenges.

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Yali Zhao

Full Text Available BACKGROUND: On-the-job training is an important strategy for general practitioners to deliver appropriately community health services in China. The development of basic professional competence for general practitioners is the main goal of on-the-job training program. The aim of this study was to explore the needs of and the challenges to on-the-job training for general practitioners, and to provide advices for policy-makers to carry out this program more effectively. METHODS: We conducted 3 nominal group techniques, 17 in-depth interviews and 3 focus groups to identify the status of, needs of and challenges to on-the-job training for general practitioners in Liaoning, Ningxia, and Fujian provinces from September 2011 until December 2011. Audiotapes and transcripts were analyzed to identify major themes. Content analysis of the data was completed from January 2012 to March 2012. RESULTS: Basic theoretical knowledge and clinical skills were the main needs for general practitioners during on-the-job training. The challenges during training included the time contradiction between work and training, deficiencies of qualified preceptors, and lack of training funds. Participants gave recommendations how to resolve the above problems. CONCLUSIONS: In order to improve the outcomes of general practice on-the-job training, it is necessary for government officials to resolve the contradiction between work and training, train preceptors continuously, and increase financial support in the training program.

General Practitioner Knowledge Levels About Circumcision

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Levent Cankorkmaz

2011-09-01

Full Text Available Objective: This study was carried out to investigate knowledge levels of general practitioners and their thoughts about circumcision in Middle Anatolia.Materials and Methods: This descriptive and cross-sectional study was carried out with 247 general practitioners working in Sivas. A questionnaire was prepared by the authors using previous reports. Questionnaires were sent to subjects by post. One hundred and seventy eight general practitioners (57 women, 121 men responded and were included in the study. For statistical analysis, Chi-square test was used and p<0.05 value was accepted as significant.Results: 42.1% of subjects believed that circumcision should be performed between 2 and 6 years of age. 2.2% of subjects declared that circumcision could be done at home and 7.3% believed that the location of the operation is not important. 9.6% of subjects believed that the person who performs the circumcision does not have to be a doctor. 21.3% of subjects believed that circumcision could be performed without anesthesia during the newborn period because of undeveloped pain sensation. Conclusion: This study demonstrated that general practitioners, who are the most easily accessible health staff for information about health, do not have updated information about the way to perform circumcision and its necessity. Therefore, it is concluded that education programs about circumcision for general practitioners must be continued and updated.

General Practitioner Education Reform in China: Most Undergraduate Medical Students do not Choose General Practitioner as a Career Under the 5+3 Model

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Shuang Wang

2018-06-01

Full Text Available Purpose: In order to train more high-level general practitioners (GPs to work in primary care institutions, China launched the 5+3 model in 2015 as a way to educate GPs nationwide. In this study, we investigated the awareness of the 5+3 model, career choices after graduation, and influences on GP career choice of undergraduate medical students from Zhengzhou University. Methods: The study population consisted of 288 undergraduate medical students from Zhengzhou University. We explored the students׳ awareness of the 5+3 model, career choices after graduation, influences on general practitioner career choice and mental status by using a self-report questionnaire and the Chinese version of the 21-item Depression Anxiety Stress Scale. Results: We found 34.2% of students did not understand the new policy. Only 23.2% of students would choose to work as a GP after graduation, and those tended to be female, to have a monthly family income less than 4000 ¥, or to be from rural areas. Only 10% of undergraduate medical students expressed a preference to work at primary care institutions. The participants showed higher anxiety and stress scores than did a previously published group of Chinese college students, and those who chose to pursue higher education had more anxiety and stress than those who decided to become general practitioners. Discussion: More efforts should be made to popularize the 5+3 model and mental intervention among medical students. More efforts should be tried to increase the income/welfare benefits and strengthen the infrastructure of primary care institutions to attract more medical students. Keywords: 5+3 model, General practitioner, Health care reform, Hierarchical medical system

Mental Health of General Practitioners in Emergency Wards

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Sepehrmanesh Z.1 PhD,

2015-01-01

Full Text Available Aims General practitioners have an essential role in patient care and are exposed to high levels of job stress. General practitioners’ mental health has effects on their functional abilities and medical managements.This study was carried out to evaluate the mental health of general practitioners in emergency wards in KashanUniversity of Medical Sciences, Iran. Materials & Methods In this cross-sectional study, all of General practitioners in emergency wards (n=87 were studied. The survey instruments includedtwo questionnaires: 1-demographic variables and 2- General Health Questionnaire (GHQ-28. Data were analyzed using SPSS 16 software and Chi square, Fisher exactand Mann-Whitney statistical tests. Findings The mean age of general practitioners was 36.11±5.67 years; 89.7% of them were married; 60.3% were male. 41% of the total general practitioners had mental health problems. The mean score of GHQ was 22.56±9.24. There were significant relationships between mental health and each age, employment situation, and number of children (p0.05. Conclusion The majority of employed general practitioners in emergency rooms do not have proper mental health statuses.

Factors influencing decision of general practitioners and managers to train and employ a nurse practitioner or physician assistant in primary care: a qualitative study.

Science.gov (United States)

van der Biezen, Mieke; Derckx, Emmy; Wensing, Michel; Laurant, Miranda

2017-02-07

Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation. A qualitative study was conducted in 2014 in which 7 managers of out-of-hours primary care services and 32 GPs who owned a general practice were interviewed. Three main topic areas were covered in the interviews: the decision-making process in the organisation, considerations and arguments to train and employ a PA/NP, and the tasks and responsibilities of a PA/NP. Employment of PAs/NPs in out-of-hours services was intended to substitute care for minor ailments in order to decrease GPs' caseload or to increase service capacity. Mangers formulated long-term planning and role definitions when changing workforce skill mix. Lastly, out-of-hours services experienced difficulties with creating team support among their members regarding the employment of PAs/NPs. In general practices during office hours, GPs indented both substitution and supplementation for minor ailments and/or target populations through changing the skill mix. Supplementation was aimed at improving quality of care and extending the range of services to patients. The decision-making in general practices was accompanied with little planning and role definition. The willingness to employ PAs/NPs was highly influenced by an employees' motivation to start the master's programme and GPs' prior experience with PAs/NPs. Knowledge about

Collaboration of general practitioners and exercise providers in promotion of physical activity a written survey among general practitioners.

NARCIS (Netherlands)

Leemrijse, C.J.; Bakker, D.H. de; Ooms, L.; Veenhof, C.

2015-01-01

Background: General practitioners have an ideal position to motivate inactive patients to increase their physical activity. Most patients are able to exercise in regular local facilities outside the health care setting. The purpose of this study was to get insight into general practitioners

Collaboration of general practitioners and exercise providers in promotion of physical activity a written survey among general practitioners

NARCIS (Netherlands)

Leemrijse, C J; de Bakker, D H; Ooms, L; Veenhof, C

2015-01-01

BACKGROUND: General practitioners have an ideal position to motivate inactive patients to increase their physical activity. Most patients are able to exercise in regular local facilities outside the health care setting. The purpose of this study was to get insight into general practitioners

General Practice On-the-Job Training in Chinese Urban Community: A Qualitative Study on Needs and Challenges

OpenAIRE

Zhao, Yali; Chen, Rui; Wang, Bo; Wu, Tao; Huang, Yafang; Guo, Aimin

2014-01-01

BACKGROUND: On-the-job training is an important strategy for general practitioners to deliver appropriately community health services in China. The development of basic professional competence for general practitioners is the main goal of on-the-job training program. The aim of this study was to explore the needs of and the challenges to on-the-job training for general practitioners, and to provide advices for policy-makers to carry out this program more effectively. METHODS: We conducted 3 n...

Burnout among family and general practitioners

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Ghaida M.J. Al-Shoraian

2011-12-01

Full Text Available Background: Job burnout is an important syndrome that can deplete the emotional health aspects of physicians. Its impacts are reflected both on the physicians and their patients through undermining the performance of physicians and degrading the quality of the administered medical care leading to dissatisfaction of the patients about the medical service. Objectives: This study is formulated to compare the prevalence of high burnout among family physicians and general practitioners and reveal the predictors of high grades of burnout among physicians. Subjects and methods: A cross sectional study was carried out. Out of 378 physicians working in two health regions in Kuwait, 200 physicians returned a filled questionnaire, of these 105 were family physicians and the rest were primary health care physicians. Maslach Burnout Inventory–Human Service Survey tool was used to estimate high degree of burnout on three domains, namely emotional exhaustion, depersonalization and personal accomplishment. Results: General practitioners were more likely to suffer from high grades of emotional exhaustion (63.2% than family physicians (19.0%. They also suffered from high grade of depersonalization (65.3% compared with family physicians (27.6%. Those suffering from high grades of personal accomplishment burnout (inverse score constituted 61.1% of primary health care physicians and 33.3% of family physicians. Those suffering from grades for the three burnout domain constituted more than one third of primary health care physicians (36.8% compared with only 5.7% of family physicians. Type of physician job and marital status proved to be significant predictors of high grades of burnout. Conclusion: Burnout is more common among primary care than family physicians. Searching for and eliminating all sources of stress in the primary health care centers in addition to training of these physicians on coping strategies to deal with stress at work seems to be an important

General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study

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Salmon Peter

2008-08-01

Full Text Available Abstract Background The successful introduction of new methods for managing medically unexplained symptoms in primary care is dependent to a large degree on the attitudes, experiences and expectations of practitioners. As part of an exploratory randomised controlled trial of reattribution training, we sought the views of participating practitioners on patients with medically unexplained symptoms, and on the value of and barriers to the implementation of reattribution in practice. Methods A nested attitudinal survey and qualitative study in sixteen primary care teams in north-west England. All practitioners participating in the trial (n = 74 were invited to complete a structured survey. Semi-structured interviews were undertaken with a purposive sub-sample of survey respondents, using a structured topic guide. Interview transcripts were used to identify key issues, concepts and themes, which were grouped to construct a conceptual framework: this framework was applied systematically to the data. Results Seventy (95% of study participants responded to the survey. Survey respondents often found it stressful to work with patients with medically unexplained symptoms, though those who had received reattribution training were more optimistic about their ability to help them. Interview participants trained in reattribution (n = 12 reported that reattribution increased their confidence to practice in a difficult area, with heightened awareness, altered perceptions of these patients, improved opportunities for team-building and transferable skills. However general practitioners also reported potential barriers to the implementation of reattribution in routine clinical practice, at the level of the patient, the doctor, the consultation, diagnosis and the healthcare context. Conclusion Reattribution training increases practitioners' sense of competence in managing patients with medically unexplained symptoms. However, barriers to its implementation are

General Medical Terminology for Vocational Rehabilitation Counselors. "A Guide for the Rehabilitation Practitioner." Final Report.

Science.gov (United States)

Phelps, William R.

This training guide is prepared primarily for the Vocational Rehabilitation practitioner, although academicians may also find it of value. Sixteen specific areas are covered, including common abbreviations, prefixes and suffixes, root words, general terms, operative terminology, special senses and body systems, general medical examination, medical…

Risk communication between general practitioners and patients with hypercholesterolemia

DEFF Research Database (Denmark)

Hansen, Bo; Kirkegaard, Pia; Lauritzen, Torsten

  Purpose: It is important that the general practitioners (GPs) are able to intervene to reduce risk of disease. One of the key points in doing so is effective risk communication that decreases uncertainty about choice of treatment and gives the patients a greater understanding of benefits......, and psychological well-being.    Methods: 40 GPs receive training in risk communication. Each GP selects 7 patients with elevated cholesterol. These patients are informed about the opportunity to receive preventive pharmacological treatment. Another 280 patients receive the same opportunity from 40 GPs without...... their psychological well-being.   Conclusion: This randomised intervention study will produce new knowledge about the effect of training GPs in risk communication....

Private or salaried practice: how do young general practitioners make their career choice? A qualitative study.

Science.gov (United States)

Kinouani, Shérazade; Boukhors, Gary; Luaces, Baptiste; Durieux, William; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Gay, Bernard

2016-09-01

Young French postgraduates in general practice increasingly prefer salaried practice to private practice in spite of the financial incentives offered by the French government or local communities to encourage the latter. This study aimed to explore the determinants of choice between private or salaried practice among young general practitioners. A qualitative study was conducted in the South West of France. Semi-structured interviews of young general practitioners were audio-recorded until data saturation. Recordings were transcribed and then analyzed according to Grounded Theory by three researchers working independently. Sixteen general practitioners participated in this study. For salaried and private doctors, the main factors governing their choice were occupational factors: working conditions, need of varied scope of practice, quality of the doctor-patient relationship or career flexibility. Other factors such as postgraduate training, having worked as a locum or self-interest were also determining. Young general practitioners all expected a work-life balance. The fee-for-service scheme or home visits may have discouraged young general practitioners from choosing private practice. National health policies should increase the attractiveness of ambulatory general practice by promoting the diversification of modes of remuneration and encouraging the organization of group exercises in multidisciplinary medical homes and community health centers.

Evaluating veterinary practitioner perceptions of communication skills and training

OpenAIRE

McDermott, M.P.; Cobb, M.A.; Tischler, Victoria; Robbé, I.J.; Dean, R.S.

2017-01-01

A survey was conducted among veterinary practitioners in the UK and the USA in 2012/2013. Thematic analysis was used to identify underlying reasons behind answers to questions about the importance of communication skills and the desire to participate in postgraduate communication skills training. Lack of training among more experienced veterinary surgeons, incomplete preparation of younger practitioners and differences in ability to communicate all contribute to gaps in communication competen...

General practitioners' perceptions of the stigma of dementia and the role of reciprocity.

Science.gov (United States)

Gove, Dianne; Small, Neil; Downs, Murna; Vernooij-Dassen, Myrra

2017-10-01

A qualitative exploration of the stigma of dementia reported that general practitioners described lack of reciprocity as one way in which people with dementia are perceived within society. This was closely linked to their perception of dementia as a stigma. In this article, we explore whether general practitioners perceive people with dementia as lacking reciprocity and, if so, if this is linked with societal opinions about dementia as a stigma. The implications of both perceptions of people with dementia failing to reciprocate and of stigma for timely diagnosis are explored. Our approach is to follow the thread of reciprocity in the data from our initial study. In this follow-up study, general practitioners' perceptions of societal views of people with dementia included a perception of a lack of reciprocity specifically linked with; failing to respond to human contact, the absence of an appropriate return on social investment and failing to contribute to, or being a burden on, society. General practitioners reported a link between societal perceptions of lack of reciprocity and stereotypes about advanced dementia, difficulties communicating with people with dementia, and lack of opportunities for people with dementia to reciprocate. General practitioners occupy a key position, they can challenge stereotypes and, with support and targeted training about communicating with people living with dementia, can emphasize the ways in which people with dementia can communicate, thereby enhancing their potential to reciprocate. Such changes have implications for improved care and quality of life through the continued maintenance of social inclusion and perceptions of personhood.

Group supervision for general practitioners

DEFF Research Database (Denmark)

Galina Nielsen, Helena; Sofie Davidsen, Annette; Dalsted, Rikke

2013-01-01

AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long-establish......AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long...... considered important prerequisites for disclosing and discussing professional problems. CONCLUSION: The results of this study indicate that participation in a supervision group can be beneficial for maintaining and developing GPs' skills in dealing with patients with mental health problems. Group supervision...... influenced other areas of GPs' professional lives as well. However, more studies are needed to assess the impact of supervision groups....

Changes in pathology test ordering by early career general practitioners: a longitudinal study.

Science.gov (United States)

Magin, Parker J; Tapley, Amanda; Morgan, Simon; Henderson, Kim; Holliday, Elizabeth G; Davey, Andrew R; Ball, Jean; Catzikiris, Nigel F; Mulquiney, Katie J; van Driel, Mieke L

2017-07-17

To assess the number of pathology tests ordered by general practice registrars during their first 18-24 months of clinical general practice. Longitudinal analysis of ten rounds of data collection (2010-2014) for the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing, multicentre, cohort study of general practice registrars in Australia. The principal analysis employed negative binomial regression in a generalised estimating equations framework (to account for repeated measures on registrars).Setting, participants: General practice registrars in training posts with five of 17 general practice regional training providers in five Australian states. The registrar participation rate was 96.4%. Number of pathology tests requested per consultation. The time unit for analysis was the registrar training term (the 6-month full-time equivalent component of clinical training); registrars contributed data for up to four training terms. 876 registrars contributed data for 114 584 consultations. The number of pathology tests requested increased by 11% (95% CI, 8-15%; P pathology test ordering by general practice registrars increased significantly during their first 2 years of clinical practice. This causes concerns about overtesting. As established general practitioners order fewer tests than registrars, test ordering may peak during late vocational training and early career practice. Registrars need support during this difficult period in the development of their clinical practice patterns.

A survey on acquaintance, orientation and behavior of general medical practitioners toward periodontal diseases

Directory of Open Access Journals (Sweden)

Supreet Kaur

2015-01-01

Full Text Available Background: An association between oral conditions such as periodontal diseases and systemic conditions is noted. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease, diabetes, adverse pregnancy outcome, atherosclerosis, stroke and hospital acquired pneumonia. The concept of diagnosing and treating a potential patient to minimize the deleterious effects of this chronic infectious and inflammatory condition on systemic conditions represents both an unprecedented challenge and opportunity to our profession. Keeping this in view, the present survey was designed to evaluate the acquaintance, orientation and behavior of general medical practitioners; concerning the effects of periodontal disease on systemic health. Materials and Methods: A typed questionnaire carrying four sets of questions was distributed among general medical practitioners of seven different government and private medical colleges and hospitals. Questionnaire was developed to assess the acquaintance, orientation and behavior of general medical practitioners toward periodontal disease. Results: Most of the respondents have knowledge regarding the signs and symptoms of periodontal disease and its association with cardiovascular disease. However, majority of them do not know about the potential effect of periodontal disease on other organ systems. Conclusion: General medical practitioners have inadequate knowledge regarding periodontal diseases. Hence, oral health related training should be an integral part of the medical curriculum.

A survey on acquaintance, orientation and behavior of general medical practitioners toward periodontal diseases.

Science.gov (United States)

Kaur, Supreet; Khurana, Pankaj; Kaur, Harjit

2015-01-01

An association between oral conditions such as periodontal diseases and systemic conditions is noted. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease, diabetes, adverse pregnancy outcome, atherosclerosis, stroke and hospital acquired pneumonia. The concept of diagnosing and treating a potential patient to minimize the deleterious effects of this chronic infectious and inflammatory condition on systemic conditions represents both an unprecedented challenge and opportunity to our profession. Keeping this in view, the present survey was designed to evaluate the acquaintance, orientation and behavior of general medical practitioners; concerning the effects of periodontal disease on systemic health. A typed questionnaire carrying four sets of questions was distributed among general medical practitioners of seven different government and private medical colleges and hospitals. Questionnaire was developed to assess the acquaintance, orientation and behavior of general medical practitioners toward periodontal disease. Most of the respondents have knowledge regarding the signs and symptoms of periodontal disease and its association with cardiovascular disease. However, majority of them do not know about the potential effect of periodontal disease on other organ systems. General medical practitioners have inadequate knowledge regarding periodontal diseases. Hence, oral health related training should be an integral part of the medical curriculum.

Evaluation of general practitioners' routine assessment of patients ...

African Journals Online (AJOL)

The authors wished to establish the use of existing diabetes management guidelines by general practitioners (GPs) in the City of Tshwane (Pretoria) Metropolitan Municipality of South Africa. Method: A cross-sectional and descriptive study was conducted. A total of 50 randomly selected general practitioners participated in ...

Primary health eye care knowledge among general practitioners ...

African Journals Online (AJOL)

Primary health eye care knowledge among general practitioners working in the Cape Town metropole. M Van Zyl, N Fernandes, G Rogers, N Du Toit. Abstract. Aim: The main purpose of this study was to determine whether general practitioners (GPs) in the Cape Town metropole have sufficient knowledge to diagnose and ...

[Violence for educational purpose: Representations of general practitioners in the Paris area, France. A qualitative study].

Science.gov (United States)

de Brie, Claire; Piet, Emmanuelle; Chariot, Patrick

2018-03-01

Violence for educational purpose refers to a modality of education that includes threats, verbal abuse, physical abuse and humiliations. Twenty European countries, not including France, have abolished corporal punishment through explicit laws and regulations. The position of general practitioners in the screening and care of violence for educational purpose in France is unknown. In this study, we aimed to assess the representations of this form of violence among general practitioners. We have performed semi-directed interviews of general practitioners in the Paris, France region (Île-de-France). Interviews were conducted until data saturation was achieved. Interviews were recorded, transcribed and analysed by two investigators. Interviews were conducted with 20 physicians (November 2015-January 2016). General practitioners considered that physical, verbal or psychological abuse had possible negative consequences on children. Uncertainty regarding the consequences of violence was a cause of tolerance towards violence for educational purpose, depending on the act committed and the context, as perceived by nearly all practitioners. General practitioners expressed interest in the field. They cited their own education and experience as the main obstacles to action. Most of them expressed a feeling of failure when they screened or took care of violence for educational purpose. This study suggests that doctors can participate in supporting the parents in the prevention of violence for educational purpose. Support to parents would need specific medical training as well as a societal change. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

[General practitioner and palliative sedation].

Science.gov (United States)

Schweitzer, Bart

2014-01-01

Recent publications in Dutch national newspapers on palliative sedation have raised concerns about its use in general practice. There is now evidence that there is no significant increase in the incidence of palliative sedation. Euthanasia requests were pending in 20.8% of the cases in which palliative sedation was performed, but the general practitioners could clearly justify why they made this choice. This is important because it indicates that they are aware of a sharp distinction between euthanasia and palliative sedation. Although the decision to perform palliative sedation was discussed with almost all cancer patients, patient involvement was less present in non-cancer conditions. This may be related to different disease trajectories, but it also indicates that attention should be devoted to earlier identification of patients in need of palliative care. The findings confirm that the practice of palliative sedation by general practitioners largely reflects the recommendations of the Dutch National Guideline on Palliative Sedation.

Evaluating veterinary practitioner perceptions of communication skills and training.

Science.gov (United States)

McDermott, M P; Cobb, M A; Tischler, V A; Robbé, I J; Dean, R S

2017-03-25

A survey was conducted among veterinary practitioners in the UK and the USA in 2012/2013. Thematic analysis was used to identify underlying reasons behind answers to questions about the importance of communication skills and the desire to participate in postgraduate communication skills training. Lack of training among more experienced veterinary surgeons, incomplete preparation of younger practitioners and differences in ability to communicate all contribute to gaps in communication competency. Barriers to participating in further communication training include time, cost and doubts in the ability of training to provide value. To help enhance communication ability, communication skills should be assessed in veterinary school applicants, and communication skills training should be more thoroughly integrated into veterinary curricula. Continuing education/professional development in communication should be part of all postgraduate education and should be targeted to learning style preferences and communication needs and challenges through an entire career in practice. British Veterinary Association.

Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study.

LENUS (Irish Health Repository)

Montgomery, Anthony J

2006-01-01

BACKGROUND: To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted. METHOD: Randomly selected general practitioners (N = 51) were interviewed using 32 standardised written patient scenarios to elicit referral strategies. Main outcome measures: General practitioner referral levels and thresholds for patients developing end-stage renal disease; referral routes (nephrologist vs other physicians); influence of patient age, marital status and co-morbidity on referral. RESULTS: Referral levels varied widely with the full range of cases (0-32; median = 15) referred by different doctors after consideration of first laboratory results. Less than half (44%) of cases were referred to a nephrologist. Patient age (40 vs 70 years), marital status, co-morbidity (none vs rheumatoid arthritis) and general practitioner prior specialist renal training (yes or no) did not influence referral rates. Many patients were not referred to a specialist at creatinine levels of 129 micromol\\/l (47% not referred) or 250 micromol\\/l (45%). While all patients were referred at higher levels (350 and 480 micromol\\/l), referral to a nephrologist decreased in likelihood as scenarios became more complex; 28% at 129 micromol\\/l creatinine; 28% at 250 micromol\\/l; 18% at 350 micromol\\/l and 14% at 480 micromol\\/l. Referral levels and routes were not influenced by general practitioner age, sex or practice location. Most general practitioners had little current contact with chronic renal patients (mean number in practice = 0.7, s.d. = 1.3). CONCLUSION: The very divergent management patterns identified highlight the need for guidance to general practitioners on appropriate management of this serious condition.

Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial

Directory of Open Access Journals (Sweden)

Sladden Michael

2007-09-01

Full Text Available Abstract Background Childhood asthma is common in Cape Town, a province of South Africa, but is underdiagnosed by general practitioners. Medications are often prescribed inappropriately, and care is episodic. The objective of this study is to assess the impact of educational outreach to general practitioners on asthma symptoms of children in their practice. Methods This is a cluster randomised trial with general practices as the unit of intervention, randomisation, and analysis. The setting is Mitchells Plain (population 300,000, a dormitory town near Cape Town. Solo general practitioners, without nurse support, operate from storefront practices. Caregiver-reported symptom data were collected for 318 eligible children (2 to 17 years with moderate to severe asthma, who were attending general practitioners in Mitchells Plain. One year post-intervention follow-up data were collected for 271 (85% of these children in all 43 practices. Practices randomised to intervention (21 received two 30-minute educational outreach visits by a trained pharmacist who left materials describing key interventions to improve asthma care. Intervention and control practices received the national childhood asthma guideline. Asthma severity was measured in a parent-completed survey administered through schools using a symptom frequency and severity scale. We compared intervention and control group children on the change in score from pre-to one-year post-intervention. Results Symptom scores declined an additional 0.84 points in the intervention vs. control group (on a nine-point scale. p = 0.03. For every 12 children with asthma exposed to a doctor allocated to the intervention, one extra child will have substantially reduced symptoms. Conclusion Educational outreach was accepted by general practitioners and was effective. It could be applied to other health care quality problems in this setting.

Assessment of Training Needs for Arizona Student Financial Aid Practitioners. Final Report.

Science.gov (United States)

Fenske, Robert H.

The present and future training needs of financial aid practitioners (financial aid officers, counselors, and support staff personnel) at Arizona colleges and government agencies were assessed. Attention was directed to the literature on training and programs for financial aid practitioners, as well as the possibilities of developing a…

Thomas James Walker (1835-1916): Surgeon and general practitioner.

Science.gov (United States)

Thomas, Martyn

2018-02-01

Thomas James Walker was a surgeon and general practitioner who worked in the city of Peterborough at a time when there were changes and innovations in the practice of medicine. After training in medicine and surgery at Edinburgh University, he qualified in London in 1857. He was a pioneer of laryngoscopy. He played an important role in introducing antiseptic surgery to the Peterborough Infirmary and was instrumental in the development of the operating theatre which opened in 1894. He was a philanthropist and collector of Roman and Saxon artefacts. In 1915, he was recognized as an outstanding member of the Peterborough community when he was offered the Freedom of the City.

Burnout contagion among general practitioners.

NARCIS (Netherlands)

Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.

2001-01-01

This study used a representative sample of 507 general practitioners (GPs) to test the hypothesis that burnout is contagious. Following a two-dimensional conceptualization of burnout, it is assumed that burnout is comprised of emotional exhaustion and negative attitudes (i.e., depersonalization and

Telehealth and eHealth in nurse practitioner training: current perspectives

Directory of Open Access Journals (Sweden)

Rutledge CM

2017-06-01

Full Text Available Carolyn M Rutledge,1 Karen Kott,2 Patty A Schweickert,3 Rebecca Poston,1 Christianne Fowler,1 Tina S Haney1 1College of Health Sciences, School of Nursing, 2College of Health Sciences, School of Physical Therapy, Old Dominion University, Norfolk, 3Department of Neuroradiology, University of Virginia, Charlottesville, VA, USA Abstract: Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this article focuses on topics including 1 defining telehealth, 2 telehealth etiquette, 3 interprofessional collaboration, 4 regulations, 5 reimbursement, 6 security/Health Insurance Portability and Accountability Act (HIPAA, 7 ethical practice in telehealth, and 8 satisfaction of patients and providers. A multimodal approach based on a review of the literature is presented for providing the training: 1 didactics, 2 simulations including standardized patient encounters, 3 practice immersions, and 4 telehealth projects. Studies found that training using the multimodal approach allowed the students to develop comfort, knowledge, and skills needed to embrace the utilization of telehealth in health care. Keywords: telehealth, nurse practitioner education, telemedicine, simulation, health care

Why and when do Danish medical doctors choose to become a general practitioner?

DEFF Research Database (Denmark)

Lewandowska, Karolina; Kjær, Niels Kristian; Lillevang, Gunver

of study is to examine why and when Danish junior doctors choose family medicine as their future specialty. Method: We carried out two focus group interviews with medical doctors from two regions. An academic employee from the Danish College of Family Medicine mediated the interviews assisted by a family......Background and Aim: Continued supply of qualified general practitioners is essential for the vitality of the primary health care sector. In Denmark however we have observed a decline in the number of applicants for our family medicine specialist training program, leaving some posts vacant. The aim......-graduate training the structure of the postgraduate educational program, working conditions, respect for general practice, uncertainty about the future for general practice as a profession, when did I decide to choose family medicine. Out of these themes we identified factors, which influenced the choice...

Creation and implementation of an emergency medicine education and training program in Turkey: an effective educational intervention to address the practitioner gap

OpenAIRE

Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby

2013-01-01

Background The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. Methods To address this ?practitioner gap,? the authors developed a four-phase comprehensive emergency medicine education and training program for gen...

Evaluating an australian emergency nurse practitioner candidate training program.

Science.gov (United States)

Plath, Sharyn J; Wright, Mary; Hocking, Julia

2017-11-01

Nurse Practitioners (NPs) receive core clinical training at master's level, with their employer providing the opportunity to upskill in clinical and procedural competencies. It is increasingly recognised that this generic education requires supplementary training for operating effectively within a specific clinical environment. In this paper we describe a pilot program designed to train Australian NP Candidates to work effectively within the Emergency Department Fast Track model of care. The training program consisted of a 12-month period: four hours in-house training per week over two semesters, running concurrently with the NP candidate's University semesters, and 3 months' clinical practice to consolidate. The training team defined milestones for Semesters one and two, and developed a case review form to assess application of the candidate's knowledge in new clinical situations, as well as check for gaps in understanding. A clinical skills guide was developed for the candidate to work toward, and a comprehensive assessment was carried out at two time points in the training program. Feedback was obtained from the mentors and the candidate at the end point of the training program, and has been used to refine the program for 2017. This in-house training program provided specialised, evidence-based training for the emergency department environment, resulting in development of the nurse practitioner candidate as a high functioning team member. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

Feedback-Training für Lehrärzte in der Allgemeinmedizin [Feedback training for general practitioners involved in teaching

Directory of Open Access Journals (Sweden)

Engeser, Peter

2010-02-01

Full Text Available [english] Background: Ever since the last amendment to the German Medical Licensing Act took effect in 2002, medical students may complete four months of the Practical Year (PY in general practices. Formative feedback between the teaching general practitioner (GP and the PY student is a key element in creating a learning environment. GPs involved in teaching therefore need further education in giving feedback.Methods: A 4-hour feedback training session for GPs involved in teaching which used standardized patients and students was developed and tested in a pilot study. In role plays, GPs experienced feedback situations. Using an evaluation questionnaire, changes in self-perceived feedback skills were assessed (familiarity of feedback rules, preparation for giving feedback to PY students, possibilities to improve communication skills in doctor–patient situations.Results: Sixteen GPs who were involved or interested in PY teaching participated in the feedback training program. Afterwards, participants said they felt more comfortable in giving formative feedback and more assured in their communication skills. The confidence in their own feedback improved, especially by taking the student’s part in the role plays. An exercise between a standardized patient and a standardized stubborn student was a challenge, but proved to be extremely useful.Conclusion: The opinions of the participating GPs to the feedback training underscore its importance. Therefore, we recommend integrating such a feedback training program into the education of GPs involved in teaching.[german] Hintergrund: Seit der letzten Novelle der Approbationsordnung 2002 besteht die Möglichkeit, ein Tertial des Praktischen Jahres (PJ in Hausarztpraxen zu absolvieren. Konstruktives Feedback zwischen Arzt und PJ-Studenten ist dabei ein zentrales Element in der Gestaltung des Lernumfeldes in der Arztpraxis. Es bedarf dahingehend einer Ausbildung der in die Lehre involvierten

From novice to proficient general practitioner: a critical incident study.

Science.gov (United States)

Sim, M G; Kamien, M; Diamond, M R

1996-09-01

To obtain information about any change in the performance or perceptions of doctors undertaking the Royal Australian College of General Practitioners (RACGP) Training Program, with advancing general practice experience. The critical incident technique' was used, which is a comparative qualitative analysis. It involved interviews at 12 to 18 months after the basic term interview. Eighteen Western Australian doctors, who had been interviewed in 1992, at the end of their first 6 months of general practice training and were now completing their advanced or mentor terms in the RACGP Training Program took part in the study. Doctors reported an average of 4.4 critical incidents in their first interview and 5.0 in their second interview. The major areas of positive change included relationships with patients and other health care professionals, including supervisors; paediatrics and orthopaedics skills; the skills of developing a therapeutic relationship to enhance patient compliance and the ability to manage complex cardiovascular and psychiatric problems without reliance on specialist referral; attitudes of responsibility for and enjoyment of long term care of patients and families; and reduced levels of anxiety over difficult problems. New or continuing areas of difficulty were found in gynaecology; pharmacotherapy and dermatology; the diagnosis of common complaints with uncommon presentations; the skill of managing difficult or angry patients; the organisation for the follow-up of patients with potentially severe disorders; and in managing feelings of guilt over missed diagnoses or poor management. An analysis of commonly occurring positive and negative critical incidents shows that RACGP Training Program doctors develop competence, confidence and reduced levels of performance anxiety with advancing experience. All but one doctor found the Training Program helpful in achieving these proficiencies. However, many ongoing areas of difficulty remain. The Critical Incident

General practitioners' views on leadership roles and challenges in primary health care: a qualitative study

OpenAIRE

Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

2017-01-01

Objective To explore general practitioners? (GPs) views on leadership roles and leadership challenges in general practice and primary health care. Design We conducted focus groups (FGs) with 17 GPs. Setting Norwegian primary health care. Subjects 17 GPs who attended a 5 d course on leadership in primary health care. Results Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical...

Current sedation practice among general dental practitioners and dental specialists in Jordan: an example of a developing country

Science.gov (United States)

Al-Shayyab, Mohammad H; Ryalat, Soukaina; Dar-odeh, Najla; Alsoleihat, Firas

2013-01-01

Purpose The study reported here aimed to identify current sedation practice among general dental practitioners (GDPs) and specialist dental practitioners (SDPs) in Jordan in 2010. Methods Questionnaires were sent by email to 1683 GDPs and SDPs who were working in Jordan at the time of the study. The contact details of these dental practitioners were obtained from a Jordan Dental Association list. Details on personal status, use of, and training in, conscious sedation techniques were sought by the questionnaires. Results A total of 1003 (60%) questionnaires were returned, with 748 (86.9%) GDPs and 113 (13.1%) SDPs responding. Only ten (1.3%) GDPs and 63 (55.8%) SDPs provided information on the different types of treatments related to their specialties undertaken under some form of sedation performed by specialist and/or assistant anesthetists. Approximately 0.075% of the Jordanian population received some form of sedation during the year 2010, with approximately 0.054% having been treated by oral and maxillofacial surgeons. The main reason for the majority of GDPs (55.0%) and many SDPs (40%) not to perform sedation was lack of training in this field. While some SDPs (26.0%) indicated they did not use sedation because of the inadequacy of sedative facilities. Conclusion Within the limitations of the present study, it can be concluded that the provision of conscious sedation services in general and specialist dental practices in Jordan is inconsistent and inadequate. This stresses the great need to train practitioners and dental assistants in Jordan to enable them to safely and effectively perform all forms of sedation. PMID:23700369

Creation and implementation of an emergency medicine education and training program in Turkey: an effective educational intervention to address the practitioner gap.

Science.gov (United States)

Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby

2013-07-22

The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. To address this "practitioner gap," the authors developed a four-phase comprehensive emergency medicine education and training program for general practitioners practicing in government hospitals in Turkey. From April 2006 until June 2009, 42 courses were taught by 62 trainers across seven regions in Turkey. A total of 2,262 physicians were trained. The mean course pre-test score for all regions was 42.3 (95% CI 39.8 to 44.7). The mean course post-test score was 70.1 (95% CI 67.2 to 72.9). The difference between the mean scores was 27.8 (95% CI 25.3 to 30.4, P emergency medicine department and an emergency medicine society to implement country-wide training of physicians practicing in public emergency departments can serve as a successful model for capacity-building global emergency medicine endeavors.

49 CFR 1103.15 - The practitioner's duty to clients, generally.

Science.gov (United States)

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false The practitioner's duty to clients, generally... Practitioner's Duties and Responsibilities Toward A Client § 1103.15 The practitioner's duty to clients... all clients to observe the statutory law to the best of his knowledge or as interpreted by competent...

Should general practitioners call patients by their first names?

Science.gov (United States)

McKinstry, B

1990-10-06

To assess the acceptability to patients of the use of patients' first names by doctors and doctors' first names by patients in general practice. An administered questionnaire survey. 5 General practices in Lothian. 475 Patients consulting 30 general practitioners. Response by patients to questionnaire on attitude to use of first names. Most of the patients either liked (223) or did not mind (175) being called by their first names. Only 77 disliked it, most of whom were aged over 65. Most patients (324) did not, however, want to call the doctor by his or her first name. General practitioners should consider using patients' first names more often, particularly with younger patients.

Revisiting reflexology: Concept, evidence, current practice, and practitioner training.

Science.gov (United States)

Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

2015-10-01

Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

Revisiting reflexology: Concept, evidence, current practice, and practitioner training

Directory of Open Access Journals (Sweden)

Nurul Haswani Embong

2015-10-01

Full Text Available Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

Perceptions of mental illness among Muslim general practitioners in ...

African Journals Online (AJOL)

Background. Mental health literacy on the part of medical practitioners is an important component of mental healthcare. General practitioners (GPs) are typically the first doctors consulted by a person who is ill. Exploration of their perceptions regarding mental illness, aetiological issues and treatment is important. Objective.

Guidance of eruption for general practitioners.

Science.gov (United States)

Ngan, Peter W; Kao, Elizabeth C; Wei, Stephen H

2003-04-01

The principle of early treatment through well-planned extraction of primary teeth followed by removal of permanent teeth has stood the test of time. The objective of this article is to develop some simple guidelines for general dental practitioners to perform 'guidance of eruption' in malocclusion with severe crowding.

The pattern of clinical advice sought by general practitioners from a medical consultant in clinical biochemistry.

Science.gov (United States)

Bhatnagar, D

1997-01-01

Clinical biochemistry departments can be a valuable source of clinical advice for further investigations and the need for referral to specialist clinics. This paper outlines the pattern of clinical advice sought by general practitioners in a district hospital setting, and addresses some of the issues regarding seeking such advice and the implications for continuing medical education and training. PMID:9196966

Training doctors for primary care in China: Transformation of general practice education.

Science.gov (United States)

Li, Donald

2016-01-01

China is known for developing a cadre of "Barefoot Doctors" to address her rural healthcare needs in past. The tradition of barefoot doctors has inspired similar developments in several other countries across world. Recently China has embarked upon an ambitious new mission to create a primary care workforce consisting of trained general practitioners having international standard skillsets. This editorial provides an insight into the current status of policy deliberations with regards to training of primary care doctors and a new surge in general practice education in China.

Designing, Developing, and Implementing Diversity Training: Guidelines for Practitioners.

Science.gov (United States)

Kincaid, Tanna M.; Horner, Erin R.

1997-01-01

Discusses diversity in the workplace and offers guidelines for practitioners in designing, developing, and implementing diversity training. Highlights include linking the diversity initiative to the organization's mission, cultural climate assessments, reviewing policies and procedures, needs assessment, learner analysis, establishing objectives,…

Video-assisted feedback in general practice internships using German general practitioner's guidelines

NARCIS (Netherlands)

Bolter, R.; Freund, T.; Ledig, T.; Boll, B.; Szecsenyi, J.; Roos, M.

2012-01-01

Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the

Violence against General Practitioners in Turkey

Science.gov (United States)

Aydin, Berna; Kartal, Mehtap; Midik, Ozlem; Buyukakkus, Alper

2009-01-01

We aimed to determine the violence against general practitioners (GPs) through their suggestions on its cause and prevention. This is a descriptive cross-sectional study based on self-administered questionnaire answered by a convenience study population consisting of 522 GPs between November and December 2006. Of the participating GPs, 82.8%…

Mental health, job satisfaction, and job stress among general practitioners.

OpenAIRE

Cooper, C. L.; Rout, U.; Faragher, B.

1989-01-01

OBJECTIVE--To identify sources of job stress associated with high levels of job dissatisfaction and negative mental wellbeing among general practitioners in England. DESIGN--Multivariate analysis of large database of general practitioners compiled from results of confidential questionnaire survey. Data obtained on independent variables of job stress, demographic factors, and personality. Dependent variables were mental health, job satisfaction, alcohol consumption, and smoking. SETTING--Natio...

Management of arterial hypertension in Cotonou city, Benin: general practitioners' knowledge, attitudes and practice.

Science.gov (United States)

Houenassi, Martin Dèdonougbo; Codjo, Léopold Houétondji; Dokoui, David; Dohou, Serge Hugues Mahougnon; Wanvoegbe, Armand; Agbodande, Anthelme; Attinsounon, Angelo Cossi; Alassani, Adebayo; Ahoui, Séraphin; Dovonou, Albert Comlan; Adoukonou, Thierry Armel

2016-08-23

We aimed to assess the management of hypertensive patients by general practitioners in Cotonou city. This was a cross-sectional study based on a multicentre survey conducted from 1 May to 31 July 2011. We recruited all consenting general practitioners who worked in public and private centres in Cotonou city. We used the 7th report of the Joint National Committee to assess the management of hypertension by general practitioners. A tested and validated self-questionnaire was used to collect the data on hypertension management by general practitioners. In eight centres that approved the study, 41 general practitioners were included. The definition of hypertension was known by 20 (48.8%) practitioners. Only 25 (61.0%) could describe the conditions for blood pressure measurement. Ten of them were unable to list half of the minimum recommended tests for hypertension, and the majority (92.7%) did not have any idea of global cardiovascular risk. The blood pressure goal was known by only 18 (43.9%) practitioners. Lifestyle (82.9%) and monotherapy (70.7%) were the therapeutic modalities most prescribed. Antihypertensive agents commonly used by practitioners were calcium channel blockers (82.9%), angiotensin converting enzyme inhibitors (53.7%) and diuretics (36.6%). The general practitioners referred their patients to cardiologists mainly for uncontrolled hypertension (63.4%) and the onset of acute complications (56.1%). The general practitioners' knowledge of hypertension was insufficient and their management did not reflect international guidelines.

General practitioner participation in intranatal care in the northern region in 1983.

OpenAIRE

Marsh, G N; Cashman, H A; Russell, I T

1985-01-01

In 1983 a quarter of general practitioners in the Northern region of England cared for obstetric deliveries and half of these for a minimum of 10 deliveries a year. Most expected their intranatal work to remain at the same level or increase in the next 10 years. Most participating general practitioners did their own forceps deliveries and initiated inductions. Most out of hours deliveries were attended by the mother's own general practitioner or a partner. A quarter of all respondents had car...

Perception of drug teratogenicity among general practitioners and specialists in obstetrics/gynecology

DEFF Research Database (Denmark)

Gils, Charlotte; Pottegård, Anton; Ennis, Zandra Nymand

2016-01-01

the perception of the teratogenic risk of 9 commonly and 3 rarely prescribed drugs among general practitioners and specialists in obstetrics/gynecology. METHODS: All 811 general practitioners in the Region of Southern Denmark and all 502 specialist obstetricians/gynecologists in Denmark as a whole were invited...... to participate in the study based on an online questionnaire. Medians and interpercentile ranges of the perceived background risk and perceived risks for each of the drugs were included in the questionnaire. RESULTS: One hundred forty three (18 %) general practitioners and 138 (27 %) obstetricians...... by a dermatologist, and warfarin treatment is only rarely initiated in women of the fertile age without involvement of specialists in internal medicine. Hence, the active knowledge on the teratogenic potential of these drugs is likely to be less accurate among general practitioners and obstetricians...

Treatment management between orthodontists and general practitioners performing clear aligner therapy.

Science.gov (United States)

Best, Alexandra D; Shroff, Bhavna; Carrico, Caroline K; Lindauer, Steven J

2017-05-01

To investigate differences in case selection, treatment management, and aligner treatment expertise between orthodontists and general practitioners. A parallel pair of original surveys with three sections (case selection, treatment management, and demographics) was sent to orthodontists (N = 1000) and general dentists (N = 1000) who were providers of aligner treatment. Orthodontists had treated significantly more patients with aligners, had treated more patients with aligners in the previous 12 months, and had received more aligner training than general dentists (P aligner case confidence between orthodontists and general dentists for several malocclusions. General dentists were more confident than orthodontists in treating deep bite, severe crowding, and Class II malocclusions with aligners (P ≤ .0001). Significant differences were also found for all treatment management techniques except interproximal reduction. There was a significant difference in case selection, treatment management, and aligner expertise between orthodontists and general dentists, although the differences in case selection were small. Overall, it was shown that orthodontists and general dentists elected to treat a variety of moderate to severe malocclusions with aligners but with different utilization of recommended auxiliaries, perhaps demonstrating a difference in treatment goals.

Does general practitioner gatekeeping curb health care expenditure?

NARCIS (Netherlands)

Delnoij, D.; Merode, G. van; Paulus, A.; Groenewegen, P.

2000-01-01

Objectives: It is generally assumed that health care systems in which specialist and hospital care is only accessible after referral by a general practitioner (GP) have lower total health care costs. In this study, the following questions were addressed: do health care systems with GPs acting as

Training and development of the Assistant Practitioners (APs) in radiography

International Nuclear Information System (INIS)

Stewart-Lord, Adéle

2014-01-01

A mixed methods study conducted over three phases (Phase I – scoping exercise, Phase II – questionnaire and Phase III – semi-structured interviews) aimed to explore the role and integration of the assistant practitioner (AP) practitioner in radiography from the AP perspective. Findings of the overall study are presented across a range of articles where this publication only presents the findings in relation to the training and education of APs from all three phases. Results showed the educational routes undertaken by APs in radiography during training. Training whilst working in the clinical department has highlighted a number of key issues relating to educational pathways and delivery methods. Findings showed that APs felt that more could be done to prepare the individual for clinical practice thereby increasing their confidence and facilitating role development. Results also identified a number of challenges in the training and education of APs in radiography. Clear routes of progression and career pathways are not available to APs in radiography. In conclusion the findings suggest the need for a review of existing educational programmes and future standardisation. The need exists to clarify the justifiable methods of training and differentiate between recognised educational qualifications to enable informed career development decisions by APs and their employers

Role of Danish general practitioners in AIDS prevention

DEFF Research Database (Denmark)

Sandbæk, Annelli

1996-01-01

OBJECTIVE: To describe Danish general practitioners' perception of their own role and to register their actual behaviour in the prevention of HIV/AIDS. DESIGN: Data collection was carried out by a) questionnaire and b) prospective registration of consultations dealing with HIV/AIDS in a two...... (94%) were of the opinion that GPs should play a central part in the prevention of HIV; 96% found that their knowledge was sufficient to advise on the prevention of HIV, and 90% thought that the GP should take the initiative to talk about HIV. The median number of consultations dealing with HIV......-week period in September 1992. SETTING: General practice, Denmark. SUBJECTS: One thousand general practitioners (GPs), selected at random, were asked to participate. The study population comprised 352 GPs who returned the questionnaire and participated in the prospective registration. RESULTS: Most of the GPs...

CT colonography: a survey of general practitioners' knowledge and interest.

Science.gov (United States)

Flor, Nicola; Laghi, Andrea; Peri, Mauro; Cornalba, Gianpaolo; Sardanelli, Francesco

2016-01-01

To verify the knowledge and interest of general practitioners on computed tomography colonography (CTC). In 2014, a Web-based questionnaire was proposed to all general practitioners of [Milan, Italy]. The questionnaire consisted of ten questions concerning general practitioners' knowledge about CTC, including application of guidelines in clinical scenarios and diagnostic performance. Out of 1,053 general practitioners, 231 (22%), 155 men and 76 women (mean age 58 years), completed the survey. We found a significant difference between the age of responders and that of non-responders (p = 0.0033). Of the 231 responders, 84% were aware of the possibility of using CTC as a method for examining the colon-rectum. However, only 57% were aware about low X-ray exposure delivered by CTC and about the possibility of using a reduced cleansing protocol. Only 48% were aware that CTC accuracy in diagnosing 10-mm or larger polyps and colorectal cancers was similar to that of conventional colonoscopy, while 62% were informed about CTC advantages in comparison with double-contrast barium enema; 59% thought that CTC had a potential role as a screening test; 85-86% suggested CTC in the case of refused or incomplete conventional colonoscopy; 79% suggested immediate conventional colonoscopy in the case of at least one 10-mm polyp. About 54% usually prescribe one CTC every 4-6 months, while 36% never have, 3% one CTC per month, and 7% one every 2-3 months. Ninety-four per cent declared that they were willing to attend a course on CTC. General practitioners have limited knowledge concerning CTC. Radiological societies should fill this gap offering dedicated educational initiatives.

A training approach for the transition of repeatable collaboration processes to practitioners

NARCIS (Netherlands)

Kolfschoten, G.L.; De Vreede, G.J.; Pietron, L.R.

2011-01-01

This paper presents a training approach to support the deployment of collaboration process support according to the Collaboration Engineering approach. In Collaboration Engineering, practitioners in an organization are trained to facilitate a specific collaborative work practice on a recurring

Medical emergencies facing general practitioners: Drugs for the doctor's bag

OpenAIRE

Janković Slobodan

2014-01-01

General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever), morphine (for severe pain), naloxone (for heroin poisoning), ceftriaxone (for meningococcal ...

Prescribing Behavior of General Practitioners : Competition Matters!

NARCIS (Netherlands)

Schaumans, C.B.C.

2014-01-01

Background: General Practitioners have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives: We investigate whether GPs exhibit different prescribing behavior (volume and value of

[Ankle brachial index: motivations, training, and practices among 165 general practitioners in Île-de-France].

Science.gov (United States)

Meyer, D; Bureau, J-M; Vu Tri, D

2014-02-01

Peripheral arterial disease (PAD) is under-diagnosed despite its predictive value for cardiovascular mortality. The ankle brachial index (ABI), a simple reliable measure recommended by the French health authorities to detect and evaluate the severity of PAD, is used by too few general practitioners (GPs). This study aimed at identifying motivations and barriers for using ABI in general practice. A representative, descriptive, cross-sectional survey was conducted amongst 165 GPs practicing in Île-de-France who were interviewed using stratified quotas. Although 1 out of 5 GPs considered ABI to be an irrelevant indicator, most had a favorable opinion about its use (OR: 4.9 [CI 95 %: 4.2-5.7]). Only 42 % (CI 95 %: 34 %-49 %) of GPs knew ABI was recommended by the health authorities. This information had a critical impact on the acceptance of ABI relevancy (OR: 3.7 [CI 95 %: 3.2-4.2]). Training reinforced acceptance (OR: 5.0 [CI 95 %: 4.4-5.6]) and pre-residency education provided a better understanding of ABI (OR: 2.8 [CI 95 %: 2.3-3.4]). Time needed to measure ABI was the main barrier (OR: 0.6 [CI 95 %: 0.6-0.7]). A Doppler-calculation kit (OR: 11.8 [CI 95 %: 8.9-15.6]), equipment cost≤300Euros (OR: 3.4 [CI 99 %: 3.0-3.9]), a specific fee in addition to the regular consultation fee (OR: 2.6 [CI 95 %: 2.3-3.0]) and inclusion of ABI in the GP's evaluation scheme (OR: 2.6 [CI 95 %: 2.3-2.9]) would motivate more GPs. Seven out of 10 GPs agreed that ABI has a positive impact on patient adherence to treatment and follow-up, but ABI remained underexploited for symptomatic patients (OR: 0.4 [CI 95 %: 0.3-0.4]). Better communication and training together with an upgraded status for ABI would provide motivation for GPs to measure ABI. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The Effect of a Surgical Skills Course on Confidence Levels of Rural General Practitioners: An Observational Study.

Science.gov (United States)

Byrd, Pippa; Ward, Olga; Hamdorf, Jeffrey

2016-10-01

Objective  To investigate the effect of a short surgical skills course on general practitioners' confidence levels to perform procedural skills. Design  Prospective observational study. Setting  The Clinical Evaluation and Training Centre, a practical skills-based educational facility, at The University of Western Australia. Participants  Medical practitioners who participated in these courses. Nurses, physiotherapists, and medical students were excluded. The response rate was 61% with 61 participants providing 788 responses for pre- and postcourse confidence levels regarding various surgical skills. Intervention  One- to two-day surgical skills courses consisting of presentations, demonstrations, and practical stations, facilitated by specialists. Main Outcome Measures  A two-page precourse and postcourse questionnaire was administered to medical practitioners on the day. Participants rated their confidence levels to perform skills addressed during the course on a 4-point Likert scale. Results  Of the 788 responses regarding confidence levels, 621 were rated as improved postcourse, 163 were rated as no change, and 4 were rated as lower postcourse. Seven of the courses showed a 25% median increase in confidence levels, and one course demonstrated a 50% median increase. All courses showed statistically significant results ( p  skills course resulted in a statistically significant improvement in the confidence levels of rural general practitioners to perform these skills.

Prescribing behavior of general practitioners : Competition matters!

NARCIS (Netherlands)

Schaumans, C.B.C.

Background General Practitioners (GP) have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives I investigate whether GPs prescribe more units when confronted with more competition. As

Factors influencing general practitioners in the referral of elderly cancer patients

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Demeaux Jean-Louis

2011-01-01

Full Text Available Abstract Background A number of studies have identified advanced age as a barrier to accessing specialised oncological care. Many factors can influence the care provided for elderly patients after a diagnosis of cancer has been established or is suspected. Only one European study has analysed the decision processes leading general practitioners (GPs to refer elderly patients with cancer to oncologists. The objectives of the current study are to describe the factors that influence these decisions and to identify the particular factors and GP characteristics that are associated with systematic referral of these patients in South-West France. Methods This is a cross-sectional study on a representative sample of GPs in Aquitaine, South-West France. Questionnaire items were selected using a Delphi consensus approach and sent by post. Two logistic regression models were constructed to investigate GPs' decisions to refer these patients. Results The response rate obtained was 30%. Half of the general practitioners reported "always" referring their elderly cancer patients to oncologists. More than 75% reported being influenced by patient-related elements (patient and/or family wishes, comorbid factors, unsuitability of invasive investigations, physical and mental autonomy, by cancer-related elements (severity of symptoms, expected side-effects and an organisational element (whether the general practitioner was used to collaborating with oncologists. Logistic regression analysis showed that cancer site and organisational difficulties in patient management were significantly associated with the decision to refer elderly patients with early-stage cancer. For advanced stages, oncology training, patient age, organisational difficulties in patient management and stage of cancer were significantly associated with the decision to refer elderly patients. Conclusions Cancer-linked factors and organisational difficulties have been highlighted as influencing the

How can a postgraduate professional education and development course benefit general practitioners?: a qualitative study

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Steven Agius

2015-06-01

Full Text Available Purpose: The rationale for ‘professional education and development’ (PED courses is to support general practitioners, enabling them to access a range of theoretical and practical skills within a supportive schema. It aims to identify whether and how a regional PED course has had a beneficial impact upon participants. Methods: The study comprised a qualitative investigation of participants’ assessed coursework portfolios. The content of each portfolio gives individual accounts of the impact of the course on personal and practice development. Permission to access extant portfolios was obtained from 16 recent alumni of the course. The anonymous written material was analysed by the research team for recurring discourses and themes using a thematic framework analysis. Results: Seven major thematic categories were extrapolated from the data: leadership, resilience, quality improvement, change management, development of new services, educational expertise, and patient safety. In each category, we found evidence that the course enabled development of practitioners by enhancing knowledge and skills which had a positive impact upon their self-perceived effectiveness and motivation. Conclusion: Extended specialty training is on the horizon but such courses may still serve a valuable purpose for current trainees and the existing general practitioners workforce which will be responsible for leading the shift towards community-based service delivery.

Evaluating the Quantity and Quality of Continuing medical education Programs from the Viewpoint of General Medical Practitioners, Ilam Province

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Mohsen Fatahi

2015-07-01

Full Text Available Background and purpose: The purpose of this research was to evaluate the quantity and quality of continuing medical education programs from the viewpoint of general medical practitioners in Ilam province.Methods: The research method was descriptive survey and the statistic sample was a group of 61 general medical practitioners who have been working in Ilam during 2010-2011 and were chosen by simple random sampling method. The data collection tool was a questionnaire with 50 items and reliability coefficient obtained using Cronbach's alpha which was 88%.Results: The findings showed that there is a meaningful/significant relationship between CME (Continuing Medical Education/retraining programs and improving GPs (General Practitioner clinical skills with reliability of 99% and this relationship is direct and positive (r=0.502. It means that increasing the quality and quantity of these programs has positive effect on improving general practitioners’ clinical skills. There was no meaningful/significant relationship between the method of teaching and GPs satisfaction (r=0.160. It means most of these practitioners were not satisfied with using training equipment, teaching methods, teachers' knowledge and manners. Also, there was no meaningful/significant relationship between teaching times and educational materials and GPs satisfaction (r=0.73 .It shows that the rate of GPs satisfaction from teaching times and educational materials is very low and there is little coherence between them. But there was a meaningful/significant relationship between GPs job requirements and educational materials with reliability of 95% (r=0.326. It means presenting suitable teaching materials and content related to GPs jobs requirements led to increase GPs desire to attend educational classes .There was no meaningful/significant relationship between time dedicated to each topic and improving GPs skills (r=0.096. So, findings indicate that there is no coincidence between

General practitioners' views on leadership roles and challenges in primary health care: a qualitative study.

Science.gov (United States)

Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

2017-03-01

To explore general practitioners' (GPs) views on leadership roles and leadership challenges in general practice and primary health care. We conducted focus groups (FGs) with 17 GPs. Norwegian primary health care. 17 GPs who attended a 5 d course on leadership in primary health care. Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. KEY POINTS Little is known about doctors' experiences and views about leadership in general practice and primary health care. Our study suggests that: There is a lack of preparation and formal training for the leadership role. GPs experience tensions between the clinical and leadership role. GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care.

Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: a cross-sectional study of early career general practitioners.

Science.gov (United States)

Catzikiris, Nigel; Tapley, Amanda; Morgan, Simon; Holliday, Elizabeth G; Ball, Jean; Henderson, Kim; Elliott, Taryn; Spike, Neil; Regan, Cathy; Magin, Parker

2017-08-10

Objectives Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the 'baby boomer' GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPs is essential to sustaining this workforce training capacity. The aim of the present study was to establish the prevalence and associations of in-practice clinical teaching and supervision in early career GPs. Methods The present study was a cross-sectional questionnaire-based study of recent (within 5 years) alumni of three of Australia's 17 regional general practice training programs. The outcome factor was whether the alumnus taught or supervised medical students, GP registrars or other learners in their current practice. Logistic regression analysis was used to establish associations of teaching and supervision with independent variables comprising alumnus demographics, current practice characteristics and vocational training experiences. Results In all, 230 alumni returned questionnaires (response rate 37.4%). Of currently practising alumni, 52.4% (95% confidence interval (CI) 45.6-59.0%) reported current teaching or supervisory activities. Factors significantly (Pinterest in and undertaking of teaching roles have been documented for GP or family medicine trainees, studies investigating the engagement in these clinical roles by GPs during their early post-training period are lacking. What does this paper add? This paper is the first to document the prevalence of teaching and supervision undertaken by early career GPs as part of their regular clinical practice. We also demonstrate associations of practice rurality, country of medical graduation and undertaking non-practice-based clinical roles with GPs' engagement in teaching and supervisory roles. What are the implications for practitioners? Establishing current teaching patterns of GPs enables appropriate targeting of new strategies to

The current and future role of general practitioners in skin cancer care: an assessment of 268 general practitioners

NARCIS (Netherlands)

Rijsingen, M.C.J. van; Bon, B.W. van; Wilt, G.J. van der; Lagro-Janssen, A.L.M.; Gerritsen, M.J.P.

2014-01-01

BACKGROUND: Given the increase in skin cancer (SC) it seems inevitable that general practitioners (GPs) will play a larger role in SC care in the near future. OBJECTIVES: To obtain insights into the opinion of GPs with respect to their role in SC care, and their SC knowledge and skills. METHODS: A

Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand

Directory of Open Access Journals (Sweden)

Critchley Julia

2005-06-01

Full Text Available Abstract Background Over-prescribing of benzodiazepines appears common in many countries, a better understanding of prescribing practices and attitudes may help develop strategies to reduce prescribing. This study aimed to evaluate benzodiazepine prescribing behaviour and attitudes in general practitioners practising in Chiang Mai and Lampoon, Thailand. Methods Questionnaire survey of general practitioners in community hospitals, to estimate: i use of benzodiazepines for anxiety/insomnia, panic disorder, depression, essential hypertension, and uncomplicated low back pain and ii views on the optimal duration of benzodiazepine use. Results Fifty-five of 100 general practitioners returned the completed questionnaires. They reported use of benzodiazepines for anxiety/insomnia (n = 51, 93%, panic disorder (n = 43, 78%, depression (n = 26, 43%, essential hypertension (n = 15, 27 % and uncomplicated low back pain (n = 10, 18%. Twenty-eight general practitioners would prescribe benzodiazepines for non-psychiatric conditions, 17 for use as muscle relaxants. Seventy-five per cent, 62% and 29% of the general practitioners agreed or totally agreed with the use of benzodiazepines for insomnia, anxiety and depression, respectively. Practitioners agreed that prescribing should be less than one week (80%; or from 1 week to 1 month (47%; or 1 to 4 months (16%; or 4 to 6 months (5% or more than 6 months (2%. Twenty-five general practitioners (45% accepted that they used benzodiazepines excessively in the past year. Conclusion A considerable proportion of general practitioners in Chiang Mai and Lampoon, Thailand inappropriately use benzodiazepines for physical illnesses, especially essential hypertension and uncomplicated low back pain. However, almost half of them thought that they overused benzodiazepines. General practitioner's lack of time, knowledge and skills should be taken into account in improving prescribing behaviour and attitudes.

Practitioners Who Work with Parents with Intellectual Disability: Stress, Coping and Training Needs

Science.gov (United States)

Clayton, Olivia; Chester, Andrea; Mildon, Robyn; Matthews, Jan

2008-01-01

Background: Challenges for practitioners who work with parents with intellectual disability arise from several sources. The purpose of the current study was to identify the stressors experienced by practitioners who work with parents with intellectual disability in Australia, investigate coping strategies and explore training needs so as to inform…

The new era of postgraduate certified general practice training in Japan.

Science.gov (United States)

Takamura, Akiteru

2016-09-01

This paper describes the background to, and the recent evolution of general practice as a recognised medical specialism in Japan (2015), and the evolution of a system of training to support this development. We, the general practitioners (GPs) in Japan have not been recognised as one body of medical specialists and have been training in our own way. A new certified training system will commence in 2018, authorised by a new third organisation, the Japanese Medical Specialty Board. An effective educational system has been developed for medical graduates that have a career intention in general practice that is distinct from other basic medical fields, but collaborates with them. A challenge exists to provide clarity to the Japanese population about what the specialty of general practice is, and what professionals in general practice can do for them. Japan currently has approximately 500 certified GPs and it is unclear at present what numbers will eventually be required. This paper reviews some of the challenges facing the development of general practice from the perspective of the Japan Primary Care Association.

Ways of Improving the Training of Interns Pediatricians and General Practitioners — Family Physicians in «Pediatrics» Discipline

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S.A. Mokiia-Serbina

2015-09-01

Full Text Available Graduates of medical schools having sufficient theoretical and practical skills often have difficulty in communicating with patients — children and their parents, as well as with colleagues. Objective: improving the efficiency of the educational process in the training of interns pediatricians and general practitioners — family physicians in «Pediatrics» course. Methods of the study: theoretical analysis of gathered experience. Results and discussion. During internship at the department, there are used seminars-discussions, seminars — training conferences, seminars — round tables that allows you to work out the tactics of speech, methods of discussion, reasoning of judgments, review, assessment, analysis. Interns most of the time must participate in the examination of a sick child, discussions of the results, conversations with parents. Clinical analysis of patients should be carried out using the method of structured group discussion when each intern can express his views. Interns are involved in scientific work, speak at scientific conferences. The department created a series of ambulatory pediatrics, -during which the intern talks to a child, his parents and he must to conciliate them, to inspire confidence and to prove himself as a specialist. During this course, special attention is paid to the psychological component of medical trai-ning. Clas-ses are conducted by assistant pediatrician, a graduate majoring in «Practical Psychology». Conclusions. The use of interactive teaching methods at different stages of the educational process contributes not only to improvement of theoretical activity, but also the formation in interns of professional qualities of clinical and scientific thinking, competence in the construction and development of interpersonal relations, humanism.

Does the Use of Multifactorial Training Methods Increase Practitioners' Competence?

Science.gov (United States)

Pittman, Corinthus Omari; Lawdis, Katina

2017-01-01

Skilled therapy practitioners are required by their governing associations to seek professional development per licensure requirements. These requirements facilitate clinical reasoning and confidence during patient care. There are limited online professional development workshops, especially ones that offer multifactorial training as an…

Effects of questionnaire-based diagnosis and training on inter-rater reliability among practitioners of traditional Chinese medicine.

Science.gov (United States)

Mist, Scott; Ritenbaugh, Cheryl; Aickin, Mikel

2009-07-01

To investigate whether a training process that focused on a questionnaire-based diagnosis in Traditional Chinese Medicine (TCM), and developing diagnostic consensus, would improve the agreement of TCM diagnoses among 10 TCM practitioners evaluating patients with temporomandibular joint disorder (TMJD). Evaluation of a diagnostic training program at the Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, and the Oregon College of Oriental Medicine, Portland, Oregon. Screened participants for a study of TCM for TMJD. PRACTITIONERS: Ten (10) licensed acupuncturists with a minimum of 5 years licensure and education in Chinese herbs. A training session using a questionnaire-based diagnostic form was conducted, followed by waves of diagnostic sessions. Between sessions, practitioners discussed the results of the previous round of participants with a focus on reducing variability in primary diagnosis and severity rating of each diagnosis: 3 waves of 5 patients were assessed by 4 practitioner pairs for a total of 120 diagnoses. At 18 months, practitioners completed a recalibration exercise with a similar format with a total of 32 diagnoses. These diagnoses were then examined with respect to the rate of agreement among the 10 practitioners using inter-rater correlations and kappas. The inter-rater correlation with respect to the TCM diagnoses among the 10 practitioners increased from 0.112 to 0.618 with training. Statistically significant improvements were found between the baseline and 18 month exercises (p reliability of TCM diagnosis may be improved through a training process and a questionnaire-based diagnosis process. The improvements varied by diagnosis, with the greatest congruence among primary and more severe diagnoses. Future TCM studies should consider including calibration training to improve the validity of results.

Are biochemistry interpretative comments helpful? Results of a general practitioner and nurse practitioner survey.

Science.gov (United States)

Barlow, Ian M

2008-01-01

Adding or incorporating clinical interpretative comments on biochemistry results is widespread in UK laboratories; although this consumes considerable human resource, there is still little evidence to suggest that it is either effective or appreciated by our clinical colleagues. I therefore decided to survey our local general practitioners (GPs) and nurse practitioners to analyse whether they found biochemistry comments on reports helpful. A simple questionnaire was designed and sent to 159 GPs and 81 nurse practitioners asking them whether they found this activity useful for the limited range of test groups that we routinely comment on and also whether they would like to see commenting on more groups of tests. Overall, 49.6% of questionnaires were returned. Of these, there was overwhelming support for commenting on reports and 77% would like to see comments on a greater range of tests. Although adding clinical interpretative comments is very time-consuming for senior laboratory staff, there is overwhelming support of this activity among our GPs and nurse practitioner users; therefore, our local policy of routinely adding clinical comments will remain for the foreseeable future.

Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

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Schellevis François G

2007-09-01

Full Text Available Abstract Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%. In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation.

Mutual influences of general practitioners in partnerships

NARCIS (Netherlands)

Judith, D. de; Groenewegen, Peter P.; Westert, Gert P.

2003-01-01

The aim of this study was to find out whether or not general practitioners (GPs) within the same partnership show more similarities in attitudes and behaviour than GPs in different partnerships, and what the causes of these similarities might be. Knowledge of the causes of patterns of similarities

Airway management by the general practitioner in trauma patients. Technical and non-technical skills

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Juan David Dominguez-Sánchez

2016-07-01

Full Text Available General practitioners must constantly face challenges imposed by their profession when performing interventions that are necessary for their patients. Many of these interventions not only require proper use of theoretical knowledge, but also putting into practice non-technical and psychomotor skills developed through professional training. Given the specific characteristics of each patient, the clinical setting in the which procedure takes place and the limited skills of the professional, the management of the airway of a patient with trauma injuries in the emergency room represents a major challenge for physicians.

Current sedation practice among general dental practitioners and dental specialists in Jordan: an example of a developing country

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Al-Shayyab MH

2013-05-01

Full Text Available Mohammad H Al-Shayyab,1 Soukaina Ryalat,1 Najla Dar-odeh,1 Firas Alsoleihat21Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology and Periodontology, Faculty of Dentistry, 2Department of Conservative Dentistry and Fixed Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, JordanPurpose: The study reported here aimed to identify current sedation practice among general dental practitioners (GDPs and specialist dental practitioners (SDPs in Jordan in 2010.Methods: Questionnaires were sent by email to 1683 GDPs and SDPs who were working in Jordan at the time of the study. The contact details of these dental practitioners were obtained from a Jordan Dental Association list. Details on personal status, use of, and training in, conscious sedation techniques were sought by the questionnaires.Results: A total of 1003 (60% questionnaires were returned, with 748 (86.9% GDPs and 113 (13.1% SDPs responding. Only ten (1.3% GDPs and 63 (55.8% SDPs provided information on the different types of treatments related to their specialties undertaken under some form of sedation performed by specialist and/or assistant anesthetists. Approximately 0.075% of the Jordanian population received some form of sedation during the year 2010, with approximately 0.054% having been treated by oral and maxillofacial surgeons. The main reason for the majority of GDPs (55.0% and many SDPs (40% not to perform sedation was lack of training in this field. While some SDPs (26.0% indicated they did not use sedation because of the inadequacy of sedative facilities.Conclusion: Within the limitations of the present study, it can be concluded that the provision of conscious sedation services in general and specialist dental practices in Jordan is inconsistent and inadequate. This stresses the great need to train practitioners and dental assistants in Jordan to enable them to safely and effectively perform all forms of sedation.Keywords: Jordan Dental

Vertical integration of teaching in Australian general practice--a survey of regional training providers.

Science.gov (United States)

Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah

2011-06-06

To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.

General practitioner participation in intranatal care in the northern region in 1983.

Science.gov (United States)

Marsh, G N; Cashman, H A; Russell, I T

1985-03-30

In 1983 a quarter of general practitioners in the Northern region of England cared for obstetric deliveries and half of these for a minimum of 10 deliveries a year. Most expected their intranatal work to remain at the same level or increase in the next 10 years. Most participating general practitioners did their own forceps deliveries and initiated inductions. Most out of hours deliveries were attended by the mother's own general practitioner or a partner. A quarter of all respondents had cared for planned and unplanned home births. Few were happy about attending them, but most would provide planned home care if urged to do so.

Effectiveness of an online knowledge training and assessment program for stop smoking practitioners.

Science.gov (United States)

Brose, Leonie S; West, Robert; Michie, Susan; Kenyon, Jennifer A M; McEwen, Andy

2012-07-01

In English National Health Service (NHS) stop smoking services, stop smoking practitioners (SSPs) provide behavioral support and medication to support smokers wanting to quit. This study aimed to evaluate an evidence-based national online knowledge training program for SSPs developed by the NHS Centre for Smoking Cessation and Training (NCSCT). Knowledge required to deliver effective stop smoking interventions was assessed using 25 multiple-choice questions drawn randomly from a common larger pool at baseline and after use of the training program in 778 consecutive users. Change in knowledge and association of this change with time spent on the training were assessed. Baseline and change in knowledge of SSPs with different amounts of experience, prior training, and time dedicated to smoking cessation were compared. Knowledge improved from 64.4% correct to 77.7% (p < .001). Time spent on the training predicted improvement. Pretraining knowledge scores differed with experience, prior training, and time practicing. Training improved even the highest performing SSPs and minimized differences between groups. Knowledge required to deliver effective stop smoking intervention is improved efficiently by using the NCSCT online training program for English smoking cessation practitioners. SSPs with all levels of prior knowledge benefit.

Teamwork in primary palliative care: general practitioners' and specialised oncology nurses' complementary competencies.

Science.gov (United States)

Johansen, May-Lill; Ervik, Bente

2018-03-07

Generalists such as general practitioners and district nurses have been the main actors in community palliative care in Norway. Specialised oncology nurses with postgraduate palliative training are increasingly becoming involved. There is little research on their contribution. This study explores how general practitioners (GPs) and oncology nurses (ONs) experience their collaboration in primary palliative care. A qualitative focus group and interview study in rural Northern Norway, involving 52 health professionals. Five uni-professional focus group discussions were followed by five interprofessional discussions and six individual interviews. Transcripts were analysed thematically. The ideal cooperation between GPs and ONs was as a "meeting of experts" with complementary competencies. GPs drew on their generalist backgrounds, including their often long-term relationship with and knowledge of the patient. The ONs contributed longitudinal clinical observations and used their specialised knowledge to make treatment suggestions. While ONs were often experienced and many had developed a form of pattern recognition, they needed GPs' competencies for complex clinical judgements. However, ONs sometimes lacked timely advice from GPs, and could feel left alone with sick patients. To avoid this, some ONs bypassed GPs and contacted palliative specialists directly. While traditional professional hierarchies were not a barrier, we found that organization, funding and remuneration were significant barriers to cooperation. GPs often did not have time to meet with ONs to discuss shared patients. We also found that ONs and GPs had different strategies for learning. While ONs belonged to a networking nursing collective aiming for continuous quality improvement, GPs learned mostly from their individual experience of caring for patients. The complementary competences and autonomous roles of a specialised nurse and a general practitioner represented a good match for primary palliative

DO GENERAL MEDICAL PRACTITIONERS EXAMINE INJURED RUNNERS?

DEFF Research Database (Denmark)

Videbæk, Solvej; Jensen, A V; Rasmussen, S

2017-01-01

BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study...

Entrepreneurial training for Human Resource practitioners and potential services rendered to Small Enterprises

Directory of Open Access Journals (Sweden)

R. van der Walt

2008-12-01

Full Text Available This article examines to what extent current South African university courses/programmes in Human Resources Management and Industrial Psychology prepare students for a career in entrepreneurship. It is argued that human resources practitioners have much to offer in the line of services and advice to small enterprises on how to succeed. The data of the survey are analysed through a qualitative approach. The findings indicate that entrepreneurship training currently receives limited attention in the training of human resources practitioners and industrial psychologists.   Key words and phrases: entrepreneurial education, human resources management, industrial psychology

Empathy Variation in General Practice: A Survey among General Practitioners in Denmark

DEFF Research Database (Denmark)

Charles, Justin; Ahnfeldt-Mollerup, Peder; Søndergaard, Jens

2018-01-01

Background: Previous studies have demonstrated that high levels of physician empathy may be correlated with improved patient health outcomes and high physician job satisfaction. Knowledge about variation in empathy and related general practitioner (GP) characteristics may allow for a more informe...

Attitude and awareness of general dental practitioners toward radiation hazards and safety.

Science.gov (United States)

Aravind, B S; Joy, E Tatu; Kiran, M Shashi; Sherubin, J Eugenia; Sajesh, S; Manchil, P Redwin Dhas

2016-10-01

The aim and objective is to evaluate the level of awareness and attitude about radiation hazards and safety practices among general dental practitioners in Trivandrum District, Kerala, India. A questionnaire-based cross-sectional study was conducted among 300 general dental practitioners in Trivandrum District, Kerala, India. Postanswering the questions, a handout regarding radiation safety and related preventive measures was distributed to encourage radiation understanding and protection. Statistical analysis were done by assessing the results using Chi-square statistical test, t -test, and other software (Microsoft excel + SPSS 20.0 trail version). Among 300 general practitioners (247 females and 53 males), 80.3% of the practitioners were found to have a separate section for radiographic examination in their clinics. Intraoral radiographic machines were found to be the most commonly (63.3%) used radiographic equipment while osteoprotegerin was the least (2%). Regarding the practitioner's safety measures, only 11.7% of them were following all the necessary steps while 6.7% clinicians were not using any safety measure in their clinic, and with respect to patient safety, only 9.7% of practitioners were following the protocol. The level of awareness of practitioners regarding radiation hazards and safety was found to be acceptable. However, implementation of their knowledge with respect to patient and personnel safety was found wanting. Insisting that they follow the protocols and take necessary safety measures by means of continuing medical education programs, pamphlets, articles, and workshops is strongly recommended.

Community orientation of general practitioners in 34 countries.

NARCIS (Netherlands)

Groenewegen, P.

2017-01-01

Background: General practitioners (GPs) differ roughly speaking in whether they care for patients that visit their practice or whether they have a responsibility for a population. As a consequence of changes in demography (aging populations), epidemiology (multimorbidity) and healthcare policy, an

'Just a lovely luxury?' What can public health attachments add to postgraduate general practice training?

Science.gov (United States)

Wills, Jane; Reynolds, Joanna; Swanwick, Tim

2009-07-01

Changing trends in the role of general practice and general practitioners (GPs), including a focus on commissioning and practice population health needs, were reflected in the specialty training curriculum published by the Royal College of General Practitioners (RCGP) in 2007. In response to these developments the London Deanery established training attachments to the public health departments of ten primary care trusts (PCTs) across London, incorporated into three-year GP specialty training programmes. These attachments were evaluated in 2008 by London South Bank University. The aims of the evaluation were to assess the attachment's suitability for addressing areas of the RCGP curriculum; and to explore perceptions of its value for GP training and for future practice. Semi-structured interviews were carried out with two cohorts of trainees towards the end of their public health attachment, and with public health trainers and GP training programme directors from participating schemes. The training attachments were generally considered to offer good opportunities for trainees to fulfil both public health competences and to address relevant areas of the RCGP curriculum, through a variety of types of work. However, this did not necessarily influence either the level of importance attributed to public health in comparison with other clinical training posts or the perceived impact of the attachment on the trainees' future practice as GPs. The reported learning outcomes and value of the attachment for the public health trainers and programme directors reflected the changing and perceived future demands on GPs, but these views were not generally shared by trainees. Public health attachments may offer general practice training programme opportunities for the development of skills and knowledge that are relevant to the changing nature of general practice. Yet, there still appears to be a barrier for trainee GPs in acknowledging their role in non-clinical, population

Developing Common Competencies for Southeast Asian General Dental Practitioners.

Science.gov (United States)

Chuenjitwongsa, Supachai; Poolthong, Suchit; Bullock, Alison; Oliver, Richard G

2017-09-01

Current policy in Southeast Asian dental education focuses on high-quality dental services from new dental graduates and the free movement of dental practitioners across the region. The Southeast Asian Nations (ASEAN) Dental Councils have proposed the "Common Major Competencies for ASEAN General Dental Practitioners" to harmonize undergraduate dental education. This article discusses how the ASEAN competencies were developed and established to assist the development of general dental practitioners with comparable knowledge, skills, and attitudes across ASEAN. The competencies were developed through four processes: a questionnaire about current national oral health problems, a two-round Delphi process that sought agreement on competencies, a panel discussion by representatives from ASEAN Dental Councils, and data verification by the representatives after the meeting. Key themes of the ASEAN competencies were compared with the competencies from the U.S., Canada, Europe, Australia, and Japan. A total of 33 competency statements, consistent with other regions, were agreed upon and approved. Factors influencing the ASEAN competencies and their implementation include oral health problems in ASEAN, new knowledge and technology in dentistry, limited institutional resources, underregulated dental schools, and uneven distribution of dental practitioners. The ASEAN competencies will serve as the foundation for further developments in ASEAN dental education including policy development, curriculum revision, quality assurance, and staff development. Collaboration amongst stakeholders is essential for successful harmonization of ASEAN dental education.

General practitioners and their role in maternity care.

NARCIS (Netherlands)

Wiegers, T.A.

2003-01-01

During the last century the perception of pregnancy and childbirth has changed from a normal, physiological life-event to a potentially dangerous condition. Maternity care has become more and more obstetrical care, focussed on pathology and complications. The involvement of general practitioners

[The practice guideline 'Anemia' from the Dutch College of General Practitioners; a response from the perspective of general practice medicine

NARCIS (Netherlands)

Bosch, W.J.H.M. van den

2003-01-01

The practice guideline 'Anaemia' from the Dutch College of General Practitioners will certainly be a support for the Dutch general practitioner. The inclusion of an algorithm to make a more precise diagnosis is an experiment that needs to be evaluated in the near future. However, many general

Self-referral in a gatekeeping system: patients' reasons for skipping the general-practitioner.

NARCIS (Netherlands)

Kulu Glasgow, I.; Delnoij, D.; Bakker, D. de

1998-01-01

In the Netherlands general practitioners act as the primary level to the more specialized and more expensive secondary health-care. As a rule, patients are required to have a referral from their general practitioners to be able to utilize these services. Not all private insurance companies, however,

General practitioner reported follow–up visits among asthma ...

African Journals Online (AJOL)

shobha

Methods: It was a cross–sectional survey conducted among GPs in three ... patients 2 weeks prior to the study reported that their ... Keywords: Asthma care, follow—up visits general practitioners, Nigeria ..... not go to their GPs for follow–up treatment of .... National and international guidelines for the.

Attitudes of general dental practitioners towards implant dentistry in an environment with widespread provision of implant therapy.

Science.gov (United States)

Lang-Hua, Bich Hue; Lang, Niklaus P; Lo, Edward C M; McGrath, Colman P J

2013-03-01

To determine attitudes of general dental practitioners in a community where provision dental implants is a well-known treatment modality; and to identify variations in the attitudes with respect to dentists' factors, training factors and implant provision factors. A questionnaire survey to a random sample of registered dentists In Hong Kong was performed. Attitudes towards implant dentistry with respect to (i) perceived superiority of implant therapy, (ii) perceived outcomes of dental implant therapy, (iii) perceived complications & maintenance issues and (iv) placement issues were ascertained. In addition, information was collected on dentists' factors, training factors and implant provision factors. Variations in attitudes towards implant dentistry were explored in bivariate and regression analyses. Among eligible practitioners (n = 246), the response rate was 46.3%. Dentists perceived implants to be superior to conventional prostheses for the replacement of a single missing posterior tooth (80%, 67) and likewise, for the replacement of a single missing anterior tooth (67%, 67), P attitudes with respect to attitudes exists with respect to dentists' factors (years in practice [P attitudes are not wholly in line with evidence-based knowledge. Variations in their attitudes existed with respect to dentist factors, training and experience issues. © 2012 John Wiley & Sons A/S.

Women with urinary incontinence: self-perceived worries and general practitioners' knowledge of problem.

Science.gov (United States)

Lagro-Janssen, T L; Smits, A J; Van Weel, C

1990-01-01

In the context of a large scale survey of health problems in women aged 50 to 65 years, a study was undertaken on the effects of incontinence on daily life. For this purpose 1442 women randomly selected from the practice files of 75 general practitioners in the eastern part of the Netherlands were interviewed at home (response rate 60%). In cases of moderate or severe incontinence the general practitioner of the woman concerned was asked whether this problem had been diagnosed in general practice. Incontinence was reported in 22.5% of the women. Overall, 77.8% of the women did not feel worried about it and 75.4% did not feel restricted in their activities; even for women with severe incontinence (daily frequency and needing protective pads) only 15.6% experienced much worry and 15.7% much restriction. About a third of the women with incontinence (32.0%) had been identified by their general practitioner. The greater the worries and restrictions owing to incontinence, the greater the chance that the incontinence was known to the general practitioner concerned. Only a small minority of the women who felt severely restricted were not identified by their general practitioner. There was a positive relation between recognized incontinence and a history of hysterectomy. This study contradicts the image of the incontinent woman as isolated and helpless; most women in this study seemed able to cope. PMID:2121179

Old persons' contact with general practitioners in relation to health: a Danish population study

DEFF Research Database (Denmark)

Almind, G; Holstein, B E; Holst, E

1991-01-01

The study describes health, social situation, and contact with general practitioners in a random sample of non-institutionalized persons 70-95 years old in Denmark. There was a strong correlation between health and contact with general practitioners. A small group, 3% of the respondents, had...... no health problems, but had been in contact with a general practitioner within the previous month. This group was characterized by a strong social network and a high degree of life satisfaction. Another small group, including 3% of the respondents, had extensive health problems, but had nevertheless...

Acceptability to general practitioners of national health insurance ...

African Journals Online (AJOL)

D. Mch1tyre. Objective. To determine general practitioners' attitudes to national health insurance (NHI) and to capitation as a ... GPs who approved the introduction of NHI varied depending ... Health Economics Unit, Department of Community Health, University .... in Table I. They were then asked a series of closed questions.

Changing relationships: attitudes and opinions of general practitioners and pharmacists regarding the role of the community pharmacist.

NARCIS (Netherlands)

Muijrers, P.E.; Knottnerus, J.A.; Sijbrandij, J.; Janknegt, R.; Grol, R.P.T.M.

2003-01-01

BACKGROUND: Relationship between general practitioners and pharmacists. AIM: To explore similarities and differences in opinions between general practitioners and pharmacists about the pharmacist's role. To identify factors which determine the attitude of the general practitioner towards the role of

Consumer preferences for general practitioner services.

Science.gov (United States)

Morrison, Mark; Murphy, Tom; Nalder, Craig

2003-01-01

This study focuses on segmenting the market for General Practitioner services in a regional setting. Using factor analysis, five main service attributes are identified. These are clear communication, ongoing doctor-patient relationship, same gender as the patient, provides advice to the patient, and empowers the patient to make his/her own decisions. These service attributes are used as a basis for market segmentation, using both socio-demographic variables and cluster analysis. Four distinct market segments are identified, with varying degrees of viability in terms of target marketing.

How do general practitioners, pharmacists and patients evaluate the substitution system for prescription in Denmark?

DEFF Research Database (Denmark)

Rubak, Sune; Andersen, Marie-Louise Elkjær; Mainz, Jan

2002-01-01

Aim/Objectives: Evaluation of how the substitution system has been implemented, how it was assessed by the general practitioners (GPs), pharmacists (PHs) and patients, and clarification of benefits and problems related to the system. Methods: The study was based on specific question-naires to GPs....... How do general practitioners, pharmacists and patients evaluate the substitution system for prescription in Denmark?. Available from: http://www.researchgate.net/publication/243131968_How_do_general_practitioners_pharmacists...

Ethics education: a priority for general practitioners in occupational medicine.

Science.gov (United States)

Alavi, S Shohreh; Makarem, Jalil; Mehrdad, Ramin

2015-01-01

General practitioners (GPs) who work in occupational medicine (OM) should be trained continuously. However, it seems that ethical issues have been neglected. This cross-sectional study aimed to determine educational priorities for GPs working in OM. A total of 410 GPs who participated in OM seminars were asked to answer a number of questions related to items that they usually come across in their work. The respondents were given scores on 15 items, which pertained to their frequency of experience in OM, their felt needs regarding education in the field, and their knowledge and skills. Ethical issues were the most frequently utilised item and the area in which the felt need for education was the greatest. The knowledge of and skills in ethical issues and matters were the poorest. Ethical principles and confidentiality had the highest calculated educational priority scores. It is necessary to consider ethical issues as an educational priority for GPs working in the field of OM.

How do Dutch general practitioners diagnose children's urinary tract infections?

NARCIS (Netherlands)

Harmsen, M.; Wolters, R.J.; Wouden, J.C. van der; Grol, R.P.T.M.; Wensing, M.J.P.

2009-01-01

OBJECTIVE: To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice. DESIGN: Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed

Pre-eclampsia and eclampsia: for the general practitioner ...

African Journals Online (AJOL)

Pre-eclampsia and eclampsia: for the general practitioner. LAR Mtimavalye. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

[Knowledge and experience of palliative medicine among general practitioners in Germany].

Science.gov (United States)

Papke, J; Freier, W

2007-12-01

Levels of experience and competence in palliative medicine vary considerably among physicians. The aim of the study was to collect information from specially interested general practitioners on education, pivotal lectures and experience regarding the delivery of palliative care. 92 general practitioners (41 women and 22 men) attending a basic course in palliative medicine were asked to fill in a standardized questionnaire relating to their knowledge and experience of palliative medicine. 63 responded (68%), 54 in general private practice, nine worked in a hospital. The same number worked in urban and in rural health care facilities. The majority of those questioned (53%) gained their first experience in palliative medicine as junior hospital doctors about a quarter (26%) only after starting in private practice. Many of the doctors (31%) admitted to taking more interest in palliative medicine only after having made mistakes, a significant percentage (20%) after the death of a relative. 28% expressed the view that practical courses were an important part in learning about palliative medicine. The implementation of practice-based c tuition of medical students and of continuing education of established general practitioners and hospital physicians in palliative medicine is indispensable.

Survey to child/adolescent psychiatry and developmental/behavioral pediatric training directors to expand psychiatric-mental health training to nurse practitioners.

Science.gov (United States)

Schwartz, Richard H; O'Laughlen, Mary C; Kim, Joshua

2017-06-01

There is an ongoing shortage of child mental health professionals. Nurse practitioners (NPs) who completed behavioral and mental health training have proven that they can diagnose and manage many pediatric problems. To ask the training directors of both child/adolescent psychiatry (CAP) and developmental/behavioral pediatric (DBP) programs about their receptivity and willingness to give additional training for NPs who provide care to children with behavioral and mental health issues and examine the main obstacles to the development of such programs. A survey was sent to 151 CAP and DBP training directors in the United States. The return rate was 67% (N = 101). Only 12% expressed objection to the concept of additional NP training in CAP or DBP, but only 53% of training directors currently reported having sufficient faculty to do so. Some training directors reported already having advanced behavioral and mental health training programs for NPs (31%) and most (82%) would consider expanding, if funded. There is support for advanced training for NPs, but funding is needed to make this a reality. Expansion of such programs might rapidly improve accessibility and reduce waiting time of mental health providers for children and adolescents. ©2017 American Association of Nurse Practitioners.

Creating training opportunities for public health practitioners.

Science.gov (United States)

Greene, D; Healton, C; Hamburg, M; Rosenfield, A; Cagan, E; Van Wie, W; Haviland, M L

1999-04-01

In response to several reports issued by the federal government and private foundations on the under-training of public health practitioners, Joseph L. Mailman School of Public Health of Columbia University (SPH) and the New York City Department of Health (NYC DOH) initiated the Public Health Scholars program (SPH-PHS) to make degree-level public health training available to NYC DOH employees. Public Health Scholars receive a 50% tuition scholarship and enroll part-time while working full-time at NYC DOH. Sixteen scholars have enrolled during the past three years. The SPH-PHS program is considered a success by both SPH and NYC DOH. This article details the history of the collaboration between the two agencies and the structure of the program and provides a critical analysis of the SPH-PHS program based on interviews with 16 scholars. It also examines the cost and benefit to other schools of public health of implementing such a program.

Effect of comprehensive oncogenetics training interventions for general practitioners, evaluated at multiple performance levels.

Directory of Open Access Journals (Sweden)

Elisa J F Houwink

Full Text Available General practitioners (GPs are increasingly called upon to identify patients at risk for hereditary cancers, and their genetic competencies need to be enhanced. This article gives an overview of a research project on how to build effective educational modules on genetics, assessed by randomized controlled trials (RCTs, reflecting the prioritized educational needs of primary care physicians. It also reports on an ongoing study to investigate long-term increase in genetic consultation skills (1-year follow-up and interest in and satisfaction with a supportive website on genetics among GPs. Three oncogenetics modules were developed: an online Continuing Professional Development (G-eCPD module, a live genetic CPD module, and a "GP and genetics" website (huisartsengenetica.nl providing further genetics information applicable in daily practice. Three assessments to evaluate the effectiveness (1-year follow-up of the oncogenetic modules were designed: 1.An online questionnaire on self-reported genetic competencies and changes in referral behaviour, 2.Referral rates from GPs to clinical genetics centres and 3.Satisfaction questionnaire and visitor count analytics of supportive genetics website. The setting was Primary care in the Netherlands and three groups of study participants were included in the reported studies:. Assessment 1. 168 GPs responded to an email invitation and were randomly assigned to an intervention or control group, evaluating the G-eCPD module (n = 80 or the live module (n = 88. Assessment 2. Referral rates by GPs were requested from the clinical genetics centres, in the northern and southern parts of the Netherlands (Amsterdam and Maastricht, for the two years before (2010 [n = 2510] and 2011 [n = 2940] and the year after (2012 [n = 2875] launch of the oncogenetics CPD modules and the website. Assessment 3. Participants of the website evaluation were all recruited online. When they visited the website during the month of February

Continuing professional development for general practitioners

DEFF Research Database (Denmark)

Tulinius, Charlotte; Hølge-Hazelton, Bibi

2010-01-01

OBJECTIVES: The profession of medicine has long been characterised by virtues such as authorisation, specialisation, autonomy, self-regulation and adherence to an ethical code of practice, and its complexity has granted it the privilege of self-regulation. Studies have shown continuing professional...... development (CPD) for general practitioners (GPs) to be most effective when it is set up within a multi-method design. This paper reports a research-based evaluation of a 2-year educational CPD project for 21 GPs. METHODS: The project focused on the issue of 'children in need' and was delivered through group...

Skin conditions are the commonest new reason people present to general practitioners in England and Wales.

Science.gov (United States)

Schofield, J K; Fleming, D; Grindlay, D; Williams, H

2011-11-01

Knowledge of the prevalence and incidence of skin conditions is a prerequisite for designing clinical services and providing appropriate training for primary health care professionals. In the U.K. the general practitioner and practice nurse are the first point of medical contact for persons with skin conditions. We aimed to obtain contemporary data in age-, gender- and diagnosis-specific detail on persons presenting to primary care with skin problems. Comparisons were made with similar data for other major disease groups and with similar data from other recent years. We used surveillance data collected in the Weekly Returns Service (WRS) of the Royal College of General Practitioners during 2006 and trend data for subsequent years. The WRS sentinel practices monitor all consultations by clinical diagnosis in a representative population of 950,000 in England and Wales. For conditions included in chapter XII of the International Classification of Diseases Ninth Revision (ICD9), 15% of the population consulted; a further 9% presented with skin problems classified elsewhere in the ICD9, making a total of 24%. There was no evidence of increasing or decreasing trend since 2006. Skin infections were the commonest diagnostic group, while 20% of children skin disorders (including diagnoses outside chapter XII) exceeded incidences for all other major disease groupings. Compared with other major disease groups, skin conditions are the most frequent reason for consultation in general practice. This result emphasizes the need for appropriate education and training for all medical students and particularly for continuing education in dermatology for all primary health care professionals. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

VIEWS OF GENERAL PRACTITIONERS ON INDOOR ENVIRONMENTAL HEALTH RISKSIN THE PERINATAL PERIOD

Directory of Open Access Journals (Sweden)

Gladys eIbanez

2015-05-01

Full Text Available IntroductionThe aim of this study was to determine the views of general practitioners (GP on pollution in infant's home.MethodsFour semi-structured focus group with 31 general practitioners (GP were conducted in two french departments in November 2009, February, March and April 2010. The focus group meetings were analysed using a general thematic analysis.ResultsPerinatal care is a special health issue and a time of privileged sensitisation. The attitude of health risks are well known in the case of traditionally toxic substances. In the case of emerging environmental exposure, these attitudes depend on the knowledge, beliefs and experience specific to each practitioner. GPs were acquiring a new role in the field of environmental health, whilst at the same time coming to grips with their own strengths and limitations. The implementation of prevention depends on factors which are specific to the practitioner, but also related to the parents and the organisation of the medical practice.DiscussionThe sensitisation of GPs to environmental medicine, promotion of eco-citizen education, development of research, and the distribution of information, are some of the means which need to be implemented to prevent harmful exposure of the infant.

Effect of educational intervention on adoption of new endodontic technology by general dental practitioners: a questionnaire survey.

Science.gov (United States)

Koch, M; Eriksson, H G; Axelsson, S; Tegelberg, A

2009-04-01

To survey the clinical endodontic protocols of general dental practitioners (GDPs) in public dental clinics and to assess the effect of an educational intervention on the adoption of a nickel-titanium (Ni-Ti) rotary system. General dental practitioners in a Swedish Intervention County (IC), underwent an educational programme in endodontics. A follow-up questionnaire was posted to 98 GDPs in the IC and to 97 GDPs in a Control County (CC), where no specific training had been provided. The questionnaire concerned demographics, clinical endodontic protocols and instrumentation techniques. The response rate to the questionnaire was 87%. More than 90% of all GDPs reported they always or generally used rubber dam, determined working length, used the canal irrigant 0.5% buffered NaOCl and calcium hydroxide as an interappointment dressing. Two of three GDPs reported, they generally or always informed the patient of the prognosis. Every second GDP reported routines for postoperative recall and follow-up. The Ni-Ti rotary technique was reported to be completely adopted by 77% of the GDPs in the IC, significantly higher than in the CC (6%), P educational programme in Ni-Ti rotary instrumentation reported they had successfully integrated the technique into daily clinical practice.

The care provided by general practitioners for persistent depression

NARCIS (Netherlands)

Van Os, TWDP; Van den Brink, RHS; Van der Meer, K; Ormel, J

Purpose. - To examine the care provided by general practitioners (GPs) for persistent depressive illness and its relationship to patient, illness and consultation characteristics. Subjects and method. - Using the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC) a

Medical emergencies facing general practitioners: Drugs for the doctor's bag

Directory of Open Access Journals (Sweden)

Janković Slobodan

2014-01-01

Full Text Available General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever, morphine (for severe pain, naloxone (for heroin poisoning, ceftriaxone (for meningococcal meningitis, albuterol (for bronchial asthma attack, hydrocortisone (for bronchial asthma attack, glucagon (for severe hypoglycemia, dextrose (for mild to moderate hypoglycemia, diazepam (for febrile convulsions or epileptic status, epinephrine (for anaphylaxis and cardiac arrest, atropine (for symptomatic bradicardia, chloropyramine (for acute allergy, aspirin (for acute myocardial infarction, nitroglycerine (for acute coronary syndrome, metoclopramide (for nausea and vomiting, haloperidol (for delirium, methylergometrine (for control of bleeding after delivery or abortion, furosemide (for acute pulmonary edema and flumazenil (for benzodiazepine poisoning. For each of the listed drugs a physician should well know the recommended doses, indications, contraindications and warnings. All of the listed drugs are either registered in Serbia or available through special import, so general practitioners may fill their bags with all necessary drugs and effectively and safely treat medical emergencies.

When and why do doctors decide to become general practitioners? Implications for recruitment into UK general practice specialty training.

Science.gov (United States)

Irish, Bill; Lake, Jonathan

2011-01-01

All applicants to round 1 of national recruitment into the general practice specialty recruitment process were surveyed as to the reasons for, and the timing of their career choices. Most applicants reported decision making after completing undergraduate training citing variety, continuity of care and work-life balance as their main drivers for a career in general practice. Applicants were statistically more likely to have undertaken a Foundation placement in general practice than their peers on a Foundation programme. Reasons for choice of deanery were largely related to location and social ties, rather than to the educational 'reputation' of its programmes.

Does training of general practitioners for intensive treatment of people with screen-detected diabetes have a spillover effect on mortality and cardiovascular morbidity in 'at risk' individuals with normoglycaemia?

DEFF Research Database (Denmark)

Simmons, Rebecca Kate; Bruun, Niels H; Witte, Daniel R

2017-01-01

the two treatment groups (HR 1.02 [95% CI 0.92, 1.14]). Conclusions/interpretation: Training of general practitioners to provide target-driven intensive management of blood glucose levels and other cardiovascular risk factors showed some evidence of a spillover effect on the risk of CVD over a 9 year......Aims/hypothesis: Within a trial of intensive treatment of people with screen-detected diabetes, we aimed to assess a potential spillover effect of the trial intervention on incident cardiovascular disease (CVD) and all-cause mortality among people who screened positive on a diabetes risk......-detected diabetes (control group); or (2) screening plus training and support in intensive multifactorial treatment of individuals with screen-detected diabetes (intervention group). We identified all individuals who screened positive on a diabetes risk questionnaire in ADDITION-Denmark but were normoglycaemic...

[Preferences of general practitioners in metropolitan France with regard to the delegation of medico-administrative tasks to secretaries assisting medico-social workers: Study in conjoint analysis].

Science.gov (United States)

Chanu, A; Caron, A; Ficheur, G; Berkhout, C; Duhamel, A; Rochoy, M

2018-05-01

A general practitioner's office is an economic unit where task delegation is an essential component in improving the quality and performance of work. To classify the preferences of general practitioners regarding the delegation of medical-administrative tasks to assistant medical-social secretaries. Conjoint analysis was applied to a random sample of 175 general practitioners working in metropolitan France. Ten scenarios were constructed based on seven attributes: training for medical secretaries, logistical support during the consultation, delegation of management planning, medical records, accounting, maintenance, and taking initiative on the telephone. A factorial design was used to reduce the number of scenarios. Physicians' socio-demographic variables were collected. One hundred and three physicians responded and the analysis included 90 respondents respecting the transitivity of preferences hypothesis. Perceived difficulty was scored 2.8 out of 5. The high rates of respondents (59%; 95% CI [51.7-66.3]) and transitivity (87.5%; 95% CI [81.1-93.9]) showed physicians' interest in this topic. Delegation of tasks concerning management planning (OR=2.91; 95% CI [2.40-13.52]) and medical records (OR=1.88; 95% CI [1.56-2.27]) were the two most important attributes for physicians. The only variable for which the choice of a secretary was not taken into account was logistical support. This is a first study examining the choices of general practitioners concerning the delegation of tasks to assistants. These findings are helpful to better understand the determinants of practitioners' choices in delegating certain tasks or not. They reveal doctors' desire to limit their ancillary tasks in order to favor better use of time for "medical" tasks. They also expose interest for training medical secretaries and widening their field of competence, suggesting the emergence of a new professional occupation that could be called "medical assistant". Copyright © 2018 Elsevier Masson

How do general practitioners in Denmark promote physical activity?

DEFF Research Database (Denmark)

Jørgensen, Tanja K; Nordentoft, Merete; Krogh, Jesper

2012-01-01

The primary objective of this study was to quantify the frequency of advice given on type, frequency, duration, and intensity of exercise during physical activity (PA) promoting sessions by general practitioners. Second, to find GP characteristics associated with high quality of PA counselling....

The factors associated to psychosocial stress among general practitioners in Lithuania. Cross-sectional study

Directory of Open Access Journals (Sweden)

Vanagas Giedrius

2005-06-01

Full Text Available Abstract Background There are number of studies showing that general practice is one of the most stressful workplace among health care workers. Since Baltic States regained independence in 1990, the reform of the health care system took place in which new role and more responsibilities were allocated to general practitioners' in Lithuania. This study aimed to explore the psychosocial stress level among Lithuanian general practitioner's and examine the relationship between psychosocial stress and work characteristics. Methods The cross-sectional study of 300 Lithuanian General practitioners. Psychosocial stress was investigated with a questionnaire based on the Reeder scale. Job demands were investigated with the R. Karasek scale. The analysis included descriptive statistics; interrelationship analysis between characteristics and multivariate logistic regression to estimate odds ratios for each of the independent variables in the model. Results Response rate 66% (N = 197. Our study highlighted highest prevalence of psychosocial stress among widowed, single and female general practitioners. Lowest prevalence of psychosocial stress was among males and older age general practitioners. Psychosocial stress occurs when job demands are high and job decision latitude is low (χ2 = 18,9; p Conclusion One half of respondents suffering from work related psychosocial stress. High psychological workload demands combined with low decision latitude has the greatest impact to stress caseness among GP's. High job demands, high patient load and young age of GP's can be assigned as significant predictors of psychosocial stress among GP's.

Gambling addiction in primary care: a survey of general practitioners ...

African Journals Online (AJOL)

Arun Kumar Agnihotri

experiences of, and confidence in, managing these patients in primary care, their perceived role and ... KEY WORDS: Gambling addiction; Primary care; General practitioners; Management ..... Petry NM, Blanco C, Auriacombe M, Borges.

General practitioners and national health insurance results of a ...

African Journals Online (AJOL)

Objective. To determine the attitudes of South African general practitioners (GPs) to national health insurance (NHI), social health insurance (SHI) and other related health system reforms. Design. A national survey using postal questionnaires and telephonic follow-up of non-responders. Setting. GPs throughout South Africa.

Job satisfaction among general practitioners : A systematic literature review

NARCIS (Netherlands)

van Ham, I.; Verhoeven, A.A.; Groenier, K.H.; Groothoff, J.W.; de Haan, J.

2006-01-01

Objective: In recent years, the incidence of being overworked and burnt out has increased among general practitioners (GPs). One of the factors that influences the development of burnout is the job satisfaction that physicians experience. Therefore, we conducted a literature review to answer the

Job satisfaction among general practitioners: A systematic literature review

NARCIS (Netherlands)

van Ham, I.; Verhoeven, A.A.; Groenier, K.H.; Groothoff, J.W.; de Haan, J.

2006-01-01

Objective: In recent years, the incidence of being overworked and burnt out has increased among general practitioners (GPs). One of the factors that influences the development of burnout is the job satisfaction that physicians experience. Therefore, we conducted a literature review to answer the

Preconception care by family physicians and general practitioners in Japan

Directory of Open Access Journals (Sweden)

Fetters Michael D

2005-07-01

Full Text Available Abstract Background Preconception care provided by family physicians/general practitioners (FP/GPs can provide predictable benefits to mothers and infants. The objective of this study was to elucidate knowledge of, attitudes about, and practices of preconception care by FP/GPs in Japan. Methods A survey was distributed to physician members of the Japanese Academy of Family Medicine. The questionnaire addressed experiences of preconception education in medical school and residency, frequency of preconception care in clinical practice, attitudes about providing preconception care, and perceived need for preconception education to medical students and residents. Results Two hundred and sixty-eight of 347 (77% eligible physicians responded. The most common education they reported receiving was about smoking cessation (71%, and the least was about folic acid supplementation (12%. Many participants reported providing smoking cessation in their practice (60%, though only about one third of respondents advise restricting alcohol intake. Few reported advising calcium supplementation (10% or folic acid supplementation (4%. About 70% reported their willingness to provide preconception care. Almost all participants believe medical students and residents should have education about preconception care. Conclusion FP/GPs in Japan report little training in preconception care and few currently provide it. With training, most participants are willing to provide preconception care themselves and think medical students and residents should receive this education.

Opinions of practitioners and program directors concerning accreditation standards for postdoctoral pediatric dentistry training programs.

Science.gov (United States)

Casamassimo, P S; Wilson, S

1999-01-01

This study was performed to assess opinions of program directors and practitioners about the importance and necessary numbers of experiences required by current accreditation standards for training of pediatric dentists. A 32-item questionnaire was sent to all program directors of ADA-accredited postdoctoral pediatric dentistry training programs and to a random sample of 10% of the fellow/active membership of the American Academy of Pediatric Dentistry. An overall response rate of 56% was obtained from the single mailing. Practitioners and program directors differed significantly (P dentistry: initiating and completing a research paper, biostatistics/epidemiology, and practice management. Program directors had little difficulty obtaining required experiences, and program dependence on Medicaid did not negatively affect quality of education. Practitioners and program directors agreed on the importance of most experiences and activities required by current accreditation standards.

Segmenting a general practitioner market to improve recruitment outcomes.

Science.gov (United States)

Hemphill, Elizabeth; Kulik, Carol T

2011-05-01

Recruitment is an ongoing challenge in the health industry with general practitioner (GP) shortages in many areas beyond rural and Indigenous communities. This paper suggests a marketing solution that identifies different segments of the GP market for recruitment strategy development. In February 2008, 96 GPs in Australia responded to a mail questionnaire (of which 85 questionnaires were useable). A total of 350 GPs were sent the questionnaire. Respondents considered small sets of attributes in the decision to accept a new job at a general practice and selected the most and least important attribute from each set. We identified latent class clusters (cohorts) of GPs from the most-least important data. Three cohorts were found in the GP market, distinguishing practitioners who emphasised job, family or practice attributes in their decision to join a practice. Few significant demographic differences exist between the cohorts. A segmented GP market suggests two alternative recruitment strategies. One option is for general practices to target members of a single cohort (family-, job-, or practice-focussed GPs). The other option is for general practices to diversify their recruitment strategies to target all three cohorts (family-, job- and practice-focussed GPs). A single brand (practice) can have multiple advertising strategies with each strategy involving advertising activities targeting a particular consumer segment.

CPD - The learning preferences of general practitioners | Van den ...

African Journals Online (AJOL)

Introduction: General Practitioners need to stay up to date and to maintain professional competence. The Health Professions Council of SA has introduced a mandatory recertification system starting in 1999. Insufficient research exists locally to reliably identify the continuing professional development (CPD) habits of GP's in ...

Process evaluation of a practice nurse-led smoking cessation trial in Australian general practice: views of general practitioners and practice nurses.

Science.gov (United States)

Halcomb, Elizabeth J; Furler, John S; Hermiz, Oshana S; Blackberry, Irene D; Smith, Julie P; Richmond, Robyn L; Zwar, Nicholas A

2015-08-01

Support in primary care can assist smokers to quit successfully, but there are barriers to general practitioners (GPs) providing this support routinely. Practice nurses (PNs) may be able to effectively take on this role. The aim of this study was to perform a process evaluation of a PN-led smoking cessation intervention being tested in a randomized controlled trial in Australian general practice. Process evaluation was conducted by means of semi-structured telephone interviews with GPs and PNs allocated in the intervention arm (Quit with PN) of the Quit in General Practice trial. Interviews focussed on nurse training, content and implementation of the intervention. Twenty-two PNs and 15 GPs participated in the interviews. The Quit with PN intervention was viewed positively. Most PNs were satisfied with the training and the materials provided. Some challenges in managing patient data and follow-up were identified. The Quit with PN intervention was acceptable to participating PNs and GPs. Issues to be addressed in the planning and wider implementation of future trials of nurse-led intervention in general practice include providing ongoing mentoring support, integration into practice management systems and strategies to promote greater collaboration in GPs and PN teams in general practice. The ongoing feasibility of the intervention was impacted by the funding model supporting PN employment and the competing demands on the PNs time. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Possibilities and limitations of telemedicine in general practitioner practices].

Science.gov (United States)

van den Berg, N; Meinke, C; Hoffmann, W

2009-09-01

According to the AGnES concept (general-practitioner-supporting, community-based, e-health-assisted systemic intervention), general practitioners (GPs) can delegate certain components of medical care in the context of home visits by qualified AGnES employees. Within the framework of six AGnES projects, different telemedical applications have been implemented. Telemedical monitoring of patients was implemented to analyse the feasibility and acceptance within GP practices. One hundred sixty-two patients used a telemedical monitoring system (e.g. scale/sphygmomanometer and intraocular pressure measurement system). Regarding communication in cases of acutely necessary GP consultations, telephone calls and videoconferences between the GP and the AGnES employee were analysed. Unscheduled telephone calls or videoconferences were necessary for only a few home visits; the reasons included pain, anomalous values, and medication problems. The main result of the analysis was that implementation of telemedicine in GP practices is feasible and is accepted both by patients and GPs.

General practitioners' and psychiatrists' responses to emotional disclosures in patients with depression.

Science.gov (United States)

Davidsen, Annette Sofie; Fosgerau, Christina Fogtmann

2014-04-01

To investigate general practitioners' (GPs') and psychiatrists' responses to emotional disclosures in consultations with patients with depression. Thirteen patient consultations with GPs and 17 with psychiatrists were video-recorded and then analyzed using conversation analysis (CA). Psychiatrists responded to patients' emotional disclosures by attempting to clarify symptoms, by rational argumentation, or by offering an interpretation of the emotions from their own perspectives. GPs responded by claiming to understand the emotions or by formulating the patients' statements, but without further exploring the emotions. GPs displayed a greater engagement with patients' emotions than psychiatrists. Their approach could be described as empathic, corresponding to a mentalizing stance. The different approaches taken by psychiatrists could represent conceptual differences and might affect fruitful interdisciplinary work. Psychiatric nurses' responses to patients' emotions must also be studied to complete our knowledge from psychiatry. Experiences from training in mentalization could be used to develop physicians' empathic or mentalizing approach. As most patients with depression are treated in primary care, developing GPs' mentalizing capacity instead of offering didactic training could have a substantial effect in the population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Irish general practitioner attitudes toward decriminalisation and medical use of cannabis: results from a national survey.

Science.gov (United States)

Crowley, Des; Collins, Claire; Delargy, Ide; Laird, Eamon; Van Hout, Marie Claire

2017-01-13

Governmental debate in Ireland on the de facto decriminalisation of cannabis and legalisation for medical use is ongoing. A cannabis-based medicinal product (Sativex®) has recently been granted market authorisation in Ireland. This unique study aimed to investigate Irish general practitioner (GP) attitudes toward decriminalisation of cannabis and assess levels of support for use of cannabis for therapeutic purposes (CTP). General practitioners in the Irish College of General Practitioner (ICGP) database were invited to complete an online survey. Anonymous data yielded descriptive statistics (frequencies, percentages) to summarise participant demographic information and agreement with attitudinal statements. Chi-square tests and multi-nominal logistic regression were included. The response rate was 15% (n = 565) which is similar to other Irish national GP attitudinal surveys. Over half of Irish GPs did not support the decriminalisation of cannabis (56.8%). In terms of gender, a significantly higher proportion of males compared with females (40.6 vs. 15%; p cannabis should be decriminalised (54.1 vs. 31.5%; p = 0.021). Over 80% of both genders supported the view that cannabis use has a significant effect on patients' mental health and increases the risk of schizophrenia (77.3%). Over half of Irish GPs supported the legalisation of cannabis for medical use (58.6%). A higher percentage of those who were level 1-trained (trained in addiction treatment but not to an advanced level) agreed/strongly agreed cannabis should be legalised for medical use (p = 0.003). Over 60% agreed that cannabis can have a role in palliative care, pain management and treatment of multiple sclerosis (MS). In the regression response predicator analysis, females were 66.2% less likely to agree that cannabis should be decriminalised, 42.5% less likely to agree that cannabis should be legalised for medical use and 59.8 and 37.6% less likely to agree that cannabis has a role in

The incidence of sexual dysfunction in patients attending Dutch general practitioners.

NARCIS (Netherlands)

Kedde, H.; Donker, G.; Leusink, P.; Kruijer, H.

2011-01-01

Data on patients with a sexual dysfunction were collected in 45 Dutch general practices between 2003 and 2008. The aim of the study was to determine the incidence of patients with a sexual dysfunction, associated health problems, and related interventions performed by their general practitioners

Perceptions of mental illness among Muslim general practitioners in South Africa

OpenAIRE

Mohamed-Kaloo, Z; Laher, S

2014-01-01

BACKGROUND: Mental health literacy on the part of medical practitioners is an important component of mental healthcare. General practitioners (GPs) are typically the first doctors consulted by a person who is ill. Exploration of their perceptions regarding mental illness, aetiological issues and treatment is important. OBJECTIVE: To investigate perceptions of mental illness in a sample of 10 South African Muslim GPs (five male, five female) in the Lenasia area (Johannesburg, South Africa). ME...

Training and validation of standardized patients for evaluation of general practitioners′ performance in management of obesity and overweight

Directory of Open Access Journals (Sweden)

Tahereh Changiz

2014-01-01

Conclusion: SP could be a powerful instrument for evaluating medical performance of general practitioners in the field of obesity/overweight management. Further research is needed to find the more aspects of training and validation of unannounced SPs in this field.

[Diagnostic rationalism. Views of general practitioners on fibromyalgia].

Science.gov (United States)

Daehli, B

1993-09-20

Clinical practice is characterized by having to make numerous important decisions, including the diagnosis. In this study, general practitioners were asked to agree or to disagree with statements of fibromyalgia. The main purpose was to test the usefulness of two well-known models for decision-making when studying diagnosis in cases of uncertainty and scepticism. The results show that the models are inadequate to explain the decisions.

Surgical instruction for general practitioners: how, who and how often?

LENUS (Irish Health Repository)

Collins, Anne M

2010-07-01

Educational programmes, designed to meet the training needs of General Practitioners (GPs) performing minor surgical procedures, have previously been shown to increase their surgical workload. The change in the level of competence following these programmes has not been assessed. The aims of this study were two-fold: to evaluate the vertical mattress suture for construct validity and to assess the impact of plastic surgery training on the surgical skill of GPs. Thirty non-consultant hospital doctors and 27 self-selected GPs were included. Using a modified objective structured assessment of technical skills (OSATS) scoring system, construct validity of the vertical mattress suture was confirmed. The median total OSATS score was 16 points (26.7%) in the novice group (medical registrars), 38.5 points (64.2%) in the intermediate group (surgical SHOs) and 59 points (98.3%) in the expert group (surgical registrars, p<0.001, Kruskal-Wallis test). Objective assessment in the GP group immediately following practical instruction revealed a median overall improvement of 31.7% (19 points) in total OSATS scores (p<0.001, Friedman non-parametric test, F). At six months follow-up all course participants had improved compared to their baseline. A median overall improvement of 13 points (21.7%) was noted (p<0.001, F). However, the majority (80%, n=20) had deteriorated from the standard set immediately after the course with a median overall reduction in total OSATS scores of six points (10%, p=0.001, F). Plastic surgery training is immediately efficacious in improving the technical proficiency of GPs. Through objective assessment of a standardised suture task we demonstrated a low rate of educational decay of 10% over a six-month period.

The electronic locum record for general practitioners: Outcome of an evaluation study in the Netherlands

NARCIS (Netherlands)

Dumay, A.C.M.; Haaker, T.I.

2010-01-01

Background: A locum practitioner is an out-of-hours general practitioner who needs access to the electronic health record of visiting patients. The electronic locum record is a summary of the electronic health record available to the locum practitioner and includes the most significant health

Training for the Future? A Case Study of Emerging Education, Training and Development Practitioners in the South African Clothing Manufacturing Industry

Science.gov (United States)

Jones, Barbara; Cooper, Linda; McMillan, Janice

2006-01-01

This article investigates how training instructors in the South African clothing industry were prepared for their roles as Education, Training and Development Practitioners (ETDPs) by a university adult education programme. The key focus is on how these emerging ETDPs experienced their changing roles, identities and approaches to teaching and the…

Building interdisciplinary leadership skills among health practitioners in the 21st century: an innovative training model

Directory of Open Access Journals (Sweden)

Preeti eNegandhi

2015-10-01

Full Text Available Transformational learning is the focus of 21st century global educational reforms. In India there is a need to amalgamate the skills and knowledge of medical, nursing and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners, and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing and public health institutions partnered in this endeavour. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in inter-professional health education and the key competencies required. The interdisciplinary leadership competencies identified were: self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team-building, innovation and being an effective change agent. Subsequently, a training program was developed and three training sessions were piloted with 66 participants. Each cohort comprised of a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.

Building Interdisciplinary Leadership Skills among Health Practitioners in the Twenty-First Century: An Innovative Training Model.

Science.gov (United States)

Negandhi, Preeti; Negandhi, Himanshu; Tiwari, Ritika; Sharma, Kavya; Zodpey, Sanjay P; Quazi, Zahiruddin; Gaidhane, Abhay; Jayalakshmi N; Gijare, Meenakshi; Yeravdekar, Rajiv

2015-01-01

Transformational learning is the focus of twenty-first century global educational reforms. In India, there is a need to amalgamate the skills and knowledge of medical, nursing, and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing, and public health institutions partnered in this endeavor. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in interprofessional health education and the key competencies required. The interdisciplinary leadership competencies identified were self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team building, innovation, and being an effective change agent. Subsequently, a training program was developed, and three training sessions were piloted with 66 participants. Each cohort comprised a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing, and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.

Postnatal gestational diabetes mellitus follow-up: Perspectives of Australian hospital clinicians and general practitioners.

Science.gov (United States)

Kilgour, Catherine; Bogossian, Fiona Elizabeth; Callaway, Leonie; Gallois, Cindy

2018-05-04

The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up. Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care. Purposive sampling and convergent interviews explored participants' communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory. Clinicians who provided maternity care at a tertiary referral hospital (n=13) in Queensland, Australia, and general practitioners (n=16) who provided maternity shared care with that hospital between December 2012 and July 2013. Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared. Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights

Guidelines prescribed by general practitioners to patients with acute ...

African Journals Online (AJOL)

The aim of this study was to investigate the guidelines prescribed by general practitioners (GPs) to patients with acute low back pain (ALBP) regarding 'return to work'. Methods: A systematic sample of 212 GPs, selected from a list supplied by the Health Professions Council of South Africa (HPCSA), was selected to complete ...

The efficacy of an automated feedback system for general practitioners

NARCIS (Netherlands)

Bindels, Rianne; Hasman, Arie; Kester, Arnold D.; Talmon, Jan L.; de Clercq, Paul A.; Winkens, Ron A. G.

2003-01-01

OBJECTIVE: An automated feedback system that produces comments about the non-adherence of general practitioners (GPs) to accepted practice guidelines for ordering diagnostic tests was developed. Before implementing the automated feedback system in daily practice, we assessed the potential effect of

The importance of gender of patients and general practitioners in relation to treatment practices for overweight

DEFF Research Database (Denmark)

Rohde, Jeanett Friis; Hessner, Marie Vik; Lous, Jørgen

2014-01-01

BACKGROUND: Several studies suggest that men and women are treated differently for similar disease including diabetes and cardiovascular disease. Differences in attitudes and treatment practices towards men and women with obesity are not well recognized. OBJECTIVE: To investigate the attitudes...... and treatment practices among Danish general practitioners (GPs), in relation to treatment of overweight, while taking gender of both the patients and practitioners into account. DESIGN: Questionnaire inventory covertly examining attitudes and practices among Danish general practitioners towards treatment......: Among general practitioners in Denmark, treatment for weight loss is more often practiced for overweight male than overweight female patients presenting with same symptoms. In addition, hyperlipidemia among overweight males is also more often treated with lipid lowering medicine than hyperlipidemia...

Care for patients with severe mental illness: the general practitioner's role perspective

Directory of Open Access Journals (Sweden)

Groenier Klaas H

2009-05-01

Full Text Available Abstract Background Patients with severe mental illness (SMI experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. Methods A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. Results 186 general practitioners distributed over urban areas (49%, urbanised rural areas (38% and rural areas (15% of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices. GPs also saw their role as giving support and information to the patient's family. However, they felt a need for recognition of their competencies when working with mental health care specialists. Conclusion GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.

Care for patients with severe mental illness: the general practitioner's role perspective.

Science.gov (United States)

Oud, Marian J T; Schuling, Jan; Slooff, Cees J; Groenier, Klaas H; Dekker, Janny H; Meyboom-de Jong, Betty

2009-05-06

Patients with severe mental illness (SMI) experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. 186 general practitioners distributed over urban areas (49%), urbanised rural areas (38%) and rural areas (15%) of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices.GPs also saw their role as giving support and information to the patient's family.However, they felt a need for recognition of their competencies when working with mental health care specialists. GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.

Toys are a potential source of cross-infection in general practitioners' waiting rooms.

Science.gov (United States)

Merriman, Eileen; Corwin, Paul; Ikram, Rosemary

2002-01-01

The waiting rooms of general practitioners' surgeries usually have toys provided for children. The level of contamination of these toys and the effectiveness of toy decontamination was investigated in this study. Hard toys from general practitioners' waiting rooms had relatively low levels of contamination, with only 13.5% of toys showing any coliform counts. There were no hard toys with heavy contamination by coliforms or other bacteria. Soft toys were far more likely to be contaminated, with 20% of toys showing moderate to heavy coliform contamination and 90% showing moderate to heavy bacterial contamination. Many waiting-room toys are not cleaned routinely. Soft toys are hard to disinfect and tend to rapidly become recontaminated after cleaning. Conversely, hard toys can be cleaned and disinfected easily. Soft toys in general practitioners' waiting rooms pose an infectious risk and it is therefore recommended that soft toys are unsuitable for doctors' waiting rooms. PMID:11885823

Advance directives or living wills: reflections of general practitioners ...

African Journals Online (AJOL)

Background: Living wills have long been associated with end-of-life care. This study explored the promotion of living wills by general practitioners (GPs) and frail care nursing coordinators who were directly involved in the care of the elderly in Howick, KwaZulu-Natal. The study also explored their views regarding the pro ...

Prescription of technical aids by general practitioners in the Netherlands.

NARCIS (Netherlands)

Biermans, M.C.J.; Dekker, J.; Ende, C.H.M. van den

2004-01-01

This study focused on the allocation of technical aids, in particular which technical aids general practitioners (GPs) prescribe for what patients. Data was collected by 64 Dutch GPs participating in a nationwide representative sentinel practice network. The GPs gathered information on type of

Responses to language barriers in consultations with refugees and asylum seekers: a telephone survey of Irish general practitioners.

LENUS (Irish Health Repository)

MacFarlane, Anne

2008-01-01

BACKGROUND: Refugees and asylum seekers experience language barriers in general practice. Qualitative studies have found that responses to language barriers in general practice are ad hoc with use of both professional interpreters and informal interpreters (patients\\' relatives or friends). However, the scale of the issues involved is unknown. This study quantifies the need for language assistance in general practice consultations and examines the experience of, and satisfaction with, methods of language assistance utilized. METHODS: Data were collected by telephone survey with general practitioners in a regional health authority in Ireland between July-August 2004. Each respondent was asked a series of questions about consulting with refugees and asylum seekers, the need for language assistance and the kind of language assistance used. RESULTS: There was a 70% (n = 56\\/80) response rate to the telephone survey. The majority of respondents (77%) said that they had experienced consultations with refugees and asylum seekers in which language assistance was required. Despite this, general practitioners in the majority of cases managed without an interpreter or used informal methods of interpretation. In fact, when given a choice general practitioners would more often choose informal over professional methods of interpretation despite the fact that confidentiality was a significant concern. CONCLUSION: The need for language assistance in consultations with refugees and asylum seekers in Irish general practice is high. General practitioners rely on informal responses. It is necessary to improve knowledge about the organisational contexts that shape general practitioners responses. We also recommend dialogue between general practitioners, patients and interpreters about the relative merits of informal and professional methods of interpretation so that general practitioners\\' choices are responsive to the needs of patients with limited English.

The first international training course on basic nuclear forensic methodologies for practitioners

International Nuclear Information System (INIS)

Schwantes, Jon M.; Smith, David K.

2013-01-01

The IAEA, in cooperation with the United States National Nuclear Security Administration, developed and conducted the first international training course on basic nuclear forensic methodologies for practitioners in 2012. An overview of the major elements of this landmark workshop as well as successes and recommendations for future improvement are presented here. (author)

Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

LENUS (Irish Health Repository)

Agyapong, Vincent Israel Opoku

2012-04-17

Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

[Awareness of breast cancer screening among general practitioners in Mohammedia (Morocco)].

Science.gov (United States)

Zine, Karima; Nani, Samira; Lahmadi, Imad Ait; Maaroufi, Abderrahmane

2016-01-01

Breast cancer is a major public health problem in Morocco. It is the most common cancer in women. Our study aims to evaluate the extent of breast cancer awareness among general practitioners (GP) in the prefecture of Mohammedia, Morocco. We conducted a cross-sectional, descriptive, exhaustive study including 97 GP working in primary health care facilities (public and private sector) of the province of Mohammedia. Participation rate was 87%. The average age of GP was 49.6 ± 8.1. Eighty percent (n = 55) of the GP misstated the incidence of breast cancer, 77.6% (n = 85) recognized the existence of a national plan to prevent and control cancer (NPPCC) in Morocco and 67.1% of GP reported the existence of a cancer registry in Morocco. General practice sector was significantly related to the awareness of NPPCC among GP and to the existence of guidelines for the early detection of breast cancer (p = 0.003 and p = 0.001 respectively). A significant relationship was found between seniority and the existence of guidelines for the early detection of breast cancer and a breast cancer registry (p = 0.005 and p = 0.002 respectively). In light of these results GP awareness and practices should be enhanced by promoting initial and continuing training on breast cancer screening.

Are age and gender associated to tobacco use and knowledge among general practitioners?: Results of a survey in Italy

Directory of Open Access Journals (Sweden)

Brigid Unim

2013-09-01

Full Text Available OBJECTIVES: The aim of this study was to assess knowledge and opinions of Italian general practitioners about the effectiveness of smoking cessation interventions and physicians' attitudes in addressing tobacco-related issues. METHODS: The survey was carried out through a questionnaire administered to general practitioners (GPs attending a medical refresher course. 133 Italian GPs participated in the study with a mean age of 51.4 years (SD = 6.2. RESULTS: The GPs had good knowledge about the predictors of smoking onset, pharmacotherapies for tobacco cessation and the clinical guidelines recommendations. Wrong answers were encountered for the prevalence of smokers in Italy, the Fagerstrom Test for nicotine dependence and minimal advice. Females were more subjected to higher knowledge about tobacco, and at lower risk to be a smoker/ex smoker. Furthermore, physicians > 50 years old living in northern Italy had higher knowledge score. CONCLUSIONS: Physician education on tobacco counseling is associated to increased comfort and practice in advising patients who smoke. Tobacco cessation training might increase the success rate of helping patients to quit smoking.

Do general medical practitioners examine injured runners?

DEFF Research Database (Denmark)

Andersen, Solvej Videbæk; Jensen, A V; Rasmussen, Sten

2017-01-01

BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study....... METHODS: An online survey was distributed in October and November 2015 to more than 370 GMPs in Denmark and completed by 27. RESULTS: The median prevalence proportion of consultations caused by running-related injuries in the prior two weeks was 0.80% [25th percentile = 0.00%; 75th percentile = 1...

The payment for performance model and its influence on British general practitioners' principles and practice.

Science.gov (United States)

Norman, Armando Henrique; Russell, Andrew J; Macnaughton, Jane

2014-01-01

This article explores some effects of the British payment for performance model on general practitioners' principles and practice, which may contribute to issues related to financial incentive modalities and quality of primary healthcare services in low and middle-income countries. Aiming to investigate what general practitioners have to say about the effect of the British payment for performance on their professional ethos we carried out semi-structured interviews with 13 general practitioner educators and leaders working in academic medicine across the UK. The results show a shift towards a more biomedical practice model and fragmented care with nurse practitioners and other health care staff focused more on specific disease conditions. There has also been an increased medicalisation of the patient experience both through labelling and the tendency to prescribe medications rather than non-pharmacological interventions. Thus, the British payment for performance has gradually strengthened a scientific-bureaucratic model of medical practice which has had profound effects on the way family medicine is practiced in the UK.

Screening for depression in patients with myocardial infarction by general practitioners

DEFF Research Database (Denmark)

Larsen, K. K.; Vestergaard, M.; Sondergaard, J.

2013-01-01

Background: Depression in patients with myocardial infarction (MI) is highly prevalent and associated with increased morbidity and mortality. Routine screening for post-MI depression is recommended. We studied general practitioners' practice of screening for post-MI depression and analysed whether...... the screening rate varied among subgroups of MI patients with a particular high risk of depression. Design: Population-based cohort study in the Central Denmark Region. Methods: All patients with a first-time MI in 2009 received a questionnaire 3 months after discharge from hospital. The questionnaire included...... information on anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS), severity of the disease, and smoking habits. The responders' general practitioners received a questionnaire 1 year after the patient had been discharged from hospital. This questionnaire provided information...

Preparing tomorrow's behavioral medicine scientists and practitioners: a survey of future directions for education and training.

Science.gov (United States)

Goldstein, Carly M; Minges, Karl E; Schoffman, Danielle E; Cases, Mallory G

2017-02-01

Behavioral medicine training is due for an overhaul given the rapid evolution of the field, including a tight funding climate, changing job prospects, and new research and industry collaborations. The purpose of the present study was to collect responses from trainee and practicing members of a multidisciplinary professional society about their perceptions of behavioral medicine training and their suggestions for changes to training for future behavioral medicine scientists and practitioners. A total of 162 faculty and 110 students (total n = 272) completed a web-based survey on strengths of their current training programs and ideas for changes. Using a mixed-methods approach, the survey findings are used to highlight seven key areas for improved preparation of the next generation of behavioral medicine scientists and practitioners, which are grant writing, interdisciplinary teamwork, advanced statistics and methods, evolving research program, publishable products from coursework, evolution and use of theory, and non-traditional career paths.

Systematic review protocol of interventions to improve the psychological well-being of general practitioners.

Science.gov (United States)

Murray, Marylou; Murray, Lois; Donnelly, Michael

2015-09-22

The challenges and complexities faced by general practitioners are increasing, and there are concerns about their well-being. Consequently, attention has been directed towards developing and evaluating interventions and strategies to improve general practitioner well-being and their capacity to cope with workplace challenges. This systematic review aims to evaluate research evidence regarding the effectiveness of interventions designed to improve general practitioner well-being. Eligible studies will include programmes developed to improve psychological well-being that have assessed outcomes using validated tools pertaining to well-being and related outcomes. Only programmes that have been evaluated using controlled study designs will be reviewed. An appropriately developed search strategy will be applied to six electronic databases: the Cochrane Database of Systematic Reviews, MEDLINE, Embase, CINAHL, PsycINFO and Web of Science. Studies will be screened in two stages by two independent reviewers. A third reviewer will arbitrate when required. Pre-specified inclusion and exclusion criteria will be assessed during a pilot phase early on in the review process. The Cochrane data extraction form will be adapted and applied to each eligible study by two independent reviewers, and each study will be appraised critically using standardised checklists from the Cochrane Handbook. Methodological quality will be taken into account in the analysis of the data and the synthesis of results. A narrative synthesis will be undertaken if data is unsuited to a meta-analysis. The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidance. This will be the first systematic review on this topic, and the evidence synthesis will aid decision-making by general practitioners, policy makers and planners regarding ways in which to improve GP well-being. Findings will be disseminated at general practitioner meetings

Non-western immigrants' satisfaction with the general practitioners' services in Oslo, Norway.

Science.gov (United States)

Lien, Else; Nafstad, Per; Rosvold, Elin O

2008-02-27

Over the last few years the number of immigrants from the non-western parts of the world living in Oslo, has increased considerably. We need to know if these immigrants are satisfied with the health services they are offered. The aim of this study was to assess whether the immigrants' level of satisfaction with visits to general practitioners was comparable with that for ethnic Norwegians. Two population-based surveys, the Oslo Health Study and the Oslo Immigrant Health Study, were performed on selected groups of Oslo citizens in 2000 and 2002. The response rates were 46% and 33%, respectively. In all, 11936 Norwegians and 1102 non-western immigrants from the Oslo Health Study, and 1774 people from the Oslo Immigrant Health Study, were included in this analysis. Non-western immigrants' and ethnic Norwegians' level of satisfaction with visits to general practitioners were analysed with respect to age, gender, health, working status, and use of translators. Bivariate (Chi square) and multivariate analyses (logistic regression) were performed. Most participants were either moderately or very satisfied with their last visit to a general practitioner. Non-western immigrants were less satisfied than Norwegians. Dissatisfaction among the immigrants was associated with young age, a feeling of not having good health, and coming from Turkey, Iran, Pakistan, or Vietnam as compared to Sri Lanka. The attendance rates in the surveys were rather low and lowest among the non-western immigrants. Although the degree of satisfaction with the primary health care was relatively high among the participants in these surveys, the non-western immigrants in this study were less satisfied than ethnic Norwegians with their last visit to a general practitioner. The rather low response rates opens for the possibility that the degree of satisfaction may not be representative for all immigrants.

Preparedness of Lithuanian general practitioners to provide mental healthcare services

DEFF Research Database (Denmark)

Jaruseviciene, Lina; Sauliune, Skirmante; Jarusevicius, Gediminas

2014-01-01

BACKGROUND: A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners' (GPs) experience in mental healthcare and their perceptions about how to increase th...

Do general dental practitioners leave teeth on 'open drainage'?

Science.gov (United States)

Eliyas, S; Barber, M W; Harris, I

2013-12-01

There is a need to ascertain the use of evidence-based dentistry in both primary and secondary care in order to tailor education. This study aims to evaluate the use of 'open drainage' as part of endodontic treatment in primary care in South Yorkshire. A questionnaire was circulated to 141 randomly selected general dental practitioners in the South Yorkshire area between January 2012 and January 2013. The response rate was 79% (112/141). Five of the returned questionnaires were incomplete and therefore not usable. Seventy-nine percent of respondents were general dental practitioners (GDPs) working in mainly NHS or mixed practices. The year of graduation varied between 1970 and 2011. Forty-one percent (44/107) stated that they had never left a tooth on open drainage. Twenty-nine percent (31/107) stated that they sometimes leave teeth on open drainage. Of those respondents who currently leave teeth on open drainage, most (68%) would leave teeth on open drainage for one to two days or less. This survey revealed that the practice of leaving teeth on open drainage is still present in general dental practice. Current guidelines do not comment on the use of this treatment modality. There is a need to ascertain further information about practices throughout the United Kingdom in order to provide clear evidence-based guidelines.

Perception of the nuclear industry by general practitioner in Champagne-Ardennes (France)

International Nuclear Information System (INIS)

Bouet, P.; Goasguen, P.; Lewicki, M.; Petit, J.F.; Villette, M.

1990-06-01

In the case of a nuclear accident, the general practitioners should be the relay in the population information. In order to confront their knowledge and sensitivity with the nuclear industry problems, the authors have conducted an inquiry near to 144 general practitioners in Champagne-Ardennes area, in the immediate neighbourhood of nuclear facilities (CHOOZ, Nogent-sur-Seine, Gravelines) or not. Four subjects are studied: -their perception of the nuclear industry in the environment problems - their knowledge in nuclear physics - their knowledge about the nuclear power plant - their attitude in front of a radiation accident. The authors show that their education and knowledges about the nuclear industry is insufficient and propose several solutions in order to cope with these difficulties

Delivering stepped care for depression in general practice : Results of a survey amongst general practitioners in the Netherlands

NARCIS (Netherlands)

Sinnema, Henny; Franx, Gerdien; Spijker, Jan; Ruiter, Marijke; van Haastrecht, Harry; Verhaak, Peter; Nuyen, Jasper

2013-01-01

Background: Revised guidelines for depression recommend a stepped care approach. Little is known about the implementation of the stepped care model by general practitioners (GPs) in daily practice. Objectives: To evaluate the performance of Dutch GPs in their general practice regarding important

Interoperability prototype between hospitals and general practitioners in Switzerland.

Science.gov (United States)

Alves, Bruno; Müller, Henning; Schumacher, Michael; Godel, David; Abu Khaled, Omar

2010-01-01

Interoperability in data exchange has the potential to improve the care processes and decrease costs of the health care system. Many countries have related eHealth initiatives in preparation or already implemented. In this area, Switzerland has yet to catch up. Its health system is fragmented, because of the federated nature of cantons. It is thus more difficult to coordinate efforts between the existing healthcare actors. In the Medicoordination project a pragmatic approach was selected: integrating several partners in healthcare on a regional scale in French speaking Switzerland. In parallel with the Swiss eHealth strategy, currently being elaborated by the Swiss confederation, particularly medium-sized hospitals and general practitioners were targeted in Medicoordination to implement concrete scenarios of information exchange between hospitals and general practitioners with a high added value. In this paper we focus our attention on a prototype implementation of one chosen scenario: the discharge summary. Although simple in concept, exchanging release letters shows small, hidden difficulties due to the multi-partner nature of the project. The added value of such a prototype is potentially high and it is now important to show that interoperability can work in practice.

How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark.

Science.gov (United States)

Jensen, Natasja Koitzsch; Norredam, Marie; Priebe, Stefan; Krasnik, Allan

2013-01-28

Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients' refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this

How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

Directory of Open Access Journals (Sweden)

Jensen Natasja Koitzsch

2013-01-01

Full Text Available Abstract Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE. Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy

How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

Science.gov (United States)

2013-01-01

Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management

Open Access to General Practice Was Associated with Burnout among General Practitioners

DEFF Research Database (Denmark)

Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

2013-01-01

Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without....... In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach...... Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters...

Adolescents' Suicidal Thinking and Reluctance to Consult General Medical Practitioners

Science.gov (United States)

Wilson, Coralie J.; Deane, Frank P.; Marshall, Kellie L.; Dalley, Andrew

2010-01-01

Appropriate help-seeking is widely recognized as a protective factor, and vital for early treatment and prevention of mental health problems during adolescence. General medical practitioners (GPs), that is, family doctors, provide a vital role in the identification of adolescents with mental health problems and the provision of treatment as well…

The role of general dental practitioner in oral health | Nwoku ...

African Journals Online (AJOL)

Other diseases that affect the oral cavity include, but not limited to caries, infections of the gum and jaws, malformations, benign and malignant tumours, as well as diabetes. The general dental practitioner therefore has very important duties. These include early recognition and diagnosis of oral health problems, oral health ...

Everyday symptoms in childhood: occurrence and general practitioner consultation rates.

NARCIS (Netherlands)

Bruijnzeels, M.A.; Foets, M.; Wouden, J.C. van der; Heuvel, W.J.A. van den; Prins, A.

1998-01-01

Background. Fewer than 20% of all illnesses that occur in the home require the attention of a general practitioner (GP). Whether specific illnesses in children are more likely to need the attention of a GP is poorly understood, as is the influence of various other factors. Health diaries are the

Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study

Directory of Open Access Journals (Sweden)

Mazza Danielle

2013-01-01

Full Text Available Abstract Background Despite strong evidence of the benefits of preconception interventions for improving pregnancy outcomes, the delivery and uptake of preconception care and periconceptional folate supplementation remain low. General practitioners play a central role in the delivery of preconception care. Understanding general practitioners’ perceptions of the barriers and enablers to implementing preconception care allows for more appropriate targeting of quality improvement interventions. Consequently, the aim of this study was to examine the barriers and enablers to the delivery and uptake of preconception care guidelines from general practitioners’ perspective using theoretical domains related to behaviour change. Methods We conducted a qualitative study using focus groups consisting of 22 general practitioners who were recruited from three regional general practice support organisations. Questions were based on the theoretical domain framework, which describes 12 domains related to behaviour change. General practitioners’ responses were classified into predefined themes using a deductive process of thematic analysis. Results Beliefs about capabilities, motivations and goals, environmental context and resources, and memory, attention and decision making were the key domains identified in the barrier analysis. Some of the perceived barriers identified by general practitioners were time constraints, the lack of women presenting at the preconception stage, the numerous competing preventive priorities within the general practice setting, issues relating to the cost of and access to preconception care, and the lack of resources for assisting in the delivery of preconception care guidelines. Perceived enablers identified by general practitioners included the availability of preconception care checklists and patient brochures, handouts, and waiting room posters outlining the benefits and availability of preconception care consultations

Informal Interpreting in General Practice: Comparing the perspectives of General Practitioners, migrant patients and family interpreters.

NARCIS (Netherlands)

Zendedel, R.; Schouten, B.C.; van Weert, J.C.M.; van den Putte, B.

Objective To explore differences in perspectives of general practitioners, Turkish-Dutch migrant patients and family interpreters on interpreters’ role, power dynamics and trust in interpreted GP consultations. Methods 54 semi-structured in-depth interviews were conducted with the three parties

An Innovative Child CBT Training Model for Community Mental Health Practitioners in Ontario

Science.gov (United States)

Manassis, Katharina; Ickowicz, Abel; Picard, Erin; Antle, Beverley; McNeill, Ted; Chahauver, Anu; Mendlowitz, Sandra; Monga, Suneeta; Adler-Nevo, Gili

2009-01-01

Objective: Cognitive behavior therapy (CBT) for children has been shown efficacious, but community access to it is often limited by the lack of trained therapists. This study evaluated a child, CBT-focused, 20-session weekly group supervision seminar with a didactic component which was provided to community mental health practitioners by…

Electrocardiogram interpretation in general practice: relevance to prehospital thrombolysis.

Science.gov (United States)

McCrea, W A; Saltissi, S

1993-01-01

OBJECTIVE--To assess, in the context of their possible role in prehospital thrombolysis, the ability of general practitioners to recognise acute transmural myocardial ischaemia/infarction on an electrocardiogram. DESIGN--150 doctors (every fifth name) were selected from the alphabetical list of 750 on Merseyside general practitioner register and without prior warning were asked to interpret a series of six 12 lead electrocardiograms. Three of these showed acute transmural ischaemia/infarction, one was normal, and two showed non-acute abnormalities. Details of doctors' ages, postgraduate training, and clinical practice were sought. SETTING--General practitioners' surgeries and postgraduate centres within the Merseyside area. PARTICIPANTS--106 general practitioners (mean age 45 years) agreed to participate. MAIN OUTCOME MEASURE--Accuracy of general practitioners' interpretations of the six electrocardiograms. RESULTS--82% of general practitioners correctly recognised a normal electrocardiogram. Recognition of acute abnormalities was less reliable. Between 33% and 61% correctly identified acute transmural ischaemia/infarction depending on the specific trace presented. Accurate localisation of the site of the infarct was achieved only by between 8% and 30% of participants, while between 22% and 25% correctly interpreted non-acute abnormalities. Neither routine use of electrocardiography nor postgraduate hospital experience in general medicine was associated with significantly greater expertise. CONCLUSION--The current level of proficiency of a sample of general practitioners in the Merseyside area in recognising acute transmural ischaemia/infarction on an electrocardiogram suggests that refresher training is needed if general practitioners are to give prehospital thrombolysis. Images PMID:8398491

[The general practitioner and the unemployed].

Science.gov (United States)

Ruud, J

1992-02-20

Unemployment has increased in Norway during the last years. In order to study the impact of unemployment on primary health care in Hedmark county, a questionnaire was sent to 132 general practitioners. 70% replied. Some of the questions dealt with the doctors' requests for social security benefits for patients whose problems were related to loss of job. During one week 30% of the doctors had written this kind of sickness certificate. Further, during one month, 35% had recommended rehabilitation or disability pension. During the last year, 26% of the doctors had received requests activity proposing sickness certification for some of their employees from companies that were forced to reduce activity. The author discusses these results, and outlines the possible consequences for patient, doctor and the social security system.

Individual and organizational predictors of depression in general practitioners.

OpenAIRE

Firth-Cozens, J

1998-01-01

BACKGROUND: High levels of stress and depression are seen in both general practitioners (GPs) and hospital doctors, and this has implications for patient care. It is therefore important to discover the individual and organizational causes of elevated symptoms so they can be tackled. AIM: To discover the relative importance of individual characteristics measured 10 years earlier compared with current organizational stressors in predicting depression in GPs. METHOD: Longitudinal questionnaire s...

Vulvovaginal candidiasis: Diagnostic and therapeutic approaches used by Dutch general practitioners

NARCIS (Netherlands)

Engberts, M.K.; Korporaal, H.; Vinkers, M.T.; Belkum, A. van; Binsbergen, J.J. van; Lagro-Janssen, A.L.M.; Helmerhorst, T.J.M.; Meijden, W.I. van der

2008-01-01

Objective: To establish how general practitioners (GPs) in the Netherlands diagnose and treat vaginal candidiasis. Methods: Questionnaires were sent to 1160 Dutch GPs. The GPs were asked to make an inventory of the annual number of consultations for vulvovaginal candidiasis. Furthermore, information

Vulvovaginal candidiasis: diagnostic and therapeutic approaches used by Dutch general practitioners.

NARCIS (Netherlands)

Engberts, M.K.; Korporaal, H.; Vinkers, M.T.; Belkum, A. van; Binsbergen, J.J. van; Lagro-Janssen, A.L.M.; Helmerhorst, T.J.M.; Meijden, W.I. van der

2008-01-01

OBJECTIVE: To establish how general practitioners (GPs) in the Netherlands diagnose and treat vaginal candidiasis. METHODS: Questionnaires were sent to 1160 Dutch GPs. The GPs were asked to make an inventory of the annual number of consultations for vulvovaginal candidiasis. Furthermore, information

Collaboration with general practitioners : preferences of medical specialists - a qualitative study

NARCIS (Netherlands)

Berendsen, Annette J.; Benneker, Wim H. G. M.; Schuling, Jan; Rijkers-Koorn, Nienke; Slaets, Joris P. J.; Meyboom-de Jong, Betty

2006-01-01

Background: Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates medical specialists to initiate and continue

General practitioners' perspectives regarding competence and confidentiality in an adolescent with suspected anorexia nervosa: legal and ethical considerations.

Science.gov (United States)

Bartholomew, Terence P; Paxton, Susan J

2003-02-01

In Victoria, Australia, the legal position regarding young people's competence to make medical treatment decisions has not been clarified in legislation, and a number of often vague common law decisions must be relied on for guidance. This situation produces a degree of uncertainty about appropriate professional practice, while also potentially impeding young people's rights claims in health care settings. With this in mind, the present research explored general practitioners' competence and confidentiality decisions regarding a 17-year-old female who presented with symptoms of an eating disorder. Questionnaires were sent to a random sample of 500 Victorian general practitioners, of whom 190 responded. After reading a case vignette, general practitioners indicated whether they would find the hypothetical patient competent and if they would maintain her confidentiality. Seventy-three per cent of respondents found the patient competent and most would have maintained confidentiality, at least initially. However, subsequent analysis of the rationales supplied for these decisions revealed a wide diversity in general practitioners' understandings and implementations of extant legal authority. This research highlights the need for general practitioners to be exposed to up-to-date and clinically relevant explanations of contemporary legal positions.

The impact of substituting general practitioners with nurse practitioners on resource use, production and health-care costs during out-of-hours: a quasi-experimental study

NARCIS (Netherlands)

Biezen, M.G. van der; Adang, E.M.; Burgt, R. Van Der; Wensing, M.; Laurant, M.G.

2016-01-01

BACKGROUND: The pressure in out-of-hours primary care is high due to an increasing demand for care and rising health-care costs. During the daytime, substituting general practitioners (GPs) with nurse practitioners (NPs) shows positive results to contribute to these challenges. However, there is a

Gut feelings as a third track in general practitioners' diagnostic reasoning.

NARCIS (Netherlands)

Stolper, E.; Wiel, M. van de; Royen, P. Van; Bokhoven, M. Van; Weijden, G.D.E.M. van der; Dinant, G.J.

2011-01-01

BACKGROUND: General practitioners (GPs) are often faced with complicated, vague problems in situations of uncertainty that they have to solve at short notice. In such situations, gut feelings seem to play a substantial role in their diagnostic process. Qualitative research distinguished a sense of

Determinants of general practitioners' wages in England.

Science.gov (United States)

Morris, Stephen; Goudie, Rosalind; Sutton, Matt; Gravelle, Hugh; Elliott, Robert; Hole, Arne Risa; Ma, Ada; Sibbald, Bonnie; Skåtun, Diane

2011-02-01

We analyse the determinants of annual net income and wages (net income/hours) of general practitioners (GPs) using data for 2271 GPs in England recorded during Autumn 2008. The average GP had an annual net income of £97,500 and worked 43 h per week. The mean wage was £51 per h. Net income and wages depended on gender, experience, list size, partnership size, whether or not the GP worked in a dispensing practice, whether they were salaried of self-employed, whether they worked in a practice with a nationally or locally negotiated contract, and the characteristics of the local population (proportion from ethnic minorities, rurality, and income deprivation). The findings have implications for pay discrimination by GP gender and ethnicity, GP preferences for partnership size, incentives for competition for patients, and compensating differentials for local population characteristics. They also shed light on the attractiveness to GPs in England of locally negotiated (personal medical services) versus nationally negotiated (general medical services) contracts.

General practitioners: Between integration and co-location. The case of primary care centers in Tuscany, Italy.

Science.gov (United States)

Barsanti, Sara; Bonciani, Manila

2018-01-01

Healthcare systems have followed several strategies aimed at integrating primary care services and professionals. Medical homes in the USA and Canada, and primary care centres across Europe have collocated general practitioners and other health and social professionals in the same building in order to boost coordination among services and the continuity of care for patients. However, in the literature, the impact of co-location on primary care has led to controversial results. This article analyses the possible benefits of the co-location of services in primary care focusing on the Italian model of primary care centres (Case della Salute) in terms of general practitioners' perception. We used the results of a web survey of general practitioners in Tuscany to compare the experiences and satisfaction of those general practitioners involved and not involved in a primary care centre, performed a MONAVA and ANOVA analysis. Our case study highlights the positive impact of co-location on the integration of professionals, especially with nurses and social workers, and on organizational integration, in terms of frequency of meeting to discuss about quality of care. Conversely, no significant differences were found in terms of either clinical or system integration. Furthermore, the collaboration with specialists is still weak. Considering the general practitioners' perspective in terms of experience and satisfaction towards primary care, co-location strategies is a necessary step in order to facilitate the collaboration among professionals and to prevent unintended consequences in terms of an even possible isolation of primary care as an involuntary 'disintegration of the integration'.

When general practitioners meet new evidence

DEFF Research Database (Denmark)

Olsen, Ole

2017-01-01

out the local information leaflet about home birth were prepared to do so. The time lag between presentation of the evidence and the GPs’ decision to hand out the leaflets was up to one and a half year. Conclusions: A significant number of GPs were prepared to change their information practices......Objective: To explore how general practitioners (GPs) think and act when presented with new evidence in relation to planned home birth and a proposal to change information practices. Design: Exploratory ethnographic study of GPs. The GPs were encountered one or more times during a two-year period......, 2011–2013, while the author tried to set up formal focus group interviews. Dialogues about the evidence, personal experiences, values and other issues unavoidably occurred. Field notes were written concomitantly. Setting: Danish GPs, primarily in Copenhagen. Subjects: Fifty Danish GPs. Results: The GPs...

Are "part-time" general practitioners workforce idlers or committed professionals?

Science.gov (United States)

Dwan, Kathryn M; Douglas, Kirsty A; Forrest, Laura E

2014-09-19

The traditional view of general practice holds that only general practitioners (GPs) in full-time clinical practice can provide quality patient care. Nevertheless, increasing numbers of GPs are choosing to work sessionally, that is, ostensibly "part-time". There are concerns about the health workforce's ability to meet demand and also fears that patient care may be compromised. We sought answers to a) what activities do GPs undertake when not consulting patients, b) why do they choose to work sessionally, and c) does sessional general practice reflect a lack of commitment to patients and the profession? Semi-structured interviews were conducted with GPs who worked sessionally, (i.e. six or fewer sessions a week in clinical general practice, where a session comprises four consecutive hours of patient care). These data were analysed qualitatively and saturation was reached. The majority of participants were in full-time paid employment, while part-time in clinical general practice. They reported that consultations increasingly required the management of patients with complex, chronic conditions who also required psychological management. Coupled with unrealistic patient expectations, these factors led GPs to be concerned about maintaining the quality patient care they considered professionally desirable. Many diversified their work activities to ensure that they retained their professional standards. "Part-time" general practice is a misnomer that masks the contribution these GPs make as part of the health workforce. Sessional practice more accurately describes the nature of our participants' clinical work. Their choice of sessional work is a professional response to the increasing demands within the consultation. It enables GPs to maintain their commitment to quality patient care and their profession, while attenuating the challenges of demanding consultations. Sessional general practitioners demonstrate strong commitment to their patients and the profession.

Stress among general practitioners of Kwa-Dukuza, Kwa-Zulu Natal

Directory of Open Access Journals (Sweden)

Indiran Govender

2009-08-01

Method: A cross-sectional, descriptive study using a self-administered, standardised questionnaire (12-item General Health Questionnaire [GHC] was performed on the 30 general practitioners in Kwa-Dukuza. Confidentiality and anonymity were maintained. Results: 26 of the 30 GPs (87% responded to the survey. 10 GPs (38% were stressed as per the GHQ, six of whom were severely stressed. 22 reported that they felt stressed at work (subjectively. Conclusion: The results indicated that stress among Kwa-Dukuza GPs is slightly higher (38% than found in other studies that indicate a prevalence of 28% among doctors.

Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study.

Science.gov (United States)

van der Plas, Annicka G M; Onwuteaka-Philipsen, Bregje D; Vissers, Kris C; Deliens, Luc; Jansen, Wim J J; Francke, Anneke L

2016-01-01

To investigate how general practitioners and community nurses value the support that they receive from a nurse case manager with expertise in palliative care, whether they think the case manager is helpful in realizing appropriate care and what characteristics of the patient and case management are associated with this view. For sustainable palliative care in an ageing society, basic palliative care is provided by generalists and specialist palliative care is reserved for complex situations. Acceptance of and cooperation with specialist palliative care providers by the general practitioner and community nurse is pivotal. Cross-sectional questionnaire study. Questionnaire data from 168 general practitioners and 125 community nurses were analysed using chi-square tests, univariate and multivariate logistic regression. Data were gathered between March 2011-December 2013. Of general practitioners, 46% rated the case manager as helpful in realizing care that is appropriate for the patient; for community nurses this was 49%. The case manager did not hinder the process of care and had added value for patients, according to the general practitioners and community nurses. The tasks of the case manager were associated with whether or not the case manager was helpful in realizing appropriate care, whereas patient characteristics and the number of contacts with the case manager were not. General practitioners and community nurses are moderately positive about the support from the case manager. To improve cooperation further, case managers should invest in contact with general practitioners and community nurses. © 2015 John Wiley & Sons Ltd.

Development of the EMAP tool facilitating existential communication between general practitioners and cancer patients

DEFF Research Database (Denmark)

Assing Hvidt, Elisabeth; Hansen, Dorte Gilså; Ammentorp, Jette

2017-01-01

BACKGROUND: General practice recognizes the existential dimension as an integral part of multidimensional patient care alongside the physical, psychological and social dimensions. However, general practitioners (GPs) report substantial barriers related to communication with patients about existen...

The role of private general practitioners in the treatment of alcohol ...

African Journals Online (AJOL)

Objectives: The study was undertaken to investigate the role of private general practitioners (GPs) in the treatment of alcohol dependence in the Free State province. Design: A descriptive cross-sectional study. A questionnaire was used to describe the experiences of GPs with patients with alcohol dependence. Outcome ...

Propensity for paying home visits among general practitioners and the associations with cancer patients' place of care and death

DEFF Research Database (Denmark)

Winthereik, Anna K; Hjertholm, Peter; Neergaard, Mette Asbjoern

2017-01-01

BACKGROUND: Previous studies of associations between home visits by general practitioners and end-of-life care for cancer patients have been subject to confounding. AIM: To analyse associations between general practitioners' propensity to pay home visits and the likelihood of hospitalisation...... and dying out of hospital among their cancer patients. DESIGN: A national register cohort study with an ecological exposure. Standardised incidence rates of general practitioner home visits were calculated as a measure for propensity. Practices were grouped into propensity quartiles. Associations between...... propensity groups and end-of-life outcomes for cancer patients aged 40 or above were calculated. SETTING/PARTICIPANTS: Danish general practitioners and citizens aged 40 or above were included from 2003 to 2012. RESULTS: We included 2670 practices with 2,518,091 listed patients (18,364,679 person...

[Tests and scales: restrains to use them by general practitioners. Descriptive transversal study].

Science.gov (United States)

Cario, Camille; Levesque, Jean-Louis; Bouche, Gauthier

2010-12-20

Tests, even though recommended, are only few used by general practitioners (GP's). The aim of this study was to understand the reasons of this underuse. Descriptive transversal study, to explore knowledge, use and restrains to using ten tests related in the first 50 results of consultation in general practice. We questioned 121 GP's from Charente, selected ad random. The oldest tests (MMS, MNA, Fagerström, mini-GDS, IPSS, depression) are known by more than half of the GP's. Only one third is familiar with more recent tests devoted to ambulatory care (TSTS, FACE, venous thromboembolic risk), which are also used less (20% at most). Systematic use of all tests mixed up, never exceeds 30% of all GP's. The principal restrain to use these tests is lack of training (53%), which seems indeed to be inefficient in this domain; 20 to 60% of GP's who know the tests, do not use them, mainly because of doubts regarding their usefulness (38%). What really is the utility of these tests in ambulatory care? Their validity in general practice shows some gaps: their validation results seldom on studies conducted in primary care, impact studies to evaluate the benefits for patients are lacking, and tests designed for specific use by GP's are rare and lacking in validity. Development of research in primary care in this field would be desirable in order to develop relevant, feasible and acceptable tools to help decision making in general practice.

[Summary of the practice guideline 'Vaginal discharge' (first revision) from the Dutch College of General Practitioners].

Science.gov (United States)

Boukes, F S; Boeke, A J P; Dekker, J H; Wiersma, T; Goudswaard, A N

2007-06-16

The 1996 practice guideline of the Dutch College of General Practitioners (NHG) on vaginal discharge has been updated. Most women who visit their doctor with complaints about vaginal discharge do not have an increased risk of a sexually-transmitted disease. Investigations into vaginal discharge comprise history taking, physical examination and microscopic analysis in the laboratory of the general practitioner. Additional investigation into Chlamydia, gonorrhoea and Trichomonas infection is only necessary if the patient history reveals an increased risk of a sexually-transmitted disease. A Candida infection or bacterial vaginosis should only be treated if the patient experiences bothersome complaints. Treatment of a Candida infection consists of a vaginally applied imidazole compound. Bacterial vaginosis can be treated with oral administration of metronidazole. Patients with vaginal fluor can be examined and, if necessary, treated by their general practitioner. Referral to a gynaecologist is rarely necessary.

General Practitioner's Attitudes and Confidence in Managing Patients with Dementia in Singapore.

Science.gov (United States)

Subramaniam, Mythily; Ong, Hui Lin; Abdin, Edimansyah; Chua, Boon Yiang; Shafie, Saleha; Siva Kumar, Fiona Devi; Foo, Sophia; Ng, Li Ling; Lum, Alvin; Vaingankar, Janhavi A; Chong, Siow Ann

2018-03-01

The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs' attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the "GP Attitudes and Competencies Towards Dementia" questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n=296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed that early recognition of dementia served the welfare of the patients (n=385; 96%) and their relatives (n=387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of questionnaire revealed 4 factors representing "benefits of early diagnosis and treatment of patients with dementia", "confidence in dealing with patients and caregiver of dementia", "negative perceptions towards dementia care" and "training needs". GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs' knowledge, confidence and comfort in managing patients with dementia.

Routines for interocclusal appliance therapy among general dental practitioners in a Swedish county.

Science.gov (United States)

Gnauck, Maja; Helkimo, Martti; Magnusson, Tomas

2012-01-01

The aims of this study were to investigate what kind of interocclusal appliances that were chosen among Swedish dentists when treating temporomandibular disorders (TMD), the clinical rationale for the treatment, the diagnoses that warranted the appliance treatment, the use of adjunct TMD treatments and prognostic considerations, and possible differences in these respects between children/adolescents and adults with TMD, and, finally, possible differences between private practitioners and general practitioners in the public dental service. During the 12-months-period April 2009-March 2010 all general dental practitioners in the county of Jönköping, Sweden, were asked to fill in a questionnaire when performing a TMD treatment with an interocclusal appliance. A total of 394 questionnaires were filled in and returned, 216 (55%) from dentists in public dental service and 178 (45%) from private practitioners. It was found that in 40% of the cases, no pre-treatment recording of the functional status in the masticatory system had been made. The commonest reasons for the treatment were bruxism, headache, and replacement of a previous appliance. Less than half of the appliances made were hard acrylic appliances. Some kind of adjunct therapy had been made in 22% of the cases treated in public dental service. The corresponding figure for those treated by private practitioners was 25%. Therapeutic jaw exercises was the commonest adjunct therapy followed by selective occlusal adjustment. In the vast majority of cases, the dentists judged the prognosis of the treatment to be good. It is concluded that a large number of appliances made to treat TMD were soft appliances, especially in public dental service. This reflects a possible overuse of soft appliances at the expense of hard acrylic appliances. Furthermore, in a large number of cases, the treatment was performed without any pre-treatment registrations, and adjunct therapies were rarely used. In all these respects,there is

[The Dutch College of General Practitioners practice guideline 'The menopause'; reaction of the field of general practice

NARCIS (Netherlands)

Bosch, W.J.H.M. van den

2002-01-01

The Dutch College of General Practitioners' practice guideline on the menopause will not be any major cause for discussion. The hot issue of giving oestrogens to peri- and postmenopausal women to prevent osteoporosis or cardiovascular disease was already covered in the practice guideline on

General practitioners' needs for ongoing support for the interpretation of spirometry tests.

NARCIS (Netherlands)

Poels, P.J.P.; Schermer, T.R.J.; Akkermans, R.P.; Jacobs, A.; Bogart-Jansen, M.; Bottema, B.J.A.M.; Weel, C. van

2007-01-01

BACKGROUND: Although one out of three general practitioners (GPs) carries out spirometry, the diagnostic interpretation of spirometric test results appears to be a common barrier for GPs towards its routine application. METHODS: Multivariate cross-sectional analysis of a questionnaire survey among

Emergency contraception. General practitioner knowledge, attitudes and practices in New South Wales.

Science.gov (United States)

Weisberg, E; Fraser, I S; Carrick, S E; Wilde, F M

1995-02-06

To assess the knowledge, attitudes and practices of general practitioners in New South Wales regarding the provision of emergency contraception. Randomised group comparison of 100 rural and 100 urban general practitioners (GPs) by questionnaire. Eighty-four rural and 76 urban GPs responded. More rural GPs were knowledgeable about emergency contraception than urban GPs (95% v. 78%), and more women knew about it than men. More urban GPs frequently prescribed emergency contraception than rural GPs (26% v. 6%) and female GPs prescribed it more readily than male GPs (22% v. 12%). There was great variation in the regimens prescribed, especially among rural GPs. Twenty-five per cent of urban GPs and 31% of rural GPs did not offer women information about emergency contraception, while 16% of both groups included such information in any discussion about contraceptive options, and 18% gave information only if requested by the woman. More than 60% of the GPs would provide information about emergency contraception as a back-up to use of barrier methods. The sex, attitude and knowledge of the GPs influence the likelihood of women being made aware of or being given emergency contraception in NSW. There is a need to further educate both the public and practitioners about emergency contraception.

Individual and organizational predictors of depression in general practitioners.

Science.gov (United States)

Firth-Cozens, J

1998-10-01

High levels of stress and depression are seen in both general practitioners (GPs) and hospital doctors, and this has implications for patient care. It is therefore important to discover the individual and organizational causes of elevated symptoms so they can be tackled. To discover the relative importance of individual characteristics measured 10 years earlier compared with current organizational stressors in predicting depression in GPs. Longitudinal questionnaire study, using data from those of the original cohort of 318 medical students who are now GPs (n = 131), considering perceptions of current stressors and comparing through regression analyses the relative strength of early personality and mood with current organizational factors of sleep, hours worked, and practice size in predicting current depression levels. There were 22 (17%) stressors scoring above threshold for depression. Relationships with senior doctors and patients are the main reported stressors, followed by making mistakes and conflict of career with personal life. The predictors of symptom levels varied for men and women. In men, depression and self-criticism as students, and current sleep levels; and in women, sibling rivalry and current alcohol use, were the main predictors: in men, 27% of the variance was accounted for by early dispositional factors alone compared with 14% in women. A model is suggested linking sleep loss with workplace stressors, self-critical cognitions, and depression. Interventions can be made throughout training, targeting self-criticism and recognizing early depression, while later addressing the organizational stressors, particularly work relationships and sleep patterns.

General practice education and training in southern China: recent development and ongoing challenges under the health care reform

Directory of Open Access Journals (Sweden)

Wang Jia-Ji

2013-12-01

Full Text Available China has launched a general practice (GP-orientated primary care reform in 2009 to develop a more productive, coordinated, and cost-effective system to maintain and improve the health and wellbeing of one-fifth of the world population. The restructure of the health care system with a focus on primary care requires practitioners working on GP as gatekeepers for service delivery that is responsive to the needs of people. It is particularly prioritised to establish a sound education and training system to ensure that the competencies of practitioners are aligned with local health care needs. This article aims to provide a brief review of the development of GP, including exemplary model of education and training currently implemented in southern China, as well as the challenges to be addressed in the next step. There is a shortage of well-trained and qualified general practitioners in China where more than half of the licensed clinicians in primary care are educated below the undergraduate level. Although there is a stepwise increase in recognition that the capacity of GP is pivotal to the success of primary care development in China, challenges coming from resource restriction, rural and urban disparity, social attitude, and community involvement are highlighted as major bottlenecks that currently hinder the rapid development of GP in China. Supportive policy and guidelines are necessary to build up strong GP recognition and ensure adequate resources to underpin a robust primary care system to deliver affordable and effective health care services for the world’s largest population. It might share some similar experiences with other countries that are struggling to develop a GP-based primary care system.

General practice education and training in southern China: recent development and ongoing challenges under the health care reform.

Science.gov (United States)

Wang, H H X; Wang, J J; Zhou, Z H; Wang, X W; Xu, L

2013-01-01

China has launched a general practice (GP)-orientated primary care reform in 2009 to develop a more productive, coordinated, and cost-effective system to maintain and improve the health and well-being of one-fifth of the world population. The restructure of the health care system with a focus on primary care requires practitioners working on GP as gatekeepers for service delivery that is responsive to the needs of people. It is particularly prioritised to establish a sound education and training system to ensure that the competencies of practitioners are aligned with local health care needs. This article aims to provide a brief review of the development of GP, including exemplary model of education and training currently implemented in southern China, as well as the challenges to be addressed in the next step. There is a shortage of well-trained and qualified general practitioners in China where more than half of the licensed clinicians in primary care are educated below the undergraduate level. Although there is a stepwise increase in recognition that the capacity of GP is pivotal to the success of primary care development in China, challenges coming from resource restriction, rural and urban disparity, social attitude, and community involvement are highlighted as major bottlenecks that currently hinder the rapid development of GP in China. Supportive policy and guidelines are necessary to build up strong GP recognition and ensure adequate resources to underpin a robust primary care system to deliver affordable and effective health care services for the world's largest population. It might share some similar experiences with other countries that are struggling to develop a GP-based primary care system.

Developing Web-Based Training for Public Health Practitioners: What Can We Learn from a Review of Five Disciplines?

Science.gov (United States)

Ballew, Paula; Castro, Sarah; Claus, Julie; Kittur, Nupur; Brennan, Laura; Brownson, Ross C.

2013-01-01

During a time when governmental funding, resources and staff are decreasing and travel restrictions are increasing, attention to efficient methods of public health workforce training is essential. A literature review was conducted to inform the development and delivery of web-based trainings for public health practitioners. Literature was gathered…

The development and piloting of a leadership questionnaire for general dental practitioners: preliminary results from the North West of England and Tokyo.

Science.gov (United States)

Brocklehurst, P; O'Malley, L; Hill, H; Ozaki, T; Nomura, M; Matsuda, R

2014-11-01

Key reforms in England and Japan have called for greater clinical leadership from general dental practitioners to deliver improvements in the quality of care for patients. In England, the reorganisation of the National Health Service has led to the development of Local Professional Networks to ensure services are clinically led, patient and outcome focused. In Japan, the rapidly changing demographics have led to calls for general dental practitioners to become more active in meeting the emerging population health challenges. Both require engagement at a strategic and a local level. However, little is known about what is meant by clinical leadership in dentistry or what training needs exist. The aim of this study was to develop and pilot a questionnaire to understand what general dental practitioners feel is important about clinical leadership and how they rate themselves. A 61-item questionnaire was developed from the literature, an earlier qualitative study and refined through cognitive interviews. Questionnaires were distributed to general dental practitioners across the North West of England and Tokyo, using random sequence generation. For each item, the participant had to record whether they thought the statement was an important component of clinical leadership and how they rated themselves. Both were rated using a seven-point Likert scale. Data reduction was undertaken using principal component analysis to examine for factor loadings within the questionnaire. Differences in mean scores were also used to highlight substantive differences in how general dental practitioners rated the different components of leadership and how they rated themselves. The response rate for the pilot was low (22.9% and 7.5% for North West and Tokyo respectively). The items that were considered to be important in leadership reduced to two components in the North West (accounting for 62.1% of the total variance): 'How to lead' and 'How not to lead'. In Tokyo, 56.4% of the total

Aftercare for prostate cancer survivors: information for General Practitioners in international guidelines.

NARCIS (Netherlands)

Spronk, I.; Schellevis, F.G.; Korevaar, J.C.

2015-01-01

Background: The number of prostate cancer survivors requiring aftercare is rising. This places extra burden on hospital care. Therefore there are increasing appeals for greater involvement of General Practitioners (GPs) in the aftercare of prostate cancer survivors. To date, there is little

Preparing general practitioners to receive cancer patients following treatment in secondary care

DEFF Research Database (Denmark)

Guassora, Ann Dorrit Kristiane; Jarlbæk, Lene; Thorsen, Thorkil

2015-01-01

for professionals in both primary and secondary healthcare. Participants discussed solutions to problems which had previously been identified in patient interviews and in focus groups with general practitioners (GPs), hospital doctors, and nursing staff. The data were analyzed using framework analysis. Results...

Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice

DEFF Research Database (Denmark)

Mørk, Trine; Andersen, Pernille Tanggaard; Taket, Ann

2014-01-01

Thirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner...... violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women’s views and attitudes are regarding being asked about IPV. Data...... were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data. This study provides important...

Treating body, treating mind: The experiences of people with psychotic disorders and their general practitioners - Findings from the Australian National Survey of High Impact Psychosis.

Science.gov (United States)

Waterreus, Anna; Morgan, Vera A

2017-09-01

To describe from the perspective of people living with psychotic illness their use of general practitioner services over a 12-month period and the experiences, attitudes and challenges general practitioners face providing health care to this population. A two-phase design was used. Phase 1, screening for psychosis, occurred in public specialised mental health services and non-government organisations within seven catchment sites across Australia. In Phase 2, 1825 people who were screened positive for psychosis were randomly selected for interview which included questions about frequency and reason for general practitioner contact in the 12 months prior to interview. General practitioners (1473) of consenting participants were also surveyed. Almost all (90.3%) survey participants had consulted a general practitioner in the 12-month period, on average 8.9 times, and 28.8% of attenders had consulted 12 times or more. The majority (83.5%) attended one general practitioner practice. Most (77.6%) general practitioners wanted to be involved in the mental health care of their patient. Although 69.1% said the management of their patient was not problematic for their practice, one in five general practitioners reported issues related to patient non-compliance with treatment and non-attendance at scheduled appointments; time constraints; and lack of feedback from treating mental health services. People with psychotic disorders consult general practitioners, some very frequently. Most Australian general practitioners believe they have a responsibility to review the physical and mental health of their patients. Improved communication between general practitioners and mental health services, and easier access to mental health support, may help general practitioners manage the complex mental, physical and social problems of their patients.

The informal curriculum - general practitioner perceptions of ethics in clinical practice.

Science.gov (United States)

Sturman, Nancy J; Parker, Malcolm; van Driel, Mieke L

2012-12-01

Australian medical students should graduate with an understanding of the principles of medical law and ethics, and their application to clinical settings. Although student perspectives have been studied previously, the teacher experience of ethical issues also needs to be understood, particularly in the general practice setting. Interviews were conducted with a convenience sample of 13 general practitioner teachers. They were asked to reflect on common and/or important ethical issues in their day-to-day practice. An inductive thematic analysis of the data was performed by two investigators, who reached a consensus on major themes using an iterative, dialogic process. Participants reported negotiating ethical issues frequently. Major themes included patient-doctor relationships, professional differences, truth-telling, ethically 'grey' areas and the personal demands of ethical decision making. General practitioners in this study describe sometimes needing to apply judgement and compromise in situations involving legal or ethical issues, in order to act in the best interests of patients and to successfully negotiate the patient-doctor relationship. Students learning in this clinical context may perceive mixed messages and ethical lapses in these challenging 'grey' areas. The ethical acumen and emotional resilience of both students and clinical teachers may be enhanced by ongoing reflective discussion with colleagues.

The role of the General Practitioner in weight management in primary care – a cross sectional study in General Practice

Directory of Open Access Journals (Sweden)

Young Doris

2008-12-01

Full Text Available Abstract Background Obesity has become a global pandemic, considered the sixth leading cause of mortality by the WHO. As gatekeepers to the health system, General Practitioners are placed in an ideal position to manage obesity. Yet, very few consultations address weight management. This study aims to explore reasons why patients attending General Practice appointments are not engaging with their General Practitioner (GP for weight management and their perception of the role of the GP in managing their weight. Methods In February 2006, 367 participants aged between 17 and 64 were recruited from three General Practices in Melbourne to complete a waiting room self – administered questionnaire. Questions included basic demographics, the role of the GP in weight management, the likelihood of bringing up weight management with their GP and reasons why they would not, and their nominated ideal person to consult for weight management. Physical measurements to determine weight status were then completed. The statistical methods included means and standard deviations to summarise continuous variables such as weight and height. Sub groups of weight and questionnaire answers were analysed using the χ2 test of significant differences taking p as Results The population sample had similar obesity co-morbidity rates to the National Heart Foundation data. 74% of patients were not likely to bring up weight management when they visit their GP. Negative reasons were time limitation on both the patient's and doctor's part and the doctor lacking experience. The GP was the least likely person to tell a patient to lose weight after partner, family and friends. Of the 14% that had been told by their GP to lose weight, 90% had cardiovascular obesity related co-morbidities. GPs (15% were 4th in the list of ideal persons to manage weight after personal trainer Conclusion Patients do not have confidence in their GPs for weight management, preferring other health

What's growing on General Practitioner's stethoscope?

Science.gov (United States)

Carducci, A; Cargnelutti, M; Tassinari, F; Bizzarro, A; Cordio, G; Carletti, S; Maccarini, L; Pelissero, G

2016-01-01

Non-critical medical devices, as stethoscopes, have long been considered as vectors in microorganisms' transmission. Cleaning standards for non-critical medical equipment are often unclear. This study was designed to assess the attitude of General Practitioners (GPs) towards cleaning their stethoscope and the degree of microbiological contamination of doctor's instrument in outpatient setting. Observational, crossover study. A structured questionnaire was administered to GPs to test their knowledge about medical instrument's cleanliness recommendations and the surface of the diaphragm of their stethoscopes was analyzed for bacteriological isolates using mass spectrometry technique. Most of GPs declared they don't know cleaning recommendations for non-critical medical devices and a relevant bacterial growth was identified on the majority of the stethoscopes' membranes. Almost all microbiological isolates resulted typically found in cutaneous flora. We can't state that the GP's stethoscopes feature a risk of transmission for microbiological pathogens; anyway, because of the level of contamination we observed, cleaning recommendations to disinfect instruments on a regular basis should be better indicated.

Workload and job satisfaction among general practitioners: a review of the literature.

NARCIS (Netherlands)

Groenewegen, P.P.; Hutten, J.B.F.

1991-01-01

The workload of general practitioners (GPs) is an important issue in health care systems with capitation payment for GPs services. This article reviews the literature on determinants and consequences of workload and job satisfaction of GPs. Determinants of workload are located on the demand side

Alternative medicine and general practitioners in The Netherlands: towards acceptance and integration.

NARCIS (Netherlands)

Visser, G.J.; Peters, L.

1990-01-01

A questionnaire on alternative medicine was sent to 600 general practitioners in the Netherlands. Most of the 360 (60%) GPs who replied expressed on interest in alternative practice; and 47% revealed that they used one or more alternative methods themselves, most often homoeopathy. However, the

Training rural practitioners to use buprenorphine; using The Change Book to facilitate technology transfer.

Science.gov (United States)

McCarty, Dennis; Rieckmann, Traci; Green, Carla; Gallon, Steve; Knudsen, Jeff

2004-04-01

The Opiate Medication Initiative for Rural Oregon Residents trained physicians and counselors in Central and Southwestern Oregon to use buprenorphine and develop service models that supported patient participation in drug abuse counseling. The Change Book from Addiction Technology Transfer Centers was used to structure the change process. Fifty-one individuals (17 physicians, 4 pharmacists, 2 nurse practitioners, and 28 drug abuse counselors and administrators) from seven counties completed the training and contributed to the development of community treatment protocols. A pre-post measure of attitudes and beliefs toward the use of buprenorphine suggested significant improvements in attitude after training, especially among counselors. Eight months after training, 10 of 17 physicians trained had received waivers to use buprenorphine and 29 patients were in treatment with six of the physicians. The Change Book facilitated development of county change teams and structured the planning efforts. The initiative also demonstrated the potential to concurrently train physicians, pharmacists, and counselors on the use of buprenorphine.

[Child protection system: Knowledge and role of the general practitioners in Ille-et-Vilaine].

Science.gov (United States)

Balençon, M; Arrieta, A; You, C A; Brun, J-F; Federico-Desgranges, M; Roussey, M

2016-01-01

On 5 March 2007 the law concerning the child protection system was reformed. Since this date, child protection services are responsible for child abuse and neglect. Child protection services are now attempting to determine the rightful place for parents. Asking for child protection is now easier for the general practitioner (GP), who can submit a "preoccupying information (PI)" form. The aim of this study was to review GPs' knowledge on this issue 6 years after the passage of this new law. Prospective postal investigation between 04/01/2013 and 06/01/2013. A total of 298 (113 women) of the 899 GPs of the Ille-et-Vilaine area in Brittany answered a few questions about their activity and their knowledge on child abuse and neglect. The sample's mean age, sex, and practice was representative of the GPs in this area. Only 25.5% of the GPs had any knowledge of this new law. The term "preoccupying information" was unfamiliar to 70.1% of the GPs and what to do with the PI was unknown to 77.2%. The GPs did not know which type of letter to send nor where to send it between legal child protection and social protection services. Only 5% of the GPs had child protection training on PI. The main problem informing the child protection services was the lack of training. Consequently, 91.9% of the GPs would like training. The GPs in the Ille-et-Vilaine area in Brittany are unfamiliar with the child protection updates and need special training. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Spatial variation in general medical services income in dublin general practitioners.

Science.gov (United States)

Teljeur, Conor; Kelly, Alan; O'Dowd, Tom

2011-01-01

The general medical services (GMS) scheme provides care free at the point of use for the 30% most economically deprived section of the population and the elderly. Almost all people of over-70-year olds are eligible for the GMS scheme potentially directing resources away from those most in need. The aim of this study is to analyse the relationship between practice GMS income and deprivation amongst Dublin-based general practitioners (GPs). The practice GMS income in Dublin was analysed in relation to practice characteristics including the number of GPs, catchment area population, proportion of over-70-year olds in the catchment area, catchment deprivation, number of GMS GPs within 2 km, and average GMS practice income within 2 km. Practice GMS income was highest in deprived areas but is also a valuable source of income in the least deprived areas. The capitation rate for over-70-year olds provides an incentive for GPs to locate in affluent areas and potentially directs resources away from those in greater need.

Themes Underlying Australian General Practitioner Views towards Chiropractic and Osteopathy: An Assessment of Free Text Data from a Cross-Sectional Survey

Directory of Open Access Journals (Sweden)

Sandra Grace

2018-01-01

Full Text Available The Australian chiropractic and osteopathic professions underwent a period of significant transformation between 1960 and 2000. This resulted in an improvement in the views held by the medical profession towards the two professions. However, a recent survey of Australian general practitioners (GPs reported that a number of GPs still hold negative views towards chiropractors and osteopaths. This paper examines these views from the perspective of critical realism and explores the generative mechanisms that can influence the willingness of health practitioners to collaborate over patient care. A qualitative analysis of open-ended responses to a survey of 630 Australian GPs was conducted. Unfavourable attitudes of GPs towards chiropractors and osteopaths included perceived lack of safety, efficacy, and inadequacy of training, despite chiropractic’s and osteopathy’s reliance on the same evidence base and similar training to those of other manual therapy professions such as physiotherapy. These attitudes may be underpinned by the professional biases against chiropractic and osteopathy that continue to marginalise the professions within the Australian healthcare system. Continued investment in the research base for chiropractic and osteopathic practice is required, along with raising the awareness of GPs about the education and skills of chiropractors and osteopaths.

Brief cognitive behavioral therapy compared to general practitioners care for depression in primary care: a randomized trial

Science.gov (United States)

2010-01-01

Background Depressive disorders are highly prevalent in primary care (PC) and are associated with considerable functional impairment and increased health care use. Research has shown that many patients prefer psychological treatments to pharmacotherapy, however, it remains unclear which treatment is most optimal for depressive patients in primary care. Methods/Design A randomized, multi-centre trial involving two intervention groups: one receiving brief cognitive behavioral therapy and the other receiving general practitioner care. General practitioners from 109 General Practices in Nijmegen and Amsterdam (The Netherlands) will be asked to include patients aged between 18-70 years presenting with depressive symptomatology, who do not receive an active treatment for their depressive complaints. Patients will be telephonically assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to ascertain study eligibility. Eligible patients will be randomized to one of two treatment conditions: either 8 sessions of cognitive behavioral therapy by a first line psychologist or general practitioner's care according to The Dutch College of General Practitioners Practice Guideline (NHG- standaard). Baseline and follow-up assessments are scheduled at 0, 6, 12 and 52 weeks following the start of the intervention. Primary outcome will be measured with the Hamilton Depression Rating Scale-17 (HDRS-17) and the Patient Health Questionnaire-9 (PHQ-9). Outcomes will be analyzed on an intention to treat basis. Trial Registration ISRCTN65811640 PMID:20939917

Asymptomatic aortic stenosis: An assessment of patients' and of their general practitioners' knowledge, after an indexed specialized assessment in community practice.

Directory of Open Access Journals (Sweden)

Raphaëlle-Ashley Guerbaii

Full Text Available Clinical and echocardiography follow-up is recommended in patients with aortic stenosis to detect symptom onset, thus a watchful waiting approach has to be safe and effective. For both AS patients and their general practitioners, evaluation of valvular heart disease (VHD knowledge, after the indexed specialized assessment has never been measured.To evaluate the knowledge of clinical symptoms of aortic stenosis by both patients and their general practitioner.Sixty-four patients, with moderate to severe and initially asymptomatic AS (median AVA (interquartile range 1.01(0.80-1.15 cm2 previously referred to a tertiary center and medically managed for at least 6 months after the index echocardiogram, and their primary care doctors were interviewed on the phone and asked to answer specific questions related to knowledge of aortic stenosis symptoms.Fifty-six percent of patients quoted shortness of breath as one of the aortic stenosis symptoms, and only 16% knew the 3 aortic stenosis symptoms. Fifty percent of patients reported having received sufficient information regarding aortic stenosis; only 48% remembered receiving information regarding specific symptoms. Only 14% general practitioners quoted the 3 specific symptoms. According to the initial recommendation, only 41 patients (64% benefitted from a 6-to-12 month clinical and echocardiography follow up.GPs are not sufficiently trained to safely manage AS patients in the community and to ensure adequate follow-up and monitoring. AS patients were not properly informed about their diagnosis and symptomatology. Hence, therapeutic education should be improved for patients with asymptomatic AS and continuous medical education on VHD should be reinforced, for GPs.

Attitudes and behaviours in smoking cessation among general practitioners in Finland 2001.

Science.gov (United States)

Barengo, Noël C; Sandström, H Patrick; Jormanainen, Vesa J; Myllykangas, Markku T

2005-01-01

To investigate whether smoking by general practitioners (GPs) and gender influence smoking cessation advice. A self-administered questionnaire, originally developed by the WHO and modified according to the Finnish health care system was sent by mail to physicians who were members of the Finnish Medical Association (FMA). Participants were restricted to those who were living in Finland and were younger than 65 years. Numbers of participants was 3,057 and the response rate 69%. Smoking male GPs gave less smoking cessation advice only to patients with a stomach ulcer or patients using oral contraceptive pills compared with their non-smoking colleagues. Male GPs gave less smoking cessation advice to pregnant patients or patients using contraceptive pills than female GPs. Female smoking GPs less likely advised patients who were pregnant or who were using oral contraceptive pills to stop smoking than non-smoking female GPs (p non-smoking general practitioners were found. The little involvement of GPs in health promotion activities regarding tobacco control is of concern.

Practitioner review: When parent training doesn't work: theory-driven clinical strategies.

Science.gov (United States)

Scott, Stephen; Dadds, Mark R

2009-12-01

Improving the parent-child relationship by using strategies based on social learning theory has become the cornerstone for the treatment of conduct problems in children. Over the past 40 years, interventions have expanded greatly from small, experimental procedures to substantial, systematic programmes that provide clear guidelines in detailed manuals on how practitioners should implement the standardised treatments. They are now widely disseminated and there is a great deal of empirical support that they are very effective for the majority of cases. However, evaluations of even the best of these evidence-based programmes show that a quarter to a third of families and their children do not benefit. What does the practitioner then do, when a standard social learning approach, diligently applied, doesn't work? We argue that under these circumstances, some of the major theories of child development, family functioning and individual psychology can help the skilled practitioner think his or her way through complex clinical situations. This paper describes a set of practical strategies that can then be flexibly applied, based on a systematic theoretical analysis. We hold that social learning theory remains the core of effective parent training interventions, but that ideas from attachment theory, structural family systems theory, cognitive-attribution theory, and shared empowerment/motivational interviewing can each, according to the nature of the difficulty, greatly enrich the practitioner's ability to help bring about change in families who are stuck. We summarise each of these models and present practical examples of when and how they may help the clinician plan treatment.

Co-payments for general practitioners in Denmark

DEFF Research Database (Denmark)

Hansen, Camilla; Andrioti, Despena

2017-01-01

BACKGROUND: The increasing health expenditure for general practitioners (GPs) in Denmark requires that other ways of financing the health system are investigated. This study aims to analyse possibilities for implementing out-of-pocket payments to GPs in Denmark. METHODS: The study was conducted...... as a literature review with 11 articles included. The Health Policy Triangle and the Kingdon Model were used in analysing and discussing the implementation of a cost-sharing policy with an emphasis on the out-of-pocket payments method. RESULTS: The Danish Parliament has expressed mixed opinions about out......-of-pocket payments, whereas the Danish population, the GPs and the media are against introducing payments. The public debate and the fact that Danes are used to healthcare being free of charge both work against introducing co-payments. However, experiences from Sweden, Norway and OECD countries serve to promote...

The general practitioner in the Giant's web.

Science.gov (United States)

Heimly, Vigdis

2011-01-01

Most General Practitioners (GPs) in Norway use Electronic Health Record (EHR) systems to support their daily work processes. These systems were developed with basis in local needs. Electronic collaboration between the different actors has developed over time. Larger national projects like the ePrescription and the Core EHR are examples of projects that interact with the GPs EHR systems. The requirements from these projects need to be addressed by the vendors of the EHR systems. At the same time the GPs see a need for further development of their EHR systems to make them more suited as tools to support the daily work processes. This paper addresses the how GPs can influence on the design and development of their EHR systems in a situation with a preexisting installed base of systems and increasing requirements from many actors.

33 CFR 127.503 - Training: General.

Science.gov (United States)

2010-07-01

... operations. (5) LNG release response procedures. (6) First aid procedures for— (i) Frostbite; (ii) Burns... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Training: General. 127.503... Waterfront Facilities Handling Liquefied Natural Gas Personnel Training § 127.503 Training: General. The...

Usefulness of a virtual community of practice and web 2.0 tools for general practice training: experiences and expectations of general practitioner registrars and supervisors.

Science.gov (United States)

Barnett, Stephen; Jones, Sandra C; Bennett, Sue; Iverson, Don; Bonney, Andrew

2013-01-01

General practice training is a community of practice in which novices and experts share knowledge. However, there are barriers to knowledge sharing for general practioner (GP) registrars, including geographic and workplace isolation. Virtual communities of practice (VCoP) can be effective in overcoming these barriers using social media tools. The present study examined the perceived usefulness, features and barriers to implementing a VCoP for GP training. Following a survey study of GP registrars and supervisors on VCoP feasibility, a qualitative telephone interview study was undertaken within a regional training provider. Participants with the highest Internet usage in the survey study were selected. Two researchers worked independently conducting thematic analysis using manual coding of transcriptions, later discussing themes until agreement was reached. Seven GP registrars and three GP supervisors participated in the study (average age 38.2 years). Themes emerged regarding professional isolation, potential of social media tools to provide peer support and improve knowledge sharing, and barriers to usage, including time, access and skills. Frequent Internet-using GP registrars and supervisors perceive a VCoP for GP training as a useful tool to overcome professional isolation through improved knowledge sharing. Given that professional isolation can lead to decreased rural work and reduced hours, a successful VCoP may have a positive outcome on the rural medical workforce.

Improvement of decision-making criteria for the care of elderly cancer patients by general practitioners (Lorraine, France

Directory of Open Access Journals (Sweden)

Niemier JY

2018-05-01

Full Text Available Jean-Yves Niemier,1,2 Frédérique Claudot,3,4 Phi Linh Nguyen-Thi,4 Jean-Marie Hubert,5 Hubert Rousselot,2,6 Athanase Benetos,1 Christine Perret-Guillaume1,3 1Department of Geriatric Medicine, CHRU de Nancy, Nancy, France; 2UCOG Lorraine, Nancy, France; 3EA 4360 APEMAC, Faculté de Médecine, Université de Lorraine, Nancy, France; 4PARC, CHRU de Nancy, Nancy, France; 5Spincourt Multidisciplinary MSP, Spincourt, France; 6SISSPO Department, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France Objective: The objective of this study was to identify changes in the decision-making criteria of general practitioners (GPs concerning the care of elderly cancer patients after 1 year of corrective measures for care practices in the Lorraine region, France. Materials and methods: In 2014, a postal mail questionnaire was sent to all GPs in the Lorraine region. This questionnaire was designed to identify GPs’ decision-making criteria. It was based on the results of a literature review and on existing guidelines. During 1 year, corrective measures were implemented to improve practices, especially training sessions for physicians and production of specific tools, including a guide to the accepted ideas in geriatric oncology. In 2015, the same questionnaire was resent to all GPs to compare the answers. Results: In 2014, 430 questionnaires were returned out of 2,048 sent, and in 2015, 378 questionnaires were returned out of 2,066 sent. Our results show for the first time that there exists a significant difference in the overall decision criteria between the two survey periods. This difference mainly concerns criteria related to the cancerous diseases. Physicians tend to consider the principal decision criteria to be less important after the training period. GPs express the importance of accessibility to specialists for additional advice in both 2014 and 2015; the distance between the patient’s home and an adapted care facility and the

Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial.

Science.gov (United States)

Butler, Christopher C; Simpson, Sharon A; Hood, Kerenza; Cohen, David; Pickles, Tim; Spanou, Clio; McCambridge, Jim; Moore, Laurence; Randell, Elizabeth; Alam, M Fasihul; Kinnersley, Paul; Edwards, Adrian; Smith, Christine; Rollnick, Stephen

2013-03-19

To evaluate the effect of training primary care health professionals in behaviour change counselling on the proportion of patients self reporting change in four risk behaviours (smoking, alcohol use, exercise, and healthy eating). Cluster randomised trial with general practices as the unit of randomisation. General practices in Wales. 53 general practitioners and practice nurses from 27 general practices (one each at all but one practice) recruited 1827 patients who screened positive for at least one risky behaviour. Behaviour change counselling was developed from motivational interviewing to enable clinicians to enhance patients' motivation to change health related behaviour. Clinicians were trained using a blended learning programme called Talking Lifestyles. Proportion of patients who reported making beneficial changes in at least one of the four risky behaviours at three months. 1308 patients from 13 intervention and 1496 from 14 control practices were approached: 76% and 72% respectively agreed to participate, with 831 (84%) and 996 (92%) respectively screening eligible for an intervention. There was no effect on the primary outcome (beneficial change in behaviour) at three months (362 (44%) v 404 (41%), odds ratio 1.12 (95% CI 0.90 to 1.39)) or on biochemical or biometric measures at 12 months. More patients who had consulted with trained clinicians recalled consultation discussion about a health behaviour (724/795 (91%) v 531/966 (55%), odds ratio 12.44 (5.85 to 26.46)) and intended to change (599/831 (72%) v 491/996 (49%), odds ratio 2.88 (2.05 to 4.05)). More intervention practice patients reported making an attempt to change (328 (39%) v 317 (32%), odds ratio 1.40 (1.15 to 1.70)), a sustained behaviour change at three months (288 (35%) v 280 (28%), odds ratio 1.36 (1.11 to 1.65)), and reported slightly greater improvements in healthy eating at three and 12 months, plus improved activity at 12 months. Training cost £1597 per practice. Training primary

General Employee Radiological Training and Radiological Worker Training: Program management manual

International Nuclear Information System (INIS)

1992-10-01

This manual defines and describes the DOE General Employee Radiological Training (GERT) and Radiological Worker I and II (RW I and II) Training programs. It includes material development requirements, standards and policies, and program administration. This manual applies to General Employee Radiological Training and Radiological Worker Training at all DOE contractor sites. The training materials of both GERT and RW I and II training reflect the requirements identified in the DOE Radiological Control Manual and DOE Order 5480.11. The training programs represent the minimum requirement for the standardized core materials. Each contractor shall implement the program in its entirety and may augment the standardized core materials to increase the general employee and radiological worker level of competency

Inequalities in utilisation of general practitioner and specialist services in 9 European countries

NARCIS (Netherlands)

Stirbu, I.; Kunst, A.E.; Mielck, A.; Mackenbach, J.P.

2011-01-01

ABSTRACT: BACKGROUND: The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia

General practitioners' views of pharmacists' current and potential contributions to medication review and prescribing in New Zealand

Directory of Open Access Journals (Sweden)

Hatah E

2013-09-01

Full Text Available INTRODUCTION: Internationally, non-medical practitioners are increasingly involved in tasks traditionally undertaken by general practitioners (GPs, such as medication review and prescribing. This study aims to evaluate GPs' perceptions of pharmacists' contributions to those services. METHODS: Semi-structured interviews were carried out in two localities with GPs whose patients had and had not undergone a pharmacist-led adherence support Medication Use Review (MUR. GPs were asked their opinions of pharmacists' provision of MUR, clinical medication review and prescribing. Data were analysed thematically using NVivo 8 and grouped by strengths, weaknesses, opportunities and threats (SWOT category. FINDINGS: Eighteen GPs were interviewed. GPs mentioned their own skills, training and knowledge of clinical conditions. These were considered GPs' major strengths. GPs' perceived weaknesses were their time constraints and heavy workloads. GPs thought pharmacists' strengths were their knowledge of pharmacology and having more time for in-depth medication review than GPs. Nevertheless, GPs felt pharmacist-led medication reviews might confuse patients, and increase GP workloads. GPs were concerned that pharmacist prescribing might include pharmacists making a diagnosis. This is not the proposed model for New Zealand. In general, GPs were more accepting of pharmacists providing medication reviews than of pharmacist prescribing, unless appropriate controls, close collaboration and co-location of services took place. CONCLUSION: GPs perceived their own skills were well suited to reviewing medication and prescribing, but thought pharmacists might also have strengths and skills in these areas. In future, GPs thought that working together with pharmacists in these services might be possible in a collaborative setting.

The first general practitioner hospital in The Netherlands: towards a new form of integrated care?

NARCIS (Netherlands)

Moll van Charante, E.; Hartman, E.; IJzermans, J.; Voogt, E.; Klazinga, N.; Bindels, P.

2004-01-01

Objective: To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function. Design: A prospective observational study. Setting. The remaining 20-bed ward of a former district general hospital west of

The first general practitioner hospital in The Netherlands: towards a new form of integrated care?

NARCIS (Netherlands)

Moll van Charante, Eric; Hartman, Esther; Yzermans, Joris; Voogt, Elsbeth; Klazinga, Niek; Bindels, Patrick

2004-01-01

Objective - To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function. Design - A prospective observational study. Setting - The remaining 20-bed ward of a former district general hospital west

General practice registrars' views on maternity care in general practice in New Zealand.

Science.gov (United States)

Preston, Hanna; Jaye, Chrystal; Miller, Dawn L

2015-12-01

The number of general practitioners (GPs) providing maternity care in New Zealand has declined dramatically since legislative changes of the 1990s. The Ministry of Health wants GPs to provide maternity care again. To investigate New Zealand general practice registrars' perspectives on GPs' role in maternity care; specifically, whether maternity services should be provided by GPs, registrars' preparedness to provide such services, and training opportunities available or required to achieve this. An anonymous online questionnaire was distributed to all registrars enrolled in The Royal New Zealand College of General Practitioners' (RNZCGP's) General Practice Education Programme (GPEP) in 2012, via their online learning platform OWL. 165 of the 643 general practice registrars responded (25.7% response rate). Most (95%) believe that GPs interested and trained in maternity care should consider providing antenatal, postnatal or shared care with midwives, and 95% believe women should be able to access maternity care from their general practice. When practising as a GP, 90% would consider providing antenatal and postnatal care, 47.3% shared care, and 4.3% full pregnancy care. Professional factors including training and adequate funding were most important when considering providing maternity care as a GP. Ninety-five percent of general practice registrars who responded to our survey believe that GPs should provide some maternity services, and about 90% would consider providing maternity care in their future practice. Addressing professional issues of training, support and funding are essential if more GPs are to participate in maternity care in New Zealand.

Effectiveness of a multifaceted implementation strategy compared to usual care on low back pain guideline adherence among general practitioners.

Science.gov (United States)

Suman, Arnela; Schaafsma, Frederieke G; van de Ven, Peter M; Slottje, Pauline; Buchbinder, Rachelle; van Tulder, Maurits W; Anema, Johannes R

2018-05-11

To improve patient care, and to reduce unnecessary referrals for diagnostic imaging and medical specialist care for low back pain, an evidence-based guideline for low back pain was developed in the Netherlands in 2010. The current study evaluated the effect of a multifaceted implementation strategy on guideline adherence among Dutch general practitioners. The implementation strategy included a multidisciplinary training, provision of educational material and an interactive website for healthcare professionals, supported by a multimedia eHealth intervention for patients with low back pain. Adherence was measured using performance indicators based on 3 months data extracted from the contacts with patients with low back pain recorded in the electronic medical records of participating general practitioners. Performance indicators were compared between two groups: a usual care group and an implementation group. Performance indicators were referrals to consultations with medical specialists, to diagnostic imaging, and to psychosocial and/or occupational physician consultations, and inquiries about psychosocial and occupational risk factors. The electronic medical records of 5130 patient contacts for LBP were analysed; 2453 patient contacts in the usual care group and 2677 patient contacts in the implementation group. Overall, rates of referral and of recorded inquiries regarding psychosocial and occupational risk factors remained low in both groups over time. The only statistically significant difference found was a reduction in the number of referrals to neurologists in the implementation group (from 100 (7%) to 50 (4%)) compared to the usual care group (from 48 (4%) to 50 (4%), (p strategy did not result in improved guideline adherence among general practitioners, and it is not recommended for widespread use. However, baseline referral rates in participating practices were already low, possibly leaving only little room for improvement. Inquiries for psychosocial and

Knowledge and Awareness among Parents and General Dental Practitioners regarding Rehabilitation with Full Coverage Restoration in Children: A Multi-centric Trial.

Science.gov (United States)

Moda, Aman; Saroj, Gyanendra; Sharma, Swati; Gupta, Basant

2016-01-01

The aim of this study was to evaluate the knowledge and awareness among parents and general dental practitioners regarding rehabilitation with full coverage restoration in children following pulp therapy. A multiple choice questionnaire was given to 1,000 parents and 400 general practitioners in this multicentric trial. The questionnaire assessed their beliefs, knowledge regarding care of primary teeth, assessment of treating children, and knowledge regarding importance of primary teeth. All the questionnaires were then compiled and statistically analyzed using Statistical Package for Social Sciences (SPSS) software. 53% parents did not know the importance of primary teeth and 73% parents also thought that no treatment is possible for pulpally involved primary teeth. 20% parents believed that root canal treatment can be possible for children and only 10% knew about full coverage restorations. 40% of the general dentists felt that the best treatment in the case of primary necrotic teeth is extraction and only 13% knew about stainless steel crowns. 62% of general dental practitioners pointed out patients' noninterest in providing crowns whereas 68% parents reported non-information by dentists. Both parents and general dental practitioners have incomplete and inadequate knowledge regarding full coverage restorations, and we need to improve the knowledge and dental awareness of the parents and the general dental practitioners. How to cite this article: Moda A, Saroj G, Sharma S, Gupta B. Knowledge and Awareness among Parents and General Dental Practitioners regarding Rehabilitation with Full Coverage Restoration in Children: A Multi-centric Trial. Int J Clin Pediatr Dent 2016;9(2):177-180.

Open Access to General Practice Was Associated with Burnout among General Practitioners.

Science.gov (United States)

Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

2013-01-01

Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without. In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters of GPs. In all, 8% of GPs had open access and the prevalence of burnout was 24%. GPs with walk-in open access were more likely to suffer from burnout. Having open access was associated with a 3-fold increased likelihood of burnout (OR = 3.1 (95% CI: 1.1-8.8, P = 0.035)). Although the design cannot establish causality, it is recommended to closely monitor possible negative consequences of open access in general practice.

Domestic violence in patients visiting general practitioners--prevalence, phenomenology, and association with psychopathology.

Science.gov (United States)

Marais, A; de Villiers, P J; Möller, A T; Stein, D J

1999-06-01

It has been suggested that domestic violence is not only highly prevalent and associated with significant morbidity, but that it is also overlooked by medical practitioners. Despite this, few studies have focused on domestic violence in the South African setting, so that there is a paucity of data here on its prevalence, phenomenology, and associated psychopathology. Sixteen general practitioners from the South African Sentinel Practitioner Research Network (SASPREN) screened all their female patients aged 18 years or older for a 3-month period (N = 1,050). A sociodemographic questionnaire was completed, and symptoms of post-traumatic stress disorder (PTSD) and major depression were assessed, both in subjects with a history of domestic violence and in a control group without such a history. 21.5% of patients reported a history of domestic violence at screening. Patients and controls did not differ significantly in terms of age or race. However, patients with a history of domestic violence were significantly more likely to be married, not to have begun a high-school education, and to be working outside the home. Both PTSD and major depression were significantly more common in patients with a history of domestic violence (35.3% and 48.2%, respectively) than in controls (2.6% and 11.4%, respectively). Compared with other patients reporting domestic violence, those with either PTSD or major depression were subjected to more violence and were more likely to report a suicide attempt. In a large, diverse population of adult female patients presenting to a range of general practitioners in South Africa, there was a high prevalence of reported domestic violence. A significant association was found between domestic violence and both PTSD and major depression, with these diagnoses indicative of increased severity of abuse and increased morbidity. Routine screening by medical practitioners of all female patients for a history of domestic violence seems warranted, and patients

Somali refugees' experiences with their general practitioners: frames of reference and critical episodes.

NARCIS (Netherlands)

Feldmann, C.T.; Bensing, J.M.; Ruijter, A. de; Boeije, H.R.

2006-01-01

The article presents the results of a qualitative study based on in-depth interviews with Somali refugees living in The Netherlands, on their experiences with general practitioners (GPs). The central question is: what are the frames of reference participants use to interpret their experiences? The

Somali refugees’ experiences with their general practitioners: frames of reference and critical episodes

NARCIS (Netherlands)

Titia Feldmann, C.; Bensing, J.; Ruijter, Arie de; Boeije, H.R.

2006-01-01

The article presents the results of a qualitative study based on in-depth interviews with Somali refugees living in The Netherlands, on their experiences with general practitioners (GPs). The central question is: what are the frames of reference participants use to interpret their experiences? The

Critical Thinking Disposition of Nurse Practitioners in Taiwan.

Science.gov (United States)

Hsu, Hsiu-Ying; Chang, Shu-Chen; Chang, Ai-Ling; Chen, Shiah-Lian

2017-09-01

Critical thinking disposition (CTD) is crucial for nurse practitioners who face complex patient care scenarios. This study explored the CTD of nurse practitioners and related factors. The study was a cross-sectional descriptive design. A purposive sample was recruited from a medical center and its hospital branches in central Taiwan. A structured questionnaire was used to collect data from 210 nurse practitioners. The participants obtained the highest average score on systematicity and analyticity. CTD had a significant positive correlation with fundamental knowledge readiness, professional knowledge readiness, and confidence in making clinical decisions. Professional knowledge readiness, education level, and on-the-job training predicted the score of the participants on overall CTD. On-the-job training and education level may influence the CTD of nurse practitioners. Providing formal or on-the-job continuing education training to nurse practitioners may help enhance their CTD. J Contin Educ Nurs. 2017;48(9):425-430. Copyright 2017, SLACK Incorporated.

Validation of the diagnosis of autism in general practitioner records

Directory of Open Access Journals (Sweden)

Smith Peter G

2004-03-01

Full Text Available Abstract Background We report on the validity of the computerized diagnoses of autism in a large case-control study investigating the possible association between autism and the measles, mumps and rubella vaccine in the UK using the General Practitioner Research Database (GPRD. We examined anonymized copies of all relevant available clinical reports, including general practitioners' (GP notes, consultant, speech therapy and educational psychologists reports, on 318 subjects born between 1973 and 1997 with a diagnosis of autism or a related disorder recorded in their electronic general practice record. Methods Data were abstracted to a case validation form allowing for the identification of developmental symptoms relevant to the diagnosis of pervasive developmental disorders (PDDs. Information on other background clinical and familial features was also abstracted. A subset of 50 notes was coded independently by 2 raters to derive reliability estimates for key clinical characteristics. Results For 294 subjects (92.5% the diagnosis of PDD was confirmed after review of the records. Of these, 180 subjects (61.2% fulfilled criteria for autistic disorder. The mean age at first recording of a PDD diagnosis in the GPRD database was 6.3 years (SD = 4.6. Consistent with previous estimates, the proportion of subjects experiencing regression in the course of their development was 19%. Inter-rater reliability for the presence of a PDD diagnosis was good (kappa = .73, and agreement on clinical features such as regression, age of parental recognition of first symptoms, language delay and presence of epilepsy was also good (kappas ranging from .56 to 1.0. Conclusions This study provides evidence that the positive predictive value of a diagnosis of autism recorded in the GPRD is high.

[The practice guideline 'Sore throat' (second revision) from the Dutch College of General Practitioners; a response from the perspective of otorhinolaryngology

NARCIS (Netherlands)

Marres, H.A.M.

2008-01-01

In this comment, the practice guideline 'Sore throat' (second revision) is discussed. This guideline, composed by the Dutch College of General Practitioners, offers general practitioners a well-appreciated overview of the common practices regarding diagnostic tests and treatment of pharyngitis and

The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China.

Science.gov (United States)

Chen, Fei; Xu, Xiang-Long; Yang, Zhan; Tan, Hua-Wei; Zhang, Liang

2015-08-10

In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters' willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters' payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters' general practitioners using contractual service supply cost. This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60-85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox's proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox's proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However

The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China

Directory of Open Access Journals (Sweden)

Fei Chen

2015-08-01

Full Text Available Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters’ willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters’ payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters’ general practitioners using contractual service supply cost. Methods: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city aged 60–85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox’s proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. Results: More than seventy percent (76.6% of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year in 2013. Cox’s proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. Conclusions: The willingness-to-pay for general practitioners by contractual service is high among city empty

How well do general practitioners know their elderly patients' social relations and feelings of loneliness?

DEFF Research Database (Denmark)

Due, Tina Drud; Sandholdt, Håkon; Siersma, Volkert Dirk

2018-01-01

BACKGROUND: Social relationships are important to people and affect their quality of life, morbidity and mortality. The aim of this study was to examine the correlation between elderly patients' descriptions of their social relations and feelings of loneliness, and their general practitioners......' assessments of these. METHODS: Cross-sectional study in 12 general practices in the Capital Region of Denmark. During a three-week period each practice asked their patients aged 65 and older to fill out a questionnaire regarding health, social relations and loneliness; the general practitioner (GP) filled out...... a matching questionnaire regarding their perception of the patient's social relations and loneliness. Data were collected from February to September 2014. RESULTS: Of the 767 eligible patients 476 were included in the study. For 447 patients both GP and patient had answered at least one question...

[Summary of the practice guideline 'Thyroid disorders' (first revision) from the Dutch College of General Practitioners

NARCIS (Netherlands)

Lieshout, J. van; Wessels, P.; Rijswijk, E. van; Boer, A.M; Wiersma, A.; Goudswaard, A.N.

2007-01-01

--The practice guideline 'Thyroid disorders' developed by the Dutch College of General Practitioners replaces the practice guideline 'Functional thyroid disorders' from 1996. Recommendations for palpable thyroid disorders have been added. --Hypothyroidism can often be treated by the general

Inequalities in utilisation of general practitioner and specialist services in 9 European countries

NARCIS (Netherlands)

Stirbu, Irina; Kunst, Anton E.; Mielck, Andreas; Mackenbach, Johan P.

2011-01-01

The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the

Practical use of natriuretic peptide measurement: questionnaire results from general practitioners and cardiologists.

Science.gov (United States)

Husby, Simon; Lind, Bent; Goetze, Jens P

2012-02-01

To elucidate the knowledge regarding B-type natriuretic peptide (BNP)/N-terminal proBNP (NT-proBNP) measurement among doctors using this biomarker. We performed a questionnaire-based study on the use of BNP/NT-proBNP measurement among doctors; 21 general practitioners and 23 randomly chosen doctors at cardiology departments were interviewed. 12 general practitioners (57%) answered 'yes', eight (38%) answered 'no' and one (5%) was 'undecided' for use of BNP/NT-proBNP measurement to exclude a diagnosis of heart failure. Among cardiologists, 11 (48%) answered 'yes', ten (43%) answered 'no' and two (9%) were 'undecided' (no difference between groups, p = 0.56). The majority of doctors were familiar with BNP/NT-proBNP being affected by age but were unaware of the impact of gender and obesity. We propose that BNP/NT-proBNP measurement results should be supplied with age- and gender-related cut-off values, along with a notion of the negative predictive value and other parameters affecting the concentration in plasma.

Clinical performance of IPS-Empress 2 ceramic crowns inserted by general dental practitioners.

Science.gov (United States)

Mansour, Yasar F; Al-Omiri, Mahmoud K; Khader, Yousef Saleh; Al-Wahadni, Ahed

2008-05-01

The aim of this study was to evaluate the clinical performance of IPS-Empress 2(R) all-ceramic crowns placed by general dental practitioners. Eighty-two IPS-Empress 2 crowns placed in 64 patients (27 females and 37 males) were evaluated. These crowns had been in place for 15.2 to 57.2 months (mean 25.3 months, SD=9.3). Survival analysis was conducted using the Kaplan-Meier method. Of the 82 crowns 93.9% were rated satisfactory. In terms of the integrity of the restorations, fracture was observed in three crowns and two showed a crack upon transillumination. Five crowns were rated unsatisfactory for color match; one for marginal adaptation; and none for discoloration, secondary caries, or sensitivity. IPS-Empress 2(R) is a suitable material to fabricate all-ceramic crowns; when these all-ceramic crowns were inserted by general dental practitioners, they functioned satisfactorily with low failure rates during an observation period ranging between 15.2 to 57.2 months.

How do private general practitioners manage tuberculosis cases? A survey in eight cities in Indonesia.

Science.gov (United States)

Mahendradhata, Yodi; Lestari, Trisasi; Probandari, Ari; Indriarini, Lucia Evi; Burhan, Erlina; Mustikawati, Dyah; Utarini, Adi

2015-10-14

Private practitioners (PPs) in high-burden countries often provide substandard tuberculosis (TB) treatment, leading to increased risk of drug resistance and continued transmission. TB case management among PPs in Indonesia has not been investigated in recent years, despite longstanding recognition of inadequate care and substantial investment in several initiatives. This study aimed to assess case management practices of private general practitioners (GPs) in eight major cities across Indonesia. A cross-sectional survey of private GPs was carried out simultaneously in eight cities by trained researchers between August and December 2011. We aimed for a sample size of 627 in total, and took a simple random sample of GPs from the validated local registers of GPs. Informed consent was obtained from participants prior to interview. Diagnostic and treatment practices were evaluated based on compliance with national guidelines. Descriptive statistics are presented. Of 608 eligible GPs invited to participate during the study period, 547 (89.9%) consented and completed the interview. A low proportion of GPs (24.6-74.3%) had heard of the International Standards for TB care (ISTC) and only 41.2-68.9% of these GPs had participated in ISTC training. As few as 47.3% (90% CI: 37.6-57.0%) of GPs reported having seen presumptive TB. The median number of cases of presumptive TB seen per month was low (0-5). The proportion of GPs who utilized smear microscopy for diagnosing presumptive adult TB ranged from 62.3 to 84.6%. In all cities, a substantial proportion of GPs (12.0-45.5%) prescribed second-line anti-TB drugs for treating new adult TB cases. In nearly all cities, less than half of GPs appointed a treatment observer (13.8-52.0%). The pattern of TB case management practices among private GPs in Indonesia is still not in line with the guidelines, despite longstanding awareness of the issue and considerable trialing of various interventions.

Primary prevention of cardio-metabolic diseases in general practice: a Dutch survey of attitudes and working methods of general practitioners.

NARCIS (Netherlands)

Nielen, M.M.J.; Assendelft, W.J.J.; Drenthen, A.J.M.; Hombergh, P. van den; Dis, I. van; Schellevis, F.G.

2010-01-01

BACKGROUND: To study the attitudes and working methods of general practitioners (GPs) in primary prevention of cardiovascular diseases, diabetes mellitus and chronic kidney diseases. METHODS: A questionnaire with questions about attitude and working methods in the primary prevention of

General practitioners' willingness to request plain lumbar spine radiographic examinations

International Nuclear Information System (INIS)

Ryynaenen, Olli-Pekka; Lehtovirta, Jukka; Soimakallio, Seppo; Takala, Jorma

2001-01-01

Objectives: To examine general practitioners' attitudes to plain lumbar spine radiographic examinations. Design: A postal questionnaire consisting of questions on background data and doctors' opinions about plain lumbar spine radiographic examinations, as well as eight vignettes (imaginary patient cases) presenting indications for lumbar radiography, and five vignettes focusing on the doctors' willingness to request lumbar radiography on the basis of patients' age and duration of symptoms. The data were analysed according to the doctor's age, sex, workplace and the medical school of graduation. Setting: Finland. Subjects: Six hundred and fifteen randomly selected physicians working in primary health care (64% of original target group). Results: The vignettes revealed that the use of plain lumbar radiographic examination varied between 26 and 88%. Patient's age and radiation protection were the most prominent factors influencing doctors' decisions to request lumbar radiographies. Only slight differences were observed between the attitudes of male and female doctors, as well as between young and older doctors. Doctors' willingness to request lumbar radiographies increased with the patient's age in most vignettes. The duration of patients' symptoms had a dramatic effect on the doctor's decision: in all vignettes, doctors were more likely to request lumbar radiography when patient's symptoms had exceeded 4 weeks. Conclusions: General practitioners commonly use plain lumbar spine radiographic examinations, despite its limited value in the diagnosis of low back pain. Further consensus and medical education is needed to clarify the indications for plain lumbar radiographic examination

Helicobacter pylori in out-patients of a general practitioner

DEFF Research Database (Denmark)

Rothenbacher, D; Bode, G; Winz, T

1997-01-01

Data on prevalence and determinants of Helicobacter pylori infection in well-defined populations are scarce. We investigated the prevalence and determinants of active H. pylori infection in a population of out-patients attending a general practitioner in Southern Germany. Infection status.......4%). Prevalence of H. pylori infection increased with age from 10.8% (95% CI 5.7-18.1%) in the age group 15-29 years to 30.8% (95% CI 22.1-40.6%) in the age group 60-79 years and was 20.3%, 30.4% and 28.2% for the age groups 30-39, 40-49 and 50-59 years, respectively. Education and childhood living conditions...

General practitioners believe that hypnotherapy could be a useful treatment for irritable bowel syndrome in primary care

Directory of Open Access Journals (Sweden)

de Lusignan Simon

2004-10-01

Full Text Available Abstract Background Irritable bowel syndrome is a common condition in general practice. It occurs in 10 to 20% of the population, but less than half seek medical assistance with the complaint. Methods A questionnaire was sent to the 406 GPs listed on the West Sussex Health Authority Medical List to investigate their views of this condition and whether they felt hypnotherapy had a place in its management Results 38% of general practitioners responded. The achieved sample shared the characteristics of target sample. Nearly half thought that irritable bowel syndrome (IBS was a "nervous complaint" and used a combination of "the placebo effect of personal care," therapeutic, and dietary advice. There is considerable divergence in the perceived effectiveness of current approaches. Over 70% thought that hypnotherapy may have a role in the management of patients with IBS; though the majority (68% felt that this should not be offered by general practitioners. 84% felt that this should be offered by qualified hypnotherapist, with 40% feeling that this should be offered outside the health service. Conclusions General practitioners vary in their perceptions of what constitutes effective therapy in IBS. They are willing to consider referral to a qualified hypnotherapist.

Why and how do general practitioners teach? An exploration of the motivations and experiences of rural Australian general practitioner supervisors.

Science.gov (United States)

Ingham, Gerard; Fry, Jennifer; O'Meara, Peter; Tourle, Vianne

2015-10-29

In medical education, a learner-centred approach is recommended. There is also a trend towards workplace-based learning outside of the hospital setting. In Australia, this has resulted in an increased need for General Practitioner (GP) supervisors who are receptive to using adult learning principles in their teaching. Little is known about what motivates Australian GP supervisors and how they currently teach. A qualitative study involving semi-structured interviews with 20 rural GP supervisors who work within one Regional Training Provider region in Australia explored their reasons for being a supervisor and how they performed their role. Data was analysed using a thematic analysis approach. GP supervisors identified both personal and professional benefits in being a supervisor, as well as some benefits for their practice. Supervision fulfilled a perceived broader responsibility to the profession and community, though they felt it had little impact on rural retention of doctors. While financial issues did not provide significant motivation to teach, the increasing financial inequity compared with providing direct patient care might impact negatively on the decision to be or to remain a supervisor in the future. The principal challenge for supervisors was finding time for teaching. Despite this, there was little evidence of supervisors adopting strategies to reduce teaching load. Teaching methods were reported in the majority to be case-based with styles extending from didactic to coach/facilitator. The two-way collegiate relationship with a registrar was valued, with supervisors taking an interest in the registrars beyond their development as a clinician. Supervisors report positively on their teaching and mentoring roles. Recruitment strategies that highlight the personal and professional benefits that supervision offers are needed. Practices need assistance to adopt models of supervision and teaching that will help supervisors productively manage the increasing

[What factors aid in the recruitment of general practice as a career? An enquiry by interview of general practitioners].

Science.gov (United States)

Natanzon, Iris; Ose, D; Szecsenyi, J; Joos, S

2010-05-01

In some parts of Germany there is already a lack of general practitioners (GPs). The reasons for this lack are complex. On the one hand there is an increasing demand for GPs as a result to demographic changes and an increase in the number of chronic diseases. On the other hand fewer medical students decide to become a general practitioner. The aim of this study was to explore, from the perspective of GPs, factors influencing the choice of general practice as a career. Also analysed is the extent to which those factors influence medical students in their carrier choice. 16 GPs were interviewed. Qualitative content analysis according to Mayring has been assisted by the Atlas.ti software program. GPs thought that the occupational orientation of medical students would be strongly dependent on the attractiveness of their future profession. Factors affecting the day-to-day work of general practice and may deterring the carrier choice of students were: poor working and general conditions leading to an increasing dissatisfaction among GPs; decreasing prestige of GPs caused by changed personal and occupational values and attitudes within the society; as well as poor representation and image of general practice as a discipline within the medical curriculum. Various approaches aimed at different target groups can be derived from these identified factors: the government providing general and occupational conditions that would relieve GPs of excessive bureaucracy; universities and medical associations meeting the challenge by improving undergraduate and postgraduate education in general practice; and GPs themselves giving a more self-confident presentation of general practice. Georg Thieme Verlag KG Stuttgart * New York.

Where have all the doctors gone? (2). Intraurban trends: changes in the geographic distribution of general practitioners in Auckland, 1980-7.

Science.gov (United States)

Barnett, J R

1991-08-14

During the 1980s the Auckland metropolitan area increased its share of all general practitioners in New Zealand at a much faster rate than its share of the population, resulting in a high level of availability by 1987. In the light of such trends, neoclassical theory would predict a diffusion of general practitioners into areas with fewer doctors where there is less competition for patients. Data for 1980-7, however, indicates that for every FTE general practitioner who located in doctor poor areas of the city, 1.87 general practitioners continued to open practices in areas already well provided for. Or, for every extra consultation that took place in low income suburbs, 1.51 extra consultations occurred in more affluent localities. These results do not provide strong support for a market led diffusion of doctors into areas of need and any gains in increased equity appear to have been achieved at the expense of considerable inefficiency given the likely presence of induced demand.

Retirement intentions of general practitioners aged 45-65 years.

Science.gov (United States)

Brett, Thomas D; Arnold-Reed, Diane E; Hince, Dana A; Wood, Ian K; Moorhead, Robert G

2009-07-20

To ascertain the retirement intentions of a cohort of Australian general practitioners. Postal questionnaire survey of members of four Divisions of General Practice in Western Australia, sent out November 2007 - January 2008. A sample of 178 GPs aged 45-65 years. Intention to work in general practice until retirement; reasons for retiring before age 65 years; factors that might encourage working beyond chosen retirement age; and perceived obstacles to working in general practice. 63% of GPs intended to work to at least age 65 years, with men more likely to retire early. Of 63 GPs intending to retire early, 46% gave pressure of work, exhaustion and burnout as reasons for early retirement. Better remuneration, better staffing levels and more general support were incentives to continue working for 46% of the 64 GPs who responded to the question about incentives, and more flexible working hours, part-time work and reduced workload for 41%. Of 169 participants, 65% gave increasing bureaucracy, poor job satisfaction and disillusionment with the medical system or Medicare as obstacles to working in general practice in Australia, whereas workforce shortage, increasing patient demands and diminishing lifestyle through overwork were obstacles named by 48%. Many GPs are planning to retire early, reflecting an emerging trend among professionals and society generally. Declining job satisfaction, falling workforce numbers, excessive workload and increasing bureaucracy were recurrent concerns of older WA GPs considering premature retirement.

The workload of general practitioners does not affect their awareness of patients' psychological problems.

NARCIS (Netherlands)

Zantinge, E.M.; Verhaak, P.F.M.; Bakker, D.H. de; Kerssens, J.J.; Meer, K. van der; Bensing, J.M.

2007-01-01

OBJECTIVE: To investigate if general practitioners (GPs) with a higher workload are less inclined to encourage their patients to disclose psychological problems, and are less aware of their patients' psychological problems. METHODS: Data from 2095 videotaped consultations from a representative

International developments in revenues and incomes of general practitioners from 2000 to 2010.

NARCIS (Netherlands)

Kroneman, M.; Meeus, P.; Kringos, D.S.; Groot, W.; Zee, J. van der

2013-01-01

Background: The remuneration system of General Practitioners (GPs) has changed in several countries in the past decade. The aim of our study was: to establish the effect of these changes on the revenues and income of GPs in the first decade of the 21st century. Methods: Annual GP revenue and

Theory-based training strategies for modifying practitioner concerns about exposure therapy.

Science.gov (United States)

Farrell, Nicholas R; Deacon, Brett J; Dixon, Laura J; Lickel, James J

2013-12-01

Despite the well-established efficacy of exposure therapy in the treatment of pathological anxiety, many therapists believe this treatment carries an unacceptably high risk for harm, is intolerable for patients, and poses a number of ethical quandaries. These beliefs have been shown to account for two related problems: (a) underutilization of exposure therapy, and (b) overly cautious and suboptimal delivery the treatment, which likely attenuates treatment outcomes. At present, there is little guidance for those who train exposure therapists to address these concerns. This article reviews therapist negative beliefs about exposure therapy and discusses their modification based on findings from social and cognitive psychology pertinent to belief change, including dual-processing in reasoning, the need for cognition and affect, and attitude inoculation. A number of strategies are offered for augmenting training in exposure therapy in order to promote positive beliefs about the treatment. These strategies involve: (a) therapists engaging in simulated exposure therapy exercises and presenting arguments in defense of exposure's safety, tolerability, and ethicality, and (b) training therapists using emotion-based appeals (e.g., case examples) to supplement research findings. Directions for future research on practitioner concerns about exposure therapy are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Factors influencing career intentions on completion of general practice vocational training in England: a cross-sectional study.

Science.gov (United States)

Dale, Jeremy; Russell, Rachel; Scott, Emma; Owen, Katherine

2017-08-17

General practice is experiencing a growing crisis with the numbers of doctors who are training and then entering the profession in the UK failing to keep pace with workforce needs. This study investigated the immediate to medium term career intentions of those who are about to become general practitioners (GPs) and the factors that are influencing career plans. Online questionnaire survey, with quantitative answers analysed using descriptive statistics and free text data analysed using a thematic framework approach. Doctors approaching the end of 3-year GP vocational training in the West Midlands, England. 178 (57.2%) doctors completed the survey. Most participants planned to work as salaried GPs or locums rather than entering a general practice partnership for at least the first 5 years post-completion of training; others failed to express a career plan or planned to leave general practice completely or work overseas. Many were interested in developing portfolio careers.The quality of general practice experience across undergraduate, foundation and vocational training were reported as influencing personal career plans, and in particular perceptions about workload pressure and morale within the training practices in which they had been placed. Experience of a poor work-life balance as a trainee had a negative effect on career intentions, as did negative perceptions about how general practice is portrayed by politicians and the media. This study describes a number of potentially modifiable factors related to training programmes that are detrimentally influencing the career plans of newly trained GPs. In addition, there are sociodemographic factors, such as age, gender and having children, which are also influencing career plans and so need to be accommodated. With ever-increasing workload in general practice, there is an urgent need to understand and where possible address these issues at national and local level. © Article author(s) (or their employer(s) unless

General Practitioners' Attitudes towards Essential Competencies in End-of-Life Care: A Cross-Sectional Survey.

Science.gov (United States)

Giezendanner, Stéphanie; Jung, Corinna; Banderet, Hans-Ruedi; Otte, Ina Carola; Gudat, Heike; Haller, Dagmar M; Elger, Bernice S; Zemp, Elisabeth; Bally, Klaus

2017-01-01

Identifying essential competencies in end-of-life care, as well as general practitioners' (GPs) confidence in these competencies, is essential to guide training and quality improvement efforts in this domain. To determine which competencies in end-of-life care are considered important by GPs, to assess GPs' confidence in these competencies in a European context and their reasons to refer terminally ill patients to a specialist. Cross-sectional postal survey involving a stratified random sample of 2000 GPs in Switzerland in 2014. Survey development was informed by a previous qualitative exploration of relevant end-of-life GP competencies. Main outcome measures were GPs' assessment of the importance of and confidence in 18 attributes of end-of-life care competencies, and reasons for transferring care of terminally-ill patients to a specialist. GP characteristics associated with main outcome measures were tested using multivariate regression models. The response rate was 31%. Ninety-nine percent of GPs considered the recognition and treatment of pain as important, 86% felt confident about it. Few GPs felt confident in cultural (16%), spiritual (38%) and legal end-of-life competencies such as responding to patients seeking assisted suicide (35%) although more than half of the respondents regarded these competencies as important. Most frequent reasons to refer terminally ill patients to a specialist were lack of time (30%), better training of specialists (23%) and end-of-life care being incompatible with other duties (19%). In multiple regression analyses, confidence in end-of-life care was positively associated with GPs' age, practice size, home visits and palliative training. GPs considered non-somatic competencies (such as spiritual, cultural, ethical and legal aspects) nearly as important as pain and symptom control. Yet, few GPs felt confident in these non-somatic competencies. These findings should inform training and quality improvement efforts in this domain, in

Danish general practitioners? self-reported competences in end-of-life care

OpenAIRE

Winthereik, Anna; Neergaard, Mette; Vedsted, Peter; Jensen, Anders

2016-01-01

Objective General practitioners (GPs) are pivotal in end-of-life (EOL) care. This study aimed to assess GP-reported provision of EOL care and to assess associations with GP characteristics. Design Population-based questionnaire study. Setting Central Denmark Region with approximately 1.3 million inhabitants. Subjects All 843 active GPs in the Central Denmark Region were sent a questionnaire by mail. Main outcome measures Responses to 18 items concerning four aspects: provision of EOL care to ...

An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice.

Science.gov (United States)

McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

2015-09-01

To identify facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general (family) practice. Internationally, a shortage of doctors entering and remaining in general practice and an increasing burden of chronic disease has diversified the nurse's role in this setting. Despite a well-established general practice nursing workforce, little attention has been paid to the ways doctors and nurses collaborate in this setting. Integrative literature review. CINAHL, Scopus, Web of Life, Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews and Trove (dissertation and theses) were searched for papers published between 2000 and May 2014. This review was informed by the approach of Whittemore and Knafl (2005). All included papers were assessed for methodological quality. Findings were extracted, critically examined and grouped into themes. Eleven papers met the inclusion criteria. Thematic analysis revealed three themes common to the facilitators of and barriers to collaboration and teamwork between GPs in general practice: (1) roles and responsibilities; (2) respect, trust and communication; and (3) hierarchy, education and liability. This integrative review has provided insight into issues around role definition, communication and organizational constraints which influence the way nurses and general practitioners collaborate in a team environment. Future research should investigate in more detail the ways doctors and nurses work together in general practice and the impact of collaboration on nursing leadership and staff retention. © 2015 John Wiley & Sons Ltd.

Consensus analysis of sastric formulations used by non-institutionally trained siddha medical practitioners of Virudhunagar and Tirunelveli districts of Tamil Nadu, India.

Science.gov (United States)

Mutheeswaran, S; Pandikumar, P; Chellappandian, M; Ignacimuthu, S; Duraipandiyan, V; Logamanian, M

2014-04-11

Siddha system of traditional medicine has been practiced in Tamil Nadu. This system of medicine has a high number of non-institutionally trained practitioners but studies on their traditional medicinal knowledge are not adequate. The present study is aimed to document and analyze the sastric (traditional) formulations used by the non-institutionally trained siddha medical practitioners in Virudhunagar and Tirunelveli districts of Tamil Nadu, India. After obtaining prior informed consent, interviews were conducted with 115 non-institutionally trained siddha medical practitioners about the sastric formulations used by them for the treatment. Successive free listing method was adopted to collect the data and the data were analyzed by calculating Informant Consensus Factor (Fic) and Informant Agreement Ratio (IAR). The study documented data regarding 194 sastric formulations and they were classified into plant, mineral and animal based formulations. Quantitative analysis showed that 62.5% of the formulations were plant based, while the mineral based formulations had a high mean number of citations and versatile uses. Gastrointestinal (12.0%), kapha (11.3%) and dermatological (10.8%) ailments had a high percentage of citations. Jaundice had a high Fic value (0.750) followed by the dermatological ailments. The illness categories with high Fic values under each type of formulation were as follows: jaundice, aphrodisiac and urinary ailments (plant based); jaundice, cuts & wounds and dermatological ailments (mineral based); and hemorrhoids, kapha ailments and heart ailments (animal based formulations). The scientific studies conducted with important formulations under each illness category are discussed. The present study indicated the importance of some illnesses over the others and inclusion of new illnesses under each formulation. The ingredients used to prepare these formulations have shown varying degrees of scientific evidence; generally limited studies were available

Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice.

NARCIS (Netherlands)

Feijen-de Jong, E.I.; Baarveld, F.; Jansen, D.E.M.C.; Ursum, J.; Reijneveld, S.A.; Schellevis, F.G.

2013-01-01

Background: Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP) during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of

Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice

NARCIS (Netherlands)

Feijen-de Jong, Esther I.; Baarveld, Frank; Jansen, Danielle E. M. C.; Ursum, Jennie; Reijneveld, Sijmen A.; Schellevis, Francois G.

2013-01-01

Background: Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP) during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of

International developments in revenues and incomes of general practitioners from 2000 to 2010

NARCIS (Netherlands)

Kroneman, Madelon; Meeus, Pascal; Kringos, Dionne Sofia; Groot, Wim; van der Zee, Jouke

2013-01-01

The remuneration system of General Practitioners (GPs) has changed in several countries in the past decade. The aim of our study was: to establish the effect of these changes on the revenues and income of GPs in the first decade of the 21st century. Annual GP revenue and practice costs were

Postgraduate education for Chinese medicine practitioners: a Hong Kong perspective

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Mercer Stewart W

2009-02-01

Full Text Available Abstract Background Despite Hong Kong government's official commitment to the development of traditional Chinese medicine (TCM over the last ten years, there appears to have been limited progress in public sector initiated career development and postgraduate training (PGT for public university trained TCM practitioners. Instead, the private TCM sector is expected to play a major role in nurturing the next generation of TCM practitioners. In the present study we evaluated TCM graduates' perspectives on their career prospects and their views regarding PGT. Method Three focus group discussions with 19 local TCM graduates who had worked full time in a clinical setting for fewer than 5 years. Results Graduates were generally uncertain about how to develop their career pathways in Hong Kong with few postgraduate development opportunities; because of this some were planning to leave the profession altogether. Despite their expressed needs, they were dissatisfied with the current quality of local PGT and suggested various ways for improvement including supervised practice-based learning, competency-based training, and accreditation of training with trainee involvement in design and evaluation. In addition they identified educational needs beyond TCM, in particular a better understanding of western medicine and team working so that primary care provision might be more integrated in the future. Conclusion TCM graduates in Hong Kong feel let down by the lack of public PGT opportunities which is hindering career development. To develop a new generation of TCM practitioners with the capacity to provide quality and comprehensive care, a stronger role for the government, including sufficient public funding, in promoting TCM graduates' careers and training development is suggested. Recent British and Australian experiences in prevocational western medicine training reform may serve as a source of references when relevant program for TCM graduates is planned in

Periodontal instrumentation for the general dental practitioner: Pt. 2. Management maintenance and sterilization

Energy Technology Data Exchange (ETDEWEB)

Touyz, L.Z.G. (University of the Witwatersrand, Johannesburg (South Africa). Dept. of Oral Medicine and Periodontology); De Waal, J.

1983-03-01

The purpose of this article is to describe the management, maintenance and sterilization of periodontal instrumentation used by the general dental practitioner. The pre-sterilization, decontamination and cleaning, the sharpening of instrumentation and the packaging, identification and grouping for sterilization are discussed. Attention is also given to various techniques of sterilization, including gamma radiation.

Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa

NARCIS (Netherlands)

Barth, R. E.; van der Meer, J. T. M.; Hoepelman, A. I. M.; Schrooders, P. A.; van de Vijver, D. A.; Geelen, S. P. M.; Tempelman, H. A.

2008-01-01

The purpose of this study was to assess the one-year efficacy of highly active antiretroviral therapy (HAART) administered by general practitioners in a primary care community clinic in rural South Africa. We performed an observational cohort study of 675 treatment-naive human immunodeficiency virus

Pediatric Oncology Palliative Care: Experiences of General Practitioners and Bereaved Parents.

OpenAIRE

Neilson, SJ; Gibson, F; Greenfield, SM

2015-01-01

Objective: This qualitative study set in the West Midlands region of the United Kingdom, aimed to examine the\\ud role of the general practitioner (GP) in children's oncology palliative care from the perspective of GPs who had cared for a child with cancer receiving palliative care at home and bereaved parents.\\ud Methods: One-to-one semi-structured interviews were undertaken with 18 GPs and 11 bereaved parents\\ud following the death. A grounded theory data analysis was undertaken; identifying...

General Practitioners' Knowledge and Concern about Electromagnetic Fields

DEFF Research Database (Denmark)

Berg-Beckhoff, Gabriele; Breckenkamp, Jürgen; Larsen, Pia Veldt

2014-01-01

Our aim is to explore general practitioners' (GPs') knowledge about EMF, and to assess whether different knowledge structures are related to the GPs' concern about EMF. Random samples were drawn from lists of GPs in Germany in 2008. Knowledge about EMF was assessed by seven items. A latent class...... analysis was conducted to identify latent structures in GPs' knowledge. Further, the GPs' concern about EMF health risk was measured using a score comprising six items. The association between GPs' concern about EMF and their knowledge was analysed using multiple linear regression. In total 435 (response...... "don't know". There was no association between GPs' latent knowledge classes or between the number of correct answers given by the GPs and their EMF concern, whereas the number of incorrect answers was associated with EMF concern. Greater EMF concern in subjects with more incorrect answers suggests...

[Need for information concerning medical rehabilitation of the federal german pension fund--findings of an online survey of general practitioners].

Science.gov (United States)

Walther, A L; Pohontsch, N J; Deck, R

2015-05-01

General practitioners complain about information deficits, uncertainties and unclear requirements associated with medical rehabilitation. In this study General practitioners' specific information needs are identified and the preferred form for the presentation of information is determined. In a secondary analysis of several focus groups with different stakeholders, rehabilitation specific aspects were identified for which General practitioners could have further information needs. Those were transferred into an online-questionnaire. GPs in Schleswig-Holstein were invited to the online-survey via E-Mail by different medical associations. A total of 194 questionnaires were available for analysis. In general, high information needs covering all rehabilitation topics in the questionnaire are evident. The highest information need is recognised for the following aspects: in which cases it makes sense to file an objection, which measures have to take place before it makes sense to file an objection and what the term "ambulant measures have been exhausted" exactly means. GPs clearly prefer a website as a means of informational source. Under the option of multiple replies 74.2% prefer a website, followed by the option of a brochure (44.8%) and further education (22.2%). General practitioners have high information needs regarding different aspects of rehabilitation which are not satisfied with existing sources of information. The development of a user-friendly website with comprehensible information on the required aspects seems necessary to increase the acceptance and understanding of medical rehabilitation among practitioners and therefore to optimise rehabilitation processes. © Georg Thieme Verlag KG Stuttgart · New York.

Home care by general practitioners for cancer patients in the last 3 months of life: An epidemiological study of quality and associated factors

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Pivodic, Lara; Harding, Richard; Calanzani, Natalia; McCrone, Paul; Hall, Sue; Deliens, Luc; Higginson, Irene J; Gomes, Barbara

2016-01-01

Background: Stronger generalist end-of-life care at home for people with cancer is called for but the quality of end-of-life care delivered by general practitioners has been questioned. Aim: To determine the degree of and factors associated with bereaved relatives’ satisfaction with home end-of-life care delivered by general practitioners to cancer patients. Design: Population-based mortality followback survey. Setting/participants: Bereaved relatives of people who died of cancer in London, United Kingdom (identified from death registrations in 2009–2010), were invited to complete a postal questionnaire surveying the deceased’s final 3 months of life. Results: Questionnaires were completed for 596 decedents of whom 548 spent at least 1 day at home in the last 3 months of life. Of the respondents, 55% (95% confidence interval: 51%–59%) reported excellent/very good home care by general practitioners, compared with 78% (95% confidence interval: 74%–82%) for specialist palliative care providers and 68% (95% confidence interval: 64%–73%) for district/community/private nurses. The odds of high satisfaction (excellent/very good) with end-of-life care by general practitioners doubled if general practitioners made three or more compared with one or no home visits in the patient’s last 3 months of life (adjusted odds ratio: 2.54 (95% confidence interval: 1.52–4.24)) and halved if the patient died at hospital rather than at home (adjusted odds ratio: 0.55 (95% confidence interval: 0.31–0.998)). Conclusion: There is considerable room for improvement in the satisfaction with home care provided by general practitioners to terminally ill cancer patients. Ensuring an adequate offer of home visits by general practitioners may help to achieve this goal. PMID:26036688

Should the General Practitioner Consider Mesotherapy (Intradermal Therapy) to Manage Localized Pain?

OpenAIRE

Mammucari, M; Maggiori, E; Lazzari, M; Natoli, S

2016-01-01

Wide variations in the types of pain and response to analgesic pharmacotherapy mean that a variety of treatment strategies are needed. One approach is mesotherapy (intradermal therapy). This consists of microinjections into the skin and is ideally suited to the management of localized pain. Advantages include increasing the duration of drug activity, reduced risk of adverse events and interactions, and possible synergy with other therapies. Mesotherapy provides general practitioners with anot...

Workplace Learning among General Practitioners and Specialists: The Use of Videoconferencing as a Tool

Science.gov (United States)

Nilsen, Line Lundvoll

2011-01-01

Purpose: Videoconferencing between general practitioners and hospitals has been developed to provide higher quality health care services in Norway by promoting interaction between levels of care. This article aims to explore the use of videoconferencing for information exchange and consultation throughout the patient trajectory and to investigate…

Dental Implants and General Dental Practitioners of Nepal: A study of existing knowledge and need for further education

Directory of Open Access Journals (Sweden)

Bhageshwar Dhami

2017-03-01

Full Text Available Background & Objectives: The use of dental implants in partially or completely edentulous patients has proved effective and an accepted treatment modality with predictable long-term success. Dental implants are becoming a popular choice for replacing the missing teeth because of increased awareness about implants both in dentists and patients. The objective of the study was to assess the basic knowledge and education about dental implants among general dental practitioners (GDPs of Nepal.Materials & Methods:  A cross sectional questionnaire was carried out among 110 GDPs which consist of twenty questions that were divided into three categories; first with some basic knowledge in implant dentistry, second with clinical knowledge of dental implants and third with dental implant education and training.Results: Out of 110 GDPs, 72.7% had basic knowledge about implant dentistry and 65.5% were not aware about advance surgical procedures like sinus lift and guided bone regeneration. All the GDPs were positive regarding more training and education in dental implants and 95.5% of them would like to incorporate dental implant treatment in their practice in future. Conclusion: GDPs should have adequate knowledge and training of dental implants which can be incorporated at undergraduate or post doctoral level so that they are skilled to provide quality dental implant therapy to their patients confidently.

Periodontal Diseases and Systemic Disorders: What Do Our Doctors Know? A General Practitioner's Survey Conducted in Southern France.

Science.gov (United States)

Alexia, Vinel; Chloé, Vachon; Pierre, Barthet; Sara, Laurencin-Dalicieux

2017-12-01

With 39,359 entries on PubMed, periodontal medicine has a prominent position in periodontal research. Good patient care requires well-advised physicians, and whereas the dental community is informed about the relationships between periodontal diseases (PDs) and an increasing number of systemic pathologies, we wondered whether general practitioners were too. Thus, we aimed to evaluate their knowledge of the links between periodontal and systemic diseases. To this end, we sent an electronic questionnaire to the 2350 general practitioners registered to the URPS (Union régionale des Professionnels de Santé) of Midi-Pyrénées, France. They were asked about their practice, their attitude during a medical examination, and their knowledge about PDs. The analysis of 222 properly answered questionnaires showed that while most general practitioners are aware of the relationships between PDs and diabetes or cardiovascular diseases, the majority of them are unaware that obesity and respiratory and joint diseases are also concerned. Indeed, 94% of the questioned subjects consider their insight of PDs to be insufficient. Nevertheless, more than half of the interrogated physicians cared about their patients' oral health and dental care. Education regarding relationships between periodontal and systemic diseases must be improved among general practitioners who are in the front line to refer high-risk patients to a periodontist. Copyright © 2017 Elsevier Inc. All rights reserved.

Preparing palliative home care nurses to act as facilitators for physicians' learning: Evaluation of a training programme.

Science.gov (United States)

Pype, Peter; Mertens, Fien; Wens, Johan; Stes, Ann; Van den Eynden, Bart; Deveugele, Myriam

2015-05-01

Palliative care requires a multidisciplinary care team. General practitioners often ask specialised palliative home care teams for support. Working with specialised nurses offers learning opportunities, also called workplace learning. This can be enhanced by the presence of a learning facilitator. To describe the development and evaluation of a training programme for nurses in primary care. The programme aimed to prepare palliative home care team nurses to act as facilitators for general practitioners' workplace learning. A one-group post-test only design (quantitative) and semi-structured interviews (qualitative) were used. A multifaceted train-the-trainer programme was designed. Evaluation was done through assignments with individual feedback, summative assessment through videotaped encounters with simulation-physicians and individual interviews after a period of practice implementation. A total of 35 nurses followed the programme. The overall satisfaction was high. Homework assignments interfered with the practice workload but showed to be fundamental in translating theory into practice. Median score on the summative assessment was 7 out of 14 with range 1-13. Interviews revealed some aspects of the training (e.g. incident analysis) to be too difficult for implementation or to be in conflict with personal preferences (focus on patient care instead of facilitating general practitioners' learning). Training palliative home care team nurses as facilitator of general practitioners' workplace learning is a feasible but complex intervention. Personal characteristics, interpersonal relationships and contextual variables have to be taken into account. Training expert palliative care nurses to facilitate general practitioners' workplace learning requires careful and individualised mentoring. © The Author(s) 2014.

General Practitioners' Management of Psychostimulant Drug Misuse: Implications for Education and Training

Science.gov (United States)

Alkhamis, Ahmed; Matheson, Catriona; Bond, Christine

2009-01-01

Aims: To provide baseline data regarding GPs' knowledge, experience, and attitudes toward the management of PsychoStimulant Drug Misuse (PSDM) patients to inform future education and training initiatives. Methods: A structured cross-sectional postal questionnaire was developed following initial content setting interviews, piloted then sent to a…

The supply of general practitioners across local areas: accounting for spatial heterogeneity.

Science.gov (United States)

McIsaac, Michelle; Scott, Anthony; Kalb, Guyonne

2015-10-03

The geographic distribution of general practitioners (GPs) remains persistently unequal in many countries despite notable increases in overall supply. This paper explores how the factors associated with the supply of general practitioners (GPs) are aligned with the arbitrary geographic boundaries imposed by the use of spatially referenced GP supply data. Data on GP supply in postcodes within Australia are matched to data on the population characteristics and levels of amenities in postcodes. Tobit regression models are used that examine the associations between GP supply and postcode characteristics, whilst accounting for spatial heterogeneity. The results demonstrate that GPs do not consider space in a one-dimensional sense. Location choice is related to both neighbourhood-specific factors, such as hospitals, and broader area factors, such as area income and proximity to private schools. Although the proportion of females and elderly were related to GPs supply, mortality rate was not. This paper represents the first attempt to map the factors influencing GP supply to the appropriate geographic level at which GPs may be considering that factor. We suggest that both neighbourhood and broader regional characteristics can influence GPs' locational choices. This finding is highly relevant to the design and evaluation of relocation incentive programmes.

A standardised questionnaire for evaluating hospital-based rotations in general practice vocational training.

Science.gov (United States)

Viniol, Annika; Lommler-Thamer, Martina; Baum, Erika; Banzhoff, Norbert Donner

2015-05-01

The residency period of vocational training is a fundamental component for a general practitioner's (GP's) qualification. During the residency, teaching is given by consultants and staff from different medical disciplines who do not necessarily know the GP registrar's training objectives. To develop a standardised feedback questionnaire to evaluate residency attachments and enable GP registrars and their supervisors to discuss the actual training environment and areas for improvement. A cross-sectional study was carried out to assess GP registrars' ratings of items preselected by an expert group to reflect important elements in high-quality vocational training. We recruited GP registrars in Germany via mailing lists and online discussion forums and used the importance-severity-score method to score the content and importance of the selected items. On the basis of these ratings, we eliminated 74 items. This version of the questionnaire then underwent an intra-observer-reliability evaluation by the same GP registrars after eight weeks. Items with a correlation of less than 0.4 (Pearson correlation coefficient) were dropped or rephrased. Our initial questionnaire featured 117 potential items. We reduced this to 43 items after the first study; two additional items were dropped following the reliability test. To our knowledge, this is the first standardised feedback questionnaire evaluating the residency period of vocational training. We hope our work will improve the quality of GPs' vocational training. The importance-severity-score method is a fast and efficient method for developing instruments using personal judgement to evaluate constructs.

Changes in job stress and coping skills among caregivers after dementia care practitioner training.

Science.gov (United States)

Takizawa, Takeya; Takahashi, Megumi; Takai, Michiko; Ikeda, Taichiro; Miyaoka, Hitoshi

2017-01-01

Dementia care practitioner training is essential for professional caregivers to acquire medical knowledge and care skills for dementia patients. We investigated the significance of training in stress management by evaluating caregivers' job stress and coping style before and after they have completed training. The subjects included 134 professional caregivers (41 men, 93 women) recruited from participants in training programmes held in Kanagawa Prefecture from August 2008 to March 2010. A survey using a brief job stress questionnaire and a coping scale was carried out before and after they completed their training. A t-test and multiple regression analysis were performed to evaluate the effects of the training. After the training, the scores of modifiers on the job stress scale and of the coping scale increased, whereas the scores of stress reactions on the job stress scale decreased. However, there were no changes in participants' subjective cognition concerning their workplace environment. Furthermore, the change in stress reaction score tended to correlate with the change in consultation score in all participants and with the change in problem-solving and consultation in male participants. Among female participants, the change in stress reaction score tended to correlate with change in support from superiors and colleagues as modifiers. The factors that correlated to the change in stress reaction score differed between genders. The findings suggest that training caregivers improves their stress reaction and coping skills. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

[Summary of the practice guideline 'Viral hepatitis and other liver diseases' (second revision) from the Dutch College of General Practitioners].

Science.gov (United States)

Bouma, M; van Geldrop, W J; Numans, M E; Wiersma, Tj; Goudswaard, A N

2008-12-06

The revised Dutch College of General Practitioners' practice guideline 'Viral hepatitis and other liver diseases' offers advice in the diagnosis and management of viral hepatitis A, B and C and other liver diseases. The guideline is important for general practitioners as well as specialists in internal medicine and gastroenterology. The emphasis is on the management of chronic hepatitis B en C, because the prevalence of these diseases has increased in the Netherlands and, in addition, the treatment options for chronic hepatitis have improved. Consequently, timely recognition and adequate referral of patients with chronic hepatitis B or hepatitis C have become more important. However, many patients with a chronic liver disease have no symptoms. Therefore, the general practitioner should be aware that a patient visiting the practice with fatigue and malaise could have a liver disease if he or she belongs to a high-risk group or has had high-risk contacts. If the general practitioner repeatedly finds increased liver transaminase values during routine examination of asymptomatic patients, additional diagnostic tests should be performed. Further tests should focus on viral hepatitis as well as on non-alcoholic fatty liver disease and non-alcoholic steatohepatitis or, depending on the history-taking, liver damage due to excessive alcohol, medication or drug use.

Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

Directory of Open Access Journals (Sweden)

Bowden Francis J

2010-09-01

Full Text Available Abstract Background Genital chlamydia is the most commonly notified sexually transmissible infection (STI in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis. Methods In-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT. Transcripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed. Results Perceived barriers to patients telling partners (patient referral included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT - many felt concerned that it is not

[Fax Survey to Elucidate the Information Needs of General Practitioners in Lower Saxony Regarding the Topic of Medical Implants].

Science.gov (United States)

Schaper, M; Berndt, M; Schrimpf, C; Wilhelmi, M; Elff, M; Haverich, A; Wilhelmi, M

2016-12-01

Background: Medial implants help a multitude of patients to gain more health, mobility and thus, quality of life. In collaboration with a still growing expectation of life especially, i.e., within Western industrial countries, this has led to an increasing use of implants over the last years. However, although biomechanical characteristics of modern implant materials have improved considerably, one big challenge still exists - the implant-associated infection. Early diagnostic and therapeutic interventions could clearly mitigate this issue, but are general practitioners sufficiently informed regarding this topic? Material and Methods: In March 2013 and in close cooperation with the Lower Saxony association of general practitioners, we initiated a survey to elucidate the information demands of general practitioners regarding the topic of medical implants. A total of 939 members of the association were contacted via fax and 101 (10.8 %) responded. Based on the obtained data, we then evaluated which topics are most interesting for this group of medical professionals. Results: The survey clearly indicates that general practitioners request more general implant-related data, e.g., type and specification of an implant as well as its location within the individual patient and contact addresses of the implanting hospital, but also want more specific information regarding diagnostic and therapeutic strategies in the case of implant-associated complications. Conclusion: The present article reports in detail on the conducted fax survey and shows some initial strategies as to how the identified challenges might be faced. Georg Thieme Verlag KG Stuttgart · New York.

[General practice research units in Denmark: multidisciplinary research in support of practical work].

Science.gov (United States)

Reventlow, Susanne; Broholm, Katalin Alexa Király; Mäkelä, Marjukka

2014-01-01

In Denmark the general practice research units operating in connection with universities provide a home base, training and methodology support for researchers in the field from medical students to general practitioners carrying out practical work. Research issues frequently require a multidisciplinary approach and use of different kinds of materials. Problems arising from the practical work of general practitioners take priority in the wide selection of topics. The units have networked efficiently with organizations of general practitioners and medical education. The combination of research environments has created synergy benefiting everybody and increased the scientific productivity and visibility of the field.

Perceived barriers and facilitators for general practitioner-patient communication in palliative care: a systematic review

NARCIS (Netherlands)

Slort, W.; Schweitzer, B.P.M.; Blankenstein, A.H.; Abarshi, E.A.; Riphagen, I.I.; Echteld, M.A.; Aaronson, N.K.; van der Horst, H.E.; Deliens, L.

2011-01-01

While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic

Perceived barriers and facilitators for general practitioner-patient communication in palliative care: A systematic review

NARCIS (Netherlands)

Slort, W.; Schweitzer, B.P.M.; Blankenstein, A.H.; Abarshi-Fatiregun, E.A.B.; Riphagen, I.; Echteld, M.A.; Aaronson, N.K.; van der Horst, H.E.; Deliens, L.

2011-01-01

While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic

Molar incisor hypomineralisation: experience and perceived challenges among dentists specialising in paediatric dentistry and a group of general dental practitioners in the UK.

Science.gov (United States)

Kalkani, M; Balmer, R C; Homer, R M; Day, P F; Duggal, M S

2016-04-01

To assess the views and experience of the UK dentists specialising in paediatric dentistry (trainees) about molar incisor hypomineralisation (MIH) and compare the findings with the responses from a group of UK general dental practitioners. A web-based questionnaire was sent to dentists undergoing specialist training in paediatric dentistry. The same questionnaire was completed by a group of general dentists who stated an interest in treating children, with various levels of experience. The questionnaire sought information on clinical experience and the views of the dentists on the impact of MIH on children and families. Specialty trainees (37) from different paediatric dental departments in the UK completed the online survey, giving a total response rate of 71%. The questionnaire was also completed by 31 general dental practitioners. There was difficulty in distinguishing MIH from other conditions for both groups. Increased sensitivity of affected teeth was the most frequently encountered problem with 51% of the trainees and 76% of the dentists saying this was often or always a challenge. The trainees were particularly concerned about the pain children experienced and about the appearance of the condition. Both groups felt that parental anxiety occurred in almost all cases. Both groups felt that MIH presents several clinical challenges and has a negative effect on the quality of life of the affected children and their families. There were significant differences in the views and perceptions between the two groups.

[Burnout of general practitioners in Belgium: societal consequences and paths to solutions].

Science.gov (United States)

Kacenelenbogen, N; Offermans, A M; Roland, M

2011-09-01

The definition of burn-out the most often cited and proposed by Maslach and Jackson, clarifies the three cardinal symptoms affecting doctors, namely, emotional exhaustion, with depersonalization of their patients and reduction of the feeling of personal accomplishment. The causes of this phenomenon are relatively well-known: individual psychological factors, stressful factors intrinsic to the medical practice and finally extrinsic factors related to the professional environment and its organization. The purpose of this review is to estimate the prevalence of burnout within the population of Belgian family physicians and to understand both individual and societal consequences. About the method. This is a literature review using databases Medline, Cochrane Library, and the American Psychological Association from 2000 to 2011 with the keywords: primary health care, family practice, burnout, emotional exhaustion, psychological stressors, distress, fatigue, depersonalization, substance and alcohol abuse, depression, well-being, quality of life, job satisfaction, professional efficiency, patient care, physician-patient relations, medical errors, quality of health care, pharmaceutical/health expenditure/statistics-numerical data, obstacles to prevention, health system assessment, medical demography. Selecting of the most relevant articles through the reading of abstracts and then full text reading of 49 selected articles. In conclusion, the exact prevalence of burn-out amongst Belgian general practitioners is not known. From some works, it is estimated that about half of them would be achieved at least in terms of emotional exhaustion. The symptoms related to burn-out are potentially serious: ea depression, alcohol and tobacco abuse and cardiovascular complications. There are also arguments demonstrating the fact that this disorder amongst general practitioners influences negatively the quality of care, their cost, but also medical demography of primary care with as a

Menopause as a long-term risk to health: implications of general practitioner accounts of prevention for women's choice and decision-making.

Science.gov (United States)

Murtagh, Madeleine J; Hepworth, Julie

2003-03-01

Over the past two decades medical researchers and modernist feminist researchers have contested the meaning of menopause. In this article we examine various meanings of menopause in major medical and feminist literature and the construction of menopause in a semi-structured interview study of general practitioners in rural South Australia. Three discursive themes are identified in these interviews; (i) .the hormonal menopause - symptoms, risk, prevention; (ii). the informed menopausal woman; and (iii). decision-making and hormone replacement therapy. By using the discourse of prevention, general practitioners construct menopause in relation to women's health care choices, empowerment and autonomy. We argue that the ways in which these concepts are deployed by general practitioners in this study produces and constrains the options available to women. The implications of these general practitioner accounts are discussed in relation to the proposition that medical and feminist descriptions of menopause posit alternative but equally-fixed truths about menopause and their relationship with the range of responses available to women at menopause. Social and cultural explanations of disease causality (c.f. Germov 1998, Hardey 1998) are absent from the new menopause despite their being an integral part of the framework of the women's health movement and health promotion drawn on by these general practitioners. Further, the shift of responsibility for health to the individual woman reinforces practice claims to empower women, but oversimplifies power relations and constructs menopause as a site of self-surveillance. The use of concepts from the women's health movement and health promotion have nevertheless created change in both the positioning of women as having 'choices' and the positioning of some general practitioners in terms of greater information provision to women and an attention to the woman's autonomy. In conclusion, we propose that a new menopause has evolved

General practitioners' tacit and stated policies in the prescription of lipid lowering agents.

Science.gov (United States)

Evans, J S; Harries, C; Dennis, I; Dean, J

1995-01-01

BACKGROUND. Research into general practitioners' prescribing behaviour with regard to lipid lowering agents has relied on survey methods which presume that doctors have insight into their prescribing behaviour and can describe it accurately. AIM. This study set out to measure the tacit policies used by general practitioners in prescribing lipid lowering agents and to compare these with their stated policies. METHOD. Effects of 13 separate cues on decisions to prescribe were examined. The cues included cholesterol levels and a number of associated risk factors for coronary heart disease. Doctors rated 130 imaginary cases presented by a computer. Thirty five general practitioners in the Plymouth area participated in the study. Their ages ranged from 31 to 55 years and all but four were men. The raw data in each case was a rating of the likelihood that the doctor would prescribe for the patient described. These were converted into statistical weightings by use of multiple linear regression. The pattern of (standardized) weights constituted the tacit policy for each doctor. Stated policies were measured in a subsequent interview by asking doctors to rate the influence of each cue. RESULTS. Both tacit and stated policies diverged widely between different doctors. Most doctors overestimated the number of cues that had actually influenced their decisions, and many believed that they had taken into account associated factors for coronary heart disease when they had not. On lifestyle related risks doctors were generally less likely to treat overweight people and most stated this as their policy. Most were also less likely to treat smokers but some had the opposite policy. Those less likely to treat smokers were also less likely to treat obese patients. There was also considerable variation in the extent to which the doctors took account of the attitude of the patient to receiving treatment. CONCLUSION. Doctors' policies are highly variable and particularly inconsistent in

The PULSAR primary care protocol: a stepped-wedge cluster randomized controlled trial to test a training intervention for general practitioners in recovery-oriented practice to optimize personal recovery in adult patients.

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Enticott, Joanne C; Shawyer, Frances; Brophy, Lisa; Russell, Grant; Fossey, Ellie; Inder, Brett; Mazza, Danielle; Vasi, Shiva; Weller, Penelope June; Wilson-Evered, Elisabeth; Edan, Vrinda; Meadows, Graham

2016-12-20

General practitioners (GPs) in Australia play a central role in the delivery of mental health care. This article describes the PULSAR (Principles Unite Local Services Assisting Recovery) Primary Care protocol, a novel mixed methods evaluation of a training intervention for GPs in recovery-oriented practice. The aim of the intervention is to optimize personal recovery in patients consulting study GPs for mental health issues. The intervention mixed methods design involves a stepped-wedge cluster randomized controlled trial testing the outcomes of training in recovery-oriented practice, together with an embedded qualitative study to identify the contextual enablers and challenges to implementing recovery-oriented practice. The project is conducted in Victoria, Australia between 2013 and 2017. Eighteen general practices and community health centers are randomly allocated to one of two steps (nine months apart) to start an intervention comprising GP training in the delivery of recovery-oriented practice. Data collection consists of cross-sectional surveys collected from patients of participating GPs at baseline, and again at the end of Steps 1 and 2. The primary outcome is improvement in personal recovery using responses to the Questionnaire about the Process of Recovery. Secondary outcomes are improvements in patient-rated measures of personal recovery and wellbeing, and of the recovery-oriented practice they have received, using the INSPIRE questionnaire, the Warwick-Edinburgh Mental Well-being Scale, and the Kessler Psychological Distress Scale. Participant data will be analyzed in the group that the cluster was assigned to at each study time point. Another per-protocol dataset will contain all data time-stamped according to the date of intervention received at each cluster site. Qualitative interviews with GPs and patients at three and nine months post-training will investigate experiences and challenges related to implementing recovery-oriented practice in primary

New paths in post-graduate medical training in general practice - 8 years of experience with the pilot project Verbundweiterbildungplus Baden-Württemberg.

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Schwill, Simon; Magez, Julia; Joos, Stefanie; Steinhäuser, Jost; Ledig, Thomas; Rubik, Aline; Niebling, Wilhelm; Szecsenyi, Joachim; Flum, Elisabeth

2017-01-01

Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program "Verbundweiterbildung plus Baden-Württemberg" (VWB plus BW) was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice. Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB plus BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program's content closely on the needs of the target groups, scientifically based evaluations and research are carried out. Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016). In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied). Alongside the medical

Leadership and management curriculum planning for Iranian general practitioners.

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Khosravan, Shahla; Karimi Moonaghi, Hossein; Yazdani, Shahram; Ahmadi, Soleiman; Mansoorian, Mohammad Reza

2015-10-01

Leadership and management are two expected features and competencies for general practitioners (GPs). The purpose of this study was leadership and management curriculum planning for GPs which was performed based on Kern's curriculum planning cycle. This study was conducted in 2011- 2012 in Iran using an explanatory mixed-methods approach. It was conducted through an initial qualitative phase using two focus group discussions and 28 semi-structured interviews with key informants to capture their experiences and viewpoints about the necessity of management courses for undergraduate medical students, goals, objectives, and educational strategies according to Kern's curriculum planning cycle. The data was used to develop a questionnaire to be used in a quantitative written survey. Results of these two phases and that of the review of medical curriculum in other countries and management curriculum of other medical disciplines in Iran were used in management and leadership curriculum planning. In the qualitative phase, purposeful sampling and content analysis with constant comparison based on Strauss and Corbin's method were used; descriptive and analytic tests were used for quantitative data by SPSS version 14. In the qualitatively stage of  this research, 6 main categories including the necessity of management course, features and objectives of management curriculum, proper educational setting, educational methods and strategies, evolutionary method and feedback result were determined. In the quantitatively stage of the research, from the viewpoints of 51.6% of 126 units of research who filled out the questionnaire, ranked high necessary of management courses. The coordination of care and clinical leadership was determined as the most important role for GPs with a mean of 6.2 from sample viewpoint. Also, team working and group dynamics had the first priority related to the principles and basics of management with a mean of 3.59. Other results were shown in the paper

Assessment of knowledge of general practitioners about nuclear medicine

International Nuclear Information System (INIS)

Zakavi, R.; Derakhshan, A.; Pourzadeh, Z.

2002-01-01

Nuclear medicine is an important department in most of scientific hospitals in the world. Rapid improvement in the filed of nuclear medicine needs continuing education of medical students. We tried to evaluate the knowledge of general practitioners in the flied of nuclear medicine, hoping that this study help mangers in accurate planning of teaching programs. Methods and materials: We prepared a questionnaire with 14 questions regarding applications of nuclear medicine techniques in different specialities of medicine. We selected questions as simple as possible with considering the most common techniques and best imaging modality in some disease. One question in nuclear cardiology, one in lung disease, two questions in thyroid therapy, another two in gastrointestinal system, two in genitourinary system and the last two in nuclear oncology. Also 4 questions were about general aspects of nuclear medicine. We have another 4 questions regarding the necessity of having a nuclear medicine subject during medical study, the best method of teaching of nuclear medicine and the preferred method of continuing education. Also age, sex, graduation date and university of education of all subjects were recorded. Results: One hundred (General practitioners) were studied. including, 58 male and 42 female with age range of 27-45 years did . About 60% of cases were 27-30 years old and 40 cases were older than 40. Seventy two cases were graduated in the last 5 years. Mashad University was the main university of education 52 cases with Tehran University (16 cases) and Tabriz University (6 cases) in the next ranks. Also 26 cases were graduated from other universities. From four questions in the field of general nuclear nedione 27% were correctly answered to all questions, 37% correctly answered two questions and 10% had correct answered only one question. No correct answer was noted in 26% . correct answer was noted in 80% the held of nuclear cardiology and in 72% in the field of lung

Non-participation in preventive child health examinations at the general practitioner in Denmark

DEFF Research Database (Denmark)

Søndergaard, Grethe; Biering-Sørensen, Sofie; Michelsen, Susan Ishøy

2008-01-01

Objective. To examine demographic and socioeconomic characteristics of parents and children in families not participating in preventive child health examinations at the general practitioner in a society with free and easy access to healthcare. Design. Population-covering register linkage study...... free and easy access to the GP, the utilization of preventive child health examinations is lower among the more deprived part of the population....

Screening for depression in patients with myocardial infarction by general practitioners

DEFF Research Database (Denmark)

Larsen, Karen Kjær; Vestergaard, Mogens; Christensen, Bo

2013-01-01

information on anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS), severity of the disease, and smoking habits. The responders’ general practitioners received a questionnaire 1 year after the patient had been discharged from hospital. This questionnaire provided information......Background: Depression in patients with myocardial infarction (MI) is highly prevalent and associated with increased morbidity and mortality. Routine screening for post-MI depression is recommended. We studied general practitioners’ practice of screening for post-MI depression and analysed whether...... the screening rate varied among subgroups of MI patients with a particular high risk of depression. Design: Population-based cohort study in the Central Denmark Region. Methods: All patients with a first-time MI in 2009 received a questionnaire 3 months after discharge from hospital. The questionnaire included...

The application of foraging theory to the information searching behaviour of general practitioners.

Science.gov (United States)

Dwairy, Mai; Dowell, Anthony C; Stahl, Jean-Claude

2011-08-23

General Practitioners (GPs) employ strategies to identify and retrieve medical evidence for clinical decision making which take workload and time constraints into account. Optimal Foraging Theory (OFT) initially developed to study animal foraging for food is used to explore the information searching behaviour of General Practitioners. This study is the first to apply foraging theory within this context.Study objectives were: 1. To identify the sequence and steps deployed in identifiying and retrieving evidence for clinical decision making. 2. To utilise Optimal Foraging Theory to assess the effectiveness and efficiency of General Practitioner information searching. GPs from the Wellington region of New Zealand were asked to document in a pre-formatted logbook the steps and outcomes of an information search linked to their clinical decision making, and fill in a questionnaire about their personal, practice and information-searching backgrounds. A total of 115/155 eligible GPs returned a background questionnaire, and 71 completed their information search logbook. GPs spent an average of 17.7 minutes addressing their search for clinical information. Their preferred information sources were discussions with colleagues (38% of sources) and books (22%). These were the two most profitable information foraging sources (15.9 min and 9.5 min search time per answer, compared to 34.3 minutes in databases). GPs nearly always accessed another source when unsuccessful (95% after 1st source), and frequently when successful (43% after 2nd source). Use of multiple sources accounted for 41% of searches, and increased search success from 70% to 89%. By consulting in foraging terms the most 'profitable' sources of information (colleagues, books), rapidly switching sources when unsuccessful, and frequently double checking, GPs achieve an efficient trade-off between maximizing search success and information reliability, and minimizing searching time. As predicted by foraging theory, GPs

The role of the general practitioner in return to work after cancer-a systematic review

NARCIS (Netherlands)

de Jong, Femke; Frings-Dresen, Monique H.; van Dijk, Nynke; van Etten-Jamaludin, Faridi S.; van Asselt, Kristel M.; de Boer, Angela G. E. M.

2018-01-01

The number of cancer patients and survivors of working age is increasing. General Practitioners (GPs) may have a significant role in psychosocial cancer care, including work-related concerns. Therefore, we performed a systematic literature review to identify the role of the GP in work-related

General medicine advanced training: lessons from the John Hunter training programme.

Science.gov (United States)

Jackel, D; Attia, J; Pickles, R

2014-03-01

Recent years have seen a rapid growth in the number of advanced trainees pursuing general medicine as a specialty. This reflects an awareness of the need for broader training experiences to equip future consultant physicians with the skills to manage the healthcare challenges arising from the demographic trends of ageing and increasing comorbidity. The John Hunter Hospital training programme in general medicine has several characteristics that have led to the success in producing general physicians prepared for these challenges. These include support from a core group of committed general physicians, an appropriate and sustainable funding model, flexibility with a focus on genuine training and developing awareness of a systems approach, and strong links with rural practice. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

General practitioners' views on (long-term) prescription and use of problematic and potentially inappropriate medication for oldest-old patients-A qualitative interview study with GPs (CIM-TRIAD study).

Science.gov (United States)

Pohontsch, Nadine Janis; Heser, Kathrin; Löffler, Antje; Haenisch, Britta; Parker, Debora; Luck, Tobias; Riedel-Heller, Steffi G; Maier, Wolfgang; Jessen, Frank; Scherer, Martin

2017-02-17

Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM. As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list). The interview guideline included generic and patient-specific questions. Interviews were digitally recorded and transcribed verbatim. We content analyzed the interviews using deductive and inductive category development. The majority of the general practitioners were not aware of the PRISCUS list. Agents deemed potentially inappropriate from the general practitioners' point of view and the PRISCUS list are not completely superimposable. General practitioners named their criteria to identify appropriate medication for elderly patients (e.g. renal function, cognitive state) and emphasized the importance of monitoring. We identified prescription- (e.g. benzodiazepines on alternative private prescription), medication- (e.g. subjective perception that PIM has no alternative), general practitioner- (e.g. general practitioner relies on specialists), patient- (e.g. "demanding high-user", positive subjective benefit-risk-ratio) and system-related aspects (e.g. specialists lacking holistic view, interface problems) related to the (long term) use of PIM. While the PRISCUS list does not seem to play a decisive role in general practice, general practitioners are well aware of risks associated with PIM. Our study identifies some starting points for a safer handling of PIM, e.g. stronger dissemination of the PRISCUS list, better compensation of

Opinions of general practitioners about psychotherapy and their relationships with mental health professionals in the management of major depression: A qualitative survey.

Directory of Open Access Journals (Sweden)

Hélène Dumesnil

Full Text Available French general practitioners (GPs refer their patients with major depression to psychiatrists or for psychotherapy at particularly low rates.This qualitative study aims to explore general practitioners' (GP opinions about psychotherapy, their relationships with mental health professionals, their perceptions of their role and that of psychiatrists in treating depression, and the relations between these factors and the GPs' strategies for managing depression.In 2011, in-depth interviews based on a semi-structured interview guide were conducted with 32 GPs practicing in southeastern France. Verbatim transcripts were examined by analyzing their thematic content.We identified three profiles of physicians according to their opinions and practices about treatment strategies for depression: pro-pharmacological treatment, pro-psychotherapy and those with mixed practices. Most participants considered their relationships with psychiatrists unsatisfactory, would like more and better collaboration with them and shared the same concept of management in general practice. This concept was based both on the values and principles of practice shared by GPs and on their strong differentiation of their management practices from those of psychiatrists.Several attitudes and values common to GPs might contribute to their low rate of referrals for psychotherapy in France: strong occupational identity, substantial variations in GPs' attitudes and practices regarding depression treatment strategies, representations sometimes unfavorable toward psychiatrists. Actions to develop a common culture and improve cooperation between GPs and psychiatrists are essential. They include systems of collaborative care and the development of interdisciplinary training common to GPs and psychiatrists practicing in the same area.

Opinions of general practitioners about psychotherapy and their relationships with mental health professionals in the management of major depression: A qualitative survey

Science.gov (United States)

Dumesnil, Hélène; Apostolidis, Thémis; Verger, Pierre

2018-01-01

Background French general practitioners (GPs) refer their patients with major depression to psychiatrists or for psychotherapy at particularly low rates. Objectives This qualitative study aims to explore general practitioners' (GP) opinions about psychotherapy, their relationships with mental health professionals, their perceptions of their role and that of psychiatrists in treating depression, and the relations between these factors and the GPs' strategies for managing depression. Methods In 2011, in-depth interviews based on a semi-structured interview guide were conducted with 32 GPs practicing in southeastern France. Verbatim transcripts were examined by analyzing their thematic content. Results We identified three profiles of physicians according to their opinions and practices about treatment strategies for depression: pro-pharmacological treatment, pro-psychotherapy and those with mixed practices. Most participants considered their relationships with psychiatrists unsatisfactory, would like more and better collaboration with them and shared the same concept of management in general practice. This concept was based both on the values and principles of practice shared by GPs and on their strong differentiation of their management practices from those of psychiatrists, Conclusion Several attitudes and values common to GPs might contribute to their low rate of referrals for psychotherapy in France: strong occupational identity, substantial variations in GPs' attitudes and practices regarding depression treatment strategies, representations sometimes unfavorable toward psychiatrists. Actions to develop a common culture and improve cooperation between GPs and psychiatrists are essential. They include systems of collaborative care and the development of interdisciplinary training common to GPs and psychiatrists practicing in the same area. PMID:29385155

General practice training and virtual communities of practice - a review of the literature

Directory of Open Access Journals (Sweden)

Barnett Stephen

2012-08-01

Full Text Available Abstract Background Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Methods Major online databases Scopus, Psychlit and Pubmed were searched for the terms “Community of Practice” (CoP AND (Online OR Virtual OR Electronic AND (health OR healthcare OR medicine OR “Allied Health”. Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. Results The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders

General practice training and virtual communities of practice - a review of the literature.

Science.gov (United States)

Barnett, Stephen; Jones, Sandra C; Bennett, Sue; Iverson, Don; Bonney, Andrew

2012-08-21

Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs) in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Major online databases Scopus, Psychlit and Pubmed were searched for the terms "Community of Practice" (CoP) AND (Online OR Virtual OR Electronic) AND (health OR healthcare OR medicine OR "Allied Health"). Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders rather than single company VCoPs. Specific goals are important

[Attitudes of general practitioners to pharmaceutical sales representatives in Sousse].

Science.gov (United States)

Ben Abdelaziz, A; Harrabi, I; Rahmani, S; Ghedira, A; Gaha, K; Ghannem, H

2003-01-01

The therapeutic knowledge of physicians is the corner stone to the rational use of medicines; however information about medicines is generally obtained from the pharmaceutical industry via their sales representatives (reps). We aimed to identify general practitioners' (GPs) attitudes to pharmaceutical reps and the information they provide. We surveyed 140 GPs using a self-administered questionnaire. The response rate was 78% (72 GPs from the public sector and 68 from the private sector). About 10% of the GPs said they received daily visits from pharmaceutical reps; 84% of GPs considered them an efficient source of information and 31% said they might change their therapeutic prescribing following visits from these reps. Because of their positive perception of pharmaceutical reps, GPs are susceptible to the information they provide. Controlling the validity of the therapeutic information imparted by the pharmaceutical industry is thus a fundamental component of the programme for the rational use of medicines.

What do resource-oriented approaches mean to general practitioners and how can they be facilitated in primary care? A qualitative study.

Science.gov (United States)

Prüfer, Franziska; Joos, Stefanie; Miksch, Antje

2013-01-01

Although resource orientation, as a part of health promotion, should play a major role in general practice, the anchoring and realization of resource-oriented approaches remain small in Germany. The aim of this study was to analyze what resource orientation means to general practitioners (GPs) and develop strategies as to how this can be facilitated in GP practice. Within a qualitative research approach, 19 semi-structured telephone interviews were recorded, transcribed, and analyzed using qualitative content analysis. Within the interviews, the inclusion of the patients' individual resources is described as core competence of GPs. Supporting the patients' disease coping strategies and self-help were seen as important by GPs. However, perceptions as to which resources are considered to be fundamental ranged widely across the participant group. The results confirm the important role of resource-oriented approaches in general practice. However, a general definition of resource orientation is needed. In addition, working conditions for GPs need to be taken into account to ensure that these contribute to a healthy work-life balance. The need for GP training was identified to improve communication skills. Further integration of GPs in health promotion and communal structures would be beneficial.

What Do Resource-Oriented Approaches Mean to General Practitioners and How Can They Be Facilitated in Primary Care? A Qualitative Study

Directory of Open Access Journals (Sweden)

Franziska Prüfer

2013-01-01

Full Text Available Although resource orientation, as a part of health promotion, should play a major role in general practice, the anchoring and realization of resource-oriented approaches remain small in Germany. The aim of this study was to analyze what resource orientation means to general practitioners (GPs and develop strategies as to how this can be facilitated in GP practice. Within a qualitative research approach, 19 semi-structured telephone interviews were recorded, transcribed, and analyzed using qualitative content analysis. Within the interviews, the inclusion of the patients’ individual resources is described as core competence of GPs. Supporting the patients’ disease coping strategies and self-help were seen as important by GPs. However, perceptions as to which resources are considered to be fundamental ranged widely across the participant group. The results confirm the important role of resource-oriented approaches in general practice. However, a general definition of resource orientation is needed. In addition, working conditions for GPs need to be taken into account to ensure that these contribute to a healthy work-life balance. The need for GP training was identified to improve communication skills. Further integration of GPs in health promotion and communal structures would be beneficial.

[Do general practitioners in Geneva (Switzerland) and Poitou-Charentes (France) have different approach to the management of addictions?].

Science.gov (United States)

Teoli, Romain; Haller, Dagmar M; Ingrand, Pierre; Binder, Philippe

2016-01-01

Addiction care is mostly provided by general practitioners (GPs) but the extent of their involvement is variable. Is this related to different training or practice contexts or to awareness campaigns? To study GPs' views and behaviours in relation to addiction patients in different practice and training contexts and different levels of exposure to awareness campaigns. Cross-sectional postal survey involving 526 GPs from the canton of Geneva, Switzerland, sensitized by specific addiction care campaigns, compared to 628 GPs from two rural Departments of Poitou-Charentes, France, not exposed to this type of awareness campaign. The response rate was 46% in Switzerland and 41% in France. The 243 responding GPs in Geneva saw as many patients with tobacco, alcohol, cannabis or opiate addiction as the 256 GPs in Poitou-Charentes. They shared similar views concerning their roles in relation to these addictions. Compared to Swiss GPs, a significantly higher number of French GPs provided first-line care for tobacco addiction. In both countries, care for addiction to other substances was mostly provided in collaboration with a specialist (>75% of cases). GPs in Geneva attributed greater importance to screening and recording of substance use. They were also more involved in training and in providing brief advice and expressed interest in the network. Awareness campaigns in Geneva could explain these differences. Sensitization of GPs to these issues may contribute to modifying certain professional attitudes, regardless of the context.

General practitioners and carers: a questionnaire survey of attitudes, awareness of issues, barriers and enablers to provision of services

Directory of Open Access Journals (Sweden)

Atkins Christine

2010-12-01

Full Text Available Abstract Background Approximately one in ten of the UK population are unpaid carers supporting a family member or friend who could not manage without their help, saving the UK economy an estimated £87 billion. This role is known to sometimes have a negative impact on carers and to require support both informally and from statutory services. General practice is a first point of contact for carers but research investigating general practitioners' (GPs' attitudes towards carers and awareness of issues facing carers is rare. This study therefore aimed to identify GPs' attitudes, awareness of issues, and perceptions of the barriers and enablers to provision of services. Methods Using a self-completion questionnaire distributed at a series of workshops, this study investigates GPs' attitudes to carers; awareness and knowledge of carers' issues; services offered in general practice and barriers to supporting carers. Results Seventy eight out of a total of 95 GPs (82% response rate from a variety of areas in England completed the questionnaires. The GPs identified time, resources and lack of knowledge as barriers, but only 9% agreed with the statement that there is little support they can offer carers. However, nine in ten GPs (89% feel they have insufficient training here and approximately half of them (47% lack confidence that they are meeting carers' needs. Confidence in identifying carers is also low (45%. Issues that GPs would look out for amongst carers include emotional and physical health problems and financial and isolation difficulties. GPs specifically highlighted educational and isolation issues for young carers. Few services were described that targeted carers. Conclusions GPs recognise that they have an important role to play in supporting carers but would like training and support. Further investigation is needed both to determine how best to train and facilitate GPs and general practice teams in their role in supporting carers and to

Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

NARCIS (Netherlands)

Schene, A. H.; Baas, K. D.; Koeter, M.; Lucassen, P.; Bockting, C. L. H.|info:eu-repo/dai/nl/258267992; Wittkampf, K. F.; van Weert, H. C.; Huyser, J.

2014-01-01

Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and

Management of patients with epistaxis by general practitioners: impact of otolaryngology experience on their practice

NARCIS (Netherlands)

Tassone, Peter; Georgalas, Christos; Appleby, Esther; Kotecha, Bhik

2006-01-01

This study aims to assess the management of patients with epistaxis by general practitioners (GPs) and to show whether previous experience as a junior doctor in ear, nose and throat (ENT) surgery influences their practice. A questionnaire was sent together with self-addressed reply envelopes to a

General Practitioner trainers prescribe fewer antibiotics in primary care: Evidence from France.

Science.gov (United States)

Devillers, Louise; Sicsic, Jonathan; Delbarre, Angelique; Le Bel, Josselin; Ferrat, Emilie; Saint Lary, Olivier

2018-01-01

Antibiotic prescription is a central public health issue. Overall, 90% of antibiotic prescriptions are delivered to patients in ambulatory care, and a substantial proportion of these prescriptions could be avoided. General Practitioner (GP) trainers are similar to other GPs in terms of sociodemographic and medical activities, but they may have different prescription patterns. Our aim was to compare the antibiotic prescribing rates between GP trainers and non-trainers. This observational cross-sectional study was conducted on administrative data claims from the French National Health Insurance. The antibiotic prescribing rate was calculated. The main independent variable was the training status of the GPs. Prescribing rates were adjusted for the various GPs' characteristics (gender, age, location of the practice, number of visits per GP and the case-mix) in a multiple linear regression analysis. Between June 2014 and July 2015 the prescribing patterns of 860 GPs were analysed, among which 102 were GP trainers (12%). Over the year 363,580 patients were prescribed an antibiotic out of 3,499,248 visits for 1,299,308 patients seen over the year thus representing around 27.5% of patients. In the multivariate analyses, being a trainer resulted in a significant difference of 6.62 percentage points (IC 95%: [-8.55; -4.69]; prole of GP trainers in antibiotic prescriptions. By prescribing fewer antibiotics and influencing the next generations of GPs, the human and economic burden of antibiotics could be reduced.

Demographics of cleft care providers in Africa and reported experience in training and practice: direct analysis of continent-based practitioners.

Science.gov (United States)

Adetayo, Oluwaseun A; Martin, Mark C

2012-05-01

To elucidate the impact of several geographic, cultural, and socioeconomic variables on cleft care delivery in Africa, and to investigate the current status of cleft care delivery in Africa. Survey of practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP). The annual PACCLIP conference in Ibadan, Nigeria, West Africa, February 2007. To provide an analysis of the demographics and training experience of cleft care providers in Africa by collating information directly from the continent-based practitioners. Plastic surgeons and oral and maxillofacial surgeons provide the majority of cleft care. Most of the participants reported availability of formal training programs in their respective countries. The predominant practice settings were university and government-based. During training, half of the providers had encountered up to 30 cleft cases, and a quarter had managed more than 100 cases. Representation of visiting surgeons were equally distributed between African and non-African countries. This study provides initial and detailed analysis crucial to understanding the underlying framework of cleft care composition teams, demographics of providers, and training and practice experience. This awareness will further enable North American and other non-African plastic surgeons to effectively partner with African cleft care providers to have a further reaching impact in the region.

General practitioners' willingness to request plain lumbar spine radiographic examinations

Energy Technology Data Exchange (ETDEWEB)

Ryynaenen, Olli-Pekka E-mail: ollipekka.ryynanen@uku.fi; Lehtovirta, Jukka; Soimakallio, Seppo; Takala, Jorma

2001-01-01

Objectives: To examine general practitioners' attitudes to plain lumbar spine radiographic examinations. Design: A postal questionnaire consisting of questions on background data and doctors' opinions about plain lumbar spine radiographic examinations, as well as eight vignettes (imaginary patient cases) presenting indications for lumbar radiography, and five vignettes focusing on the doctors' willingness to request lumbar radiography on the basis of patients' age and duration of symptoms. The data were analysed according to the doctor's age, sex, workplace and the medical school of graduation. Setting: Finland. Subjects: Six hundred and fifteen randomly selected physicians working in primary health care (64% of original target group). Results: The vignettes revealed that the use of plain lumbar radiographic examination varied between 26 and 88%. Patient's age and radiation protection were the most prominent factors influencing doctors' decisions to request lumbar radiographies. Only slight differences were observed between the attitudes of male and female doctors, as well as between young and older doctors. Doctors' willingness to request lumbar radiographies increased with the patient's age in most vignettes. The duration of patients' symptoms had a dramatic effect on the doctor's decision: in all vignettes, doctors were more likely to request lumbar radiography when patient's symptoms had exceeded 4 weeks. Conclusions: General practitioners commonly use plain lumbar spine radiographic examinations, despite its limited value in the diagnosis of low back pain. Further consensus and medical education is needed to clarify the indications for plain lumbar radiographic examination.

Practitioners' Perceptions of the Soccer Extra-Time Period: Implications for Future Research.

Directory of Open Access Journals (Sweden)

Liam D Harper

Full Text Available Qualitative research investigating soccer practitioners' perceptions can allow researchers to create practical research investigations. The extra-time period of soccer is understudied compared to other areas of soccer research. Using an open-ended online survey containing eleven main and nine sub questions, we gathered the perceptions of extra-time from 46 soccer practitioners, all working for different professional soccer clubs. Questions related to current practices, views on extra-time regulations, and ideas for future research. Using inductive content analysis, the following general dimensions were identified: 'importance of extra-time', 'rule changes', 'efficacy of extra-time hydro-nutritional provision', 'nutritional timing', 'future research directions', 'preparatory modulations' and 'recovery'. The majority of practitioners (63% either agreed or strongly agreed that extra-time is an important period for determining success in knockout football match-play. When asked if a fourth substitution should be permitted in extra-time, 67% agreed. The use of hydro-nutritional strategies prior to extra-time was predominately considered important or very important. However; only 41% of practitioners felt that it was the most important time point for the use of nutritional products. A similar number of practitioners account (50% and do not (50% account for the potential of extra-time when training and preparing players and 89% of practitioners stated that extra-time influences recovery practices following matches. In the five minute break prior to extra-time, the following practices (in order of priority were advocated to players: hydration, energy provision, massage, and tactical preparations. Additionally, 87% of practitioners advocate a particular nutritional supplementation strategy prior to extra-time. In order of importance, practitioners see the following as future research areas: nutritional interventions, fatigue responses, acute injury risk

Practitioners' Perceptions of the Soccer Extra-Time Period: Implications for Future Research.

Science.gov (United States)

Harper, Liam D; Fothergill, Melissa; West, Daniel J; Stevenson, Emma; Russell, Mark

2016-01-01

Qualitative research investigating soccer practitioners' perceptions can allow researchers to create practical research investigations. The extra-time period of soccer is understudied compared to other areas of soccer research. Using an open-ended online survey containing eleven main and nine sub questions, we gathered the perceptions of extra-time from 46 soccer practitioners, all working for different professional soccer clubs. Questions related to current practices, views on extra-time regulations, and ideas for future research. Using inductive content analysis, the following general dimensions were identified: 'importance of extra-time', 'rule changes', 'efficacy of extra-time hydro-nutritional provision', 'nutritional timing', 'future research directions', 'preparatory modulations' and 'recovery'. The majority of practitioners (63%) either agreed or strongly agreed that extra-time is an important period for determining success in knockout football match-play. When asked if a fourth substitution should be permitted in extra-time, 67% agreed. The use of hydro-nutritional strategies prior to extra-time was predominately considered important or very important. However; only 41% of practitioners felt that it was the most important time point for the use of nutritional products. A similar number of practitioners account (50%) and do not (50%) account for the potential of extra-time when training and preparing players and 89% of practitioners stated that extra-time influences recovery practices following matches. In the five minute break prior to extra-time, the following practices (in order of priority) were advocated to players: hydration, energy provision, massage, and tactical preparations. Additionally, 87% of practitioners advocate a particular nutritional supplementation strategy prior to extra-time. In order of importance, practitioners see the following as future research areas: nutritional interventions, fatigue responses, acute injury risk, recovery

Identifying asthma and chronic obstructive pulmonary disease in patients with persistent cough presenting to general practitioners : descriptive study

NARCIS (Netherlands)

Thiadens, HA; de Bock, GH; Deker, FW; Huysman, JAN; Springer, MP; Postma, DS

1998-01-01

Objective: To determine the prevalence of asthma and chronic obstructive pulmonary disease in patients not known to have these disorders, who present in general practice with persistent cough, and to ascertain criteria to help general practitioners in diagnosis. Design: Descriptive study. Setting:

Hanford general employee training: Computer-based training instructor's manual

Energy Technology Data Exchange (ETDEWEB)

1990-10-01

The Computer-Based Training portion of the Hanford General Employee Training course is designed to be used in a classroom setting with a live instructor. Future references to this course'' refer only to the computer-based portion of the whole. This course covers the basic Safety, Security, and Quality issues that pertain to all employees of Westinghouse Hanford Company. The topics that are covered were taken from the recommendations and requirements for General Employee Training as set forth by the Institute of Nuclear Power Operations (INPO) in INPO 87-004, Guidelines for General Employee Training, applicable US Department of Energy orders, and Westinghouse Hanford Company procedures and policy. Besides presenting fundamental concepts, this course also contains information on resources that are available to assist students. It does this using Interactive Videodisk technology, which combines computer-generated text and graphics with audio and video provided by a videodisk player.

Becoming a general practitioner - Which factors have most impact on career choice of medical students?

OpenAIRE

Loh Andreas; Hermann Katja; Miksch Antje; Kiolbassa Kathrin; Szecsenyi Joachim; Joos Stefanie; Goetz Katja

2011-01-01

Abstract Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in ...

The reported availability of general practitioners and the influence of practice list size.

OpenAIRE

Campbell, J L

1996-01-01

BACKGROUND: Combined practice list sizes have increased, but larger practice size may be associated with disadvantage to patients. AIM: The aim of the study was to investigate the availability of general practitioners as reported by their patients and the relationship between reported availability and practice list size. METHOD: A one-week questionnaire survey of 8315 patients attending participating practices in West Lothian, Scotland, was conducted. Patients were asked about the arrangement...

The electronic patient record as a meaningful audit tool - Accountability and autonomy in general practitioner work

DEFF Research Database (Denmark)

Winthereik, Brit Ross; van der Ploeg, I.; Berg, Marc

2007-01-01

Health authorities increasingly request that general practitioners (GPs) use information and communication technologies such as electronic patient records (EPR) for accountability purposes. This article deals with the use of EPRs among general practitioners in Britain. It examines two ways in which...... makes them active in finding ways that turn the EPR into a meaningful tool for them, that is, a tool that helps them provide what they see as good care. The article's main contribution is to show how accountability and autonomy are coproduced; less professional autonomy does not follow from more...... GPs use the EPR for accountability purposes. One way is to generate audit reports on the basis of the information that has been entered into the record. The other is to let the computer intervene in the clinical process through prompts. The article argues that GPs' ambivalence toward using the EPR...

Using practitioners' feedback to contribute to organisational development in health visiting.

Science.gov (United States)

Drea, Clare; Lumsden, Virginia; Bourne, James

2014-12-01

This paper presents the findings of a survey of practitioners within a health visiting service. This service was an Early Implementer site for the Health Visitor Implementation Plan. The survey was administered in the context of training all practitioners in the Solihull Approach. It aimed to gather information from practitioners about factors they thought could help them do their work with families more effectively. Practitioners' responses were analysed using thematic analysis. The principal needs identified were: more knowledge, skills and training; increased time to support families; increased supervision and support; and improved communication and partnership working. Practitioners' needs identified through the analysis were subsequently taken into account during development of the service.

Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review.

Science.gov (United States)

Ford, Elizabeth; Shakespeare, Judy; Elias, Fatin; Ayers, Susan

2017-02-01

Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs' routine recognition, diagnosis and management of anxiety and depression in the perinatal period. A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted. Studies were eligible if they reported quantitative measures of GPs' or Family Physicians' assessment, recognition and management of anxiety or depression in pregnancy or post-partum. Thirteen papers, reporting 10 studies, were identified from the United States, Australia, UK, Netherlands and Canada. All reported on depression; two included anxiety disorders. Reported awareness and ability to diagnose perinatal depression among GPs was high. GPs knew about and used screening tools in the UK but less so in US settings. Antidepressants were the first line of treatment, with various SSRIs considered safest. Counseling by GPs and referrals to specialists were common in the post-natal period, less so in pregnancy. Treatment choices were determined by resources, attitudes, knowledge and training. Data on GPs' awareness and management of perinatal depression were sparse and unlikely to be generalizable. Future directions for research are proposed; such as exploring the management of anxiety disorders which are largely missing from the literature, and understanding more about barriers to disclosure and recognition in primary care. More standardized training could help to improve recognition and management practices. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Summary of the practice guideline 'TIA' (first revision) from the Dutch College of General Practitioners

NARCIS (Netherlands)

Wiersma, T.; Binsbergen, J.J. van; Verhoeven, S.; Bentum, S.T.B. van; Goudswaard, A.N.

2005-01-01

The new practice guideline of the Dutch College of General Practitioners on the management of patients with a TIA resembles the first version, but there are some important changes: The concept TIA has been narrowed to a neurological deficit that has resolved spontaneously by the time the patient

New paths in post-graduate medical training in general practice – 8 years of experience with the pilot project Verbundweiterbildung Baden-Württemberg

Directory of Open Access Journals (Sweden)

Schwill, Simon

2017-11-01

Full Text Available Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program “Verbundweiterbildung Baden-Württemberg” (VWB BW was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice.Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program’s content closely on the needs of the target groups, scientifically based evaluations and research are carried out.Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016. In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied. Alongside the medical

Social relations and loneliness among older patients consulting their general practitioner

DEFF Research Database (Denmark)

Due, Tina Drud; Sandholdt, Håkon; Waldorff, Frans Boch

2017-01-01

INTRODUCTION: Social relations are important for people and affect their quality of life, morbidity and mortality. This holds true especially for older persons. General practitioners (GPs) are in a unique position to address social relations and loneliness; however, no GP population-based studies...... have assessed older patients' social relations and loneliness. The aim of this study was to analyse the social relations and loneliness of patients aged 65 years and above consulting their GP. METHODS: This survey counted the participation of 12 general practices in the Capital Region of Denmark....... During a three-week period, the practices invited their patients to fill out a questionnaire on health, social relations and loneliness. RESULTS: Of 767 eligible patients, 474 were included and 461 answered one or more items about social participation or loneliness. A total of 36.2% had a high, 45.5% had...

Social relations and loneliness among older patients consulting their general practitioner

DEFF Research Database (Denmark)

Due, Tina Drud; Sandholdt, Håkon; Waldorff, Frans Boch

2017-01-01

Introduction: Social relations are important for people and affect their quality of life, morbidity and mortality. This holds true especially for older persons. General practitioners (GPs) are in a unique position to address social relations and loneliness; however, no GP population-based studies...... have assessed older patients’ social relations and loneliness. The aim of this study was to analyse the social relations and loneliness of patients aged 65 years and above consulting their GP. Methods: This survey counted the participation of 12 general practices in the Capital Region of Denmark....... During a three-week period, the practices invited their patients to fill out a questionnaire on health, social relations and loneliness. 
 Results: Of 767 eligible patients, 474 were included and 461 answered one or more items about social participation or loneliness. A total of 36.2% had a high, 45...

Developing web-based training for public health practitioners: what can we learn from a review of five disciplines?

Science.gov (United States)

Ballew, Paula; Castro, Sarah; Claus, Julie; Kittur, Nupur; Brennan, Laura; Brownson, Ross C

2013-04-01

During a time when governmental funding, resources and staff are decreasing and travel restrictions are increasing, attention to efficient methods of public health workforce training is essential. A literature review was conducted to inform the development and delivery of web-based trainings for public health practitioners. Literature was gathered and summarized from five disciplines: Information Technology, Health, Education, Business and Communications, following five research themes: benefits, barriers, retention, promotion and evaluation. As a result, a total of 138 articles relevant to web-based training design and implementation were identified. Key recommendations emerged, including the need to conduct formative research and evaluation, provide clear design and layout, concise content, interactivity, technical support, marketing and promotion and incentives. We conclude that there is limited application of web-based training in public health. This review offers an opportunity to learn from other disciplines. Web-based training methods may prove to be a key training strategy for reaching our public health workforce in the environment of limited resources.

General Practitioners' Perspective on eHealth and Lifestyle Change

DEFF Research Database (Denmark)

Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane

2018-01-01

BACKGROUND: Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how...... they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. OBJECTIVE: This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior...... or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices...

A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners.

Science.gov (United States)

Boyle, Eileen; Saunders, Rosemary; Drury, Vicki

2016-07-01

To explore patient experiences of type 2 diabetes mellitus care delivered by general practice nurses in collaboration with the general practitioner. Australian general practice nurses are expanding their role in multidisciplinary type 2 diabetes care with limited research on patient perceptions of care provision within this collaborative model. Qualitative interpretive. Purposeful sampling was used to invite the patients (n = 10). Data were collected from semi-structured face-to-face interviews. Braun and Clarke's () inductive coding thematic analysis process was used to interpret the data. All participants experienced their General Practice Nurse consultation as a clinical assessment for their General Practitioner. While they appreciated the extra time with the General Practice Nurse, they were unsure of the purpose of the consultation beyond clinical assessment. They described the ongoing challenge of living with T2DM and identified a need for additional information and advice. The results suggest that the model of general practice nurse type 2 diabetes care has an important role to play in the delivery of effective ongoing care of patients. However, this role requires further development to ensure that it is understood by the patients as a role that not only conducts clinical assessments but also provides relevant education and self-management support as part of a collaborative approach to care delivery with General Practitioners. The findings are relevant to primary health care clinicians providing diabetes care to inform more relevant supportive care by general practice nurses. © 2016 John Wiley & Sons Ltd.

The waiting room: vector for health education? The general practitioner's point of view.

Science.gov (United States)

Gignon, Maxine; Idris, Hadjila; Manaouil, Cecile; Ganry, Oliver

2012-09-18

General practitioners (GPs) play a central role in disseminating information and most health policies are tending to develop this pivotal role of GPs in dissemination of health-related information to the public. The objective of this study was to evaluate use of the waiting room by GPs as a vector for health promotion. A cross-sectional study was conducted on a representative sample of GPs using semi-structured, face-to-face interviews. A structured grid was used to describe the documents. Quantitative and qualitative analysis was performed. Sixty GPs participated in the study. They stated that a waiting room had to be pleasant, but agreed that it was a useful vector for providing health information. The GPs stated that they distributed documents designed to improve patient care by encouraging screening, providing health education information and addressing delicate subjects more easily. However, some physicians believed that this information can sometimes make patients more anxious. A large number of documents were often available, covering a variety of topics. General practitioners intentionally use their waiting rooms to disseminate a broad range of health-related information, but without developing a clearly defined strategy. It would be interesting to correlate the topics addressed by waiting room documents with prevention practices introduced during the visit.

Learning a novel technique to identify possible melanomas: are Australian general practitioners better than their U.K. colleagues?

Directory of Open Access Journals (Sweden)

Watson Tony

2009-04-01

Full Text Available Abstract Background Spectrophotometric intracutaneous analysis (SIAscopy™ is a multispectral imaging technique that is used to identify 'suspicious' (i.e. potentially malignant pigmented skin lesions for further investigation. The MoleMate™ system is a hand-held scanner that captures SIAscopy™ images that are then classified by the clinician using a computerized diagnostic algorithm designed for the primary health care setting. The objectives of this study were to test the effectiveness of a computer program designed to train health care workers to identify the diagnostic features of SIAscopy™ images and compare the results of a group of Australian and a group of English general practitioners (GPs. Methods Thirty GPs recruited from the Perth (Western Australia metropolitan area completed the training program at a workshop held in March 2008. The accuracy and speed of their pre- and post-test scores were then compared with those of a group of 18 GPs (including 10 GP registrars who completed a similar program at two workshops held in Cambridge (U.K. in March and April, 2007. Results The median test score of the Australian GPs improved from 79.5% to 86.5% (median increase 5.5%; p Conclusion Most of the SIAscopy™ features can be learnt to a reasonable degree of accuracy with this brief computer training program. Although the Australian GPs scored higher in the pre-test, both groups had similar levels of accuracy and speed in interpreting the SIAscopy™ features after completing the program. Scores were not affected by previous dermoscopy experience or dermatology training, which suggests that the MoleMate™ system is relatively easy to learn.

Causal explanations of distress and general practitioners' assessments of common mental disorder among punjabi and English attendees.

Science.gov (United States)

Bhui, Kamaldeep; Bhugra, Dinesh; Goldberg, David

2002-01-01

The literature on the primary care assessment of mental distress among Indian subcontinent origin patients suggests frequent presentations to general practitioner, but rarely for recognisable psychiatric disorders. This study investigates whether cultural variations in patients' causal explanatory models account for cultural variations in the assessment of non-psychotic mental disorders in primary care. In a two-phase survey, 272 Punjabi and 269 English subjects were screened. The second phase was completed by 209 and 180 subjects, respectively. Causal explanatory models were elicited as explanations of two vignette scenarios. One of these emphasised a somatic presentation and the other anxiety symptoms. Psychiatric disorder was assessed by GPs on a Likert scale and by a psychiatrist on the Clinical Interview Schedule. Punjabis more commonly expressed medical/somatic and religious beliefs. General practitioners were more likely to assess any subject giving psychological explanations to vignette A and English subjects giving religious explanations to vignette B as having a significant psychiatric disorder. Where medical/somatic explanations of distress were most prevalent in response to the somatic vignette, psychological, religious and work explanations were less prevalent among Punjabis but not among English subjects. Causal explanations did not fully explain cultural differences in assessments. General practitioners' assessments and causal explanations are related and influenced by culture, but causal explanations do not fully explain cultural differences in assessments.

Hanford general employee training - A million dollar cost beneficial program

International Nuclear Information System (INIS)

Gardner, P.R.

1991-02-01

In January 1990, Westinghouse Hanford Company implemented an interactive videodisc training program entitled Hanford General Employee Training. Covering all Institute of Nuclear Power Operations general employee training objectives, training mandated by US Department of Energy orders, and training prescribed by internal Westinghouse Hanford Company policies, Hanford General Employee Training presents and manages engaging training programs individually tailored to each of the 9,000 employees. Development costs for a sophisticated program such as Hanford General Employee Training were high compared to similar costs for developing ''equivalent'' traditional training. Hardware ($500,000) and labor costs ($400,000) totaled $900,000. Annual maintenance costs, equipment plus labor, are totalling about $200,000. On the benefit side, by consolidating some 17 previous Westinghouse Hanford Company courses and more effectively managing the instructional process, Hanford General Employee Training reduced the average student training time from over 11 hours to just under 4 hours. For 9,000 employees, the computed net annual savings exceeds $1.3 million. 2 refs

Quality indicators for treatment of respiratory tract infections? An assessment by Danish general practitioners

DEFF Research Database (Denmark)

Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

2013-01-01

Background: In 2008, a set of 41 quality indicators for antibiotic treatment of respiratory tract infections (RTIs) in general practice were developed in an international setting as part of the European project HAPPY AUDIT. Objectives: To investigate Danish general practitioners' (GPs') assessment...... of a set of internationally developed quality indicators and to explore if there is an association between the GPs' assessment of the indicators and their practice characteristics as well as their antibiotic prescription pattern. Methods: A total of 102 Danish GPs were invited to assess the 41 quality...

Patient demands, lack of reciprocity, and burnout: a five-year longitudinal study about general practitioners.

NARCIS (Netherlands)

Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.; Dierendonck, D. van

2000-01-01

This study among a sample of 207 general practitioners (GPs) uses a five-year longitudinal design to test a process model of burnout. On the basis of social exchange and equity theory, it is hypothesized and found that demanding patient contacts produce a lack of reciprocity in the GP-patient

Quality-Shaping Factors and Endodontic Treatment amongst General Dental Practitioners with a Focus on Denmark

DEFF Research Database (Denmark)

Demant, Sune; Markvart, Merete; Bjørndal, Lars

2012-01-01

There is a gap between the endodontic outcome that can be achieved and the outcome observed on the basis of worldwide general dental practitioner data. The quality of root canal treatment (RCT) is shaped by the dentist's knowledge, attitude, and skills, but it may also be influenced by the patient...

Why general practitioners and consultants change their clinical practice: a critical incident study.

OpenAIRE

Allery, L. A.; Owen, P. A.; Robling, M. R.

1997-01-01

OBJECTIVE: To describe the complete range of factors which doctors recognise as changing their clinical practice and provide a measure of how often education is involved in change. DESIGN: Interviews using the critical incident technique. SETTING: Primary and secondary care. SUBJECTS: Random sample of 50 general practitioners and 50 consultants. MAIN OUTCOME MEASURES: Categories of reasons for change in clinical practice. RESULTS: Doctors described 361 changes in clinical practice, with an av...

'Feel the Feeling': Psychological practitioners' experience of acceptance and commitment therapy well-being training in the workplace.

Science.gov (United States)

Wardley, Matt Nj; Flaxman, Paul E; Willig, Carla; Gillanders, David

2016-08-01

This empirical study investigates psychological practitioners' experience of worksite training in acceptance and commitment therapy using an interpretative phenomenological analysis methodology. Semi-structured interviews were conducted with eight participants, and three themes emerged from the interpretative phenomenological analysis data analysis: influence of previous experiences, self and others and impact and application The significance of the experiential nature of the acceptance and commitment therapy training is explored as well as the dual aspects of developing participants' self-care while also considering their own clinical practice. Consistencies and inconsistencies across acceptance and commitment therapy processes are considered as well as clinical implications, study limitations and future research suggestions. © The Author(s) 2014.

Knowledge, Attitude and Practice of General Practitioners toward Complementary and Alternative Medicine: a Cross-Sectional Study.

Science.gov (United States)

Barikani, Ameneh; Beheshti, Akram; Javadi, Maryam; Yasi, Marzieh

2015-08-01

Orientation of public and physicians to the complementary and alternative medicine (CAM) is one of the most prominent symbols of structural changes in the health service system. The aim of his study was a determination of knowledge, attitude, and practice of general practitioners in complementary and alternative medicine. This cross- sectional study was conducted in Qazvin, Iran in 2013. A self-administered questionnaire was used for collecting data including four information parts: population information, physicians' attitude and knowledge, methods of getting information and their function. A total of 228 physicians in Qazvin comprised the population of study according to the deputy of treatment's report of Qazvin University of Medical Sciences. A total of 150 physicians were selected randomly, and SPSS Statistical program was used to enter questionnaires' data. Results were analyzed as descriptive statistics and statistical analysis. Sixty percent of all responders were male. About sixty (59.4) percent of participating practitioners had worked less than 10 years.96.4 percent had a positive attitude towards complementary and alternative medicine. Knowledge of practitioners about traditional medicine in 11 percent was good, 36.3% and 52.7% had average and little information, respectively. 17.9% of practitioners offered their patients complementary and alternative medicine for treatment. Although there was little knowledge among practitioners about traditional medicine and complementary approaches, a significant percentage of them had attitude higher than the lower limit.

Teamwork - general practitioners and practice nurses working together in New Zealand.

Science.gov (United States)

Finlayson, Mary P; Raymont, Antony

2012-06-01

Teamwork in primary health care has been encouraged in New Zealand and in the international literature. It may improve work satisfaction for staff, and satisfaction and outcomes for patients. Teamwork may be classified as being multi-, inter- or transdisciplinary and is likely to be influenced by the nature of the work and the organisational context. To describe and analyse teamwork between general practitioners and practice nurses in New Zealand. Data were drawn from a survey of general practices and from interviews with primary health care staff and management. Doctors and nurses in general practice in New Zealand see themselves as a team. Evidence suggests that the nature of the work and the business context most often leads to a multidisciplinary style of teamwork. Some providers have adopted a more intense teamwork approach, often when serving more disadvantaged populations or in caring for those with chronic illnesses. Concepts of teamwork differ. This article provides a classification of teams and suggests that most general practice teams are multidisciplinary. It is hoped that this will help personnel to communicate their expectations of a team and encourage progressive team development where it would be of value.

Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners.

NARCIS (Netherlands)

Suijkerbuijk, A.W.M.; Broek, I.V.F. van den; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; Sande, M.A.B. van der; Kretzschmar, M.E.E.

2011-01-01

BACKGROUND: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening

Motives and preferences of general practitioners for new collaboration models with medical specialists : a qualitative study

NARCIS (Netherlands)

Berendsen, Annette J.; Benneker, Wim H. G. M.; Jong, Betty Meyboom-de; Klazinga, Niek S.; Schuling, Jan

2007-01-01

Background: Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates GPs to initiate and continue participating

Motives and preferences of general practitioners for new collaboration models with medical specialists: a qualitative study

NARCIS (Netherlands)

Berendsen, Annette J.; Benneker, Wim H. G. M.; Jong, Betty Meyboom-de; Klazinga, Niek S.; Schuling, Jan

2007-01-01

BACKGROUND: Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates GPs to initiate and continue participating

Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey.

Directory of Open Access Journals (Sweden)

Kai Xing

Full Text Available The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals.A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%.A total of 106 of the 840 (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients' relatives (62.3%, followed by the patient (22.6%; 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60 resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%. Most respondents (62.8% did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc..Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.

Prescribing of psychotropic medication for nursing home residents with dementia: a general practitioner survey

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Cousins JM

2017-10-01

Full Text Available Justin M Cousins, Luke RE Bereznicki, Nick B Cooling, Gregory M Peterson School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia Objective: The aim of this study was to identify factors influencing the prescribing of psychotropic medication by general practitioners (GPs to nursing home residents with dementia.Subjects and methods: GPs with experience in nursing homes were recruited through professional body newsletter advertising, while 1,000 randomly selected GPs from south-eastern Australia were invited to participate, along with a targeted group of GPs in Tasmania. An anonymous survey was used to collect GPs’ opinions.Results: A lack of nursing staff and resources was cited as the major barrier to GPs recommending non-pharmacological techniques for behavioral and psychological symptoms of dementia (BPSD; cited by 55%; 78/141, and increasing staff levels at the nursing home ranked as the most important factor to reduce the usage of psychotropic agents (cited by 60%; 76/126.Conclusion: According to GPs, strategies to reduce the reliance on psychotropic medication by nursing home residents should be directed toward improved staffing and resources at the facilities. Keywords: dementia, nursing homes, general practitioners, antipsychotic agents, benzodiazepines

Influence of Cone-beam Computed Tomography on Endodontic Retreatment Strategies among General Dental Practitioners and Endodontists.

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Rodríguez, Gustavo; Patel, Shanon; Durán-Sindreu, Fernando; Roig, Miguel; Abella, Francesc

2017-09-01

Treatment options for endodontic failure include nonsurgical or surgical endodontic retreatment, intentional replantation, and extraction with or without replacement of the tooth. The aim of the present study was to determine the impact of cone-beam computed tomographic (CBCT) imaging on clinical decision making among general dental practitioners and endodontists after failed root canal treatment. A second objective was to assess the self-reported level of difficulty in making a treatment choice before and after viewing a preoperative CBCT scan. Eight patients with endodontically treated teeth diagnosed as symptomatic apical periodontitis, acute apical abscess, or chronic apical abscess were selected. In the first session, the examiners were given the details of each case, including any relevant radiographs, and were asked to choose 1 of the proposed treatment alternatives and assess the difficulty of making a decision. One month later, the examiners reviewed randomly the same 8 cases with the additional information from the CBCT data. The examiners altered their treatment plan after viewing the CBCT scan in 49.8% of the cases. A significant difference in the treatment plan between the 2 imaging modalities was recorded for endodontists and general practitioners (P < .05). After CBCT evaluation, neither group altered their self-reported level of difficulty when choosing a treatment plan (P = .0524). The extraction option rose significantly to 20% after viewing the CBCT scan (P < .05). CBCT imaging directly influences endodontic retreatment strategies among general dental practitioners and endodontists. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

New ways of working: how mental health practitioners perceive their training and role.

Science.gov (United States)

Brown, J; Simons, L; Zeeman, L

2008-12-01

This paper outlines advances in the mental health workforce by detailing the development, education and training of graduates from the social sciences in mental health practice. The mental health practitioner (MHP) programme is a partnership between higher education and the National Health Service to provide graduates with a new point of entry into the mental health workforce. The MHP is a new role in mental health i.e. in principle, trans-disciplinary, traversing psychology, nursing and occupational therapy. The role is informed by a bio-psychosocial philosophy of collaborative mental health care and therefore acts as a bridge between the different professions that constitute a multidisciplinary team on acute inpatient units and in the community. However, MHPs form part of the nursing team and work most closely with mental health nurses. They see their role as linked to, but other than, nursing. This paper will discuss the development of this programme and its philosophy of care, and will present outcome research on trainee perceptions and experiences of occupying the MHP role in mental health. It will present findings from the first stage of a longitudinal study (employing interviews and survey data) about trainee perceptions of their role and training before the programme commenced, 6 months into their training and at graduation.

Building organizational supports for research-minded practitioners.

Science.gov (United States)

Austin, Michael J; Dal Santo, Teresa S; Lee, Chris

2012-01-01

One of the biggest challenges facing human service organizations is the proliferation of information from inside and outside the agency that needs to be managed if it is to be of use. The concepts of tacit and explicit knowledge can inform an approach to this challenge. Tacit knowledge is stored in the minds of practitioners (often called practice wisdom) and the explicit knowledge is often found in organizational procedure manuals and educational and training materials. Building on this perspective, this analysis provides a preliminary definition of research-minded practitioners by explicating the elements of curiosity, critical reflection, and critical thinking. The organizational implications of developing a cadre of research-minded practitioners include the commitment of top management to support "link officers", evidence request services, research and development units, and service standards. The challenges include the capacity to identify/support research-minded practitioners, promote an organizational culture of evidence-informed practice, redefine staff development and training, redefine job descriptions, and specify the nature of managerial leadership. Copyright © Taylor & Francis Group, LLC

Community pharmacist attitudes towards collaboration with general practitioners: development and validation of a measure and a model

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Van Connie

2012-09-01

Full Text Available Abstract Background Community Pharmacists and General Practitioners (GPs are increasingly being encouraged to adopt more collaborative approaches to health care delivery as collaboration in primary care has been shown to be effective in improving patient outcomes. However, little is known about pharmacist attitudes towards collaborating with their GP counterparts and variables that influence this interprofessional collaboration. This study aims to develop and validate 1 an instrument to measure pharmacist attitudes towards collaboration with GPs and 2 a model that illustrates how pharmacist attitudes (and other variables influence collaborative behaviour with GPs. Methods A questionnaire containing the newly developed “Attitudes Towards Collaboration Instrument for Pharmacists” (ATCI-P and a previously validated behavioural measure “Frequency of Interprofessional Collaboration Instrument for Pharmacists” (FICI-P was administered to a sample of 1215 Australian pharmacists. The ATCI-P was developed based on existing literature and qualitative interviews with GPs and community pharmacists. Principal Component Analysis was used to assess the structure of the ATCI-P and the Cronbach’s alpha coefficient was used to assess the internal consistency of the instrument. Structural equation modelling was used to determine how pharmacist attitudes (as measured by the ATCI-P and other variables, influence collaborative behaviour (as measured by the FICI-P. Results Four hundred and ninety-two surveys were completed and returned for a response rate of 40%. Principal Component Analysis revealed the ATCI-P consisted of two factors: ‘interactional determinants’ and ‘practitioner determinants’, both with good internal consistency (Cronbach’s alpha = .90 and .93 respectively. The model demonstrated adequate fit (χ2/df = 1.89, CFI = .955, RMSEA = .062, 90% CI [.049-.074] and illustrated that ‘interactional determinants’ was

Training generalized improvisation of tools by preschool children1

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Parsonson, Barry S.; Baer, Donald M.

1978-01-01

The development of new, “creative” behaviors was examined in a problem-solving context. One form of problem solving, improvisation, was defined as finding a substitute to replace the specifically designated, but currently unavailable, tool ordinarily used to solve the problem. The study examined whether preschool children spontaneously displayed generalized improvisation skills, and if not, whether they could be trained to do so within different classes of tools. Generalization across different tool classes was monitored but not specifically trained. Five preschool children participated in individual sessions that first probed their skill at improvising tools, and later trained and probed generalized improvisation in one or more of three tool classes (Hammers, Containers, and Shoelaces), using a multiple-baseline design. All five children were trained with Hammers, two were trained in two classes, and two were trained in all three tool classes. Four of the five children improvised little in Baseline. During Training, all five showed increased generalized improvisation within the trained class, but none across classes. Tools fabricated by item combinations were rare in Baseline, but common in Training. Followup probes showed that the training effects were durable. PMID:16795596

New dietetic practitioners' perspectives on their education and training.

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Brady, Jennifer; Lordly, Daphne; MacLellan, Debbie; Gingras, Jacqui

2012-01-01

To elucidate the complex phenomenon of dietitian professional socialization, we examined factors that influence people's decisions to pursue a career in dietetics and how education and training processes influence the professional socialization of dietitians. Participants (n=12) had less than three years of work experience and included alumni from three Canadian universities representing different models of entry to practice. Three one-on-one interviews were conducted with each participant. The key influencing factor in participants' decision to pursue dietetics was the perceived congruence between dietetics and other aspects of their lives, including early interests and experiences (sports, food and cooking, an eating disorder), career aspirations (science, health care), and social networks (the desire to be a professional). A pivotal experience during high school or while enrolled in or after graduation from another program prompted participants' awareness of and subsequent decision to pursue a career in dietetics. Supportive relationships were vital to participants' professional socialization. Recruitment materials and education opportunities should help aspiring dietitians develop a clear idea of what being a dietitian means. Dietetic educators must attend to the informational and relational aspects involved in shaping future practitioners' dietitian identities.

The application of foraging theory to the information searching behaviour of general practitioners

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Dowell Anthony C

2011-08-01

Full Text Available Abstract Background General Practitioners (GPs employ strategies to identify and retrieve medical evidence for clinical decision making which take workload and time constraints into account. Optimal Foraging Theory (OFT initially developed to study animal foraging for food is used to explore the information searching behaviour of General Practitioners. This study is the first to apply foraging theory within this context. Study objectives were: 1. To identify the sequence and steps deployed in identifiying and retrieving evidence for clinical decision making. 2. To utilise Optimal Foraging Theory to assess the effectiveness and efficiency of General Practitioner information searching. Methods GPs from the Wellington region of New Zealand were asked to document in a pre-formatted logbook the steps and outcomes of an information search linked to their clinical decision making, and fill in a questionnaire about their personal, practice and information-searching backgrounds. Results A total of 115/155 eligible GPs returned a background questionnaire, and 71 completed their information search logbook. GPs spent an average of 17.7 minutes addressing their search for clinical information. Their preferred information sources were discussions with colleagues (38% of sources and books (22%. These were the two most profitable information foraging sources (15.9 min and 9.5 min search time per answer, compared to 34.3 minutes in databases. GPs nearly always accessed another source when unsuccessful (95% after 1st source, and frequently when successful (43% after 2nd source. Use of multiple sources accounted for 41% of searches, and increased search success from 70% to 89%. Conclusions By consulting in foraging terms the most 'profitable' sources of information (colleagues, books, rapidly switching sources when unsuccessful, and frequently double checking, GPs achieve an efficient trade-off between maximizing search success and information reliability, and

General practitioners, complementary therapies and evidence-based medicine: the defence of clinical autonomy.

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Adams, J

2000-12-01

Amidst the substantial change currently gripping primary health care are two developments central to contemporary debate regarding the very nature, territory and identity of general practice - the integration of complementary and alternative medicine (CAM) and the rise of evidence-based medicine (EBM). This paper reports findings from a study based upon 25 in-depth interviews with general practitioners (GPs) personally practising complementary therapies alongside more conventional medicine to treat their NHS patients. The paper outlines the GPs' perceptions of EBM, its relationship to their personal development of CAM, and their notions of good clinical practice more generally. Analysis of the GPs' accounts demonstrates how CAM can be seen as a useful resource with which some GPs defend their clinical autonomy from what they perceive to be the threat of EBM. Copyright 2000 Harcourt Publishers Ltd.

Practices and opinions regarding HPV vaccination among French general practitioners: evaluation through two cross-sectional studies in 2007 and 2010.

Science.gov (United States)

Lasset, Christine; Kalecinski, Julie; Régnier, Véronique; Barone, Giovanna; Leocmach, Yann; Vanhems, Philippe; Chauvin, Franck; Lutringer-Magnin, Delphine

2014-06-01

To use both quantitative and qualitative methods to investigate the evolution of practices and opinions regarding human papillomavirus (HPV) vaccination among French general practitioners. A cross-sectional study (self-questionnaires) was performed in 2007 and repeated in 2010 among 271 general practitioners. Semi-structured interviews were conducted on 27 voluntary participants by a sociologist and analyzed according to content analysis. Acceptability of HPV vaccination had increased from 2007 to 2010 (79.9 vs. 87.1%, respectively), just as the practice of HPV vaccination among 14-year-old girls (19.0 vs. 49.1%, respectively). Though about 60% reported complications associated with HPV vaccination, irrespective of year, the types of difficulties have varied: difficulties related to "questions asked by patients" had decreased, though concerns about side effects had remained stable. During interviews, difficulties related to "the reason for medical consultation" and "the target age" were often associated with addressing the issue of sexuality, especially when the parents were present. Although the high level of acceptability of HPV vaccination among general practitioners, which increased from 2007 to 2010, there remain difficulties in addressing this practice.

One Way or Return? The Journey from Practitioner to Researcher

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Buoro, Ivano

2015-01-01

The journey from VET practitioner to academic researcher is not an easy one, especially for VET teachers whose educational research training in action and ethnographic research have been inculcated through years of practice. This paper discusses the highlights of the journey from practitioner to practitioner researcher including a discussion of…

[The Aut-idem Rule and the Importance of Patient-Individual Selection of Inhalers for the Therapy of Airway Diseases in Practices of Pneumologists and General Practitioners - Assessment and Implementation by Pneumologists and General Practitioners].

Science.gov (United States)

Hering, T; Andres, J; Mohrlang, C; Redeker, M; Schwarz, E

2018-03-01

Drug therapy of obstructive airway diseases mainly relies on inhaled medication. The success of this therapy depends primarily on the selection of the appropriate inhaler considering patient's choice and the correct application. The aut-idem-rule, an active exclusion of the optional substitution by the pharmacist, allows prescribing physicians to ensure the delivery of a particular inhaler, which was selected for that patient, who was trained to use specifically that inhaler. This survey shows that pneumologists and, to a greater extent general practitioners, do not consistently make use of this option, although they unanimously agree on the importance of targeted inhaler selection. As a result, patients may receive different inhalers in the pharmacy, where the inhaler is chosen under consideration of market-driven aspects such as rebate contracts or stock. This causes that patients get confused by the exchange of their inhaler. Thus the exchange of the inhaler by the pharmacist leads to uncertainty and application problems in patients. Hence, the success of the comparatively complex inhaled therapy is endangered. This could be prevented, if prescribing physicians were informed and supported consistently regarding the use of aut-idem exclusion to ensure an optimal therapy for each individual patient. © Georg Thieme Verlag KG Stuttgart · New York.

General practitioners' perceptions of the effectiveness of medical interventions: an exploration of underlying constructs

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Marteau Theresa M

2010-02-01

Full Text Available Abstract Background Many interventions shown to be effective through clinical trials are not readily implemented in clinical practice. Unfortunately, little is known regarding how clinicians construct their perceptions of the effectiveness of medical interventions. This study aims to explore general practitioners' perceptions of the nature of 'effectiveness'. Methods The design was qualitative in nature using the repertory grid technique to elicit the constructs underlying the perceived effectiveness of a range of medical interventions. Eight medical interventions were used as stimuli (diclophenac to reduce acute pain, cognitive behaviour therapy to treat depression, weight loss surgery to achieve weight loss, diet and exercise to prevent type 2 diabetes, statins to prevent heart disease, stopping smoking to prevent heart disease, nicotine replacement therapy to stop smoking, and stop smoking groups to stop smoking. The setting involved face-to-face interviews followed by questionnaires in London Primary Care Trusts. Participants included a random sample of 13 general practitioners. Results Analysis of the ratings showed that the constructs clustered around two dimensions: low patient effort versus high patient effort (dimension one, and small impact versus large impact (dimension two. Dimension one represented constructs such as 'success requires little motivation', 'not a lifestyle intervention', and 'health-care professional led intervention'. Dimension two represented constructs such as 'weak and/or minimal evidence of effectiveness', 'small treatment effect for users', 'a small proportion of users will benefit' and 'not cost-effective'. Constructs within each dimension were closely related. Conclusions General practitioners judged the effectiveness of medical interventions by considering two broad dimensions: the extent to which interventions involve patient effort, and the size of their impact. The latter is informed by trial evidence, but

Training in Endoscopy: Endoscopic Ultrasound

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Chang Min Cho

2017-07-01

Full Text Available Endoscopic ultrasound (EUS has been recently established as an indispensable modality for the diagnosis and management of pancreatobiliary and gastrointestinal (GI disorders. EUS proficiency requires both cognitive and technical abilities, including an understanding of the appropriate indications, the performance of appropriate evaluations before and after the procedure, and the management of procedure-related complications. An increasing demand for skills to handle a growing range of interventional EUS procedures and a continual shortage of EUS training programs are two major obstacles for EUS training. Acquiring the skills necessary to comprehend and conduct EUS often requires training beyond the scope of a standard GI fellowship program. In addition to traditional formal EUS training and preceptorships, regular short-term intensive EUS training programs that provide training at various levels may help EUS practitioners improve and maintain EUS-related knowledges and skills. Theoretical knowledge can be acquired from lectures, textbooks, atlases, slides, videotapes, digital video discs, interactive compact discs, and websites. Informal EUS training is generally based on 1- or 2-day intensive seminars, including didactic lectures, skills demonstrated by expert practitioners through live video-streaming of procedures, and hands-on learning using animal or phantom models.

Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

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Tsagkaraki Petroula A

2009-01-01

Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

An evaluation of the benefits and challenges of video consulting between general practitioners and residential aged care facilities.

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Wade, Victoria; Whittaker, Frank; Hamlyn, Jeremy

2015-12-01

This research evaluated a project that provided video consultations between general practitioners (GPs) and residential aged care facilities (RACFs), with the aim of enabling faster access to medical care and avoidance of unnecessary hospital transfers. GPs were paid for video consultations at a rate equivalent to existing insurance reimbursement for supporting telehealth services. Evaluation data were gathered by direct observation at the project sites, semi-structured interviews and video call data from the technical network. Three pairs of general practices and RACFs were recruited to the project. 40 video consultations eligible for payment occurred over a 6 month period, three of which were judged to have avoided hospital attendance. The process development and change management aspects of the project required substantially more effort than was anticipated. This was due to problems with RACF technical infrastructure, the need for repeated training and awareness raising in RACFs, the challenge of establishing new clinical procedures, the short length of the project and broader difficulties in the relationships between GPs and RACFs. Video consulting between GPs and RACFs was clinically useful and avoided hospital attendance on a small scale, but further focus on process development is needed to embed this as a routine method of service delivery. © The Author(s) 2015.

Reducing the use of out-of-hours primary care services: A survey among Dutch general practitioners

NARCIS (Netherlands)

Keizer, E.; Maassen, I.; Smits, M.; Wensing, M.; Giesen, P.

2016-01-01

BACKGROUND: Out-of-hours primary care services have a high general practitioner (GP) workload with increasing costs, while half of all contacts are non-urgent. OBJECTIVES: To identify views of GPs to influence the use of the out-of-hours GP cooperatives. METHODS: Cross-sectional survey study among a

Long-acting reversible contraception for adolescents and young adults - a cross-sectional study of women and general practitioners in Oslo, Norway.

Science.gov (United States)

Bratlie, Marte; Aarvold, Trine; Skårn, Elling Skeide; Lundekvam, Jonas Andre; Nesheim, Britt-Ingjerd; Askevold, Erik Tandberg

2014-06-01

To investigate awareness and use of long-acting reversible contraceptives (LARCs) in the Norwegian primary care sector. We surveyed 359 women aged 16 to 23 years visiting a free sexual health clinic and 140 general practitioners (GPs) in Oslo, Norway, to assess contraceptive usage patterns, knowledge, opinions, and counselling content. Eighty-two percent (n = 295) of the female respondents were current contraceptive users and of this group, 12% (n = 34) were LARC users. Combined oral contraceptives (COCs, 56%) and condoms (20%) were the methods most commonly used. Apart from those two, the women considered themselves insufficiently knowledgeable about other family planning modalities. Knowledge was an independent predictor of current LARC use (p Oslo, Norway. These young women need better contraceptive counselling. Dispelling misconceptions and improved provider training could encourage GPs to cover LARCs when giving contraceptive guidance.

International developments in revenues and incomes of general practitioners from 2000 to 2010

OpenAIRE

Kroneman, Madelon; Meeus, Pascal; Kringos, Dionne Sofia; Groot, Wim; van der Zee, Jouke

2013-01-01

Background: The remuneration system of General Practitioners (GPs) has changed in several countries in the past decade. The aim of our study was: to establish the effect of these changes on the revenues and income of GPs in the first decade of the 21st century. Methods: Annual GP revenue and practice costs were collected from national institutes in the eight countries included in our study (Belgium, Denmark, Finland, France, Germany, The Netherlands, Sweden, The United Kingdom (UK)) from 2000...

Childhood obesity: parents fail to recognise, general practitioners fail to act.

LENUS (Irish Health Repository)

White, A

2012-01-01

General Practitioners (GPs) have an important role to play in recognition of and intervention against childhood obesity in Ireland. Data were collected prospectively on a cohort of children aged 4-14 and their parents (n = 101 pairs) who attended consecutively to a semi-rural group general practice. Parents estimated their child\\'s weight status. Actual weight status was determined for both parent and child using the United States Centres\\' for Disease Control\\'s BMI-for-age references. 15 (14.9%) of the children and 49 (51.6%) of the parents were overweight or obese. While 71 (95.5%) of normal weight status children were correctly identified, parents showed poor concordance in identifying their children as overweight 2 (18.2%) or obese 0 (0%). BMI was only evidently recorded in the clinical records of 1 out of 15 cases of overweight children identified. With parents failing to recognise childhood obesity, GPs have a responsibility in tackling this problem at a family level.

User satisfaction with a real-time automated feedback system for general practitioners: a quantitative and qualitative study

NARCIS (Netherlands)

Bindels, Rianne; Hasman, Arie; Derickx, Mieke; van Wersch, Jan W. J.; Winkens, Ron A. G.

2003-01-01

OBJECTIVE: The GRIF automated feedback system produces real-time comments on the appropriateness of diagnostic tests ordered by general practitioners (GPs) based on recommendations from accepted national and regional practice guidelines. We investigated the experiences of GPs with this system and,

Engaging general practitioners in the management of hazardous and harmful alcohol consumption: results of a meta-analysis.

NARCIS (Netherlands)

Anderson, P.D.; Geurts-Laurant, M.G.H.; Kaner, E.; Wensing, M.J.P.; Grol, R.P.T.M.

2004-01-01

OBJECTIVE: A systematic review was undertaken of studies that test the effectiveness of different strategies used to increase general practitioners' rates of screening for and giving advice about hazardous and harmful alcohol consumption. METHOD: Resources were MEDLINE, EMBASE, Cinahl and the

General Employee Training Live, Course 15503

Energy Technology Data Exchange (ETDEWEB)

Gabel, Daniel Glen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hughes, Heather [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-08-25

This training at Los Alamos National Laboratory contains the following sections: Introduction to the Laboratory, Institutional Quality Assurance, Facilities, Policies, Procedures, and Other Requirements, Safety Expectations, Worker Protection: Occupational Safety and Health, Industrial Hygiene and Safety, Lockout/Tagout, General Employee Radiological Training, Fire Protection, Security, Emergency Operations, Occupational Health, and Environment.

Miscommunication between patients and general practitioners: implications for clinical practice

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Morgan S

2013-06-01

Full Text Available INTRODUCTION: Effective communication is integral to the general practice consultation, yet it is acknowledged that problems commonly occur. Previous research has shown that misunderstandings with potentially significant consequences occur frequently, but does not provide a clear picture of how and why miscommunication occurs, or how such problems can be prevented or resolved. This study explored the occurrence and management of specific examples of miscommunication in two routine general practice consultations. METHODS: A multi-method case study approach was used. The primary data collected for each case included a video-recorded consultation and post-consultation interviews with each general practitioner (GP and patient. Instances of communication mismatch were examined using in-depth interaction analysis techniques. FINDINGS: GPs and patients may not be aware when misunderstandings have occurred. In-depth analysis of the case studies revealed the complexity of miscommunication: it was not a straightforward matter to locate when or why instances of communication mismatch had occurred, and each of the mismatches was quite distinctive: (1 they were identified in different ways; (2 they occurred at different points in the communication process; (3 they arose because of problems occurring at different levels of the communication, and (4 they had different consequences. CONCLUSION: Given the frequency and complexity of miscommunication in general practice consultations, GPs need to consider adopting various strategies, at both the practice/systems level and the level of the consultation interaction to minimise the risk of communication problems.

Trained, generalized, and collateral behavior changes of preschool children receiving gross-motor skills training.

OpenAIRE

Kirby, K C; Holborn, S W

1986-01-01

Three preschool children participated in a behavioral training program to improve their gross-motor skills. Ten target behaviors were measured in the training setting to assess direct effects of the program. Generalization probes for two gross-motor behaviors, one fine-motor skill, and two social behaviors were conducted in other settings. Results indicated that the training program improved the gross-motor skills trained and that improvements sometimes generalized to other settings. Contrary...

Diagnosis and treatment of lower urinary tract symptoms in the elderly by general practitioners.

Science.gov (United States)

Okamura, Kikuo; Hasegawa, Tomonori; Nojiri, Yoshikatsu; Kobayashi, Mineo; Murase, Toshiyuki; Yanagihara, Takashi; Okamoto, Yoshihito

2008-06-01

We investigated the diagnosis and treatment of lower urinary tract symptoms (LUTS) by general practitioners (GPs) according to the Practical Manual for LUTS Evaluation and Treatment in the Elderly For GPs. Using the manual, 14 GPs determined LUTS severity using the International Prostate Symptom Score, Quality of Life Index, post-void residual urine volume and the International Consultation on Incontinence Questionnaire-Short Form, then evaluated utilization of the frequency volume charts and other examinations to treat LUTS and assessed treatment effectiveness. This study included 52 men (aged 71 +/- 9 years) and 37 women (73 +/- 9). Voiding symptoms were more frequent in men but storage symptoms occurred similarly in both sexes. The overall severities of LUTS were similar between sexes. Of 36 men and 27 women who were treated, water restriction for polyuria and nocturnal polyuria was recommended for 17 men and 14 women, bladder training for six women, and pelvic floor exercise for three men and 16 women as behavioral therapy. Of 27 men and 25 women whose treatment effectiveness was assessed by GPs, effectiveness was judged as "fairly good" or greater in 20 men (74%) and 23 women (92%). Eleven men (40%) and 20 women (80%) were satisfied with their treatment. It is suggested that GPs can provide high-quality LUTS practice when they follow the manual and use the recommended tools for evaluation and monitoring.

Injury survey in Choi Kwang Do (CKD) martial art practitioners around the world: CKD is a safe form of training for adults.

Science.gov (United States)

Jee, Yong-Seok; Eun, Denny

2018-02-01

Among the many sports and activities to choose from, martial arts are becoming increasingly popular for health and fitness. Due to the different nature of the various styles of martial arts, injuries are not uncommon. Though there have been studies on the injury rates of several martial art styles, there have been none regarding Choi Kwang Do (CKD), a noncompetitive martial art with relaxed and fluid movements designed to promote health and fitness for people of all ages. The purpose of this study was to examine the rate of injury for adults training in CKD to find out whether this is a safe style of martial art for adults. This study found the prevalence, causes, severity, and types of injuries from CKD practitioners around the world through an online survey targeting adults (n=122), aged 18 or older, with varying years of training experience. The annual rate of injury was 11.73 for every 100 CKD practitioners. There was no correlation between the length of training experience and injury. Training frequency and duration had no significant relationship with injury rates. A significant positive relationship between training intensity and injury existed ( P =0.009). The results of the study found that CKD can be an attractive option for adults of any age who are looking to learn a martial art or choose a physical activity with a low risk of injury, however the training intensity should be kept at a level that is not excessively high.

Elder abuse: The role of general practitioners in community-based screening and multidisciplinary action

Science.gov (United States)

Ries, Nola M; Mansfield, Elise

2018-04-01

There are growing calls for elder abuse screening to be conducted by a range of community-based service providers, including general practitioners (GPs), practice nurses, home care workers and lawyers. Improved screening may be a valuable first step towards improving elder abuse detection and response; however, practitioners need evidence-based strategies for screening and follow-up. This article summarises several brief screening tools for various forms of elder abuse. Screening tool properties and evidence gaps are noted. As elder abuse often requires multidisciplinary responses, initiatives to connect health, legal and other service providers are highlighted. GPs are trusted professionals who are well placed to identify older patients at risk of, or experiencing, various forms of abuse. They should be aware of available screening tools and consider how best to incorporate them into their own practice. They also play an important role in multidisciplinary action to address elder abuse.  .

49 CFR 214.343 - Training and qualification, general.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Training and qualification, general. 214.343... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Roadway Worker Protection § 214.343 Training and qualification, general. (a) No employer shall assign an employee to perform the duties of a...

Should the General Practitioner Consider Mesotherapy (Intradermal Therapy) to Manage Localized Pain?

Science.gov (United States)

Mammucari, Massimo; Maggiori, Enrica; Lazzari, Marzia; Natoli, Silvia

2016-06-01

Wide variations in the types of pain and response to analgesic pharmacotherapy mean that a variety of treatment strategies are needed. One approach is mesotherapy (intradermal therapy). This consists of microinjections into the skin and is ideally suited to the management of localized pain. Advantages include increasing the duration of drug activity, reduced risk of adverse events and interactions, and possible synergy with other therapies. Mesotherapy provides general practitioners with another tool for the treatment of local pain. However, it is important to provide patients with full details of the pros and cons of this approach and obtain informed patient consent.

45 CFR 60.1 - The National Practitioner Data Bank.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false The National Practitioner Data Bank. 60.1 Section 60.1 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS General...

Case-specific colleague guidance for general practitioners' management of sickness absence.

Science.gov (United States)

Nordhagen, H P; Harvey, S B; Rosvold, E O; Bruusgaard, D; Blonk, R; Mykletun, A

2017-12-02

General practitioners (GPs) report sickness absence certification as challenging. They express need for support with functional assessment beyond guidelines and reforms. Case-specific collegial one-to-one guidance for other clinical topics has proved popular with GPs and may be an acceptable and effective way to improve GPs skills and competence in sickness absence certification. To present a new model of case-specific colleague guidance focusing on the management of long-term sickness absence and to describe its feasibility in terms of application and reception among GPs, and also GPs' self-reports of effects on their practice. Randomly selected GPs received case-specific collegial guidance over a 12-month period, in two Norwegian trials, delivered by former GPs employed by the social security administration. We measured reception and perceived effects by GPs' self-report and registered participation and withdrawal rates. The participation rate (n = 165) was 94%, and no GPs withdrew during training. Among the 116 GPs responding to the survey (70%), 112 (97%; 95% CI 92-99) stated they would recommend it to their colleagues. Considerable benefit from the guidance was reported by 68 (59%; 95% CI 50-68). The GPs self-reported other effects on their sickness absence certification, specifically an increased use of part-time sickness absence (Fit-Note equivalent). This model of case-specific colleague guidance to aid GPs' management of long-term sickness absence is feasible and was popular. This type of guidance was perceived by GPs to be somewhat beneficial and to alter their sickness absence certification behaviour, though the true impact requires further testing in controlled trials. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Reasons of general practitioners for not prescribing lipid-lowering medication to patients with diabetes : a qualitative study

NARCIS (Netherlands)

Ab, Elisabeth; Denig, Petra; van Vliet, Ton; Dekker, Janny H.

2009-01-01

Background: Lipid-lowering medication remains underused, even in high-risk populations. The objective of this study was to determine factors underlying general practitioners' decisions not to prescribe such drugs to patients with type 2 diabetes. Methods: A qualitative study with semi-structured

Preferences of general practitioners regarding an application running on a personal digital assistant in acute stroke care

NARCIS (Netherlands)

Huis in 't Veld, M.H.A.; van Til, Janine Astrid; IJzerman, Maarten Joost; Vollenbroek-Hutten, Miriam Marie Rosé

2005-01-01

An application was developed to optimize information exchange in acute stroke care, with which general practitioners (GPs) could consult hospital emergency units. However, it was difficult to obtain clear preferences from GPs regarding the functional requirements of the information to be transferred