Scandinavian journal of primary health care
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Scand J Prim Health Care · Dec 2020
ReviewA client-centered approach in home care for older persons - an integrative review.
To describe and synthesize client-centered care and service in home care for older persons. ⋯ According to the results, achieving client-centered care and service in home care requires the realization of all of the above aspects. The practice of nursing must better identify all dimensions of client-centered care and take these into account in the delivery of home care services. KEY POINTS Client-centeredness is a fundamental value and the basis of nursing and care in home care provided for older persons This paper: deepens and structures the concept of client-centered care in the context of home care. assists professionals to understand the factors behind client-centered care within the home care environment. provides deeper understanding of the roles of the older person, family members, and the service system in developing client-centered services in home care for older persons.
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Scand J Prim Health Care · Dec 2020
Performance of the Eight-item Informant Interview to Differentiate Aging and Dementia within a context similar to the Swedish primary healthcare sector: a systematic review of diagnostic test accuracy studies.
Dementia is a common but underdiagnosed health problem. Instruments developed for initial screening exist internationally but are not available within the Swedish primary healthcare sector. This systematic review aimed to evaluate the diagnostic test accuracy of the Eight-item Informant Interview to Differentiate Aging and Dementia in identifying symptomatic dementia within a context similar to the Swedish primary healthcare sector. ⋯ The results show that the Eight-item Informant Interview to Differentiate Aging and Dementia has the ability to identify persons with symptomatic dementia within the target population. Thus, an evaluation of its potential benefits should be considered and evaluated within the Swedish primary healthcare context. KEY POINTS Dementia is a common but underdiagnosed health problem. Instruments developed for initial screening exist but are not available within the Swedish primary healthcare sector. We found that the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8), has the ability to identify individuals with symptomatic dementia within the target population. The Eight-item Informant Interview to Differentiate Aging and Dementia (AD8), has the potential to increase the possibility for timely detection of individuals with symptomatic dementia.
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Scand J Prim Health Care · Dec 2020
Is C-reactive protein associated with influenza A or B in primary care patients with influenza-like illness? A cross-sectional study.
Identifying influenza A or B as cause of influenza-like illness (ILI) is a challenge due to non-specific symptoms. An accurate, cheap and easy to use biomarker might enhance targeting influenza-specific management in primary care. The aim of this study was to investigate if C-reactive protein (CRP) is associated with influenza A or B, confirmed with PCR testing, in patients presenting with ILI. ⋯ There was no association between CRP and influenza A. Increased concentration of CRP was associated with a lower risk for having influenza B, a finding that lacks clinical usefulness. Hence, CRP testing should be avoided in ILI, unless bacterial pneumonia is suspected. Key points Identifying influenza A or B as cause of influenza-like illness (ILI) is a challenge due to non-specific symptoms. There was no association between concentration of CRP and influenza A. Increased concentration of CRP was associated with a lower risk for having influenza B, a finding that lacks clinical usefulness. A consequence is that CRP testing should be avoided in ILI, unless bacterial pneumonia or similar is suspected.
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Scand J Prim Health Care · Dec 2020
Plasma albumin and calcium concentrations, and long-term mortality in primary health care patients in Sweden.
Low plasma (p)-albumin and p-calcium concentrations are associated with increased mortality in hospitalised patients. There are few studies addressing this in primary care. Low p-calcium has been associated with mortality, but it is not known whether this applies to p-albumin. Could p-albumin and p-calcium be used as markers of an increased risk of mortality? ⋯ Low p-albumin could be a marker of an increased risk of mortality, especially in patients of younger ages. This finding should prompt diagnostic measures in order to identify underlying causes. KEY POINTS Low p-albumin and calcium concentrations have been associated with increased mortality in hospitalised patients, but this is unexplored in primary care patients. A low p-albumin concentration at baseline was a risk marker for mortality; highest in the younger age groups. Increased mortality in both cardiovascular and malignant diseases was seen in both men and women with low compared with normal p-albumin concentrations. Elevated but not low p-calcium concentrations were associated with increased mortality after 10-14 years of follow-up.
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Scand J Prim Health Care · Dec 2020
Selection bias in general practice research: analysis in a cohort of pregnant Danish women.
The aim of the present study was to examine selection in a general practice-based pregnancy cohort. ⋯ The skewed selection of patients was mainly caused by a high number of non-participants within practices that actively took part in the study. We recommend that a focus on the sampling within participating practices be the most important factor in representative sampling of patient populations in general practice. Key points Selection among general practitioners (GPs) is often unavoidable in practice-based studies, and we found significant differences between participating and non-participating practices. These include practice characteristics such as the number of GPs, the number of patients registered with the GP practice, as well as the sex and age of the GPs. •Despite this, only small differences in the characteristics of the eligible patients were observed between participating and non-participating practices. •In participating practices, however, significant differences were observed between recruited and non-recruited patients. •Comprehensive sampling within participating practices may be the best way to generate representative samples of patients.