Scandinavian journal of primary health care
-
Scand J Prim Health Care · Dec 2020
Validation and initial results of surveys exploring perspectives on risks and solutions for diagnostic and medication errors in primary care in Sweden.
To (1) validate and (2) display initial results of surveys to health care professionals and patients on the importance and mitigation of specified risks for diagnostic and medication errors. ⋯ The HCP survey showed some contradicting results regarding model fit and may be tentatively acceptable but validity needs further study. HCP survey answers indicated that relational continuity of care and a nationwide on-line medical platform are highly valued. Current awareness Health care professionals and patients are rather untapped sources of knowledge regarding patient safety in primary health care Main statements Validation is performed on a new survey capturing rating of risks and solutions. The validation of the health care professional survey is tentatively acceptable. Survey answers indicate that health care professionals' and patients' perspectives are complementary.
-
Scand J Prim Health Care · Dec 2020
Danish general practitioners' management of patients with COPD: a nationwide survey.
In Denmark, general practitioners (GPs) have the main responsibility for chronic obstructive pulmonary disease (COPD) management. Internationally, COPD appears to be significantly under-treated, which could be explained by 'therapeutic nihilism' or lack of knowledge. ⋯ The survey suggested that COPD maintenance support provided by GPs seemed to be inadequate regarding smoking cessation and physical activity. Moreover, some GPs expressed a need for educational support in COPD management. More research is needed to understand the potential barriers to evidence-based delivery of COPD-management. Key points In Denmark, general practitioners (GPs) have the main responsibility for the management of chronic obstructive pulmonary disease (COPD). The present study shows that non-pharmacological interventions such as supporting smoking cessation and particularly promoting physical activity received less attention than pharmacological treatment. The study suggests a need for educational support of the GPs in COPD management.
-
Scand J Prim Health Care · Dec 2020
Yield of elective coronary angiography; gender differences, patient history, risk factors and angiographic findings in a primary care population.
To assess yield of elective coronary angiography and gender differences in primary care patients suspected to have stable coronary artery disease (SCAD). ⋯ The diagnostic yield of elective coronary angiography was low in women compared to men although there were no substantial differences in evidence-based medication, risk factors or anticipated angina symptoms between genders. Key Points Coronary artery disease (CAD) is the leading cause of death globally. Invasive cardiology has expanded rapidly since the 1990s. Among symptomatic primary care patients who underwent elective coronary angiography in secondary care, obstructive CAD was identified in 73% Diagnostic yield of coronary angiography was low in women compared to men. GPs treat their male and female patients suspected of having stable CAD equitably regarding evidence-based medication.
-
Scand J Prim Health Care · Dec 2020
Elephant in the room - Family members´ perspectives on advance care planning.
To explore family members' experiences of advance care planning in nursing homes. ⋯ Our study stresses the significance of staff involving the patient and family members in the advance care planning process in nursing homes, thereby adapting the care in line with patient's wishes, and for the patient to share these preferences with family members. Education in communication related to the subject may be important to shape advance care planning. Key points Knowledge on advance care planning (ACP) in a nursing home (NH) context from the perspective of family members is limited. Role of the nurse in ACP is seen as central, whereas physician involvement is often perceived to be lacking. Significance of small details, perceive to symbolize staff competence and respect for patient autonomy. To limit family members' feeling of guilt, communicating end-of-life issues is important in order to align ACP with patient preferences.
-
Scand J Prim Health Care · Dec 2020
Motives for non-adherence to colonoscopy advice after a positive colorectal cancer screening test result: a qualitative study.
Participants with a positive faecal immunochemical test (FIT) in screening programs for colorectal cancer (CRC) have a high risk for colorectal cancer and advanced adenomas. They are therefore recommended follow-up by colonoscopy. However, more than ten percent of positively screened persons do not adhere to this advice. ⋯ Personalised screening counselling might have helped to improve the interviewees' experiences with the screening program as well as their knowledge on CRC and CRC screening. Future studies should explore whether personalised screening counselling also has potential to increase adherence rates. Key points Participants with a positive FIT in two-step colorectal cancer (CRC) screening programs are at high risk for colorectal cancer and advanced adenomas. Non-adherence after an unfavourable screening result happens in all CRC programs worldwide with the consequence that many of the participants do not undergo colonoscopy for the definitive assessment of the presence of colorectal cancer. Little qualitative research has been done to study the reasons why individuals participate in the first step of the screening but not in the second step. We found a preference for more personalised care, which was not reported in previous literature on this subject. Furthermore, intrinsic factors, such as a low risk perception and distrust, and extrinsic factors, such as the presence of other health issues and GP advice, may also play a role in non-adherence. A person-centred approach in the form of a screening counselling session may be beneficial for this group of CRC screening participants.