Scandinavian journal of primary health care
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Scand J Prim Health Care · Jun 2020
Prevalence and distribution of psychological diagnoses and related frequency of consultations in Norwegian urban general practice.
Objective: To investigate the prevalence and distribution of psychological diagnoses made by general practitioners (GPs) in urban general practice and the related frequency of consultations during 12 consecutive months in Norwegian general practice. Design: A cross-sectional study with data extracted from 16,845 electronic patient records in 35 urban GP practicesSetting: Six GP group practices in Groruddalen, Norway. Subjects: All patients aged 16-65 with a registered contact with a GP during 12 months in 2015. ⋯ Key PointsEighteen percent of patients aged 16-65 in our study of patients in urban general practice received one or more psychological diagnoses in 12 months. Depression was the most common diagnosis; followed by acute stress reaction, anxiety and sleep disturbance. Patients with psychological diagnoses had a significantly higher mean number of consultations compared to patients without such diagnoses regardless of age and sex.
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Scand J Prim Health Care · Jun 2020
Should GPs ask patients about their financial concerns? Exploration through collaborative research.
Objective: Health services should arguably be concerned about the financial situation of patients since health problems can cause financial concerns, which in turn can cause health problems. In this study, we explored the role of the general practitioner (GP) as a potential early discoverer of financial problems who can refer at-risk patients to financial counselling services. Design: A collaborative health service research experiment. ⋯ In a collaborative health services research experiment 11% of the patients at a Norwegian GP office had health problems that caused them financial concerns, or vice versa. GPs found it helpful to ask patients about their financial concerns when no clear medical explanations for their health problems was found. Then free financial counselling services could be offered.
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Scand J Prim Health Care · Jun 2020
Comparative Study Observational StudyCharacteristics of patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare.
Objective: The aim of this study was to describe patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare and to examine factors associated with depression. Design: This was an observational study. Setting: Fourteen outpatient clinics and 33 general practitioners and municipality memory teams across Norway. ⋯ Depression was associated with female gender, older age, more severe decline in cognitive functioning (IQCODE, OR 1.65), higher caregiver burden (RSS, OR 1.10) and with being assessed in primary healthcare (OR 1.53). Conclusion: Post-diagnostic support tailored to patients diagnosed with dementia in primary healthcare should consider their poor cognitive function and limitations in ADL and that these people often live alone, have BPSD and depression. Key pointsPeople diagnosed in Norwegian primary healthcare had more needs than people diagnosed in specialist healthcare. • They were older, less educated, had poorer cognitive functioning and activity limitations, more often lived alone, and had more BPSD and depression. • Depression was associated with being female, older, having cognitive decline, being assessed in primary care and the caregiver experiencing burden • Post diagnostic support for people with dementia should be tailored to the individual's symptoms and needs.
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Scand J Prim Health Care · Jun 2020
Associations between lifestyle, erectile dysfunction and healthcare seeking: a population-based study.
Objective: To investigate associations between age, lifestyle and erectile dysfunction (ED) in the general population and to explore associations between age, lifestyle and contact with a general practitioner (GP) regarding ED. Design: Cross-sectional web-based questionnaire study. Setting: The general Danish population. ⋯ Furthermore, lifestyle was significantly associated with reporting ED, but largely not associated with healthcare seeking. These findings are important for future interventions aiming to improve diagnosis and treatment of ED. Key pointsExperiencing erectile dysfunction is frequent in the general population, especially among older men. • In this large-scale national survey, age and lifestyle were significantly associated with reporting erectile dysfunction. • Healthcare seeking with erectile dysfunction was significantly associated with age, but not with lifestyle. • Diagnosis and treatment of erectile dysfunction might be challenged when erectile dysfunction does not lead to healthcare seeking.
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Scand J Prim Health Care · Jun 2020
Primary care physicians' concerned voices on sickness certification after a period of reorganization. Focus group interviews in Sweden.
Objective: This study explored the views of primary health care (PHC) physicians on sickness certification after reforms in 2005 prompted by the Swedish government to increase the quality and decrease the inequalities, and costs of sickness certification. Design: Qualitative design with focus group interviews. Data were analysed using qualitative content analysis. ⋯ Focus group interviews with Swedish primary care physicians revealed that sickness certification was challenging due to differing demands from authorities, management and patients. Coping strategies for the sick-listing task included both active measures and passive adaptation to the circumstances. A proposal for future better working conditions for physicians was to transfer lengthy sickness certifications and rehabilitation to specialized teams.