Scandinavian journal of primary health care
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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
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
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.
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Objective: To assess the use of point-of-care ultrasound (POCUS) in Norwegian general practice. Design: Retrospective register study based on general practitioners' (GPs') reimbursement claims. Setting: Norwegian general practice excluding out-of-hours clinics in 2009, 2012 and 2016. ⋯ The use of POCUS increased six-fold from 2009 to 2016. Three out of four scanning GPs performed less than 10 scans annually. Male GPs performed 80% of the claimed scans.
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Scand J Prim Health Care · Jun 2020
GPs' suspicion of child abuse: how does it arise and what is the follow-up?
Background: Child abuse is widespread, occurs in all cultures and communities, remains undiscovered in 90% of cases and has serious long-term effects. Physicians generally underidentify and underreport child abuse. To understand this low reporting rate and how the suspicion of child abuse arises, we examined GPs' experiences. ⋯ Suspicion of child abuse arose from common triggers and a gut feeling that 'something is wrong here'. GPs acted upon their suspicion by gathering more data, through history taking and physical examination. GPs found it difficult to decide whether a child was abused, because parents, despite good intentions, may lack parenting skills.