Scandinavian journal of primary health care
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Scand J Prim Health Care · Mar 2020
Randomized Controlled Trial Multicenter Study Comparative StudyLong-term effects on function, health-related quality of life and work ability after structured physiotherapy including a workplace intervention. A secondary analysis of a randomised controlled trial (WorkUp) in primary care for patients with neck and/or back pain.
Objective: To study the long-term effects of a workplace intervention in addition to structured physiotherapy regarding self-reported measures in patients with acute/subacute neck and/or back pain. Design: WorkUp - a cluster-randomised controlled trial in 32 primary care centers in Sweden, from January 2013 through December 2014 (ClinicalTrials.gov ID: NCT02609750). Intervention: Structured physiotherapy with the workplace dialogue 'Convergence Dialogue Meeting' (CDM), conducted by the treating physiotherapist as an add-on. ⋯ Key pointsIn earlier analysis of the primary outcome (work ability measured by absenteeism) in this trial, a positive effect was found when the workplace intervention 'Convergence Dialogue Meeting' (CDM) was added to structured physiotherapy for patients with neck or back pain. By contrast, in this new analysis of secondary outcomes (self-reported function, health and perceived work ability), there was no added effect of CDM above structured physiotherapy alone, although patients in both the intervention and reference group improved over time. The addition of CDM to physiotherapy is therefore justified by its specific effect on behavior (work absence) rather than any effect on clinical outcomes.
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Scand J Prim Health Care · Dec 2019
Randomized Controlled Trial Multicenter StudyInforming patients on planned consultation time - a randomised controlled intervention study of consultation time in primary care.
Objective: To investigate whether patients' pre-consultation knowledge of the time frames for the consultation influences the actual consultation time and/or patient and physician related outcomes; satisfaction and enablement. Design: Randomised controlled blinded intervention study. Setting: Four strategically chosen Primary Health Care Centres (PHCC:s) in Kronoberg county in Sweden participated. ⋯ Key pointsPatients prepare before their consultation but to influence its contents and length is difficult. Informing patients on estimated consultation time can influence actual consultation time. Informing patients on planned consultation time has no adverse effects in this study.
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Scand J Prim Health Care · Dec 2019
Multicenter StudyLegitimacy of work tasks, psychosocial work environment, and time utilization among primary care staff in Sweden.
Objective: Primary care staff faces a complex work environment including a heavy administrative work load and perceive some work tasks as illegitimate. This study aimed to elucidate associations between the perceived legitimacy of work tasks, the psychosocial work environment, and the utilization of work time among Swedish primary care staff. Design and setting: The study was designed as a multicenter study involving all staff categories, i.e. registered nurses, primary care physicians, care administrators, nurse assistants and allied professionals, at eleven primary care centers in Sweden. ⋯ Also, the perception of having to perform a large amount of illegitimate work tasks affected the psychosocial work environment negatively, which might influence staffs perception of their professional roles. These results illuminate the importance of decision makers to thoroughly consider the distribution and allocation of non-patient related work tasks among staff in primary care. Key pointsWe observed an interaction between perception of having a large proportion of illegitimate work tasks and impaired psychosocial work environment. • More than a quarter of the primary care physicians perceived a high proportion of unnecessary work tasks.• Across all staff groups, performing unreasonable work tasks was associated with an experience of having role conflicts.• Across all staff groups, a perception of performing unreasonable work tasks was associated with the proportion of non-patient related administrative work tasks.
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Scand J Prim Health Care · Dec 2019
Multicenter StudyPatients' ideas, concerns, expectations and satisfaction in primary health care - a questionnaire study of patients and health care professionals' perspectives.
Objective: Explore the perceptions of patients and health care professionals about patients' ideas, concerns, expectations (ICE), and satisfaction in consultations with general practitioners (GPs), district nurses (DNs) and physiotherapists (PTs). Design: Cross-sectional questionnaire study of participants in planned consultations. Setting: Five primary health care centers and two rehabilitation centers in Stockholm, Sweden. ⋯ In this study of planned consultations, few patients expected to receive an explanation of their symptoms, but most were satisfied with the consultation. Health care professionals thought patients' experiences were more negative than they were. This discrepancy was observed in responses to questions about patients' concerns, expectations and satisfaction.
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Scand J Prim Health Care · Dec 2019
Multicenter StudyCOPD patients need more information about self-management: a cross-sectional study in Swedish primary care.
Objective: In Sweden, patients with chronic conditions, such as chronic obstructive pulmonary disease (COPD), often receive education at specialized nurse-led clinics at primary health care centers (PHCCs). Identifying patients' needs for information about COPD is the key to individualized care. This study aimed to assess self-reported needs for information about COPD in primary care patients with either moderate (GOLD 2) or severe (GOLD 3) COPD and identify patient characteristics and exacerbation patterns associated with the findings. ⋯ GOLD 2) felt they needed more information about COPD than currently provided by health care professionals in primary care. Low information needs were strongly associated with continuity in patient-GP consultations and moderately associated with contact with a COPD nurse. GPs' part in COPD patient education should not be overlooked, as individualized COPD care relies on GPs' expertise in managing patients with multimorbidity.