Scandinavian journal of primary health care
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Scand J Prim Health Care · Mar 2024
What would primary care practitioners do differently after a delayed cancer diagnosis? Learning lessons from their experiences.
Diagnosis of cancer is challenging in primary care due to the low incidence of cancer cases in primary care practice. A prolonged diagnostic interval may be due to doctor, patient or system factors, or may be due to the characteristics of the cancer itself. The objective of this study was to learn from Primary Care Physicians' (PCP) experiences of incidents when they had failed to think of, or act on, a cancer diagnosis. ⋯ To achieve more timely cancer diagnosis, PCPs need to provide a long-term, holistic and active approach with effective communication, and to ensure shared decision-making, follow-up and continuing re-assessment of the patients' clinical conditions.
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Scand J Prim Health Care · Mar 2024
"Returning to the core tasks": a qualitative interview study about how general practitioners in home health care solved problems during the COVID-19 pandemic.
Optimizing care at home, or home health care (HHC), is necessary as the population of care-dependent older people receiving care at home steadily increases. The COVID-19 pandemic tested Swedish primary care professionals as they provided HHC for a population of very frail older homebound people, but a better understanding of what healthcare workers did to manage the crisis may be useful for the further development of HHC. In this study, we aimed to understand how HHC physicians solved the problems of providing home healthcare during the pandemic to learn lessons on how to improve future HHC. ⋯ This study indicates that a healthcare system that gives HHC physicians agency to focus on core tasks and professional values could promote person-centered care.
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Scand J Prim Health Care · Mar 2024
The burden of persistent symptom diagnoses in primary care patients: a cross-sectional study.
The burden of symptoms is a subjective experience of distress. Little is known on the burden of feeling unwell in patients with persistent symptom diagnoses. The aim of this study was to assess the burden in primary care patients with persistent symptom diagnoses compared to other primary care patients. ⋯ Patients with persistent symptom diagnoses suffer from high levels of symptoms burden. The burden in patient with persistent symptoms should not be underestimated as awareness of this burden may enhance person-centered care.
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Scand J Prim Health Care · Mar 2024
To reveal disease or to promote function - that is the question.
Medicine faces challenges that indicate that it may not be sustainable. A descriptive disease concept is apt to what philosopher of science Ian Hacking called "looping effects", which can explain why health care is faced with insatiable demands. ⋯ They are often interactive identities that have attractive properties. We suggest a shift in medical practice where descriptive perspectives are complemented with functional perspectives to enable clinicians better to help people from merging with dysfunctional disease identities.
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Scand J Prim Health Care · Mar 2024
Local management of the COVID-19 pandemic in Norway: a longitudinal interview study of municipality chief medical officers.
To explore the experiences and views of Norwegian Municipality Chief Medical Officers (MCMOs) on preparedness, collaboration, and organization during the COVID-19 pandemic to gain insight into local crisis management of value for future pandemic responses. ⋯ The Norwegian pandemic response and outcome have been regarded as successful internationally. Although the MCMOs managed to implement flexible and quick responses facilitated by teamwork, dialogue, and joint sensemaking, they also identified several challenges and shortcomings of the Norwegian pandemic preparedness requiring organizational and financial changes to sustain future health system resilience.