Priorities in primary health care. The views of patients, politicians and health care professionals

A written inquiry was undertaken to explore the expectations towards primary care physicians (general practitioners), as expressed by patients, local health board members and health centre staff members. Treatment without delay was given top priority both by patients and board members, while continuity of care was considered most important by the health care professionals. Great similarity of opinions was expressed by patients and health board members, while staff members differed significantly in their views. A low degree of participation in the study by the politicians coincided with the authors' experience of lack of interest in the content of primary health care shown by health board members.     

Cardiovascular risk among health professionals working in pre-hospital care services

The objective of this study was to assess the cardiovascular risk factors among health professionals, particularly hypertension, and stratify them according to the Framingham Risk Score (FRS). The participants were 154 professionals working in pre-hospital care in S?o Paulo, Brazil, and on the Br-116 highway. Values were considered significant for p<0.05. The prevalence of hypertension was 33%, 20.1% were smokers, 47% consumed alcoholic beverages, 64% were sedentary, 66% were obese/overweight and 70% had an altered abdominal circumference. In terms of laboratory values: glucose>110mg/dL- 11%, total cholesterol >200mg/dL- 36%, LDL-c>130mg/dL- 33%, HDL-c<60mg/dL- 89%, triglycerides>150mg/dL- 30% and C reactive protein>0.5mg/dL- 16%. The FRS was average in 10.3% and high in 1.3%. In logistic regression analysis, it was verified that hypertension was associated with: HDL-c (odds ratio: 0.257,) and FRS (odds ratio: 23.159). There was strong correlation between hypertension and FRS. Data are noteworthy, as this is a relatively young sample of health professionals.     

Job stress and coping strategies in health care professionals working with cancer patients.

The aim of this study was to determine the factors influencing stress in health care professionals working with cancer patients and the strategies used to cope with stress. The data was collected by self-report questionnaires, the Job Stress Inventory and Ways of Coping Inventory. Overall 109 health care professionals (physicians n = 52, nurses = 57) employed in five Oncology Hospitals in Ankara, Turkey, between January 2001 and July 2001 were involved in the study. It was identified that the mean job stress score of health care professionals was 30.76 (physicians = 30.53, nurses = 31.00) (range = 0-50). This stress level indicated that there were signs of physical and psychological stress. It was determined that variables influencing stress scores were marital status, age, professional career, unfairness in promotion opportunities, imbalance between jobs and responsibilities, conflict with colleagues, lack of appreciation of efforts by superiors, responsibilities of role, long and tiring work hours, inadequacy of equipment, and problems experienced with patients and their relatives. It was also determined that health care professionals utilize similar strategies in order to cope with stress. The most common strategy used by physicians and nurses was a self-confident approach (x = 1.89 and 1.82 respectively), and the strategy least used was a submissive approach (respectively, x = 1.03 and 0.85). Programmes directed towards reducing job stress and enhancing motivation and job satisfaction were recently considered by health institutions. It is thought that the findings of the study could be taken into account in preparing programmes (coping with stress, training) for health care professionals working with cancer patients.     

Integrated education of health care professionals applied to social medicine in primary health care

A Regional Health University is planned at the University of Link?ping, Sweden. To evaluate new educational principles, a trial project was carried out in which medical and nursing students trained together in a two-week full-time course aimed at patient-oriented clinical social medicine and epidemiological field work in primary health care and involving a high degree of group activity and responsibility. The students' expectations concerning improvement in theoretical and applied knowledge and motivation for co-operation in future work situations were fulfilled. The students also enjoyed the way of working. The programme requires more time in planning and supervision than a traditional one.     

Knowledge about patients' rights among professionals in public health care in Finland

Scand J Caring Sci; 2012; 26; 436–448 Knowledge about patients’ rights among professionals in public health care in Finland Background: The legal rights of patients include civil rights for patients and the duties of healthcare professionals. Knowledge of legislation and the ability to put juridical norms into practice are among the main aspects of professionals. Aim: The aim of the study was to describe the level of healthcare professionals’ knowledge about patients’ legal rights and to describe background variables associated with the knowledge. The legal rights are based on the Finnish Act on the Status and Rights of Patients. Method: The data were collected from healthcare professionals (nurses and physicians) in public health care in Finland (recruited N = 290, responded n = 191) with a questionnaire designed for the study. The response rate was 66%. The data were analysed statistically. Results: Healthcare professionals were partially familiar with patients’ legal rights. The right to good health care, treatment and access to care and right to self‐determination were the best‐known areas. The respondents lacked knowledge on the right to information and the right to use the services of patient ombudsman. Based on self‐evaluation, half of the respondents thought that they had weak knowledge of the legislation on patients’ rights. However, they perceived knowledge about patients’ rights as being important. There was no correlation between respondents’ self‐evaluated knowledge and actual scoring on the knowledge test. Conclusion: These results implicate a need for further education aimed at healthcare professionals and development of professional training about patients’ legal rights.     

Advantage profiles: a tool for health care professionals working with parents with mental retardation.

Health professionals concerned about the needs of parents with mental retardation are beginning to distinguish characteristics which facilitate and inhibit their parenting abilities. Child health is dependent on adequate parenting abilities. A composite of research findings has been derived to develop not only a risk profile that identifies potential problem areas, but also an advantage profile that identifies specific strengths of parents with mental retardation. The advantage profile uniquely focuses on parental assets that can be reinforced and used to foster child health.     

School-based health centers and the primary care physician: an opportunity for collaborative care

Located throughout the country, SBHCs are an important resource for primary care physicians caring for children and adolescents. It is beneficial for primary care physicians to become familiar with school-based resources in their community. Information about SBHCs nationwide is available from the NASBHC [4,16] and The Center for Health and Health Care in Schools [3,7,12,15]. Partnering with SBHCs can have important benefits for your practice, including improved continuity of care, management of chronic dis-eases like asthma, opportunities for group and multidisciplinary interventions for overweight children, and access to SBHC mental health services. Specializing in adolescent issues, with the advantage of proximity, SBHC providers can be an invaluable asset in managing and helping to monitor your patients, especially when other community resources are limited or services are difficult to access. In our own centers, we are currently exploring ways to simplify ongoing routine communication with primary care providers. Consider discussing this opportunity for collaborative services with your patients and contacting your local SBHC to discuss how you would like to communicate and work together.     

Use of sunscreen in health care professionals. The health belief model

The purpose of this study was to examine the relationship among perceived susceptibility, demographic variables, and use of sunscreen in health care providers, using the Health Belief Model Questionnaire. The sample consisted of 90 participants from the Southeast, ages 24 to 60 years. This sample included nurses, pharmacists, psychologists, nurse practitioners, and physicians. Demographics revealed that 63% had postgraduate or professional degrees, 91% were white, 88% were women, 4% had a family history of skin cancer, and 4% had a personal history of skin cancer. Participants at actual high risk and those at actual low risk reported appropriate perceived susceptibility scores. However, those whose actual risk was average, perceived their risk to be low. There was no significant relationship found between actual risk of developing skin cancer and use of sunscreen. There was a significant relationship between age and perceived susceptibility to skin cancer. The older the subject, the higher the perceived susceptibility. Health care providers have the ability to influence individuals to use sunscreen. Accurately perceived susceptibility to skin cancer will increase the likelihood of health care providers recommending sunscreen to their patients.     

Sources of conflict between families and health care professionals.

It is essential to examine conflict between patients and health care professionals from the patient's perspective. The purposes of this study were to 1) identify sources of conflict, 2) determine nursing interventions that alleviate conflict, and 3) test a conceptual framework of sources of conflict. This phenomenological study focused on children with cancer and their parents' perceptions of conflicts with health care professionals as well as what they thought helped with such conflicts. Their reports of conflict were compared to C. W. Moore's circle of conflict conceptual framework. A purposive sample of 27 participants (9 children, 14 mothers, and 4 fathers) participated in the study. Study findings showed that conflict occurred between health care professionals and families originating from differences in expectations and desires regarding data, interests, structure, relationships, and values, consistent with C. W. Moore's conceptual framework. Nursing interventions reported by children and parents to be helpful in preventing or alleviating conflict were identified. C. W. Moore's framework may provide a valuable structure for assessing conflict and designing nursing interventions to alleviate conflict.     

Kidney organ donation knowledge and attitudes among health care professionals: Findings from a Greek general hospital

Identified barriers of organ donation advancement include lack of knowledge, personal beliefs, and a negative attitude from health professionals. This article reports on current knowledge and attitudes toward kidney donation among nurses and physicians in a Greek general hospital. A previously used questionnaire was applied. More physicians than nurses were donor card holders, with registration rates being lower than expected. Over half of the participants did not consider themselves well informed about registering as a kidney donor. Older nurses differed significantly from younger ones in their willingness to become live donors if an adult required a kidney. Nurses who were blood donors had higher odds ratio of feeling well informed when compared with nurses who were not blood donors. Integrating organ donation issues into undergraduate health science curricula and continuous education interdisciplinary programs is essential in increasing awareness, eradicating negativism, and reversing inertia.     

Federally qualified health centers reduce the primary care provider gap in health professional shortage counties

Background

Federally qualified health centers (FQHCs) were designed to provide care in medically underserved areas. Substantial and sustained federal funding has accelerated FQHC growth.

Nurse practitioner management of hospital-affiliated primary care centers.

Escalating health care costs have forced hospitals to develop alternative sources of revenue. Hospital-affiliated primary care centers that provide comprehensive health services to patients may also supplement hospital revenues with referrals for admission and/or special services. With their documented history of effectiveness, nurse practitioners are well-qualified to manage these primary care centers. This article provides guidelines to help nurse practitioners establish and manage a hospital-affiliated primary care center. Identification of clinical-services and staffing needs, and determination of office, administrative and facility requirements are also discussed.