Scandinavian journal of primary health care
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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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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
Staff experiences of a new tool for comprehensive geriatric assessment in primary care (PASTEL): a focus group study.
Objective: Comprehensive geriatric assessment (CGA) is recommended for the management of frailty. Little is known about professionals' experiences of CGA; therefore we wanted to investigate the experiences of staff in primary care using a new CGA tool: the Primary care Assessment Tool for Elderly (PASTEL). Design: Focus group interviews. ⋯ Conclusion: The participants reported that PASTEL, a tool for CGA, gave a holistic picture of the older person and was helpful in care planning. Key pointsTo manage frailty using comprehensive geriatric assessment (CGA) in primary care, there is a need for tools that are efficient, user-friendly and which support patient involvement and teamwork•This study found that the Primary care Assessment tool for Elderly (PASTEL) is regarded as both valuable and feasible by primary care professionals•Use of carefully selected items in the tool and allowing enough time for dialogue may enhance patient-centeredness•The PASTEL tool supports the process of identifying actions to manage frailty in older adults. Teamwork related to the tool and CGA in primary care needs to be further investigated and developed.
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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.