Scandinavian journal of primary health care
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Scand J Prim Health Care · Mar 2022
Randomized Controlled TrialThe effect of a single visit to a health coach on perceived health in 50-year old residents in a high-income country - a randomised controlled trial.
To evaluate the one-year-effect of a single visit to a health coach on perceived health and exercise level in 50-year-old citizens. ⋯ A single visit to a health coach does not improve perceived health or exercise-level in 50-year-old citizens. On the contrary it may make perceived health worse.Key pointsResearch on health coaching has emerged in the last 20 years, but is diverse and the characteristics of a successful health coaching intervention are still unknown.There is a lack of randomised controlled trials evaluating long-term effectiveness of health coaching.This randomised controlled trial concludes that a single visit to a health coach does not improve, but rather impairs, perceived health in 50-year olds.
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Scand J Prim Health Care · Mar 2022
Forty-four-year longitudinal study of stroke incidence and risk factors - the Prospective Population Study of Women in Gothenburg.
To assess stroke incidence over 44 years and association with risk factors. To study total stroke incidence at 60-82 years of age and risk factors. ⋯ Several classic risk factors showed independent associations with stroke. Vulnerability factors as low education and oral health, reflected by loss of teeth, also showed association with stroke. All these factors are possible to target in primary care preventive interventions.Key PointsStroke is a common disease and the risk of stroke is a key issue demanding preventive strategies in primary health care. The present prospective population study of women showsOut of 1460 women, almost a quarter got a stroke. The stroke incidence 60-82 years of age was rather stable between the first four age cohorts but somewhat lower in the latest cohort, born 1930.Hypertension, low physical activity, low education and high triglyceride levels but not cholesterol were associated with stroke in women.Low education and loss of teeth are vulnerability factors that should need particular attention.
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Scand J Prim Health Care · Mar 2022
Health care utilization related to the introduction of designated GPs at care homes in Denmark: a register-based study.
To investigate the correlation between having designated general practitioners (GPs) in residential care homes and the residents' number of contacts with primary care, number of hospital admissions and mortality. ⋯ The designated GP model seems promising, as a high implementation degree of the model correlated with a reduced the number of acute admissions, short-term admissions and readmissions. Future studies should focus on gaining deeper insight into the mechanisms of the designated GP model to further optimize the model.Key pointsA new care model was introduced in Denmark in 2017, designating dedicated GPs to residential care homes for the elderly.Successful implementation correlated with significantly fewer hospital admissions, specifically for acute admissions, but also with fewer short-term admissions and readmissions.The implementation of the model correlated significantly with fewer e-mail and telephone contacts and with more home visits.Future studies should gain more insight into the mechanisms of the designated GP model to further optimize the model.
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Scand J Prim Health Care · Mar 2022
Prevalence, content and significance of advance care planning in nursing home patients.
Studies on advance care planning in nursing homes are rare, and despite their demonstrated favourable effects on end-of-life care, advance care plans are often lacking. Therefore, we wished to explore: (i) the prevalence of advance care plans in a Swedish nursing home setting using two different definitions, (ii) the content of advance care plans, (iii) adherence to the content of care plans and (iv) possible associations between the presence of advance care planning and background characteristics, physician attendance and end-of-life care. ⋯ In contrast to previous research, this study showed a high prevalence of advance care plans in nursing home patients. Patients with care plans more frequently received prescriptions of palliative drugs and their family members were informed to a greater extent about the patient's deterioration and impending death compared to those without care plans. These aspects are often seen as vital components of good palliative care.Key pointsStudies on advance care planning in nursing homes are rare, and despite their demonstrated positive effects on end-of-life care, advance care plans are often lacking.The present study revealed a high prevalence of advance care plans (77-97% depending on definition) in nursing home patients.Patients with dementia more often had advance care plans, and a higher physician attendance was associated with presence of care plans.Advance care plans were positively associated with components of good palliative care, such as prescriptions of palliative drugs and information to family.
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Scand J Prim Health Care · Mar 2022
Use and quality of point-of-care microscopy, urine culture and susceptibility testing for urinalysis in general practice.
Objective: To describe the use and quality of point-of-care (POC) microscopy, urine culture and susceptibility testing performed in general practice in Northern Denmark from 2013 to 2018. Design: Descriptive studySetting: General practices receiving a fee for examining urine samples. Subjects: Simulated urine samples containing uropathogenic bacteria distributed by the organisation for improvement of microbiological quality (MIKAP). ⋯ Interestingly, microscopy was the least used method even though the result may be reached within a few minutes. Key pointsThe quality of POC tests (microscopy, urine culture, susceptibility testing) performed in general practice was high when examining urine containing E. coli, whereas difficulties were observed for samples including S. saprophyticus or K. pneumoniae. Susceptibility testing was more often performed than urine culture, which indicates a problem as only urine cultures contribute with information about the flora composition and bacterial quantification.