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
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.
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Scand J Prim Health Care · Mar 2022
GP strategies to avoid imaging overuse. A qualitative study in Norwegian general practice.
The aim of the study was to identify general practitioners' (GPs) strategies to avoid unnecessary diagnostic imaging when encountering patients with such expectations and to explore how patients experience these strategies. ⋯ GPs largely combine different strategies when meeting patients' expectations of diagnostic imaging that are not strictly medically indicated. Continuity of the doctor-patient relationship with good personal knowledge and trust between doctor and patient appeared crucial for patients to accept the doctors' decisions.Key pointsGPs usually combine a broad range of strategies to avoid unnecessary medical imagingThe patients appeared generally satisfied regardless of the strategy the strategy used by the GPs and even where their referral request were rejectedFactors related to a long-term doctor-patient relationship appeared decisive.
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Scand J Prim Health Care · Mar 2022
Who should talk with patients about their end-of-life care wishes? A nationwide survey of the Hungarian population.
To explore the needs and opportunities of the general population to communicate their end-of-life care wishes and to investigate what roles are assigned to healthcare providers and family members in end-of-life care discussions. ⋯ Compared to their needs, the general population had fewer opportunities to speak about death, dying and preparing for death. Training programs for healthcare providers, particularly GPs, and public awareness campaigns may support the broader application of advance care planning in Hungary.Key PointsCurrent guidelines recommend that GPs initiate advance care planning discussions. However, little is known with whom the general population wish to discuss their end-of-life care preferences and with whom there is an opportunity to do so.An almost equal level of engagement was expected from healthcare providers -especially physicians- and family members in end-of-life conversations. Most of the general population thought that participation in end-of-life discussions was also the GPs' task.The majority of participants reported that there was no one among their healthcare providers and a sizable minority felt that there was no one among their family members or friends with whom they could talk openly about death, dying, and preparing for death.The highest levels of unmet needs regarding end-of-life conversations with healthcare providers were found among those who considered it important to discuss their end-of-life care wishes.