Journal of evaluation in clinical practice
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Infertility management in primary care is variable. National Institute of Clinical Excellence have recommended hysterosalpingography (HSG) as a first-line investigation for tubal assessment. Aim To explore general practitioners' (GPs) perceptions of, and attitudes to, the initial management of the infertile couple and their views on open access to HSG. ⋯ GPs recognize an advocacy role and many take on a significant degree of clinical responsibility welcoming the introduction of a new technology in primary care. Nevertheless, GPs feel that they lack proficiency and have little opportunity to rehearse the necessary skills. These findings contribute to an understanding of the management of infertility, an infrequently presenting problem in primary care.
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Identifying homogenous subgroups of low back pain (LBP) patients is considered a priority in musculoskeletal rehabilitation and is believed to enhance clinical outcomes. In order to achieve this, the specific features of each subgroup need to be identified. The aim of this study was to develop a list of clinical and cultural features that are included in the assessment of LBP patients in Greece, among health professionals. This 'list' will be, utilized in a clinical study for developing LBP subgroups. ⋯ An extensive Greek 'list' of clinical and cultural features was developed from the groups' analysis. Although similarities existed in most categories, there were several differences across the three focus groups which will be discussed.
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There was local concern over possible delays in the diagnosis and referral of patients with suspected colorectal cancer and interest in understanding more about patients' experiences of diagnosis. ⋯ Feeding back qualitative data from patients together with audit results seemed a powerful lever to stimulate action about hospital delays. Average waiting times dropped quickly and remained low due to the continuing national focus upon them. Seeking GP views may have promoted the use of referral pro formas, but monitoring waiting times distracted from a more thorough evaluation of their use. Qualitative data from patients raised awareness of their experience, but was time-consuming to collect and we had limited success in using it for specific initiatives around communication and support.
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To explore stakeholder perspectives of the implementation of a new, national integrated nurse-led telephone advice and consultation service [National Health Service 24 (NHS 24)], comparing the views of stakeholders from different health care organizations. ⋯ As the delivery of unscheduled primary health care crosses professional boundaries and locations, different organizations and professional groups must develop new ways of partnership working, developing trust and confidence in each other. The results of this study highlight, for the first time, the key importance of understanding the professional ownership and identity of individual organizations, in order to facilitate the most effective mechanisms to enable that partnership working.