Medical Doctors Approaches and Understanding of Health Literacy: A Systematic Literature Review.

A physician's role is critical in fostering patient health literacy (HL) and influencing various aspects, including patient-physician communication and treatment effectiveness. The purpose of this systematic literature review is to analyze physicians' perspectives, comprehension, and management of HL. The focus of this review is on physicians' views, opinions, experiences, and strategies related to HL. We conducted comprehensive searches across seven databases, including PubMed, Scopus, ProQuest, Science Direct, Web of Science, The Cochrane Library, and Google Scholar. Original research articles published between January 1, 2009, and July 31, 2020, were considered for inclusion. This literature review incorporates qualitative studies and mixed-methods studies, with a focus on extracting qualitative data. Among the 22 articles included in our review, we employed the method of inductive thematic analysis for data analysis. A detailed description of the review methodology can be found in a previously published protocol available through PROSPERO (CRD42020212599). The themes that emerged from the thematic analysis include: (a) physicians' perception and management of HL; and (b) barriers. The results of the systematic review reveal that healthcare professionals exhibit varying perceptions of patients' HL levels and ascribe different meanings to it. However, none of them employ a specific measuring tool. While there appears to be no uniform approach to managing patients with low HL, some prioritize certain communication strategies, such as repetition, simplified language, and providing written instructions, among others. Most physicians cited multiple barriers that impede the development of patients' HL, including dysfunctions within the healthcare system, staff shortages, managing a large number of patients, limited time, work-related stress, cultural and socio-economic barriers, medical jargon, and language barriers. Considering the pivotal role of physicians in fostering patient HL, it is crucial to enhance medical education in addressing and managing HL, both within academic curricula and through continuing education seminars. Furthermore, there is a pressing need to improve healthcare professionals' working conditions, ensuring that each physician can allocate the necessary time to each patient based on their individual needs, without being hindered by stress-inducing work environments.

The psychological impact of COVID-19 pandemic on primary health care professionals in Greece.

Pandemics precipitate feelings of discomfort and anxiety in healthcare professionals. This study investigates the prevalence of anxiety and depression among public primary health care professionals (PHCPs) in Greece, along with the demographic risk factors, during the second wave of the COVID-19 pandemic, in order to address work exhaustion and protect frontline professionals' psycho-emotional balance. This cross-sectional study was conducted from June 2021 to August 2021, using an online questionnaire (demographic data, GAD-7, PHQ-9). Eligible participants (medical, nursing, allied professionals) were PHCPs employed in Greek public PHC facilities. Analysis involved descriptive statistics to present sociodemographic characteristics, participants' experience with COVID-19, anxiety and depression levels. Univariate analysis was performed to evaluate the association between sociodemographic factors and the anxiety and depression levels, and multivariable logistic regression was used to investigate the presence of predictive factors for anxiety and depression. In total, 236 PHCPs participated in the study, with a mean age of 46 (SD 9.3) years and a mean professional experience of 14.71 (SD 9.2) years. Most participants were women (71.4%) and the majority were General Practitioners (38.9%) and Nurses (35.2%). Anxiety (33.1% mild, 29.9% moderate/ severe) and depression (33.9% mild, 25.9% moderate/ severe) were prevalent among PHCPs. The female gender is the most important predictor of anxiety manifestations (OR:3.50, 95%CI:1.39-10.7; p=0.014). Participants older than 50 years have a lower risk of both anxiety (OR=0.46, 95%CI:0.20-0.99; p=0.049) and depression (OR=0.48, 95%CI:0.23-0.95; p=0.039). PHCPs working in rural facilities have a lower risk of anxiety (OR:0.34, 95%CI:0.137-0.80; p=0.016). Previous infection with SARS-CoV-2 was not associated either with anxiety (p=0.087) or with depression (p=0.056). Notably, having a friend, relative, or coworker who was hospitalized for COVID-19 or died from it, was not associated with the presence of anxiety or depressive symptoms. Additionally, living with someone in a high-risk group for severe SARS-CoV-2, living with children or being at high risk for severe COVID-19 was not associated with higher GAD-7 and PHQ-9 scores. Findings indicate concerning levels of psychological distress among PHCPs. Early recognition of emotional discomfort in PHCPs and the prompt intervention could reinforce PHCPs' resilience against the pandemic.

Exploring why European primary care physicians sometimes do not think of, or act on, a possible cancer diagnosis. A qualitative study.

BACKGROUND: While primary care physicians (PCPs) play a key role in cancer detection, they can find cancer diagnosis challenging, and some patients have considerable delays between presentation and onward referral. AIM: To explore European PCPs' experiences and views on cases where they considered that they had been slow to think of, or act on, a possible cancer diagnosis. DESIGN & SETTING: A multicentre European qualitative study, based on an online survey with open-ended questions, asking PCPs for their narratives about cases when they had missed a diagnosis of cancer. METHOD: Using maximum variation sampling, PCPs in 23 European countries were asked to describe what happened in a case where they were slow to think of a cancer diagnosis, and for their views on why it happened. Thematic analysis was used to analyse the data. RESULTS: A total of 158 PCPs completed the questionnaire. The main themes were as follows: patients' descriptions did not suggest cancer; distracting factors reduced PCPs' cancer suspicions; patients' hesitancy delayed the diagnosis; system factors not facilitating timely diagnosis; PCPs felt that they had acted wrongly; and problems with communicating adequately. CONCLUSION: The study identified six overarching themes that need to be addressed. Doing so should reduce morbidity and mortality in the small proportion of patients who have a significant, avoidable delay in their cancer diagnosis. The 'Swiss cheese' model of accident causation showed how the themes related to each other.