Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.817
Filtrar
1.
Support Care Cancer ; 29(1): 223-230, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32338315

RESUMO

PURPOSE: To examine primary care physician's (PCPs) internal (confidence, training) and external (communication, receipt of survivorship care plans (SCPs)) regarding their provision of survivorship care to older breast cancer survivors METHOD: A web-based questionnaire was completed individually by PCPs about their training and areas of survivorship they address under their care. A subset of survey participants was interviewed about survivorship care for older breast cancer survivors, care coordination, and areas of improvement regarding SCPs. RESULTS: PCPs (n = 29) had an average 13.5 years in family practice. Forty-five percent surveyed as "somewhat confident" or "not confident" evaluating and managing the late effects of cancer treatment, and 25% surveyed as "somewhat confident" or "not confident" addressing the chronic comorbidities of older breast cancer survivors. More than half of PCPs surveyed that they reach out to their patients' oncologist "a little" or "none of the time" and that they receive SCPs "a little" or "none of the time." Semi-structured interviews also indicated that many PCPs did not receive a SCP from their patients' oncologists and that communication between the two providers regarding survivorship care was poor. CONCLUSION: Participants indicated that PCP confidence in providing survivorship care is lacking and that lack of training, infrequent communication with oncologists, and underutilization of SCPs may contribute to this lack of confidence. These findings provide insight into the possible need for a well-defined shared care model, which has been encouraged but not always a routine part of survivorship care in various practice settings.


Assuntos
Neoplasias da Mama/terapia , Sobreviventes de Câncer/estatística & dados numéricos , Médicos de Atenção Primária/psicologia , Atenção Primária à Saúde/métodos , Autoimagem , Adulto , Mama/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Sobrevida , Sobrevivência
2.
J Clin Pediatr Dent ; 44(4): 249-255, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-33167019

RESUMO

OBJECTIVE: To determine changes in knowledge, attitudes, and practices of primary care physicians (PCPs) regarding fluoride varnish (FV). STUDY DESIGN: Fifty-four PCPs at an urban medical center in New York completed a pre-intervention survey. A pediatric dental resident provided an hour-long educational lecture and a hands-on demonstration regarding FV application. Six months later, PCPs were sent a post-intervention survey via electronic mail. RESULTS: Fifty-four PCPs participated in the pre-survey and FV training and 48% completed the post-survey. Prior to the FV training, 57% of PCPs knew that FV application by medical practitioners was reimbursable for children under 6-years-old and 2% of PCPs were applying FV. Post FV training, 62% of PCPs reported applying FV. Pre and post survey, barriers to FV application was not enough hands-on training (43% to 15% respectively) and not enough time (50% to 85% respectively). CONCLUSIONS: Post FV training, PCPs' knowledge, attitudes and practices in regard to FV changed. Interprofessional education may be one approach to increasing FV application participation.


Assuntos
Fluoretos Tópicos , Médicos de Atenção Primária , Atitude do Pessoal de Saúde , Criança , Fluoretos , Humanos , New York , Inquéritos e Questionários
3.
Medicine (Baltimore) ; 99(45): e23031, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157953

RESUMO

RATIONALE: The evidence for outpatient pulmonary embolism (PE) management apart from hospitalization is expanding. The availability and ease of direct oral anticoagulants have facilitated this transition. The literature, however, is sparse on the topic of comprehensive management of pulmonary embolism in the primary care clinic setting. As such, the role of the primary care physician in the complete diagnosis, risk stratification for outpatient eligibility, and initiation of treatment is unclear. CASE PRESENTATIONS: Case 1: A 33-year-old man with known heterozygous Factor V Leiden mutation and a remote history of deep vein thrombosis presented to his primary care physician's office with 2 days of mild pleuritic chest pain and a dry cough after a recent transcontinental flight. Case 2: A 48-year-old man with a complex medical history including recent transverse myelitis presented to his primary care family physician with dyspnea and pleuritic chest pain for 6 days. DIAGNOSIS: Case 1: Computed tomographic pulmonary angiography that same afternoon showed multiple bilateral segmental and subsegmental emboli as well as several small pulmonary infarcts. Case 2: The patient's D-dimer was elevated at 1148 ng/mL. His physician ordered a computed tomographic pulmonary angiography, performed that evening, which showed segmental and subsegmental PE. INTERVENTIONS: Both patients were contacted by their respective physicians shortly after their diagnoses and, in shared decision-making, opted for treatment at home with 5 days of enoxaparin followed by dabigatran. OUTCOMES: Neither patient developed recurrence nor complications in the subsequent 3 months. LESSONS: These cases, stratified as low risk using the American College of Chest Physicians criteria and the PE Severity Index, are among the first in the literature to illustrate comprehensive primary care-based outpatient PE management. Care was provided within an integrated delivery system with ready, timely access to laboratory, advanced radiology, and allied health services. This report sets the stage for investigating the public health implications of comprehensive primary care-based PE management, including cost-savings as well as enhanced patient follow-up and patient satisfaction.


Assuntos
Dor no Peito/etiologia , Dispneia/etiologia , Transferência de Pacientes/métodos , Médicos de Atenção Primária/normas , Embolia Pulmonar/tratamento farmacológico , Doença Aguda , Adulto , Assistência Ambulatorial , Anticoagulantes/uso terapêutico , Antitrombinas/uso terapêutico , Dor no Peito/diagnóstico , Angiografia por Tomografia Computadorizada/métodos , Dabigatrana/uso terapêutico , Tomada de Decisão Compartilhada , Dispneia/diagnóstico , Enoxaparina/uso terapêutico , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Mielite Transversa/complicações , Mielite Transversa/diagnóstico , Transferência de Pacientes/estatística & dados numéricos , Médicos de Atenção Primária/estatística & dados numéricos , Embolia Pulmonar/diagnóstico por imagem , Medição de Risco , Resultado do Tratamento , Trombose Venosa/complicações , Trombose Venosa/diagnóstico
6.
PLoS One ; 15(10): e0230849, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031399

RESUMO

INTRODUCTION: In South Africa, in 2013-2014, provision of antiretroviral treatment (ART) shifted in some areas from NGOs to public facilities. Tuberculosis (TB) management has also been integrated into public services. We aimed to explore the opinions and experiences of service managers and healthcare providers regarding integration of HIV and TB services into primary healthcare services. METHODS: The study sites included three clinics in one peri-urban/urban administrative region of Johannesburg. From March 2015 to August 2016, trained interviewers conducted semi-structured interviews with purposively selected participants. Participants were eligible if they were city/regional managers, clinic managers, or healthcare providers responsible for HIV, TB, non-communicable diseases, or sexual and reproductive health at the three study sites. We used a grounded theory approach for iterative, qualitative analysis, and produced descriptive statistics for quantitative data. RESULTS: We interviewed 19 individuals (nine city/regional managers, three clinic managers, and seven nurses). Theoretical definitions of integration varied, as did actual practice. Integration of HIV treatment had been anticipated, but only occurred when required due to shifts in funding for ART. The change was rapid, and some clinics felt unprepared. That said, nearly all respondents were in favor of integrated care. Perceived benefits included comprehensive case management, better client-nurse interactions, and reduced stigma. Barriers to integration included staff shortages, insufficient training and experience, and outdated clinic infrastructure. There were also concerns about the impact of integration on staff workloads and waiting times. Finally, there were concerns about TB integration due to infection control issues. DISCUSSION: Integration is multi-faceted and often contingent on local, if not site-specific, factors. In the future in South Africa and in other settings contending with health service reorganization, staff consultations prior to and throughout phase-in of services changes could contribute to improved understanding of operational requirements, including staff needs, and improved patient outcomes.


Assuntos
Antivirais/uso terapêutico , Prestação Integrada de Cuidados de Saúde/estatística & dados numéricos , Infecções por HIV/tratamento farmacológico , Tuberculose/tratamento farmacológico , Atitude do Pessoal de Saúde , Feminino , Humanos , Entrevistas como Assunto , Masculino , Médicos de Atenção Primária , Atenção Primária à Saúde , Pesquisa Qualitativa , Saúde Reprodutiva , África do Sul
7.
Rev Med Suisse ; 16(707): 1767-1770, 2020 Sep 23.
Artigo em Francês | MEDLINE | ID: mdl-32969615

RESUMO

Since the creation of Balint groups in the 1950s, the concept of meeting among doctors to discuss difficult clinical situations has spread widely, whether or not in line with Michael Balint's initial model. While the latter had thought of these groups as training, their therapeutic role was quickly questioned in the medical literature. At a time when we are seeing and concerned about the poor mental health of primary care doctors, we wanted to show that the added value provided by participation in a practice exchange group is both formative and therapeutic. In this sense, the participation of GP in such a group is part of the recommendations to improve the quality of care, prevent caregivers from burnout, and improve their professional satisfaction.


Assuntos
Esgotamento Profissional/prevenção & controle , Processos Grupais , Médicos de Atenção Primária/educação , Médicos de Atenção Primária/psicologia , Humanos , Satisfação no Emprego
8.
Eur J Gen Pract ; 26(1): 129-133, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32985278

RESUMO

The COVID-19 pandemic has modified organisation and processes of primary care. In this paper, we aim to summarise experiences of international primary care systems. We explored personal accounts and findings in reporting on the early experiences from primary care during the pandemic, through the online Global Forum on Universal Health Coverage and Primary Health Care. During the early stage of the pandemic, primary care continued as the first point of contact to the health system but was poorly informed by policy makers on how to fulfil its role and ill equipped to provide care while protecting staff and patients against further spread of the infection. In many countries, the creativity and initiatives of local health professionals led to the introduction or extension of the use of telephone, e-mail and virtual consulting, and introduced triaging to separate 'suspected' COVID-19 from non-COVID-19 care. There were substantial concerns of collateral damage to the health of the population due to abandoned or postponed routine care. The pandemic presents important lessons to strengthen health systems through better connection between public health, primary care, and secondary care to cope better with future waves of this and other pandemics.


Assuntos
Infecções por Coronavirus/epidemiologia , Comportamentos Relacionados com a Saúde , Médicos de Atenção Primária , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde/métodos , Telemedicina , Triagem , Betacoronavirus , Assistência à Saúde , Humanos , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Atenção Primária à Saúde/organização & administração , Pesquisa Qualitativa , Telefone
9.
J Prim Care Community Health ; 11: 2150132720962871, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32985333

RESUMO

As COVID-19 cases began to rise in Ontario, Canada, in March 2020, increasing surge capacity in hospitals and intensive care units became a large focus of preparations. As part of these preparations, primary care physicians were ready to be redeployed to the hospitals. However, due to the effective implementation of community-wide public health measures, the hospital system was not overwhelmed. As Ontario prepares now for a potential second wave of COVID-19, primary care physicians have an opportunity to consider the full breadth and depth of scope for primary care during a pandemic. From planning to surveillance to vaccination, primary care physicians are positioned to play a unique and vital role in a pandemic. Nevertheless, there are specific barriers that will need to be overcome.


Assuntos
Infecções por Coronavirus/terapia , Pandemias , Papel do Médico , Médicos de Atenção Primária , Pneumonia Viral/terapia , Atenção Primária à Saúde , Infecções por Coronavirus/epidemiologia , Humanos , Ontário/epidemiologia , Pneumonia Viral/epidemiologia
10.
J Allergy Clin Immunol Pract ; 8(10): 3371-3377.e1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32980585

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has demonstrated significantly worse outcomes for minority (black and Hispanic) individuals. Understanding the reasons for COVID-19-related disparities among patients with asthma has important public health implications. OBJECTIVE: To determine factors contributing to health disparities in those with asthma during the COVID-19 pandemic. METHODS: An anonymous survey was sent through social media to adult patients with asthma, and a separate survey was sent to physicians who provide asthma care. The patient survey addressed demographic information including socioeconomic status, asthma control, and attitudes/health behaviors during COVID-19. RESULTS: A total of 1171 patients (10.1% minority individuals) and 225 physicians completed the survey. Minority patients were more likely to have been affected by COVID-19 (eg, became unemployed, lived in a community with high COVID-19 cases). They had worse asthma control (increased emergency visits for asthma, lower Asthma Control Test score), were more likely to live in urban areas, and had a lower household income. Initial differences in attitudes and health behaviors disappeared after controlling for baseline demographic features. Institutional racism was demonstrated by findings that minority individuals were less likely to have a primary care physician, had more trouble affording asthma medications due to COVID-19, and were more likely to have lost health insurance because of COVID-19, and that 25% of physicians found it more challenging to care for black individuals with asthma during COVID-19. CONCLUSIONS: Differences in socioeconomic status and the effects of institutional racism, but not health behaviors, sources of information, or attitudes, are playing a role in disparities seen for patients with asthma during COVID-19.


Assuntos
Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Pneumonia Viral/epidemiologia , Racismo , Desemprego/estatística & dados numéricos , Adulto , Afro-Americanos/estatística & dados numéricos , Asma/fisiopatologia , Betacoronavirus , Infecções por Coronavirus/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoas sem Cobertura de Seguro de Saúde/etnologia , Pandemias , Médicos de Atenção Primária , Pneumonia Viral/etnologia , Pneumologistas , Índice de Gravidade de Doença , Classe Social , Inquéritos e Questionários , Estados Unidos/epidemiologia
11.
PLoS One ; 15(9): e0239035, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915906

RESUMO

BACKGROUND: Trust in healthcare providers has been shown to improve several clinical and patient-reported outcomes. However, its relationship with depression and anxiety has not been investigated among patients with chronic health conditions, such as diabetes. Therefore, the aim of this study was to examine whether trust in primary care physicians among patients with diabetes is associated with their levels of depression and/or anxiety. METHOD: Adult patients (≥18 years) with a diagnosis of diabetes, confirmed through their electronic health records, were recruited and interviewed from the primary care clinics of three public hospitals. Patient trust in primary care physicians was assessed using the Health Care Relationship (HCR) Trust scale. Depression and anxiety were assessed using the Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7), respectively. Two multiple linear regression analyses were conducted to examine the association of HCR-Trust scores with PHQ-9 and GAD-7 scores controlling for age, sex, Charlson comorbidity index score, education, health literacy, annual income, nationality, duration of illness, and research site. RESULTS: The number of patients who agreed to be interviewed was 367. Most of the participants were female (61.54%) and Saudi (92.86%). High HCR-Trust scores were negatively associated with PHQ-9 scores (ß = -0.18; 95% CI: -0.23 --0.13; P = < .0001), and GAD-7 scores (ß = -0.17; 95% CI: -0.22- -0.12; P = < .0001). CONCLUSIONS: Trust in primary care physicians among patients with diabetes was associated with lower levels of depression and anxiety. Therefore, healthcare providers should adopt a patient-centered care approach that fosters trust in the relationship between their patients and themselves. Further research should explore whether interventions that foster shared decision-making and trust in healthcare providers might also improve the health outcomes of patients with diabetes.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus/psicologia , Médicos de Atenção Primária/psicologia , Relações Profissional-Paciente , Adulto , Idoso , Estudos Transversais , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Arábia Saudita/epidemiologia , Confiança
12.
Med Care ; 58(10): 853-860, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925414

RESUMO

OBJECTIVE: The objective of this study was to estimate trends in the percentage of Medicare beneficiaries cared for by nurse practitioners from 2012 to 2017, to characterize beneficiaries cared for by nurse practitioners in 2017, and to examine how the percentage of beneficiaries cared for by nurse practitioners varies by practice characteristics. DESIGN: An observational study of 2012-2017 Medicare fee-for-service beneficiaries' ambulatory visits. We computed the percentage of beneficiaries with 1 or more ambulatory visits from nurse practitioners and the percentage of beneficiaries receiving the plurality of their ambulatory visits from a nurse practitioner versus a physician (ie, predominant provider). We compared beneficiary demographics, clinical characteristics, and utilization by the predominant provider. We then characterized the predominant provider by practice characteristics. KEY RESULTS: In 2017, 28.9% of beneficiaries received any care from a nurse practitioner and 8.0% utilized nurse practitioners as their predominant provider-an increase from 4.4% in 2012. Among beneficiaries cared for by nurse practitioners in 2017, 25.9% had 3 or more chronic conditions compared with 20.8% of those cared for by physicians. Beneficiaries cared for in practices owned by health systems were more likely to have a nurse practitioner as their predominant provider compared with those attending practices that were independently owned (9.3% vs. 7.0%). CONCLUSIONS: Nurse practitioners are caring for Medicare beneficiaries with complex needs at rates that match or exceed their physician colleagues. The growing role of nurse practitioners, especially in health care systems, warrants attention as organizations embark on payment and delivery reform.


Assuntos
Medicare/estatística & dados numéricos , Múltiplas Afecções Crônicas/terapia , Profissionais de Enfermagem/tendências , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Médicos de Atenção Primária/tendências , Estados Unidos
13.
Rev Med Suisse ; 16(704): 1579-1581, 2020 Sep 02.
Artigo em Francês | MEDLINE | ID: mdl-32880116

RESUMO

Collaboration between primary care medicine and psychiatry is a well-known challenge. In order to improve access to psychological care for patients undergoing primary care, the «â€…group medical practices ¼ project proposes a collaborative care model in which a psychiatrist employed by a public psychiatric institution integrates group medical practices in order to provide assistance to primary care physicians. It is thus able to evaluate patients directly in the practices and to offer supervision and consilium spaces to primary care physicians.


Assuntos
Atenção Primária à Saúde , Psiquiatria , Humanos , Médicos de Atenção Primária
16.
N Engl J Med ; 383(14): 1349-1357, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32997909

RESUMO

BACKGROUND: The gender gap in physician pay is often attributed in part to women working fewer hours than men, but evidence to date is limited by self-report and a lack of detail regarding clinical revenue and gender differences in practice style. METHODS: Using national all-payer claims and data from electronic health records, we conducted a cross-sectional analysis of 24.4 million primary care office visits in 2017 and performed comparisons between female and male physicians in the same practices. Our primary independent variable was physician gender; outcomes included visit revenue, visit counts, days worked, and observed visit time (interval between the initiation and the termination of a visit). We created multivariable regression models at the year, day, and visit level after adjustment for characteristics of the primary care physicians (PCPs), patients, and types of visit and for practice fixed effects. RESULTS: In 2017, female PCPs generated 10.9% less revenue from office visits than their male counterparts (-$39,143.2; 95% confidence interval [CI], -53,523.0 to -24,763.4) and conducted 10.8% fewer visits (-330.5 visits; 95% CI, -406.6 to -254.3) over 2.6% fewer clinical days (-5.3 days; 95% CI, -7.7 to -3.0), after adjustment for age, academic degree, specialty, and number of sessions worked per week, yet spent 2.6% more observed time in visits that year than their male counterparts (1201.3 minutes; 95% CI, 184.7 to 2218.0). Per visit, after adjustment for PCP, patient, and visit characteristics, female PCPs generated equal revenue but spent 15.7% more time with a patient (2.4 minutes; 95% CI, 2.1 to 2.6). These results were consistent in subgroup analyses according to the gender and health status of the patients and the type and complexity of the visits. CONCLUSIONS: Female PCPs generated less visit revenue than male colleagues in the same practices owing to a lower volume of visits, yet spent more time in direct patient care per visit, per day, and per year. (Funded in part by the Robert Wood Johnson Foundation.).


Assuntos
Médicos de Atenção Primária/economia , Atenção Primária à Saúde/economia , Estudos Transversais , Registros Eletrônicos de Saúde , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Assistência ao Paciente , Atenção Primária à Saúde/organização & administração , Fatores Sexuais , Fatores de Tempo , Estados Unidos , Carga de Trabalho
17.
Univ. salud ; 22(2): 127-136, mayo-ago. 2020. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1115962

RESUMO

Introducción: La migración es un fenómeno a nivel mundial que involucra a los trabajadores de las diferentes áreas como son los profesionales de la salud. Objetivo: Determinar factores de atracción-expulsión que han motivado a los médicos extranjeros a migrar escogiendo a Chile como destino, desde la perspectiva de los encargados de salud en Atención Primaria de Salud. Materiales y métodos: Estudio de caso teórico-explicativo con abordaje cualitativo en epidemiología crítica, realizado en la municipalidad de Pedro Aguirre Cerda (Chile). Se aplicó entrevistas individuales semiestructuradas a actores tomadores de decisión en la APS. Resultados: Se identificó como factores de atracción la permanencia del médico extranjero en APS, se reconoce a Chile como su hogar, relación oferta y demanda de trabajo con alta rotación. Factores expulsión: ausencia de una política de incorporación e incentivo para los médicos al servicio de APS, formación profesional diferenciada en el extranjero. Conclusiones: La identificación de factores que influyen en la atracción y expulsión de médicos en Chile, permite generar políticas públicas que mejoren las condiciones laborales de estos profesionales.


Introduction: Migration is a worldwide phenomenon that affects workers from different areas, including health professionals. Objective: To determine the attraction-expulsion factors that have motivated foreign medical doctors to migrate to Chile, this study analyzed the perspective of those who are responsible for health care in the Primary Health Care model. Materials and methods: A theoretical-explanatory case study was carried out in the municipality of Pedro Aguirre Cerda (Chile), using a qualitative approach in critical epidemiology. Individual semi-structured interviews were administered to decision-making personnel in the Primary Health Care model. Results: The following were identified as attraction factors: (i) job stability of foreign physicians at the PHCs; (ii) recognition of Chile as their home; and (iii) the supply-demand relationship seen in high-rotation jobs. On the other hand, the absence of policies of inclusion and incentives for physicians working at PHCs, and differences in medical professional training abroad were characterized as expulsion factors. Conclusions: The identification of factors that influence the attraction and expulsion of medical doctors to/from Chile contributes to generating public policies that improve the working conditions of these health professionals.


Assuntos
Políticas Públicas de Saúde , Migração Humana , Atenção Primária à Saúde , Médicos de Atenção Primária , América Latina
19.
Healthc Q ; 23(2): 9-15, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32762813

RESUMO

Setting: Primary care is the first line of defence in healthcare, particularly during the coronavirus disease 2019 (COVID-19) pandemic. In the London-Middlesex region of Ontario, a critical shortage of personal protective equipment (PPE) was identified among primary care physicians (PCPs). Intervention: With the help of the London-Middlesex Primary Care Alliance, volunteer administrators, physicians and medical students coordinated the acquisition and redistribution of community-donated PPE to PCPs across London-Middlesex. Our scope evolved to include PPE reusability and stewardship and PCP wellness. Outcome: Beginning on March 16, 2020, our initial four-week operation provided PPE to over 200 PCPs. We received 60 donations, including over 118,000 gloves, 13,700 masks, 700 wellness kits and reusable cloth masks and gowns. Each delivery included educational pamphlets, and our online PPE stewardship session was attended by over 30 physicians. Implications: In response to the PPE shortage in COVID-19, our efforts evolved into a complex adaptive system, supported by an organizational body with a pre-existing communication infrastructure, to great success. Our scope extended beyond simple PPE provision to PCPs. Furthermore, our initiative established a framework for a centralized response to PPE shortage in Ontario Health West.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Médicos de Atenção Primária , Pneumonia Viral/prevenção & controle , Betacoronavirus , Humanos , Ontário , Equipamento de Proteção Individual/normas , Estudantes de Medicina , Voluntários
20.
Wien Med Wochenschr ; 170(13-14): 329-339, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32767159

RESUMO

Time and again, it is discussed that in medical practices, the number of patients who develop health anxieties due to extensive health information searches on the Internet is increasing. The objective of this study is to explore and describe general practitioners' experiences and attitudes towards cyberchondria patients as well as strategies to stabilize affected patients. Following a qualitative approach, oral personal semi-standardized interviews with general practitioners (N = 38) in Rhineland-Palatinate, Germany, were conducted in 2019. In the course of a content analysis, one can see that most interviewees see the emergence of Internet-related health anxieties as an increasing problem in everyday care. Affected patients not only show marked levels of doubt and nervousness as well as hypersensitivity to their own state of health, but also low confidence in the physician. In addition to compliance-related difficulties, the high need for advice and the demand for further diagnostics are regarded as major problems. Various approaches were identified by which general practitioners respond to unsettled patients (more consultation time, recommendation of reputable websites, information double-checking, expanded history questionnaire, additional psychosocial training).


Assuntos
Clínicos Gerais , Médicos de Atenção Primária , Ansiedade , Atitude do Pessoal de Saúde , Alemanha , Humanos , Internet , Pesquisa Qualitativa
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA