Search results for "Primary care"

Planning integrated care at primary care centres: lessons learnt through research in stratification tools in the Valencian Healthcare System

2018

Introduction and policy context: In the Valencian Region social services and the healthcare system are not connected. Also there is not any normative jointly regulating resources, services or aid benefits that would mean an integrated care IC portfolio.  Primary care PC centres are the closest and most trustworthy care facility for patients in the Spanish context. Also, PC is one of the most suitable resources to address needs of complex patients, as elderly and/or those with chronic conditions, through an IC approach, but there are some barriers that block its real and effective deployment. Objective and target population: Authors have studied the viability, implementation and development …

Classification characteristics of the Patient Health Questionnaire-15 for screening somatoform disorders in a primary care setting

2011

Abstract Background This study examines how effectively the Patient Health Questionnaire-15 (PHQ-15), a self-administered screening instrument, recognizes somatoform symptoms and somatoform disorders in a German primary care setting. Methods A selected sample of 308 patients (mean age 47.2 years, 71.4% women) from two regular primary care practices was screened with the PHQ-15 and additionally examined with structured interviews. Their primary care physicians rated symptoms reported in the interview as either “medically explained” or “medically unexplained.” Results Seventy-six percent of the symptoms were judged as medically unexplained. The PHQ-15 correlated significantly with the total n…

Brief depression among patients in general practice

1994

Depression with substantial psychosocial impairment, but not qualifying as depressive disorder according to the standard diagnostic manuals, is frequent among primary care patients. Recurrent brief depression (RBD) is a diagnostic category intended to identify a major proportion of this group of patients. The WHO study on "Psychological Problems in Primary Health Care" was used as a vehicle to estimate the proportion of patients with this diagnosis and to evaluate the validity of this diagnosis as well as of alternative concepts of brief depression with multiple episodes. This study applies a two-stage sampling scheme; 300 patients also underwent an additional interview tailored for variant…

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Socie…

2020

This is a pre-copyedited, author-produced version of an article accepted for publication in European Journal of Preventive Cardiology following peer review. The version of record Piepoli, M.F., Abreu, A., Albus, C., Ambrosetti, M., Brotons, C., Catapano, A.L. ... Tiberi, M. (2020). Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology*. European Journal of Preventive Cardiology (EJPC), 27(2), 181-205 is available online at: https://doi.org/10.1177/2047487319893035. European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regu…

Rural–urban inequalities in detection rates of colorectal tumours in the population

2011

Abstract Background Because few data are available on this topic, we investigated the influence of geographical determinants on colorectal adenoma detection and cancer incidence rates. Methods Between 1990 and 1999, 6220 Cote d’Or inhabitants (France) were first-diagnosed with a colorectal adenoma, and 2389 with an invasive adenocarcinoma. The impact of the rural–urban place of residence and of a physician location in municipalities on adenoma and cancer detection rates was studied using Poisson regression. Results World-standardized adenoma detection rate was significantly higher in urban areas (102 [95%CI: 97–107]) than in rural areas (78 [95%CI: 72–84]). The impact of the absence of phys…

2014

The patient-doctor relationship (PDR) as perceived by the patient is an important concept in primary care and psychotherapy. The PDR Questionnaire (PDRQ-9) provides a brief measure of the therapeutic aspects of the PDR in primary care. We assessed the internal and external validity of the German version of the PDRQ-9 in a representative cross-sectional German population survey that included 2,275 persons aged>=14 years who reported consulting with a primary care physician (PCP). The acceptance of the German version of this questionnaire was good. Confirmatory factor analysis demonstrated that the PRDQ-9 was unidimensional. The internal reliability (Cronbach's ?) of the total score was .95. …

Is interpersonal counselling (IPC) sufficient treatment for depression in primary care patients? A pilot study comparing IPC and interpersonal psycho…

2015

Abstract Background Psychotherapeutic treatment is underused in primary care, where even short-term psychotherapy can be perceived as too lengthy and labour-intensive. We tested here for the first time the preliminary efficacy of seven sessions of interpersonal counselling (IPC) by comparison with sixteen sessions of interpersonal psychotherapy (IPT) in regular clinical settings. Methods Patients seeking treatment for the first time who met the DSM-IV criteria for major depressive disorder (MDD, mild/moderate) were randomized to either IPC ( n =20) or IPT ( n =20). The efficacy of the treatments was assessed using the 34-item Clinical Outcomes in Routine Evaluation (CORE-OM) scale and the B…

Comorbidities and quality of life in obstructed adults in a primary care setting

2016

Introduction: Comorbidities are known to impair Quality of Life (QoL)in patients with chronic obstruction pulmonary disease. A poor QoL is associated with higher dyspnoea perception. How comorbidities influence QoL in these patients is limited and needs clarification. Aim: To study the role of dyspnoea perception in the relationship between comorbidities number and QoL in obstructed and not obstructed adults in a primary care setting. Methods: Seventeen general practitioners participated to the study: 566 adults, attending the Practitioner9s study for any reason, performed spirometry and fulfilled a respiratory questionnaire between January and June 2014. 259 adults (148 M, aged 40-88) acce…

Adult children and parental care-giving: making sense of participation patterns among siblings

2010

ABSTRACTThe aim of this article is to analyse 20 Finnish working carers' perceptions of their sibling relations and the sharing of the responsibility for parental care. The main focus is on the interviewees' rationales for the participation or non-participation of their siblings in the parents' care. Almost all the interviewed carers stated that the division of care responsibilities is unequal and that they are the primary carers, but the majority did not convey any clear intention to try to persuade their siblings to increase their participation in parental care. In many cases, the siblings were described either as entirely absent or as providing occasional backup, but some interviewees re…

Consumo de hierbas medicinales y medicamentos

2001

ObjetivoDada la posibilidad de efectos adversos, interacciones con medicamentos e intoxicaciones por contaminantes entre consumidores de hierbas medicinales (HM), nuestro objetivo es describir el consumo de HM en usuarios de los centros de salud en tratamiento con medicamentos.DiseñoEstudio observacional, transversal.EmplazamientoTrece centros de salud de la Comunidad Valenciana.Pacientes u otros participantesUsuarios, de sexo indistinto, mayores de 14 años, seleccionados para un estudio de utilización de medicamentos para encontrar diferencias entre sexos. Mediciones y resultados principales. Las variables de estudio, edad, sexo, nivel educativo, consumo de medicamentos y uso de HM se reco…