Search results for "Primary health"
showing 10 items of 185 documents
The Norwegian Healthy Life Centre Study: A pragmatic RCT of physical activity in primary care.
2018
Aims: The aim of this study was to evaluate the effect of behaviour change interventions at Norwegian Healthy Life Centres (HLCs) on participants’ moderate to vigorous intensity physical activity (MVPA) six months after baseline. We also explore predictors of change in MVPA, and if level of education and MVPA at baseline modify the effect. Methods: A randomised controlled trial with inclusion criteria age ⩾ 18 years and ability to participate in group-based physical activity. Participants were randomised to either behaviour change interventions or a waiting list (control). Objective recordings of physical activity were the main outcome, analysed with simple and multiple linear regression. …
Recurrent brief depression in general practice. Clinical features, comorbidity with other disorders, and need for treatment.
1994
This study tested the clinical validity of the new diagnostic entity "recurrent brief depression" (RBD) in 300 general practice patients who participated in the WHO study on "Psychological Problems in Primary Care." Patients with current RBD reported of episodes major depression more often than did a comparison group of nondepressed general practice patients: however, the majority of RBD patients had not received a diagnostic of any well-established affective disorder during the last 12 months. RBD patients (without MDE) did not suffer more frequently from dysthymia, from nonaffective psychiatric disorders, or from somatic disorders. However, RBD was associated with a higher percentage of p…
Course and prediction of somatoform disorder and medically unexplained symptoms in primary care
2011
Abstract Theory/objective Somatoform disorder (SFD) is associated with considerable psychosocial impairment. However, only a few studies have dealt with the course of this clinical subgroup. Therefore, the objective was to identify predictors for the various courses of SFD and medically unexplained symptoms (MUS). Method We screened 620 consecutive patients in primary care using the Patient Health Questionnaire (PHQ-15). Afterwards, 308 patients were studied in more detail using a diagnostic interview and a set of questionnaires. One year later, we were able to interview 277 participants a second time. Result After 1 year, 48.8% of the respondents had a remitted SFD. The following variables…
Are primary-care physician practices related to health behaviors likely to reduce social inequalities in health?
2017
Abstract Our objective was to examine patients' health behaviors and the related practices of their primary-care physicians to determine whether physicians' actions might help to reduce the social inequalities in health behaviors among their patients. Fifty-two general practitioners, who were also medical school instructors in the Parisian area, volunteered to participate. A sample of 70 patients (stratified by sex) aged 40–70 years was randomly chosen from each physician's patient panel and asked to complete a questionnaire about their social position and health behaviors: tobacco and alcohol use, diet, physical activity, and participation in breast and cervical cancer screening. Each phys…
Screening for generalized anxiety disorder in Spanish primary care centers with the GAD-7.
2017
The aim of the study was to determine the criterion validity of a computerized version of the General Anxiety Disorder-7 (GAD-7) questionnaire to detect general anxiety disorder in Spanish primary care centers. A total of 178 patients completed the GAD-7 and were administered the Composite International Diagnostic Interview (CIDI) for DSM-IV Axis I Disorders, which was used as a reference standard. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. A cut-off of 10 yielded a sensitivity of .87, a specificity of .78, a positive predictive value of .93, a negative predictive value of .64, a positive likelihood ratio o…
Role of out of hours primary care service in limiting inappropriate access to emergency department
2017
Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013. Out of 5217 patients accessing the OOH service, 408 referrals were included in our analysis. 45.3% (185) of the referrals were admitted to hospita…
Predictors of suicidal ideation in depressive primary care patients.
2009
Suicidal ideation is common in patients suffering from depression, but it often remains undetected. General practitioners play an important role in the management of depression and suicidality. The aim of this study was to identify predictors for suicidal ideation in patients with major depression in primary health care.We conducted a cross-sectional study. Patients were recruited from 74 primary care practices in Germany. Data was collected between April 2005 and July 2006. We calculated a binary logistic regression model to evaluate whether depression severity (Patient Health Questionnaire, PHQ-9), physical pain (SF-36 Physical Pain Scale), physical comorbidity, intake of antidepressant m…
Psychiatric diagnosis in primary care patients with increased depressive symptoms.
2019
Screening of depression has been recommended in primary care and Beck's 21-item Depression Inventory (BDI-21) is a commonly used tool for screening. Depression has been shown to be frequently accompanied by comorbidities.This study aimed to analyze the characteristics, psychiatric diagnoses, and psychiatric comorbidity of primary care patients who have been screened for depression and referred to a depression nurse.The study subjects were primary care patients aged ≥ 35 years with depressive symptoms (BDI-21 9). Their psychiatric diagnosis were based on a diagnostic interview (Mini-International Neuropsychiatric Interview; M.I.N.I.) conducted by a trained study nurse.Of the 705 study subje…
Diagnosing ICD-10 depressive episodes: superior criterion validity of the Patient Health Questionnaire.
2004
<i>Background:</i> Diagnosing and monitoring depression in primary care remains an issue of significant public health concern. Clinicians and researchers need to know if any one screening instrument is superior to the others in diagnosing ICD-10 depressive episodes. This study aimed to examine the criterion validity for diagnosing ICD-10 depressive episodes of the Patient Health Questionnaire (PHQ) in comparison with 2 well-established instruments, the Hospital Anxiety and Depression Scale (HADS), and the WHO Well-Being Index 5 (WBI-5). <i>Methods:</i> Five hundred and one medical outpatients completed the questionnaires and had a clinical interview. The presence of …
Utility of the PHQ-9 to identify major depressive disorder in adult patients in Spanish primary care centres.
2017
Abstract Background The prevalence of major depressive disorder (MDD) in Spanish primary care (PC) centres is high. However, MDD is frequently underdiagnosed and consequently only some patients receive the appropriate treatment. The present study aims to determine the utility of the Patient Health Questionnaire-9 (PHQ-9) to identify MDD in a subset of PC patients participating in the large PsicAP study. Methods A total of 178 patients completed the full PHQ test, including the depression module (PHQ-9). Also, a Spanish version of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was implemented by clinical psychologists that were blinded to the PHQ-9 results. We evaluat…