scholarly journals Shoulder pain in primary care: frozen shoulder

2016 ◽  
Vol 8 (1) ◽  
pp. 44 ◽  
Author(s):  
Angela Cadogan ◽  
Khalid D. Mohammed

ABSTRACT BACKGROUND AND CONTEXT Frozen shoulder is a painful condition that follows a protracted clinical course. We aim to review the management of patients with a diagnosis of frozen shoulder who are referred for specialist orthopaedic evaluation against existing guidelines in primary care. ASSESSMENT OF PROBLEM Referrals and clinical records were reviewed for all patients referred for orthopaedic specialist assessment who received a specialist diagnosis of frozen shoulder. Diagnostic, investigation and management practices from a regional primary health care setting in New Zealand were compared with guideline-recommended management. RESULTS Eighty patients with frozen shoulder were referred for orthopaedic evaluation in the 13 month study period, mostly from general practice. Fifteen patients (19%) were identified as having a frozen shoulder in their medical referral. Most (99%) had received previous imaging. Seven patients (12%) had received guideline recommended treatment. STRATEGIES FOR IMPROVEMENT Education of all clinicians involved in patient management is important to ensure an understanding of the long natural history of frozen shoulder and provide reassurance that outcomes are generally excellent. HealthPathways now include more information regarding diagnosis, imaging and evidence-based management for frozen shoulder. LESSONS Frozen shoulder may be under-diagnosed among patients referred for orthopaedic review. Ultrasound imaging is commonly used and may identify occult and unrelated pathology in this age-group. When managed according to clinical guidelines, patients report significant clinical and functional improvement with most reporting 80% function compared with normal after 1 year. KEYWORDS Adhesive capsulitis; bursitis; injections; practice guideline; primary health care; ultrasound

Author(s):  
Erno Harzheim ◽  
Luiz F. Pinto ◽  
Otávio P. D'Avila ◽  
Lisiane Hauser

Background: South Africa started to lead the cross-culturally validation and use of the Primary Care Assessment Tool (PCAT) in Africa, when Professor Bresick filled a gap, as this continent was until then the only one that had never used it in evaluation of primary health care facilities until 2015.Aim: The authors aim to demonstrate that after the consolidation of Bresick’s team to an African version of PCAT, it had been adapted to household survey in Brazil.Methods: In this letter, authors reflect on how Brazil had adapted PCAT to a national random household survey with Brazilian National Institute of Geography and Statistics (IBGE) – the Brazilian Census Bureau.Results: In the the beginning of 2019, Brazilian Ministry of Health brought back the PCAT as the official national primary health care assessment tool. Brazilian National Institute of Geography and Statistics (IBGE) included a new module (set of questions) in its National Health Survey (PNS-2019) and collected more than 100 000 households interviews in about 40% of the country’s municipalities. This module had 25 questions of the Brazilian validated version of the adult reduced PCAT.Conclusion: We believe that IBGE innovation with the Ministry of Health can encourage South Africa to establish a similar partnership with its National Institute of Statistics (Statistics South Africa) for the country to establish a baseline for future planning of primary health care, for decision-making based on scientific evidence.


2019 ◽  
Vol 72 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Leonardo Barbosa Rolim ◽  
Janássia Gondim Monteiro ◽  
Anya Pimentel Gomes Fernandes Vieira Meyer ◽  
Sharmênia de Araújo Soares Nuto ◽  
Márcio Flávio Moura de Araújo ◽  
...  

ABSTRACT Objective: To evaluate the Primary Health Care attributes of Fortaleza city, Ceará State. Method: Evaluative study carried out at 97 Primary Health Care Units, from August 2015 to June 2016. 451 professionals from the Family Health Strategy participated in the study. We used the Primary Care Assessment Tool - Brazil, which evaluates the attributes, assigning scores on a scale of zero to ten. We adopted as a cut-off point, to consider high Primary Care score, attributes with a value of 6.60 or higher. Results: Among the eight attributes evaluated the First Contact Access and the Coordination - Information System were the ones that obtained the lowest and highest scores, (2.98) and (7.82), respectively. The Overall Score, calculated by means of a mean of the attributes, was 6.34. Conclusion: The Primary Care evaluated had a low score, showing the need to discuss mechanisms to boost the attributes that obtained low scores.


2017 ◽  
Vol 26 (2) ◽  
Author(s):  
Graziela Piovesan ◽  
Cristiane Cardoso de Paula ◽  
Luis Felipe Dias Lopes ◽  
Stela Maris de Mello Padoin ◽  
Raquel Einloft Kleinubing ◽  
...  

ABSTRACT Objective: evaluate, based on the professionals’ experience, the primary health care quality in home cities of children and adolescents with HIV, treated at a specialized service. Method: cross-sectional study involving 527 professionals in 25 interior cities in Rio Grande do Sul, Brazil, in the first semester of 2014. The Primary Care Assessment Tool was applied. Pearson’s chi-square Test, the Mann Whitney Test and the Poisson Regression were used. Results: the Estratégia Saúde da Família and the primary health care service presented a high score related to the essential attributes: longitudinality (7.17 and 6.74), coordination-integration of care (6.87 and 7.03) and coordination-information systems (8.24 and 8.19); and a low score for the attribute access (3.96 and 3.8). The variables: female gender (0.009), education as general practitioner (<0.001), statutory staff (0.029), coordinator position (0.087) and not having another job (0.027) were also associated with the high score. Conclusion: the coverage of the Estratégia Saúde da Família needs to be expanded and structural and organizational shortages in the access need to be overcome.


Author(s):  
Adênia Káren Cardoso Costa ◽  
Anne Katherine Nascimento Mesquita ◽  
Anny Giselly Milhome Milhome da Costa Farre ◽  
Karenine Maria Holanda Cavalcante ◽  
Maria do Socorro Claudino Barreiro

Objetivo: avaliar a efetividade da assistência primária as crianças menores de cinco anos de idade cadastradas em uma Clínica de Saúde da Família, Lagarto-SE. Método: trata-se de uma pesquisa de resultados, de abordagem quantitativa e delineamento transversal, no qual se utilizou Primary Care Assessment Tool – Versão Criança para avaliação dos atributos de acesso, longitudinalidade, coordenação, integralidade, orientação familiar e orientação comunitária. Resultados: foram entrevistados 50 adultos, responsáveis por crianças de até cinco anos de idade cadastradas no serviço. A avaliação foi positiva para o grau de afiliação e o atributo coordenação-sistema de informações, e os demais não alcançaram o escore mínimo de referência. Conclusão: os atributos revelam há barreiras no acesso ao serviço, falha na continuidade do atendimento, fragilidade na referência e contra-referência e comprometimento na comunicação profissionais de saúde-paciente.


2020 ◽  
Author(s):  
WeiWei Zhang ◽  
Yuankai Huang ◽  
Gaojie Li ◽  
Hongjie Zhou ◽  
Xiaoyu Xi

Abstract Background Patient bypass often occurs under the loose gatekeeper system. Additionally, patients’ perceived quality of primary health care (PHC) is one of the important factors affecting bypass behaviour. Objective to explore individuals’ bypass behaviour in China and the associations between patients’ perceived quality of PHC and their bypass behaviour. MethodIn 2019, this study investigated Chinese bypass behaviour and the potential influencing factors. The questionnaire that was used assessed the following: the perceived quality of primary care using the Primary Care Assessment Tool; bypass experience; age; health insurance; and other factors. A logit regression model was used to analyse the impact of perceived quality of PHC on bypass behaviour. Results The data of 2070 residents in 706 health care facilities in China were collected. The results show that perceived quality of PHC is significantly associated with bypass behaviour in China. After adjustments were made for patients’ sociodemographic and other characteristics, an increase of one standard deviation (SD; odds ratio (OR) per 1-SD increase) in the PCAT scores led to a 2% decrease in bypass behaviour (OR 0.98, p<0.05). Gender, hukou and cold fee for PHC were negatively associated with bypass behaviour. Conclusion Patients' perceptions of PHC service quality play an active role in reducing their bypass behaviour, which may provide a new perspective for the design of PHC health policies.


2020 ◽  
Vol 23 ◽  
Author(s):  
Débora Deus Cardozo ◽  
Caroline Stein ◽  
Lisiane Hauser ◽  
Liége Teixeira Fontanive ◽  
Erno Harzheim ◽  
...  

ABSTRACT: Objective: To test the factorial validity and reliability of the Primary Care Assessment Tool adapted to Oral Health, adult patient version, an instrument used to verify the presence and extent of attributes in Primary Health Care services. Methods: Population-based cross-sectional study using conglomerate random sample carried out in Primary Health Care Dental services in Porto Alegre between 2011 and 2013. We interviewed 407 adult patients who used Primary Health Care Dental services. Construct validity was tested through factorial validity and reliability of the Primary Care Assessment Tool, that comprises 81 items distributed throughout Primary Health Care attributes. Equamax orthogonal rotation method was used in the factorial analysis; and, in order to assess reliability of each component, we used the item-total correlation and the ratio of success of the scale. Results: In the factorial analysis, 10 factors were retained, explaining 53.3% of the total variation. This result demonstrates the multidimensional structure of the instrument. The reliability assessment showed Cronbach’s alpha values ranging from 0.39 to 0.89. For the success of the scale most of the results (eight of nine attributes) were greater than 85%. Conclusions: The instrument is valid for the assessment of oral health services in Primary Health Care from the perspective of adult patients, as well as for monitoring and evaluation of oral health services in Primary Health Care attributes and comparative studies.


10.3823/2563 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Nayla Andrade Barboza ◽  
Viriato Campleo ◽  
Anselmo Alves Lustosa ◽  
Bruno Santos Sampaio ◽  
Gabriela Meireles Linhares de Araújo

Objective: Evaluate the performance of primary health care in control of leprosy in Teresina, Brazil from the perspective of users and professionals. Methods: This cross-sectional, descriptive study involved 25 healthcare users with leprosy and 34 professionals (physicians and nurses) working in 13 municipal health units within the urban area of Teresina. The data were collected from January to June, 2017, using the Instrument for Assessing the Performance of Primary Care in Leprosy Control Actions, a document based on the Primary Care Assessment Tool/PCATool Brasil which measures the presence and extension of essential and derived attributes from primary health care. Results: The mean scores obtained for the essential, derived and global attributes, through the perception of the users, were lower than 6.6, indicating that the primary health services in Teresina are not sufficiently oriented to carry out leprosy control actions, mainly in terms of access, integrality of services provided, family orientation and community orientation. The professionals showed a contrasting view, with averages exceeding 6.6 for all attributes and scores. The difference in perception between the groups was significant for all attributes except for coordination (Mann-Whitney U test, p = 0.479).The overall evaluation of quality was not influenced by the user’s clinical or socioeconomic variables, but  rather by the organization/provision of services. Conclusions: The municipal health units within the urban area of Teresina must be strongly guided by primary health care attributes in order to reach higher levels of user satisfaction.  


2021 ◽  
Vol 10 (8) ◽  
pp. e48610817584
Author(s):  
Beatriz Díaz-Fabregat ◽  
Wilmer Ramírez-Carmona ◽  
Eliane Cristina Gava Pizi ◽  
Juliane Avansini Marsicano ◽  
Rosana Leal do Prado

Aim. To evaluate the quality of Primary Health Care (PHC) models for Brazilian children. Methods. A cross-sectional study was performed with 516 parents or guardian of children in the public preschools from a city in São Paulo State, Brazil. The participants completed the questionnaires on the perception of the quality of the PHC (Primary Care Assessment Tool-PCATool), and the socioeconomic conditions in their families. The data were analyzed by statistical tests (95% confidence level). Results. Private services, Family Health Strategies (FHS), and Conventional Health Care (CHC) were the modalities of PHC used by children. Among the three modalities, in all groups were observed statistically significant differences (p<0.001), the best quality of care was provided by FHS (8.22±1.69). The CHC (5.69±1.34) and the private service (6.65±0.99) need improvement in accessibility, continuity of care, integrality, family, and community orientation. The socioeconomic class of the families was associated with modalities of PHC (p<0.001).  Conclusions. The quality of primary care for children in the public health system still requires much improvement, primarily in conventional model. However, the Family Health Strategies was the model that presented the best quality of primary health care for children.  


2014 ◽  
Vol 19 (12) ◽  
pp. 4851-4860 ◽  
Author(s):  
Lislaine Aparecida Fracolli ◽  
Maria Fernanda Pereira Gomes ◽  
Fabiana Rodrigues Zequini Nabão ◽  
Mariana Souza Santos ◽  
Verusca Kelly Cappellini ◽  
...  

This study comprises a systematic review and metasynthesis of qualitative literature on national and international databases to identify the main tools used to assess Primary Health Care (PHC). A total of 3,048 results were returned for literature written in Portuguese, Spanish and English published between 1979 and 2013. Thirty-three articles/studies were selected after thorough reading and analysis. Eight of these studies addressed the use of one or more of the following validated PHC assessment tools: the WHO Primary Care Assessment Tool (PCET); the ADHD Questionnaire for Primary Care Providers (AQ-PCP); the General Practice Assessment Questionnaire (GPAQ), PACOTAPS (primary health care software); and the PCAT (Primary Care Assessment Tool). The study showed that the majority of these tools were used internationally. The PCAT and EUROPEP were used in Brazil and the most commonly used tool in this country was the PCAT. The results show that the use of research tools to assess PHC may assist in the creation of new proposals to improve family healthcare and that PCAT is the most adequate tool for this purpose.


2015 ◽  
Vol 49 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Vanessa Bertoglio Comassetto Antunes de Oliveira ◽  
Maria de La Ó Ramallo Veríssimo

OBJECTIVE To compare the health assistance models of Basic Traditional Units (UBS) with the Family Health Strategy (ESF) units for presence and extent of attributes of Primary Health Care (APS), specifically in the care of children. METHOD A cross-sectional study of a quantitative approach with families of children attended by the Public Health Service of Colombo, Paraná. The Primary Care Assessment Tool (PCA-Tool) was applied to parents of 482 children, 235 ESF units and 247 UBS units covering all primary care units of the municipality, between June and July 2012. The results were analyzed according to the PCA-Tool manual. RESULTS ESF units reached a borderline overall score for primary health care standards. However, they fared better in their attributes of Affiliation, Integration of care coordination, Comprehensiveness, Family Centeredness and Accessibility of use, while the attributes of Community Guidance/Orientation, Coordination of Information Systems, Longitudinality and Access attributes were rated as insufficient for APS. UBS units had low scores on all attributes. CONCLUSION The ESF units are closer to the principles of APS (Primary Health Care), but there is need to review actions of child care aimed at the attributes of APS in both care models, corroborating similar studies from other regions of Brazil.


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