scholarly journals The acceptability of primary care or community‐based behavioural interventions for persistent physical symptoms: Qualitative systematic review

2021 ◽  
Author(s):  
Alison Scope ◽  
Joanna Leaviss ◽  
Andrew Booth ◽  
Anthea Sutton ◽  
Glenys Parry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Physical Symptoms ◽  
Community Based ◽  
Behavioural Interventions ◽  
Qualitative Systematic Review

scholarly journals Seeking ambulance treatment for ‘primary care’ problems: a qualitative systematic review of patient, carer and professional perspectives

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016832 ◽  
Author(s):  
Matthew J Booker ◽  
Sarah Purdy ◽  
Alison R G Shaw
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Physical Symptoms ◽  
Healthcare Management ◽  
Urgent Care ◽  
Management Information ◽  
Qualitative Approaches ◽  
Qualitative Systematic Review ◽  
Emergency Ambulance ◽  
Emotional Component

ObjectivesTo understand the reasons behind, and experience of, seeking and receiving emergency ambulance treatment for a ‘primary care sensitive’ condition.DesignA comprehensive, qualitative systematic review. Medline, Embase, PsychInfo, Cumulative Index of Nursing and Allied Health, Health Management Information Systems, Healthcare Management Information Consortium, OpenSigle, EThOS and Digital Archive of Research Theses databases were systematically searched for studies exploring patient, carer or healthcare professional interactions with ambulance services for ‘primary care sensitive’ problems. Studies using wholly qualitative approaches or mixed-methods studies with substantial use of qualitative techniques in both the methods and analysis sections were included. An analytical thematic synthesis was undertaken, using a line-by-line qualitative coding method and a hierarchical inductive approach.ResultsOf 1458 initial results, 33 studies met the first level (relevance) inclusion criteria, and six studies met the second level (methodology and quality) criteria. The analysis suggests that patients define situations worthy of ‘emergency’ ambulance use according to complex socioemotional factors, as well as experienced physical symptoms. There can be a mismatch between how patients and professionals define ‘emergency’ situations. Deciding to call an ambulance is a process shaped by practical considerations and a strong emotional component, which can be influenced by the views of caregivers. Sometimes the value of a contact with the ambulance service is principally in managing this emotional component. Patients often wish to hand over responsibility for decisions when experiencing a perceived emergency. Feeling empowered to take control of a situation is a highly valued aspect of ambulance care.ConclusionsWhen responding to a request for ‘emergency’ help for a low-acuity condition, urgent-care services need to be sensitive to how the patient's emotional and practical perception of the situation may have shaped their decision-making and the influence that carers may have had on the process. There may be novel ways to deliver some of the valued aspects of urgent care, more geared to the resource-limited environment.

scholarly journals Reducing unscheduled hospital care for adults with diabetes following a hypoglycaemic event: which community-based interventions are most effective? A systematic review

2021 ◽  
Author(s):  
Aoife Watson ◽  
Donna McConnell ◽  
Vivien Coates
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Integrated Care ◽  
Hospital Care ◽  
Hospital Admissions ◽  
Community Based Interventions ◽  
Community Based ◽  
Integrated Care Pathways ◽  
Effective Community ◽  
Balance Of Care

Abstract Aim To determine which community-based interventions are most effective at reducing unscheduled hospital care for hypoglycaemic events in adults with diabetes. Methods Medline Ovid, CINAHL Plus and ProQuest Health and Medical Collection were searched using both key search terms and medical subject heading terms (MeSH) to identify potentially relevant studies. Eligible studies were those that involved a community-based intervention to reduce unscheduled admissions in adults with diabetes. Papers were initially screened by the primary researcher and then a secondary reviewer. Relevant data were then extracted from papers that met the inclusion criteria. Results The search produced 2226 results, with 1360 duplicates. Of the remaining 866 papers, 198 were deemed appropriate based on titles, 90 were excluded following abstract review. A total of 108 full papers were screened with 19 full papers included in the review. The sample size of the 19 papers ranged from n = 25 to n = 104,000. The average ages within the studies ranged from 41 to 74 years with females comprising 57% of the participants. The following community-based interventions were identified that explored reducing unscheduled hospital care in people with diabetes; telemedicine, education, integrated care pathways, enhanced primary care and care management teams. Conclusions This systematic review shows that a range of community-based interventions, requiring different levels of infrastructure, are effective in reducing unscheduled hospital care for hypoglycaemia in people with diabetes. Investment in effective community-based interventions such as integrated care and patient education must be a priority to shift the balance of care from secondary to primary care, thereby reducing hospital admissions.

Palliative care transitions from acute care to community-based care: A qualitative systematic review of the experiences and perspectives of health care providers

2020 ◽  
Vol 34 (10) ◽  
pp. 1316-1331 ◽  
Author(s):  
Tieghan Killackey ◽  
Emily Lovrics ◽  
Stephanie Saunders ◽  
Sarina R. Isenberg
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Acute Care ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Healthcare Providers ◽  
Discharge Process ◽  
Care Providers ◽  
Community Based ◽  
Qualitative Systematic Review

Background: Transitioning from the hospital to community is a vulnerable point in patients’ care trajectory, yet little is known about this experience within the context of palliative care. While some studies have examined the patient and caregiver experience, no study to date has synthesized the literature on the healthcare provider’s perspective on their role and experience facilitating these transitions. Aim: The purpose of this systematic review was to understand the experience and perspective of healthcare providers who support the transition of patients receiving palliative care as they move from acute care to community settings. Design: A qualitative systematic review of studies using thematic analysis as outlined by Thomas and Harden. PROSPERO: ID # CRD42018109662. Data Sources: We searched four databases: MEDLINE, Embase, ProQuest and CINAHL for studies published in English from 1995 until May 22, 2020. Four reviewers screened records using the following selection criteria: (1) peer-reviewed empirical study, (2) adult sample, (3) qualitative study design, (4) perspective of healthcare providers, and (5) included a component of transitions between acute to community-based palliative care. Study findings were analyzed using thematic analysis which entailed: (1) grouping the findings into recurring themes; (2) iteratively referring back to the articles to obtain nuances of the theme and quotations; and (3) defining and solidifying the themes. Results: Overall 1,791 studies were identified and 15 met inclusion criteria. Studies were published recently (>2015, n = 12, 80%) and used a range of qualitative methods including semi-structured interviews, focus groups, and field interviews. Three core themes related to the role and experience of healthcare providers were identified: (1) assessing and preparing for transition; (2) organizing and facilitating the logistics of transition; and (3) coordinating and collaborating transitional care across sectors. The majority of studies focused on the discharge process from acute care; there was a lack of studies exploring the experiences of healthcare providers in the community who receive patients from acute care and provide them with palliative care at home. Conclusion: This review identified studies from a range of relatively high-income countries that included a diverse sample of healthcare providers. The results indicate that healthcare providers experience multiple complex roles during the transition facilitation process, and future research should examine how to better assist clinicians in supporting these transitions within the context of palliative care provision.

scholarly journals The concept and definition of therapeutic inertia in hypertension in primary care: a qualitative systematic review

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Jean-Pierre Lebeau ◽  
Jean-Sébastien Cadwallader ◽  
Isabelle Aubin-Auger ◽  
Alain Mercier ◽  
Thomas Pasquet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Therapeutic Inertia ◽  
Qualitative Systematic Review ◽  
Definition Of
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