Building a Vision of Dietitian Services In Primary Health Care

2006 ◽  
Vol 67 (S1) ◽  
pp. S54-S57 ◽  
Author(s):  
Barbara Cantwell ◽  
Carol Clarke ◽  
Jane Bellman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Common Ground ◽  
Shared Vision ◽  
Interdisciplinary Teams ◽  
Opinion Leaders ◽  
Registered Dietitians ◽  
National Review ◽  
Primary Health ◽  
Clear Vision

Purpose: Primary health care (PHC) reform, especially efforts to implement interdisciplinary teams, has implications for dietetic practice. A consistent, clear vision of the registered dietitian’s (RD’s) role in PHC is needed to develop a successful advocacy agenda. Methods: The Dietitians of Canada (DC) Central and Southern Ontario Primary Health Care Action Group organized a four-step process to engage dietitians in developing an advocacy agenda for RD PHC services in Ontario. Two facilitated workshops brought together dietitian opinion leaders to enhance the understanding of current roles, find common ground, and develop a shared vision. All DC members were invited to review the draft vision, and feedback was integrated into a revised vision. Results: Registered dietitians saw PHC reform through many lenses, and were uncertain about how reforms would affect their practices. In a national review, the majority of reviewers (approximately 85% of 270) supported the draft vision; additional clarity was needed on resources and the breadth of services that RDs would provide. Conclusion: Development of a PHC vision for RDs should be helpful in advocating for dietitian services in PHC.

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Author(s):  
Joel Freilich ◽  
Gunnar Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management.Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis.Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

scholarly journals Primary Health Care and Aging

2004 ◽  
Vol 2 (3) ◽  
pp. 99-108
Author(s):  
Martha Pelaez ◽  
Marilyn Rice
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Older People ◽  
Older Persons ◽  
Interdisciplinary Teams ◽  
Healthy Ageing ◽  
Policy Statement ◽  
Primary Health

From 21-25 February 2000, in San Jose, Costa Rica, a WHO Consultative Group was held on the topic of Primary Health Care for Older Persons, with representatives from 13 countries from around the world, as well as Headquarters and Regional offices of WHO and the private sector. In the policy statement that emerged from the meeting four basic principles were highlighted: universal accessibility and coverage on the basis of need, community and individual involvement, intersectoral action for health, and appropriate use of cost effective technologies in relation to the available resources. Three complementary integration functions are mentioned: functional with an integrated approach to the health needs of individuals over their life course taking precedence over episodic management of disease; organizational, with a focus on how health centers should function with interdisciplinary teams; and educational which addresses the knowledge and skills and attitudes needed by health professionals that will facilitate communication, networking, advocacy and mediation of resources. The proceedings go on to outline the objectives to be included in national plans on health of older people, as well as the extended benefits and outcomes to be expected from PHC strategies for older people. In promoting quality of care for older persons, positive and negative factors are mentioned, as are strategies to: stimulate interest in geriatric care, motivate general practitioners to focus on the care of elders, encourage teamwork among PHC staff, and encourage multi-sectoral collaboration in promoting the health of older persons. An example is provided of healthy ageing from Canada. The recommendations include defining and measuring an ageing friendly health center (with specific indicators for the latter), defining the role of the PHC team in promoting healthy ageing, characteristics that programs should have to promote “age friendly” services in the primary care setting, and outcome indicators for quality of care of elders at the PHC level.

scholarly journals Communicating with migrants: children’s health literacy, digital technology, health promotion tools

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Reis ◽  
L Saboga-Nunes ◽  
A Spínola ◽  
I Santos ◽  
C Santiago
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Literacy ◽  
Health Professionals ◽  
Common Ground ◽  
Care Setting ◽  
Ethnographic Study ◽  
Health Care Setting ◽  
Primary Health Care Setting ◽  
Primary Health

Abstract Background Being a migrant can enact road blocks in the process of integration, if language barriers persist in the communication between health professionals and migrants. Moreover, health literacy levels (HL) can differ, based on different cultural contexts or conceptions of health and illness. This research aims at exploring migrants (digital) HL and the mediating role of migrant’s children in primary health care setting. Health professionals’ resort to migrants’ children as interpreters and mediators has been highlighted with the younger generations’ digital literacy, as critical tools to overcome such barriers. Assessing and promoting migrant’s HL is a public health mandate in the promotion of individual and family health to establish a common ground base for communication. Methods A qualitative and ethnographic study based on narratives, participant observation, focus group and ethno biographic interviews with nurses, migrants, medical doctors and intercultural mediators, involved 52 participants in a primary health care setting in Santarém district, Portugal. Partnership with the Observatory for Migration, the High Commission for Migration (ACM) and with migrant associations, enabled the completion by migrants of an online questionnaire focusing on digital HL. Results Migrants’ children were identified as facilitators in the clinical setting at three levels: the communication, HL promotion and adherence to continuity of care. Conclusions Improve migrant’s HL and health decisions is feasible when considering several strategies to overcome cultural barriers. Migrants’ children are potential mediators in the process of communication between health professionals and adults. Awareness of their potential allows adjustments in the primary health care sector. The need to further investigate migrants’ HL and digital HL (e.g. telephone translation services, Internet-based tools for scheduling health appointments) are some tasks that need further research.

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Joel Freilich ◽  
Gunnar H. Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management. Methods A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis. Results The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals. Conclusion Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Author(s):  
Joel Freilich ◽  
Gunnar Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management. Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis. Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

scholarly journals Dietetic Staffing and Workforce Capacity Planning in Primary Health Care

2018 ◽  
Vol 79 (4) ◽  
pp. 181-185 ◽  
Author(s):  
Michele MacDonald Werstuck ◽  
Jennifer Buccino
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Capacity Planning ◽  
Registered Dietitians ◽  
Nutrition Interventions ◽  
Staffing Ratios ◽  
Primary Health ◽  
Patients With Diabetes ◽  
Workforce Capacity ◽  
Staffing Requirements

The addition of Registered Dietitians (RD) to primary health care (PHC) teams has been shown to be effective in improving health and economic outcomes with reported savings of $5 to $99 New Zealand dollars for every $1 spent on nutrition interventions. Despite proven benefits, very few Canadians have access to dietitians in PHC. This paper summarizes the literature on dietetic staffing ratios in PHC in Canada and other countries with similar PHC systems. Examples are shared to demonstrate how dietitians and others can utilize published staffing ratios to review dietitian services within their settings, identify gaps, and advocate for additional positions to meet population needs. The majority of published dietetic staffing ratios describe ranges of 1 RD: 15 000–18 500 patients, 1 RD for every 4–14 family physicians, or 1 RD for every 300–500 patients with diabetes. These staffing ratios may be inadequate as surveys report ongoing issues of limited access to dietetic counseling, under-serviced populations, and a shortage of dietitians to meet current population needs in PHC. Newer projection models based on specific population needs and ongoing workforce data are required to identify professional practice issues and accurately estimate dietetic staffing requirements in PHC.

Self-reported patient psychosocial needs in integrated primary health care: A role for social work in interdisciplinary teams

2016 ◽  
Vol 55 (1) ◽  
pp. 41-60 ◽  
Author(s):  
Shelley Craig ◽  
Rachel Frankford ◽  
Kate Allan ◽  
Charmaine Williams ◽  
Celia Schwartz ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Social Work ◽  
Interdisciplinary Teams ◽  
Psychosocial Needs ◽  
Primary Health

scholarly journals “Standing on Common Ground” - A Qualitative Study of Self-management Support for Patients With Multimorbidity in Primary Health Care

2020 ◽  
Author(s):  
Joel Freilich ◽  
Gunnar Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management. Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis. Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

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