scholarly journals Comprehensive Primary Health Care in Australia: findings from a narrative review of the literature

2008 ◽  
pp. 147-152 ◽  
Author(s):  
Catherine Hurley ◽  
Fran Baum ◽  
Julie Johns ◽  
Ronald Labonte
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Narrative Review ◽  
Review Of The Literature ◽  
Primary Health ◽  
Comprehensive Primary Health Care

scholarly journals Antimicrobial stewardship in rural and remote primary health care: a narrative review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jun Wern Yau ◽  
Sze Mun Thor ◽  
Danny Tsai ◽  
Tobias Speare ◽  
Chris Rissel
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Inappropriate Prescribing ◽  
Narrative Review ◽  
Rural And Remote ◽  
Antimicrobial Prescribing ◽  
Primary Health ◽  
Resistance Rates

Abstract Background Antimicrobial resistance is an emerging problem worldwide and poses a significant threat to human health. Antimicrobial stewardship programmes are being implemented in health systems globally, primarily in hospitals, to address the growing threat of antimicrobial resistance. Despite the significance of primary health care services in providing health care to communities, antimicrobial stewardship programmes are not well established in this sector, especially in rural and remote settings. This narrative review aims to identify in rural and remote primary health care settings the (1) correlation of antimicrobial resistance with antibiotic prescribing and volume of antibiotic use, (2) appropriateness of antimicrobial prescribing, (3) risk factors associated with inappropriate use/prescribing of antibiotics, and (4) effective antimicrobial stewardship strategies. Methods The international literature was searched for English only articles between 2000 and 2020 using specified keywords. Seven electronic databases were searched: Scopus, Cochrane, Embase, CINAHL, PubMed, Ovid Medline and Ovid Emcare. Publication screening and analysis were conducted using Joanna Briggs Institute systematic review tools. Results Fifty-one eligible articles were identified. Inappropriate and excessive antimicrobial prescribing and use directly led to increases in antimicrobial resistance. Increasing rurality of practice is associated with disproportionally higher rates of inappropriate prescribing compared to those in metropolitan areas. Physician knowledge, attitude and behaviour play important roles in mediating antimicrobial prescribing, with strong intrinsic and extrinsic influences including patient factors. Antimicrobial stewardship strategies in rural and remote primary health care settings focus on health care provider and patient education, clinician support systems, utility of antimicrobial resistance surveillance, and policy changes. Results of these interventions were generally positive with decreased antimicrobial resistance rates and improved appropriateness of antimicrobial prescribing. Conclusions Inappropriate prescribing and excessive use of antimicrobials are an important contributor to the increasing resistance towards antimicrobial agents particularly in rural and remote primary health care. Antimicrobial stewardship programmes in the form of education, clinical support, surveillance, and policies have been mostly successful in reducing prescribing rates and inappropriate prescriptions. The narrative review highlighted the need for longer interventions to assess changes in antimicrobial resistance rates. The review also identified a lack of differentiation between rural and remote contexts and Indigenous health was inadequately addressed. Future research should have a greater focus on effective interventional components and patient perspectives.

scholarly journals Erectile Dysfunction in Brazilian Primary Health Care: Dealing with Medicalization

2017 ◽  
Vol 12 (2) ◽  
pp. 431-440 ◽  
Author(s):  
Antônio Augusto Dall’Agnol Modesto ◽  
Marcia Thereza Couto
Keyword(s):  
Health Care ◽  
Erectile Dysfunction ◽  
Primary Health Care ◽  
Adult Male ◽  
Sexual Problem ◽  
Primary Health ◽  
Medical Associations ◽  
Comprehensive Primary Health Care ◽  
Hidden Agenda ◽  
Semistructured Interviews

Erectile dysfunction (ED) is a common sexual problem and has been attracting growing interest from the field of medicine. The pharmaceutical industry works together with medical associations to popularize the theme, emphasizing individual enhancement and medication, besides reinforcing an idea of a male sexuality defined by the ability to have an erection and penetrate. Patients worried about erection problems search for general practitioners (GPs), frequently without a clear complaint, and a comprehensive primary health care (PHC) must be capable of dealing with these issues considering medicalization and disease mongering. This article discusses how PHC physicians take (and might take) care of men with erection problems, and how users perceive it and search for help in two cities in the State of São Paulo, Brazil. The qualitative research, performed in five PHC services, included semistructured interviews with 16 GPs and 15 adult male users. The adult male users were invited by their doctors during consultations where questions about prostate, ED, or other sexual problems arose. Interviews were transcribed and submitted for content analysis. In addition, the five participating services were observed with help of a specific script. Results indicate that ED is frequently a hidden agenda and that doctors have trouble approaching the problem, usually focusing on the biological aspects. Based on empirical data and literature, this work indicates some measures to qualify the care of men with ED in PHC which includes contemplating users’ questions, respecting their autonomy, avoiding an antidrug stance, and considering drug and nondrug approaches as a continuum of resources.

Community midwifery: a primary health care approach to care during pregnancy for Aboriginal and Torres Strait Islander women

2021 ◽  
Vol 27 (1) ◽  
pp. 57
Author(s):  
Ailsa Munns
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Torres Strait Islander ◽  
Service Providers ◽  
Early Years ◽  
Health Staff ◽  
Liaison Officer ◽  
Primary Health ◽  
Comprehensive Primary Health Care ◽  
Torres Strait

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers’ perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.

scholarly journals Reasons for students’ poor clinical competencies in the Primary Health Care: Clinical nursing, diagnosis treatment and care programme

2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Nomasonto B. Magobe ◽  
Sonya Beukes ◽  
Ann Müller
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Health Staff ◽  
Care Programme ◽  
Clinical Competencies ◽  
Primary Health ◽  
Comprehensive Primary Health Care

‘No member of [health] staff should undertake tasks unless they are competent to do so’ is stated in the Comprehensive Primary Health Care Service Package for South Africa (Department of Health 2001)document. In South Africa, primary clinical nurses (PCNs), traditionally known as primary health care nurses (PHCNs), function as ‘frontline providers’ of clinical primary health care (PHC) services within public PHC facilities, which is their extended role. This extended role of registered nurses(set out in section 38A of the Nursing Act 50 of 1978, as amended) demands high clinical competency training by nursing schools and universities.The objectives of the study were to explore and describe the perceptions of both clinical instructors and students, in terms of the reasons for poor clinical competencies. Results established that two main challenges contributed to students’ poor clinical competencies: challenges within the PHC clinical field and challenges within the learning programme (University).OpsommingDie primêre kliniese verpleegkundiges, tradisioneel bekend as primêre gesondheidsorg verpleegkundiges, funksioneer in Suid-Afrika as eerste-linie verskaffers van kliniese primêre gesondheidsorg (PGS) dienste binne die publieke PGS fasiliteite. Dit is hulle uitgebreide rol. Hierdie uitgebreide rol van die verpleegkundige (soos deur Wet op Verpleging,No 50 van 1978, artikel 38A voorgeskryf), vereis opleiding in kliniese vaardighede van hoë gehalte deur verpleegskole en universiteite.Die doelwitte van die navorsing was om die persepsies van beide kliniese dosente en leerders,met betrekking tot die redes vir swak kliniese vaardighede, repektiewelik te verken en te beskryf.Twee temas is deur die resultate as uitdagings (hoof redes) vir die swak vaardighede van leerders aangetoon, naamlik uitdagings in die PGS kliniese praktyk en die uitdagings in die leerprogram (universiteit).

Assessment and Evaluation of Child Health Associates

PEDIATRICS ◽  
1981 ◽  
Vol 67 (1) ◽  
pp. 47-52
Author(s):  
Henry K. Silver ◽  
John E. Ott ◽  
Claibourne I. Dungy ◽  
Louis L. Fine ◽  
Virginia M. Moore ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Child Health ◽  
Health Care Providers ◽  
Evaluation Studies ◽  
Care Providers ◽  
Assessment And Evaluation ◽  
Primary Health ◽  
Comprehensive Primary Health Care ◽  
Cognitive Knowledge

More than 20 studies have been carried out of child health associates to assess their knowledge, training, and practice; their ability to interpret and integrate data; their cognitive knowledge and psychomotor and interpersonal skills; and their competence and effectiveness as primary health care providers. The results of the assessment and evaluation studies of child health associates indicate that they can determine the health status and manage the health care of patients in ambulatory settings and in the newborn nursery with a degree of skill and competence approaching that of pediatricians. Child health associates can provide comprehensive primary health care for more than 90% of children seen in these settings. The high degree of acceptance of child health associates by families and their demonstrated proficiency and cost-effectiveness document that they can be an important source of primary health care for most children.

scholarly journals Access to hypertension care and services in primary health-care settings in Vietnam: a systematic narrative review of existing literature

2019 ◽  
Vol 12 (1) ◽  
pp. 1610253 ◽  
Author(s):  
Lana Meiqari ◽  
Thi-Phuong-Lan Nguyen ◽  
Dirk Essink ◽  
Marjolein Zweekhorst ◽  
Pamela Wright ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Narrative Review ◽  
Health Care Settings ◽  
Primary Health ◽  
Primary Health Care Settings
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