Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 124
Filter
Add filters

Document Type
Year range
1.
Can Fam Physician ; 67(11): 801, 2021 11.
Article in French | MEDLINE | ID: covidwho-1579153
2.
Afr J Prim Health Care Fam Med ; 13(1): e1-e3, 2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1524285

ABSTRACT

The Kenyan Ministry of Health envisages that family physicians should play an important role in the implementation of community orientated primary care (COPC) in collaboration with the community health team. The Kenyan Community Health Strategy forms a solid basis for the implementation of the COPC model. Residents and faculty of the Family Medicine department at the Aga Khan University Hospital Nairobi collaborated with the Kaloleni sub-county of Kilifi County government near Mombasa in a five-step COPC process to better understand and act against the high prevalence of HIV stigma in the coastal region. Firstly, a deeper understanding of human immunodeficiency virus (HIV) stigma was acquired through community visits and work in the comprehensive care clinic. Secondly, a collaborative implementation team was formed to design a targeted and feasible intervention. In a participatory approach, a two-step intervention was employed, firstly sensitising healthcare workers and community health volunteers (CHVs) on the high prevalence of HIV stigma in their community and educating them on HIV-related issues. Secondly, the information was disseminated to the community through home visits by CHVs, health talks and the set-up of an HIV support group at the facility. This short report illustrates the important contribution of family physicians to implementation of COPC and capacity building of the primary healthcare team.


Subject(s)
Family Practice , HIV Infections , HIV Infections/therapy , Humans , Kenya , Primary Health Care , Social Stigma
3.
BMC Fam Pract ; 22(1): 226, 2021 11 15.
Article in English | MEDLINE | ID: covidwho-1518258

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had a negative impact on resident training in different branches and affected the physical and mental health of frontline residents adversely. This nationwide cross-sectional survey aimed to investigate the effects of the COVID-19 pandemic on family medicine residents in Turkey, including the levels of depression and burnout. METHODS: An anonymous online survey was distributed to all family medicine residents via e-mail and a web link between 28.11.2020 and 12.12.2020. Information on sociodemographic data and the residency programme were evaluated, and factors associated with depression and burnout were examined using the Patient Health Questionnaire-9 (PHQ-9) and the Burnout Measure-Short Version (BMS) respectively. RESULTS: Although the weekly average working hours of the 477 respondents increased significantly during the pandemic (p < 0.05), the average weekly working time in the Family Medicine (FM) outpatient clinic decreased. The greatest concern of 58.3% of the residents was fear of transmitting COVID-19 to their family members. 90.2% of the residents stated that training programmes were negatively or very negatively affected. According to PHQ-9 scores, 15.7% of residents had moderately severe, and 14.9% severe depression. The BMS scores of the residents demonstrated that 24.1% had a very severe burnout problem, and 23.3% should seek professional help as soon as possible. Being single, having no children, female gender, lack of personal protective equipments and increased contact time with COVID-19 patients were associated with higher scores in the depression and burnout scales (p < 0.05). CONCLUSIONS: The COVID-19 pandemic has had a negative impact on training programmes for FM residents, who are at the forefront of the pandemic in Turkey, and this situation is closely related to depression and burnout. Due to the unpredictability of the pandemic, long-term plans should be made for the training needs of residents in order to protect their physical and mental health.


Subject(s)
Burnout, Professional , COVID-19 , Internship and Residency , Burnout, Professional/epidemiology , Cross-Sectional Studies , Family Practice , Female , Humans , Mental Health , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , Turkey/epidemiology
4.
Can Fam Physician ; 67(11): 799, 2021 11.
Article in English | MEDLINE | ID: covidwho-1515746
5.
Can Fam Physician ; 67(11): e306-e311, 2021 11.
Article in English | MEDLINE | ID: covidwho-1515745

ABSTRACT

OBJECTIVE: To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on FP finances in Alberta. DESIGN: A financial model that included fees, visits per day, number of days of practice, and overhead costs. SETTING: Alberta before, during, and after the COVID-19 pandemic. PARTICIPANTS: Hypothetical fee-for-service FP practices. INTERVENTIONS: Changes in practice modes caused by the pandemic and changes to fees set by the Government of Alberta (no interventions were controlled by the researchers). MAIN OUTCOME MEASURES: Annual average FP billings and annual average FP income after overhead expenses. RESULTS: Practice changes related to COVID-19 could result in a reduction in average FP income (billings after expenses) of 27% to 78%. CONCLUSION: Practice pattern changes, including the rapid adoption of telemedicine owing to the COVID-19 pandemic, will reduce incomes for fee-for-service community FP practices in Alberta. Fees at current levels could make some practices unsustainable.


Subject(s)
COVID-19 , Pandemics , Alberta , Family Practice , Humans , SARS-CoV-2
6.
Aust J Gen Pract ; 492020 Sep 07.
Article in English | MEDLINE | ID: covidwho-1503119

ABSTRACT

COVID-19 disproportionally affects India's 81 million people living in urban informal settlements, where inadequate housing, water and sanitation increase the risk and rate of infection.


Subject(s)
COVID-19 , Pandemics , Family Practice , Humans , India/epidemiology , Primary Health Care , SARS-CoV-2
7.
Aust J Gen Pract ; 492020 Aug 12.
Article in English | MEDLINE | ID: covidwho-1503116

ABSTRACT

The concept of adaptive reserve has been identified as being critical to help practices reinforce themselves against the challenges posed by the COVID-19 pandemic.


Subject(s)
COVID-19 , General Practice , Family Practice , Humans , Pandemics , SARS-CoV-2
8.
BMJ ; 375: n2454, 2021 10 11.
Article in English | MEDLINE | ID: covidwho-1488285
9.
Prim Health Care Res Dev ; 22: e56, 2021 10 18.
Article in English | MEDLINE | ID: covidwho-1475228

ABSTRACT

AIM: To validate the Roth score as a triage tool for detecting hypoxaemia. BACKGROUNDS: The virtual assessment of patients has become increasingly important during the corona virus disease (COVID-19) pandemic, but has limitations as to the evaluation of deteriorating respiratory function. This study presents data on the validity of the Roth score as a triage tool for detecting hypoxaemia remotely in potential COVID-19 patients in general practice. METHODS: This cross-sectional validation study was conducted in Dutch general practice. Patients aged ≥18 with suspected or confirmed COVID-19 were asked to rapidly count from 1 to 30 in a single breath. The Roth score involves the highest number counted during exhalation (counting number) and the time taken to reach the maximal count (counting time).Outcome measures were (1) the correlation between both Roth score measurements and simultaneous pulse oximetry (SpO2) on room air and (2) discrimination (c-statistic), sensitivity, specificity and predictive values of the Roth score for detecting hypoxaemia (SpO2 < 95%). FINDINGS: A total of 33 physicians enrolled 105 patients (52.4% female, mean age of 52.6 ± 20.4 years). A positive correlation was found between counting number and SpO2 (rs = 0.44, P < 0.001), whereas only a weak correlation was found between counting time and SpO2 (rs = 0.15, P = 0.14). Discrimination for hypoxaemia was higher for counting number [c-statistic 0.91 (95% CI: 0.85-0.96)] than for counting time [c-statistic 0.77 (95% CI: 0.62-0.93)]. Optimal diagnostic performance was found at a counting number of 20, with a sensitivity of 93.3% (95% CI: 68.1-99.8) and a specificity of 77.8% (95% CI: 67.8-85.9). A counting time of 7 s showed the best sensitivity of 85.7% (95% CI: 57.2-98.2) and specificity of 81.1% (95% CI: 71.5-88.6). CONCLUSIONS: A Roth score, with an optimal counting number cut-off value of 20, maybe of added value for signalling hypoxaemia in general practice. Further external validation is warranted before recommending integration in telephone triage.


Subject(s)
COVID-19 , Triage , Adult , Aged , Cross-Sectional Studies , Family Practice , Female , Humans , Hypoxia/diagnosis , Male , Middle Aged , SARS-CoV-2
10.
Hong Kong Med J ; 26(3): 176-183, 2020 06.
Article in English | MEDLINE | ID: covidwho-1468777

ABSTRACT

INTRODUCTION: This study evaluated the preparedness of family doctors during the early phase of the coronavirus disease 2019 (COVID-19) outbreak in Hong Kong. METHODS: All members of the Hong Kong College of Family Physicians were invited to participate in a cross-sectional online survey using a 20-item questionnaire to collect information on practice preparedness for the COVID-19 outbreak through an email followed by a reminder SMS message between 31 January 2020 and 3 February 2020. RESULTS: Of 1589 family doctors invited, 491 (31%) participated in the survey, including 242 (49%) from private sector. In all, 98% surveyed doctors continued to provide clinical services during the survey period, but reduced clinic service demands were observed in 45% private practices and 24% public clinics. Almost all wore masks during consultation and washed hands between or before patient contact. Significantly more private than public doctors (80% vs 26%, P<0.001) experienced difficulties in stocking personal protective equipment (PPE); more public doctors used guidelines to manage suspected patients. The main concern of the respondents was PPE shortage. Respondents appealed for effective public health interventions including border control, quarantine measures, designated clinic setup, and public education. CONCLUSION: Family doctors from public and private sectors demonstrated preparedness to serve the community from the early phase of the COVID-19 outbreak with heightened infection control measures and use of guidelines. However, there is a need for support from local health authorities to secure PPE supply and institute public health interventions.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Outbreaks/prevention & control , Family Practice/organization & administration , Health Care Surveys/methods , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Surveys and Questionnaires , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/statistics & numerical data , Communicable Disease Control/methods , Coronavirus Infections/diagnosis , Disease Outbreaks/statistics & numerical data , Female , Hong Kong/epidemiology , Humans , Male , Outcome Assessment, Health Care , Physicians, Family/statistics & numerical data
11.
Br J Gen Pract ; 71(706): 196-197, 2021 05.
Article in English | MEDLINE | ID: covidwho-1448956
12.
J Am Board Fam Med ; 34(5): 883-885, 2021.
Article in English | MEDLINE | ID: covidwho-1430645

ABSTRACT

As a discipline, we continue to learn lessons from Coronavirus disease 2019 (COVID-19)-lessons for practice, systems, and patient care. This issue also includes articles focused on 2 other topics that attract increasing attention by family physicians. First, articles describe how the social determinants of health impact health and how family physicians can overcome those obstacles with their patients. Patients want assistance from health systems for 1 specific need related to social determinants of their health. Second, we see increasing evidence about opioid prescriptions in primary care. Multiple clinical articles are pertinent to family medicine, such as different implications of an elevated sedimentation rate compared with C-reactive protein, practice facilitation, adolescent vaccination, family physician accuracy with potentially malignant skin lesions, and more.


Subject(s)
COVID-19 , Social Determinants of Health , Adolescent , Family Practice , Humans , Physicians, Family , SARS-CoV-2
13.
J Am Board Fam Med ; 34(5): 1003-1009, 2021.
Article in English | MEDLINE | ID: covidwho-1430641

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic forced not only rapid changes in how clinical care and educational programs are delivered but also challenged academic medical centers (AMCs) like never before. The pandemic made clear the need to have coordinated action based on shared data and shared resources to meet the needs of patients, learners, and communities. Family medicine departments across the country have been key partners in AMCs' responses. The Duke Department of Family Medicine and Community Health (FMCH) was involved in many aspects of Duke University's and Health System's responses, including leadership contributions in delivering employee health and student health services. The pandemic also surfaced the biological and social interactions that reveal underlying socioeconomic inequalities, for which family medicine has advocated since its inception. Key to success was the department's ability to integrate "horizontally" with the broader community, thereby accelerating the institution's response to the pandemic.


Subject(s)
COVID-19 , Academic Medical Centers , Family Practice , Humans , Pandemics , SARS-CoV-2
15.
East Mediterr Health J ; 27(8): 743-744, 2021 Aug 26.
Article in English | MEDLINE | ID: covidwho-1406914

ABSTRACT

Strengthening Primary Health Care (PHC) through family practice-based model of care is an essential bedrock in achieving Universal Health Coverage (UHC), as called for in Sustainable Development Goal (SDG) 3, target 3.8. However, the shortage of family practitioners worldwide and in most countries of the Eastern Mediterranean Region (EMR) is a daunting challenge. The current production rate of family physicians in the EMR is around 700 annually, against the needed estimate of 21 000 physicians per year based on one family physician/1300 population and the current EMR population growth rate, which reflects the huge shortage of family physicians in the Region.


Subject(s)
Family Practice , Universal Health Insurance , Humans , Mediterranean Region , Physicians, Family , Primary Health Care , World Health Organization
16.
Fam Med ; 53(8): 670-675, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1405581

ABSTRACT

BACKGROUND AND OBJECTIVES: Online publication of prereviewed manuscripts disseminates research simultaneously to scientists, clinicians, and patients, enabling the media and public to act as scientific reviewers for studies that are not yet endorsed by the scientific and clinical community. This study describes the reach of prereview literature and frames it within the pursuit to teach evidence-based medicine. METHODS: In this deductive content analysis, the primary unit of analysis was the individual preprint manuscript submitted to the medRxiv preprint server during the emergence of the COVID-19 pandemic. The coding scheme included study design, negative or positive findings, dissemination status (whether it was withdrawn from the server or eventually published), and three levels of reach: user engagement, news media coverage, and social media engagement. RESULTS: Prereviewed manuscripts describe a variety of study methods. Dissemination status was significantly related to abstract views, manuscript views, news coverage, and social media exposure. Studies with negative findings had higher counts of abstract views, manuscript views, and news coverage, but no significant relationships were detected. CONCLUSIONS: Results demonstrate that not only are scientists publishing negative findings, but that those studies reach a wide audience. Notably, eventually-withdrawn manuscripts, potentially containing incomplete or uncertain science, is reaching the public domain. Increasingly, family physicians will need to critically appraise emerging literature before it is peer reviewed, whether they encounter it in their own searches or when a patient presents information they found before an appointment.


Subject(s)
COVID-19 , Social Media , Family Practice , Humans , Pandemics , SARS-CoV-2
17.
Fam Med ; 53(8): 684-688, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1399741

ABSTRACT

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic resulted in significant changes to the US residency application process for medical school graduates. Due to the lack of in-person activities, family medicine programs have utilized various social media platforms to connect with their applicants. In this paper, we describe how family medicine residency programs have adapted for the 2021 application cycle by using social media platforms. METHODS: We evaluated all family residency programs listed on the Electronic Residency Application Service (ERAS) for the presence of departmental and residency Twitter, Instagram, and Facebook accounts. We reviewed programs' websites and social media posts for posts regarding virtual opportunities for prospective applicants. We noted family medicine virtual subinternship opportunities on the Visiting Student Application Service (VSAS). We collected data from October 17, 2020 through November 2, 2020. RESULTS: Of 675 identified family medicine residency programs, 372 (55%) had some form of social media presence. Open house opportunities were offered by 46 (6.8%) programs on Twitter, 60 (8.9%) programs on Instagram, and 64 (9.5%) programs on Facebook. One hundred ninety-five of 578 residency-specific accounts were created after March 1, 2020; Instagram accounts (103 of 195) represented most of these; five virtual subinternships were identified on VSAS. CONCLUSIONS: Family medicine residency programs have adapted to the challenges that came with the COVID-19 pandemic by increasing social media outreach, particularly through Instagram. This has allowed residency programs to virtually communicate with prospective applicants during an unprecedented application cycle.


Subject(s)
COVID-19 , Internship and Residency , Family Practice , Humans , Pandemics , Prospective Studies , SARS-CoV-2
18.
Fam Med ; 53(8): 732, 2021 09.
Article in English | MEDLINE | ID: covidwho-1399740
19.
Afr J Prim Health Care Fam Med ; 13(1): e1-e4, 2021 Aug 23.
Article in English | MEDLINE | ID: covidwho-1395088

ABSTRACT

Countries around the world have mobilised health, social, and economic resources to control the coronavirus disease 2019 (COVID-19) pandemic since its discovery in December 2019. Primary care as a frontline of many health systems, played a huge role in the management of the current pandemic. This is a short report by Dr Daniel Osafo Darko, a family medicine resident at the Nyaho Medical Centre in Accra, Ghana. It details some contributions of Nyaho Medical Centre to the fight against COVID-19 in Ghana by providing clinical care, using eHealth approaches.


Subject(s)
COVID-19 , Family Practice , Ghana , Humans , Pandemics , SARS-CoV-2
20.
Fam Med Community Health ; 9(3)2021 09.
Article in English | MEDLINE | ID: covidwho-1394130

ABSTRACT

OBJECTIVE: This research project examined the effects of the COVID-19 pandemic on the required curriculum in graduate medical education for family medicine residencies. DESIGN: Our questions were part of a larger omnibus survey conducted by the Council of Academic Family Medicine Educational Research Alliance. Data were collected from 23 September to 16 October 2020. SETTING: This study was set in the USA. PARTICIPANTS: Emails were sent to 664 family medicine programme directors in the USA. Of the 312 surveys returned, 35 did not answer our questions and were excluded, a total of 277 responses (44%) were analysed. RESULTS: The level of disruption varied by discipline and region. Geriatrics had the highest reported disruption (median=4 on a 5-point scale) and intensive care unit had the lowest (median=1 on a 5-point scale). There were no significant differences for disruption by type of programme or community size. CONCLUSION: Programme directors reported moderate disruption in family medicine resident education in geriatrics, gynaecology, surgery, musculoskeletal medicine, paediatrics and family medicine site during the pandemic. We are limited in generalisations about how region, type of programme, community size or number of residents influenced the level of disruption, as less than 50% of programme directors completed the survey.


Subject(s)
COVID-19 , Curriculum , Family Practice/education , Internship and Residency , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
SELECTION OF CITATIONS
SEARCH DETAIL
...