Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 70
Filter
1.
J Prim Health Care ; 14(1): 57-63, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1795604

ABSTRACT

Introduction Efforts to contain the SARS-CoV-2 virus would fall short without strong primary health care. Aim In this study, we aimed to understand family physicians' experiences of coronavirus disease 2019 (COVID-19) in Istanbul, focusing on their coping strategies in order to draw lessons for the future management of pandemics. Methods Twelve community-based physicians working in Istanbul participated in semi-structured interviews between January and May 2021. Purposive sampling was used to ensure a range of physicians' characteristics. Individual interviews were conducted with each participant on an online platform. Participants were asked 26 open-ended questions. Phenomenological analysis was performed to describe experiences of physicians. Results The physical conditions of participants' health centres were insufficient to provide service safely during the COVID-19 pandemic. Most physicians were uncomfortable about the quality and quantity of personal protective equipment received from the Ministry of Health and took additional measures themselves. Vaccine supply was thought to be insufficient and there were problems with the associated software. Many family physicians highlighted the inadequate communication from the Ministry. Insufficient knowledge about the disease caused anxiety and fear for the physicians and hindered their performance at the beginning of the pandemic. Physicians who live with their families were more anxious than those who did not. Discussion Despite challenges, routine procedures have mostly been continued, but newly added responsibilities during the COVID-19 pandemic have had significant impact on physicians' lives.


Subject(s)
COVID-19 , COVID-19/epidemiology , Family , Humans , Pandemics , Physicians, Family , SARS-CoV-2
2.
MMW Fortschr Med ; 164(7): 19-21, 2022 Apr.
Article in German | MEDLINE | ID: covidwho-1783011
3.
Front Public Health ; 10: 757481, 2022.
Article in English | MEDLINE | ID: covidwho-1775973

ABSTRACT

Background: Some studies found that family doctor contract services (FDCSs) had positive impact on the self-measurement behaviors of hypertension patients. However, evidence concerning the association between FDCSs and blood pressure measurement awareness among hypertension patients is not clear. Objective: This study aims to explore the relationship between FDCSs and blood pressure measurement awareness among the hypertension patients, and examine whether there is a difference in this relationship among middle-aged and aged adults in rural Shandong, China. Methods: A multi-stage stratified random sampling was adopted in 2018 in Shandong Province to conduct a questionnaire survey among the sample residents, in which 982 hypertension patients were included in the study. Pearson chi-square test and logistic regression model were employed using SPSS 24.0 to explore the association between FDCSs and blood pressure measurement awareness. Results: 76.8% of hypertension patients would measure blood pressure regularly. The blood pressure measurement awareness of the signing group was significantly higher than that of the non-signing group when controlling other variables (P < 0.001, OR = 2.075, 95% CI 1.391-3.095). The interaction of age and contracting status were significantly correlated with blood pressure measurement awareness (P = 0.042, OR = 1.747, 95% CI 1.020-2.992; P = 0.019, OR = 2.060, 95% CI 1.129-3.759). Factors including gender (P = 0.011, OR = 0.499, 95% CI 0.291-0.855), household income (P = 0.031, OR = 1.764, 95% CI 1.052-2.956), smoking status (P = 0.002, OR = 0.439, 95% CI 0.260-0.739), sports habits (P < 0.001, OR = 2.338, 95% CI 1.679-3.257), self-reported health (P = 0.031, OR = 1.608, 95% CI 1.043-2.477), distance to the village clinic (P = 0.006, OR = 1.952, 95% CI 1.208-3.153) and medications (P < 0.001, OR = 3.345, 95% CI 2.282-4.904) were also found to be associated with the blood pressure measurement awareness of hypertension patients. Conclusion: The government should take efforts to strengthen publicity and education of family doctors and pay more attention to uncontracted, middle-aged, female patients and patients with unhealthy life behaviors to improve the blood pressure measurement awareness.


Subject(s)
Blood Pressure , Contract Services , Health Knowledge, Attitudes, Practice , Hypertension , Adult , China , Cross-Sectional Studies , Female , Humans , Hypertension/diagnosis , Middle Aged , Physicians, Family , Rural Population
4.
J Am Board Fam Med ; 35(2): 215-218, 2022.
Article in English | MEDLINE | ID: covidwho-1775617

ABSTRACT

This issue continues our tradition of advancing family medicine by publishing articles on issues that affect patients and the practice of family medicine, specifically with an emphasis on inequity and the COVID pandemic, which are often intertwined. We have articles on topical issues such as appropriate transgender care, newer diabetes medications, transportation as a social risk, and a thought-provoking commentary on ableism. A clinical review on olfactory loss takes on new meaning. Oregon Medicaid coverage policy supported family physicians assisting their patients by decreasing their opioid use, and a article suggests that buprenorphine should be decriminalized. Strengthening the desire to enter family medicine before starting medical school can help meet future patient needs.


Subject(s)
Buprenorphine , COVID-19 , Opioid-Related Disorders , Buprenorphine/therapeutic use , COVID-19/epidemiology , Family Practice , Humans , Opioid-Related Disorders/drug therapy , Physicians, Family , United States/epidemiology
5.
J Am Board Fam Med ; 35(2): 274-283, 2022.
Article in English | MEDLINE | ID: covidwho-1775616

ABSTRACT

INTRODUCTION: COVID-19 pandemic-related health care disruptions necessitated rapid adaptation among family physicians to safely meet patient needs while protecting themselves and their staff. On April 1, 2020, the American Board of Family Medicine (ABFM) introduced a COVID Performance Improvement (PI) activity for physicians to report on and receive Family Medicine certification credit for practice adjustments they made during the early stages of the pandemic. We aimed to understand the types of interventions implemented, and lessons physicians learned from the efforts. METHODS: We analyzed data from COVID-PI activities submitted by self-selected family physicians between April 1 and June 30, 2020. We summarized the COVID-related topics chosen for improvement and performed a qualitative content analysis on a random sample of open-text responses about lessons learned. RESULTS: The most common practice changes among 1259 unique COVID-PI activity submissions related to virtualization of patient visits, implementing new workflows, developing screening protocols, and obtaining and preserving personal protective equipment. We identified 12 themes regarding lessons learned, most commonly regarding patient and staff safety, modified practice processes and workflows, positive perceptions of and future plans for virtual visits, access to care, and patient satisfaction. Most submitters noted early successes with their interventions. CONCLUSION: A PI activity template designed for continuous board certification allowed family physicians to report on how they successfully implemented short term practice changes during the early stages of the COVID-19 pandemic. Reflections from this subset of physicians regarding lessons learned may prove useful in informing future COVID-19 related practice changes.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Certification , Family Practice , Humans , Pandemics , Physicians, Family , United States/epidemiology
6.
BMJ Open ; 12(4): e052955, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1774954

ABSTRACT

OBJECTIVES: Family physicians are usually patients' first point of contact with primary healthcare. This study aims to understand the experiences of family physicians who were infected with the COVID-19 and started working again. STUDY DESIGN AND SETTING: This qualitative study was conducted on 18 different family health centres in Adana. Data collection was performed through 18 interviews, each lasting an average of 46.6 min. The data were analysed using the qualitative content analysis method. PARTICIPANTS: The study included 18 family physicians (9 women and 9 men), and there were no significant differences between them by gender or seniority. RESULTS: The results of the study have shown that family physicians who were infected with the COVID-19 and started working again have experienced high levels of anxiety at work. In addition, due to the fear of being reinfected, family physicians' social relations with their colleagues have decreased. The results are discussed under two themes: anxieties and social relationships. CONCLUSION: In primary healthcare services, family physicians play a vital role during the pandemic. Many family physicians either lost their lives or got infected with the virus, recovered and worked in difficult conditions for a long time. Understanding the experiences of family physicians during the pandemic when they underwent COVID-19 and after they recovered could help to protect their psychological health and improve their work conditions.


Subject(s)
COVID-19 , Physicians, Family , Family Health , Female , Humans , Male , Pandemics , Qualitative Research
8.
Fam Med ; 54(3): 193-199, 2022 03.
Article in English | MEDLINE | ID: covidwho-1732593

ABSTRACT

BACKGROUND AND OBJECTIVES: In response to the COVID-19 pandemic, academic family physicians had to change their clinical, teaching, research, and administrative efforts, while simultaneously balancing their home environment demands. It is unclear how the changes in effort affected physicians' personal well-being, particularly burnout. This study sought to identify changes in faculty's clinical, teaching, research, and administrative efforts during the COVID-19 pandemic and how effort shifts were associated with burnout. We also examined associations with important demographics and burnout. METHODS: We took data from the 2020 Council of Academic Family Medicine's Educational Research Alliance survey of family medicine educators and practicing physicians during November 2020 through December 2020. We analyzed self-report measures of demographics, effort (clinical, teaching, research, and administrative) before and during the pandemic, COVID-19 exposure level, and rates of burnout (emotional exhaustion and depersonalization) using logistic regressions. RESULTS: Most participants reported no change in efforts. If changes were reported, clinical (21.6%) and administrative (24.8%) efforts tended to increase from before to during the pandemic, while teaching tended to decrease (27.7%). Increases in teaching and clinical efforts were associated with higher rates of emotional exhaustion. Higher depersonalization was associated with increased clinical efforts. Being older and working in a rural setting was associated with lower burnout, while being female was associated with higher burnout. CONCLUSIONS: Shifts in effort across academic family physicians' multiple roles were associated with emotional exhaustion and, to a lesser degree, depersonalization. The high rates of burnout demand additional attention from directors and administrators, especially among female physicians.


Subject(s)
COVID-19 , Burnout, Psychological , COVID-19/epidemiology , Faculty , Family Practice , Female , Humans , Pandemics , Physicians, Family
9.
Can Fam Physician ; 68(2): 157-158, 2022 02.
Article in English | MEDLINE | ID: covidwho-1707512
11.
Postgrad Med ; 134(2): 143-147, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1655783

ABSTRACT

In real practice, there is a paradox in the management of patients with 'long-term Covid-19.' Indeed, Family physicians (FPs) are on the front line in the management process of these patients. For 'long-term Covid-19' patients, and according to the World Health Organization guideline, the cardiopulmonary rehabilitation (CPR) should be provided not only at tertiary- or secondary care but mainly at primary care with a real implication of FPs. However, specific guidelines/recommendations were addressed for FPs. Therefore, an alternative including the CPR minimal advice that an FP should provide to 'long-term Covid-19' patients, seems to be necessary to respond to the needs of FPs to face their involvement with 'long-term Covid-19' patients. Thus, this paper aimed to report the CPR 'minimal advice' that should be provided by FPs managing 'long-term Covid-19' patients with incapacity (i.e.; alteration of the cardiorespiratory and muscular chain). According to the authors, FPs should be more cautious in the prescription of exercise and nutrition program and informed about the minimal advices related to nutritional and physical exercise rehabilitation guidelines when taking care of 'long-term Covid-19' patients, and how these guidelines can relieve the mental and physical problems, improve immunity, and accelerate the recovery process of the patients. With the occurrence of new variants of the severe acute respiratory syndrome coronavirus 2, the nutritional and exercise rehabilitation guidelines implemented by FPs become indispensable to promote the recovery of Covid-19 patients and support a return to normal life.


Subject(s)
COVID-19 , Exercise , Exercise Therapy , Humans , Physicians, Family , SARS-CoV-2
12.
Int J Environ Res Public Health ; 19(2)2022 01 16.
Article in English | MEDLINE | ID: covidwho-1635981

ABSTRACT

Trust in healthcare systems and physicians is considered important for the delivery of good healthcare. A cross-sectional survey was conducted on a random three-stage sample of the general population of Croatia (N = 1230), stratified by regions. Of respondents, 58.7% displayed a high or very high level of trust in the healthcare system, 65.6% in physicians, and 78.3% in their family physician. Respondents' views regarding patients' roles in the discussion of treatment options, confidence in physicians' expertise, and underlying motives of physicians were mixed. Respondents with a lower level of education, those with low monthly incomes, and those from smaller settlements had lower levels of trust in physicians and the healthcare system. Trust in other institutions, religiosity and religious beliefs, tolerance of personal choice, and experience of caring for the seriously ill and dying were predictors of trust in healthcare and physicians. Our findings suggest that levels of healthcare-related trust in Croatia are increasing in comparison with previous research, but need improvement. Levels of trust are lowest in populations that are most vulnerable and most in need of care and protection.


Subject(s)
Delivery of Health Care , Trust , Croatia , Cross-Sectional Studies , Humans , Physician-Patient Relations , Physicians, Family , Surveys and Questionnaires
13.
Afr J Prim Health Care Fam Med ; 13(1): e1-e3, 2021 Dec 10.
Article in English | MEDLINE | ID: covidwho-1593121

ABSTRACT

Chronic non-communicable diseases contribute significantly to Ghana's disease burden. Ghana's ability to achieve universal health coverage is threatened by the rising burden of chronic non-communicable diseases. There is a high unmet need for cardiovascular diseases care, with primary health care for cardiovascular diseases not being readily available, equitable, or sensitive to the requirements of target populations. The contribution of family physicians in the management of the chronic disease burden through care continuity cannot be overemphasised. This is a short report of the implementation of a chronic care clinic by a family physician in Manna Mission Hospital, which is located in the Greater Accra region of Ghana. Before the implementation, there was no such clinic in the hospital and patients with chronic conditions who visited the facility were sometimes lost to follow-up. The clinic which commenced in January 2019 has provided care for patients with chronic non-communicable diseases to date. The most common chronic diseases managed at the clinic include hypertension and heart failure, diabetes, stroke, asthma, sickle cell disease, and joint disorders. This report gives an account of the contribution of family physicians to chronic disease burden management through continuity of care in a low-resource setting like Ghana.


Subject(s)
Continuity of Patient Care , Physicians, Family , Chronic Disease , Disease Management , Ghana , Humans
14.
Int Arch Allergy Immunol ; 183(2): 217-224, 2022.
Article in English | MEDLINE | ID: covidwho-1593643

ABSTRACT

INTRODUCTION: Several statements and position papers on the management of childhood asthma and allergies during the COVID-19 pandemic have been published of late. The aim of this study was to evaluate the knowledge and awareness of pediatricians and family physicians regarding the management of asthma and allergic rhinitis during the pandemic according to recently published updated guidelines. METHOD: We conducted an online survey among pediatricians and family physicians in Turkey, using a questionnaire designed to evaluate 4 items: (1) the relationship between COVID-19 infection risk and pediatric asthma/allergic rhinitis and medications used in treatment; (2) the follow-up and management of asthma/allergic rhinitis according to published updated recommendations; (3) pediatricians' and family physicians' observations and perceptions of treatment compliance and the attitudes of their pediatric asthma patients; and (4) pediatricians and family physicians' attitudes to using telehealth in the follow-up and management of pediatric asthma patients during the pandemic. RESULTS: A total of 346 participants responded to the survey. The relationship between the risk of COVID-19 and asthma was known by less than 25% of the participants. More than 33% of family physicians and 20% of pediatricians were unaware that asthma medication does not lead to a susceptibility to COVID-19 infection; 55% of family physicians and 48% of pediatricians thought that patients showed better compliance with asthma controller medication; over 33% of pediatricians and approximately 50% of family physicians stated that they could not distinguish between an asthma attack and lung involvement in COVID-19 infection; of the respondents, over 75% stated that they prefer face-to-face visits with patients, even in situations that do not require a physical examination. CONCLUSION: The overall knowledge and awareness of pediatricians and, especially, family physicians regarding the management of pediatric asthma/allergic rhinitis during the pandemic is not at a satisfactory level. There is an urgent need to inform them about updated recommendations appearing in recent guidelines published by allergy organizations.


Subject(s)
Asthma/drug therapy , COVID-19/epidemiology , Health Knowledge, Attitudes, Practice , Practice Guidelines as Topic , Rhinitis, Allergic/drug therapy , SARS-CoV-2 , Adult , Child , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pediatricians , Physicians, Family
15.
S Afr Fam Pract (2004) ; 62(1): e1-e2, 2020 05 19.
Article in English | MEDLINE | ID: covidwho-1572739

ABSTRACT

No abstract available.


Subject(s)
COVID-19 , Cross-Sectional Studies , Humans , Physicians, Family , SARS-CoV-2
16.
Ann Intern Med ; 174(11): 1630-1631, 2021 11.
Article in English | MEDLINE | ID: covidwho-1524534
17.
Afr J Prim Health Care Fam Med ; 13(1): e1-e5, 2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1524286

ABSTRACT

This short report describes the role that family physicians (FPs) (and family medicine registrars) played to provide care for the homeless people in shelters (both temporary and permanent) during the coronavirus disease 2019 (COVID-19) lockdown in the City of Tshwane, South Africa. The lockdown resulted in the establishment of a large number of temporary shelters. The FPs took on the task to provide comprehensive and coordinated primary care, whilst extending their activities in terms of data management, quality improvement, capacity building and research. The FPs worked in teams with other healthcare providers and contributed a unique set of skills to the process. This report demonstrates the value of responding quickly and appropriately through communication, cooperation and innovation. It also demonstrates the large number of areas in which FPs can make a difference when engaged appropriately, with the necessary support and collaboration, thus making a positive impact in the already overburdened health services.


Subject(s)
COVID-19 , Physicians, Family , Communicable Disease Control , Health Services , Humans , SARS-CoV-2
18.
J Am Board Fam Med ; 34(6): 1071-1073, 2021.
Article in English | MEDLINE | ID: covidwho-1515527

ABSTRACT

This issue of the JABFM features research on a broad array of clinical topics. The topics of 5 articles involve controlled substances, including a sobering article on the risks of amphetamines in older adults. An excellent quick reference guide for managing common COVID-19 symptoms is presented. Two other articles consider hypertension treatment in primary care, demonstrating that treating blood pressure is anything but straightforward. Several additional clinical topics include mononucleosis, influenza, and the impact of home life on childhood weight and eating habits. A study from Virginia underscores that primary care, as a system, is distressed. A review of the existing literature on "slow medicine" comes to important conclusions. Some health systems are partnering with local resources to practically address such social determinants as food insecurity. Not surprisingly, family physicians are filling gaps in emergency care around the country.


Subject(s)
COVID-19 , Hypertension , Aged , Child , Controlled Substances , Humans , Hypertension/diagnosis , Hypertension/drug therapy , Physicians, Family , SARS-CoV-2
19.
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
20.
Afr J Prim Health Care Fam Med ; 13(1): e1-e3, 2021 Sep 30.
Article in English | MEDLINE | ID: covidwho-1463908

ABSTRACT

A group of Vanguard Community Health Centre doctors embarked on a Health System's Improvement (HSI) project with the aim of reducing harm to renal function in patients who were either commenced on or switched to a dolutegravir (DTG)-based antiretroviral therapy (ART) regimen since 2019, when the usual monitoring and evaluation of ART-regimen switches were disrupted by the coronavirus disease 2019 (COVID-19) pandemic. This intended harm-reduction exercise, involving a reflective process that was facilitated by the family physician, led to the development of a Vanguard Renal Protection Surveillance tool, which is now used at Vanguard to detect and prevent renal decline.


Subject(s)
COVID-19 , HIV Infections , HIV Infections/drug therapy , Heterocyclic Compounds, 3-Ring , Humans , Kidney/physiology , Oxazines , Physicians, Family , Piperazines , Pyridones , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL