It takes a community to conceive: an analysis of the scope, nature and accuracy of online sources of health information for couples trying to conceive.

This study examined the nature and accuracy of information available across online platforms for couples trying to conceive. A consumer simulation-based investigation of English websites and social media (Facebook, Twitter, Instagram) was undertaken using common search terms identified in a pilot study. Claims about fertility and pregnancy health were then extracted from the results and analysed thematically. The accuracy of each claim was assessed independently by six fertility and conception experts, rated on a scale of 1 (not factual) to 4 (highly factual), with scores collated to produce a median rating. Claims with a median score < 3 were classified as inaccurate. The use of the terms 'trying to conceive' and '#TTC' were common identifiers on online platforms. Claims were extracted predominantly from websites (n = 89) rather than social media, with Twitter and Instagram comprising commercial elements and Facebook focused on community-based support. Thematic analysis revealed three major themes among the claims across all platforms: conception behaviour and monitoring, lifestyle and exposures, and medical. Fact-checking by the experts revealed that 40% of the information assessed was inaccurate, and that inaccuracies were more likely to be present in the conception behaviour and monitoring advice, the topics most amenable to modification. Since online information is a readily accessible and commonly utilized resource, there is opportunity for improved dissemination of evidence-based material to reach interested couples. Further cross-disciplinary and consumer-based research, such as a user survey, is required to understand how best to provide the 'trying to conceive' community with accurate information.

Effectiveness of cognitive behavioural coaching in improving the well-being and retention of rural general practitioners.

OBJECTIVE: To determine the relationship between cognitive behavioural coaching, the well-being of rural general practitioners (GPs), their intentions to leave and actual leaving of rural general practice. DESIGN: Quasi-experimental study utilising an intervention group of rural GPs and deidentified data for a baseline group and a control group consisting of the remaining population of rural GPs in South Australia. SETTING: Rural general practice. PARTICIPANTS: Rural GPs in South Australia: intervention group (n = 69), baseline group (n = 205) and control group (n = 312). INTERVENTIONS: A 9-hour cognitive behavioural coaching program. MAIN OUTCOME MEASURE(S): Rural doctor distress, intention to leave rural general practice and actual retention rate of rural GPs. RESULTS: GPs who underwent cognitive behavioural coaching had lower rural doctor distress scores (mean = 24.50; confidence interval, 21.71-27.29) than the baseline group (mean = 28.63; confidence interval, 27.08-30.17). Before coaching, 81% of rural GPs in the intervention group had considered leaving general practice, which reduced to 40% after coaching (χ(2) (2) = 16.31, P < .001). Over a 3-year period, 94% of the coaching group remained in general practice compared with 80% of the control group (χ(2) (1) = 4.89, P = 0.027). CONCLUSIONS: Cognitive behavioural coaching reduced the stress levels of rural GPs who self-identified the need for managing stress and reduced their intention to leave rural general practice. Further, despite initially being more stressed compared with the general population of rural GPs, more GPs from the coaching group remained in rural general practice.

Impact of support initiatives on retaining rural general practitioners.

OBJECTIVE: This study aimed to evaluate the impact of the Dr DOC program, a rural doctor workforce support program, which consists of social and psychological support and practical interventions, on the well-being and retention of rural GPs. DESIGN: Rural GPs were assessed on different aspects of well-being and their intentions to leave rural general practice, and these were compared with similar data collected two years prior. SETTING: Rural general practices in South Australia. PARTICIPANTS: Two hundred and twenty-one rural GPs (55% of South Australian rural GP workforce). MAIN OUTCOME MEASURES: GPs completed a questionnaire assessing their levels of support, intention to leave rural practice, use of the dr doc program, and psychological health. RESULTS: Improvements were found in the support networks and in the physical and emotional health of rural GPs from time 1 to time 2. There was also a reduction in the number of GPs wanting to leave rural general practice in the short to medium term (from 30% to 25%). CONCLUSIONS: The initial study in this series suggested that improving psychological well-being might influence rural GPs' intentions to leave rural practice. The current study confirms these suggestions by demonstrating that programs targeted at psychological and physical well-being do indeed impact on rural GPs' intentions to leave. The results of this study highlight the role of psychological well-being in retaining rural GPs and emphasise the value of developing psychologically based programs to not only boost the physical and mental health of GPs, but also to reduce departure from rural areas.

The role of psychological well-being in retaining rural general practitioners.

OBJECTIVE: Retention of rural GPs is an increasing area of concern and is receiving considerable attention from the government, medical authorities and the media. This study aimed to examine the potential for psychological interventions to assist in the retention of rural GPs through targeting their psychological well-being. DESIGN: GPs completed a questionnaire, including questions about their level of support in rural practice, psychological health (work-related morale and distress, distress related specifically to working in rural general practice, quality of work life) and intentions to leave rural practice. SETTING: Rural general practices in South Australia. PARTICIPANTS: One hundred and eighty-seven rural GPs. RESULTS: Results indicated that rural GPs who were seriously considering leaving rural practice had higher work-related distress, higher distress related specifically to working in a rural general practice and lower quality of work life. GPs who considered leaving rural practice also reported having fewer colleagues with whom to discuss professional issues. CONCLUSION: Results indicated that psychological interventions (such as cognitive behavioural training), assistance with stress reduction and coping mechanisms (such as more interaction with colleagues) may be of benefit to GPs who are considering leaving rural practice. Such training may increase the number of GPs who ultimately stay in rural practice.

Physician you can heal yourself! Cognitive behavioural training reduces stress in GPs.

BACKGROUND: High stress and low morale is a well accepted and studied phenomenon in general practice. OBJECTIVE: This study aimed to determine the benefits and mechanisms of stress management training in improving the psychological well-being and morale of GPs. METHODS: There were 85 GPs in the treatment group and 25 GPs in the control group, all from the Adelaide metropolitan region. The treatment group GPs were surveyed by questionnaire before and after a 15 h cognitive behavioural stress management training programme. RESULTS AND CONCLUSION: The study found that following this training programme, GPs' quality of work life and morale improved while their work-related distress and general psychological distress decreased. These gains were maintained or further improved at 12 week follow-up. Furthermore, results suggested that the most robust long-term benefits came from developing a problem-focused style to cope with life and work events.