Abstract:
BACKGROUND:Patients vary widely when making decisions to consult primary care. Some present frequently with trivial illness: others delay with serious disease. Differences in health service provision may play a part in this. We aimed to explore whether and how patients' consulting intentions take account of their perceptions of health service provision. METHODS:Four focus groups and 51 semi-structured interviews with 78 participants (45 to 64 years) in eight urban and rural general practices in Northeast and Southwest Scotland. We used vignettes to stimulate discussion about what to do and why. Inductive analysis identified themes and explored the influence of their perceptions of health service provision on decision-making processes. RESULTS:Anticipated waiting times for appointments affected consulting intentions, especially when the severity of symptoms was uncertain. Strategies were used to deal with this, however: in cities, these included booking early just in case, being assertive, demanding visits, or calling out-of-hours; in rural areas, participants used relationships with primary care staff, and believed that being perceived as undemanding was advantageous. Out-of-hours, decisions to consult were influenced by opinions regarding out-of-hours services. Some preferred to attend nearby emergency departments or call 999. In rural areas, participants tended to delay until their own doctor was available, or might contact them even when not on call. CONCLUSION:Perceived barriers to health service access affect decisions to consult, but some patients develop strategies to get round them. Current changes in UK primary care are unlikely to reduce differences in consulting behaviour and may increase delays by some patients, especially in rural areas.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Campbell NC,Iversen L,Farmer J,Guest C,MacDonald Jdoi
10.1186/1471-2296-7-26subject
Has Abstractpub_date
2006-04-26 00:00:00pages
26issn
1471-2296pii
1471-2296-7-26journal_volume
7pub_type
杂志文章abstract:BACKGROUND:Obesity is an important public health problem. However, the effects of alcohol use on the risk for obesity have not been thoroughly explored. This study focuses on how frequency of alcohol use is related to the risk of obesity in a community medicine clinic population. METHODS:This study used a cross-sectio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-17
更新日期:2005-04-22 00:00:00
abstract:BACKGROUND:Since 2008 mental health practice nurses have been gradually introduced in general practices in the Netherlands as part of health policy aiming to improve early identification and treatment of mental health problems in primary care. This study aims to investigate the effect of the introduction of the practic...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-0938-3
更新日期:2019-04-02 00:00:00
abstract:BACKGROUND:Standardised generic patient-reported outcome measures (PROMs) which measure health status are often unresponsive to change in primary care. Alternative formats, which have been used to increase responsiveness, include individualised PROMs (in which respondents specify the outcomes of interest in their own w...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0850-2
更新日期:2018-09-27 00:00:00
abstract:BACKGROUND:General Practitioners (GPs) employ strategies to identify and retrieve medical evidence for clinical decision making which take workload and time constraints into account. Optimal Foraging Theory (OFT) initially developed to study animal foraging for food is used to explore the information searching behaviou...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-90
更新日期:2011-08-23 00:00:00
abstract:BACKGROUND:A well-functioning general practice sector that has a strong research component is recognised as a key foundation of any modern health system. General practitioners (GPs) are more likely to collaborate in research if they are part of an established research network. The primary aims of this study are to desc...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1100-y
更新日期:2020-02-05 00:00:00
abstract:BACKGROUND:Guidelines for primary prevention of cardiovascular disease provide little guidance on how patients' preferences should be taken into account. We wanted to explore whether general practitioners (GPs) are sensitive to patient preferences regarding survival gains from statin therapy. METHODS:In a cross sectio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0288-8
更新日期:2015-07-03 00:00:00
abstract:BACKGROUND:The role of primary care professionals in lifestyle counseling for smoking, alcohol consumption, physical activity, and diet is receiving attention at the national level in many countries. The U. S. and Sweden are two countries currently establishing priorities in these areas. A previously existing internati...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-83
更新日期:2014-05-03 00:00:00
abstract:BACKGROUND:Primary care, and its transformation into Primary Health Care (PHC), has become an area of intense policy interest around the world. As part of this trend Alberta, Canada, has implemented Primary Care Networks (PCNs). These are decentralized organizations, mandated with supporting the delivery of PHC, funded...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01330-7
更新日期:2020-12-05 00:00:00
abstract:BACKGROUND:Disabling fatigue is the main illness related reason for prolonged absence from school. Although there are accepted criteria for diagnosing chronic fatigue in adults, it remains uncertain as to how best to define disabling fatigue and Chronic Fatigue Syndrome (CFS) in children and adolescents. In this popula...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-33
更新日期:2005-08-09 00:00:00
abstract:BACKGROUND:Despite evidence supporting the effectiveness of alcohol screening and brief advice to reduce heavy drinking, implementation in primary healthcare remains limited. The challenges that clinicians experience when delivering such interventions are well-known, but we have little understanding of the patient pers...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01142-9
更新日期:2020-04-22 00:00:00
abstract:BACKGROUND:Multimorbidity poses a challenge for decision-making processes and requires that more attention is paid to patient goals, preferences and needs; however, goal setting is not yet widely recognised as a core aspect of the shared decision-making (SDM) approach. This study aims to analyse clinician perceptions o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-0966-z
更新日期:2019-06-06 00:00:00
abstract:BACKGROUND:A cluster randomised trial was conducted to determine the effectiveness of locally adapted practice guidelines and education about paediatric asthma management, delivered to general practitioners (GPs) in small group interactive workshops. METHODS:Twenty-nine practices were randomly allocated to one of thre...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-9-22
更新日期:2008-04-20 00:00:00
abstract:BACKGROUND:In order to proceed from a paper based registration to a surveillance system that is based on extraction of electronic health records (EHR), knowledge is needed on the number and representativeness of sentinel GPs using a government-certified EHR system and the quality of EHR data for research, expressed in ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-50
更新日期:2010-06-25 00:00:00
abstract:BACKGROUND:The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be bas...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-12-144
更新日期:2011-12-30 00:00:00
abstract:BACKGROUND:Accreditation is a widespread tool for quality management in health care. However, there is lack of research on the impact of accreditation, particularly in general practice. This study explores how general practitioners and their staff experienced the impact of a mandatory accreditation program in Denmark. ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-1034-4
更新日期:2019-10-28 00:00:00
abstract:BACKGROUND:Attention deficit hyperactivity disorder (ADHD) is underdiagnosed in the UK and the assessment and diagnosis pathway often involves a general practitioner (GP) referral to secondary care services. GPs' levels of knowledge and understanding about ADHD is often a significant barrier in patients accessing care....
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01289-5
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Over 60% of people have overweight or obesity, but only a third report receiving counselling from primary care providers. We explored patients' perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0596-2
更新日期:2017-02-08 00:00:00
abstract:BACKGROUND:It is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis w...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-43
更新日期:2007-07-24 00:00:00
abstract:BACKGROUND:The numbers of learners seeking placements in general practice is rapidly increasing as an ageing workforce impacts on General Practitioner availability. The traditional master apprentice model that involves one-to-one teaching is therefore leading to supervision capacity constraints. Vertically integrated (...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-144
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder, that affects approximately 10% of the general population and the majority are diagnosed in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, som...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0225-x
更新日期:2015-01-28 00:00:00
abstract:BACKGROUND:The reorientation of primary health care towards prevention is fundamental to addressing the rising burden of chronic disease. However, in Australia, cardiovascular disease prevention practice in primary health care is not generally consistent with existing guidelines. The Model for Prevention study was a wh...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0580-x
更新日期:2017-02-24 00:00:00
abstract:BACKGROUND:International disease management guidelines recommend the regular assessment of depression and anxiety in heart failure patients. Currently there is little data on the effect of screening for depression and anxiety on the quality of life and the prognosis of heart failure (HF). We will investigate the associ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-180
更新日期:2013-11-27 00:00:00
abstract:BACKGROUND:Medication review is often recommended to optimize medication use. In clinical practice it is mostly operationalized as an intervention without co-interventions during a short term intervention period. However, most systematic reviews also included co-interventions and prolonged medication optimization inter...
journal_title:BMC family practice
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12875-016-0577-x
更新日期:2017-01-17 00:00:00
abstract:BACKGROUND:Switzerland is facing a shortage of primary care physicians (PCPs); government organizations therefore suggested a broad variety of interventions to promote primary care. The aim of the study was to prioritize these interventions according to the acceptance and perceived barriers of most relevant groups of p...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0397-4
更新日期:2015-12-15 00:00:00
abstract:BACKGROUND:The objective of this study is to perform an independent evaluation of the feasibility and effectiveness of an educational programme for the primary prevention of type 2 diabetes (DM2) in high risk populations in primary care settings, implanted within the Basque Health Service - Osakidetza. METHODS/DESIGN:...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-13-109
更新日期:2012-11-16 00:00:00
abstract:BACKGROUND:Over 90% of antibiotics for human use in Europe are prescribed in primary care. We assessed the congruence between primary care treatment guidelines for skin infections and commensal Staphylococcus aureus (S. aureus) antimicrobial resistance levels in community-dwelling persons. METHODS:The prevalence of an...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-014-0175-8
更新日期:2014-10-25 00:00:00
abstract:BACKGROUND:The way GPs work does not appear to be adapted to the needs of depressive patients. Therefore we wanted to examine Swedish GPs' conceptions of depressive disorders and their treatment and GPs' ideas of factors that may influence their manner of work with depressive patients. METHODS:A postal questionnaire t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-21
更新日期:2005-05-16 00:00:00
abstract:BACKGROUND:The general practitioner (GP) can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about wei...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2296-9-58
更新日期:2008-10-14 00:00:00
abstract:BACKGROUND:The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary care systems have on t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-115
更新日期:2011-10-20 00:00:00
abstract:BACKGROUND:Depression is a major health concern, predominantly treated by general practitioners (GPs). Problem solving therapy (PST) is recognised as an effective treatment for depression that is not widely used by GPs. This research aims to explore barriers and enablers that may influence GPs use of this treatment. M...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-24
更新日期:2007-04-25 00:00:00