Abstract:
BACKGROUND:Unattached patients do not have a regular primary care provider. Initiatives are being developed to increase attachment rates across Canada. Most existing attention paid to patient unattachment has focused on quantifying the problem and health system costs. Our purpose is to qualitatively identify the implications of chronically ill patients' experiences of unattachment for health policy and planning to provide policy-relevant insights for Canadian attachment initiatives. METHODS:Three focus groups were conducted with marginalized chronically ill individuals residing in a mid-sized city in British Columbia who are unattached to a family doctor. We use the term marginalized as a descriptor to acknowledge that by virtue of their low socio-economic status and lack of attachment the participants are marginalized in Canada's health care system Focus groups were structured as an open conversation organized around a series of probing questions. They were digitally recorded and transcribed verbatim. Thematic analysis was employed. RESULTS:Twenty-six individuals participated in the focus groups. The most common chronic illnesses reported were active drug addiction or recovery (and their associated symptoms), depression, arthritis, and hepatitis C. Participants identified life transitions as being the root cause for not having a family doctor. There was a strong sense that unsuccessful attempts to get a family doctor reflected that they were undesirable patients. Participants wanted to experience having a trusting relationship with a regular family doctor as they believed it would encourage greater honesty and transparency. One of the main health concerns regarding lack of access to a regular family doctor is that participants lacked access to preventative care. Participants were also concerned about having a discontinuous medical record due to unattachment. CONCLUSIONS:Participants perceived that there are many benefits to be had by having attachment to a regular family doctor and that experiencing unattachment challenged their health and access to health care. We encourage more research to be done on the lived experience of unattachment in order to provide on-the-ground insights that policy-makers require in order to develop responsive, patient-centred supports and programs.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Crooks VA,Agarwal G,Harrison Adoi
10.1186/1471-2296-13-69subject
Has Abstractpub_date
2012-07-16 00:00:00pages
69issn
1471-2296pii
1471-2296-13-69journal_volume
13pub_type
杂志文章abstract:BACKGROUND:Multimorbidity is defined as suffering from coexistent chronic conditions. Multimorbid patients demand highly complex patient-centered care which often includes polypharmacy, taking an average of six different drugs per day. Adverse drug reactions, adverse drug events and medication errors are all potential ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-119
更新日期:2013-08-15 00:00:00
abstract:BACKGROUND:Unhealthy alcohol use involves a spectrum from hazardous use (exceeding guidelines but no harms) through to alcohol dependence. Evidence-based management of unhealthy alcohol use in primary health care has been recommended since 1979. However, sustained and systematic implementation has proven challenging. T...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1101-x
更新日期:2020-02-13 00:00:00
abstract:BACKGROUND:It has for years been discussed whether practice staff should be involved in patient care in general practice to a higher extent. The research concerning task delegation within general practice is generally increasing, but the literature focusing on its influence on general practitioners' and their staff's j...
journal_title:BMC family practice
pub_type: 杂志文章,评审
doi:10.1186/s12875-016-0565-1
更新日期:2016-11-30 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:Even though addressing lifestyle problems is a major recommendation in most guidelines for the treatment of hypertension (HTN), alcohol problems are not routinely addressed in the management of hypertension in primary health care. METHODS:Internet based survey of 3081 primary care physicians, recruited via ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0529-5
更新日期:2016-09-08 00:00:00
abstract:BACKGROUND:Many lifestyle interventions for patients with prediabetes or type 2 diabetes mellitus (T2DM) have been investigated in randomised clinical trial settings. However, the translation of these programmes into primary care seems challenging and the prevalence of T2DM is increasing. Therefore, there is an urgent ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-95
更新日期:2011-09-13 00:00:00
abstract:BACKGROUND:Registered Sick Children's Nurses and District Nurses employed at Child Health Care centres are in a position to help prevent childhood overweight and obesity. Prevention of this challenging public health threat could be improved through having a better understanding of how this group of nurses perceives chi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-57
更新日期:2012-06-14 00:00:00
abstract:BACKGROUND:Low patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telepho...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0681-6
更新日期:2018-01-11 00:00:00
abstract:BACKGROUND:This study describes the influence of educational level on bone mineral density (BMD) and investigating the relationship between educational level and bone mineral density in postmenopausal women. METHODS:A total of 569 postmenopausal women, from 45 to 86 years of age (mean age of 60.43 +/- 7.19 years) were...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-5-18
更新日期:2004-09-06 00:00:00
abstract:BACKGROUND:Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for man...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-10-9
更新日期:2009-01-26 00:00:00
abstract:BACKGROUND:Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. METHODS:We used a novel priority-setting method for i...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0552-6
更新日期:2016-11-16 00:00:00
abstract:BACKGROUND:General practitioners (GPs) often lack time and resources to invest in health education; audiovisual messages broadcast in the waiting room may be a useful educational tool. This work was designed to assess the effect of a message inviting patients to ask for a tetanus booster vaccination. METHODS:A quasi e...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-12-104
更新日期:2011-09-28 00:00:00
abstract:BACKGROUND:Little is known about psychological impact of disclosing lifestyle-related diseases. Previous studies discussed the long-term psychological impact of disease disclosure, and a significant psychological impact was not observed. This study clarified the psychological impact on anxiety state of patients when li...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0272-3
更新日期:2015-05-14 00:00:00
abstract:BACKGROUND:There is compelling evidence that there is substantial undetected vision loss amongst older people. Early recognition of undetected vision loss and timely referral for treatment might be possible within general practice, but methods of identifying those with unrecognised vision loss and persuading them to ta...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-99
更新日期:2013-07-16 00:00:00
abstract:BACKGROUND:The impact of caring for a family member or friend is a life changing experience. Often carers are struggling to cope with ongoing demands of caring for someone. At some point, most carers will approach their family physician for advice on aspects of their role. Carers Western Australia sought information an...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-7-33
更新日期:2006-05-24 00:00:00
abstract:BACKGROUND:When medically unexplained physical symptoms (MUPS) become persistent, it may have major implications for the patient, the general practitioner (GP) and for society.Early identification of patients with MUPS in electronic medical records (EMRs) might contribute to prevention of persistent MUPS by creating aw...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-109
更新日期:2014-06-05 00:00:00
abstract:BACKGROUND:We have shown previously that current recommendations in UK guidelines for monitoring long-term conditions are largely based on expert opinion. Due to a lack of robust evidence on optimal monitoring strategies and testing intervals, the guidelines are unclear and incomplete. This uncertainty may underly vari...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01331-6
更新日期:2020-12-05 00:00:00
abstract:BACKGROUND:Alcohol dependence (AD) in Europe is prevalent and causes considerable health burden. Recognition by general practitioners (GPs) and provision of or referral to treatment may contribute to reduce this burden. This paper studied AD prevalence in varying European primary care settings and examined who received...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0308-8
更新日期:2015-07-29 00:00:00
abstract:BACKGROUND:The definition of primary care varies between countries. Swedish primary care has developed from a philosophic viewpoint based on quality, accessibility, continuity, co-operation and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-8
更新日期:2007-03-08 00:00:00
abstract:BACKGROUND:Distress is an expected emotional response to a negative life event. Experiences common in later life may trigger distress such as bereavement or loss of physical mobility. Distress is considered to be distinct to anxiety and/or depression and is not diagnostically labelled as a mental health problem. Older ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01152-7
更新日期:2020-05-04 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:Ischaemic heart disease and congestive heart failure are common and important conditions in family practice. Effective treatments may be underutilized, particularly in women and the elderly. The objective of the study was to determine the rate of prescribing of evidence-based cardiovascular medications and d...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-5-6
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Urinary tract infections are one of the most common reasons for prescribing antibiotics in primary care. Current guidelines recommend fosfomycin, nitrofurantoin, or trimethoprim - sulfamethoxazol as empiric first line antimicrobial agents in uncomplicated infections. However, there is evidence that the use o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01201-1
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Chronically ill patients often experience psychosocial problems in everyday life. A biopsychosocial approach is considered to be essential in chronic care. In Dutch primary health care the current biomedically oriented clinical practice may conflict with the biopsychosocial approach. This study is aimed to e...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-14
更新日期:2012-03-12 00:00:00
abstract:BACKGROUND:People who are diagnosed with both mental and chronic medical illness present unique challenges for the health care system. In resource-limited settings, such as rural India, people with depression and anxiety are often under-served, due to both stigma and lack of trained providers and resources. These chall...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-018-0845-z
更新日期:2018-09-11 00:00:00
abstract:BACKGROUND:The increasing number of available point-of-care (POC) tests challenges clinicians regarding decisions on which tests to use, how to efficiently use them, and how to interpret the results. Although POC tests may offer benefits in terms of low turn-around-time, improved patient's satisfaction, and health outc...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0893-4
更新日期:2019-01-10 00:00:00
abstract:BACKGROUND:Survivers of stroke or transient ischaemic attacks (TIA) are at risk of new vascular events. Our objective was to study primary health care patients with stroke/TIA regarding their knowledge about risk factors for having a new event of stroke/TIA, possible associations between patient characteristics and pat...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-47
更新日期:2010-06-15 00:00:00
abstract:BACKGROUND:Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-81
更新日期:2009-12-17 00:00:00
abstract:BACKGROUND:Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0224-y
更新日期:2015-01-29 00:00:00
abstract:BACKGROUND:Biological and sociocultural differences between men and women may play an important role in medical treatment. Little is known about the awareness of these differences among general practitioners (GPs) and if they consider such differences in their medical practice. The aim of this study was to explore GPs'...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0351-5
更新日期:2015-10-13 00:00:00