Primary Health Care Nurses Research Articles

Educational technology on tuberculosis: construction shared with Primary Health Care nurses

RESUMO Objetivo: elaborar, de forma participativa, uma tecnologia educacional para auxiliar enfermeiros no manejo dos casos de tuberculose na Atenção Primária à Saúde. Métodos: pesquisa metodológica com abordagem qualitativa. Os dados foram coletados entre junho e outubro de 2022, em 25 Unidades Básicas de Saúde, com 41 enfermeiros entrevistados individualmente. Realizou-se análise de conteúdo temática para guiar a elaboração da tecnologia. Resultados: organizaram-se três categorias empíricas, demonstrando as facilidades e dificuldades no manejo da tuberculose, as concepções sobre tecnologia educacional como facilitadora do processo ensino-aprendizagem na Atenção Primária à Saúde e o desenvolvimento participativo da tecnologia. Os enfermeiros foram favoráveis à construção de uma tecnologia na forma de guia instrutivo, e teceram sugestões para incentivar sua criação e utilização no cotidiano dos serviços. Considerações finais: o processo participativo possibilitou criar a tecnologia para auxiliar enfermeiros no processo ensino-aprendizagem na Atenção Primária à Saúde sobre os cuidados à pessoa com tuberculose.

User experiences of an app-based mHealth intervention (MINISTOP 2.0) integrated in Swedish primary child healthcare among Swedish-, Somali- and Arabic-speaking parents and child healthcare nurses: A qualitative study.

Preventive and scalable interventions, accessible to all, to counteract childhood obesity are urgently needed. We have recently developed a novel, digital parental intervention (MINISTOP 2.0 app) available in Swedish, Somali, Arabic and English. We have previously reported its positive effects on children's health behaviors and on parental self-efficacy. However, before introducing the app at scale in primary child healthcare, implementation aspects also need to be explored. This study aims to explore and describe user experiences as well as acceptability and feasibility of the MINISTOP 2.0 app-based intervention in a diverse group of parents (end-users) and Swedish child healthcare nurses (implementers). Individual interviews were conducted with Swedish- (n = 9), Somali- (n = 9), Arabic- (n = 5) and English-speaking (n = 1) parents as well as Swedish primary child healthcare nurses (n = 15). Data was analyzed using content analysis with an inductive latent approach. Parents described how the app facilitated behavior change through increased awareness regarding current diet and physical activity behaviors. Furthermore, the evidence-based app content further facilitated trust and behavior change. Both parents and nurses acknowledged the app's preventive potential and the potential for reaching parents with diverse backgrounds or in need of extra support. The MINISTOP 2.0 app was perceived as a useful tool for health promotion both by parents and healthcare professionals, especially since it was adapted to several languages. These findings coupled with the previously shown beneficial effects on health behaviors support the large-scale implementation of the app in primary child healthcare.

Educational action to monitor children's growth and development based on the theory of meaningful learning.

Evaluating the effect of an educational program on the knowledge of Primary Health Care nurses regarding the surveillance of growth and development during childcare appointments. A before-after intervention study with 30 nurses. The nurses' knowledge and practice assessment were done using a tool that had been developed and validated. The educational activity was carried out, linking child growth and development indicators with public policies for early childhood and nurses' practices. David Ausubel's Significant Learning Theory was used as a teaching-learning strategy. The same instrument was reapplied after one month. Descriptive statistics were used in the analysis and the proportion test, Wilcoxon test and Item Response Theory with the Rasch model were applied. The nurses checked more items right in the instrument after the intervention; there was an increase in the scores of correct answers and a decrease in the item response difficulty index in the knowledge and practice section, post-intervention. The educational activity had a positive effect, affecting changes in nurses' knowledge and practice, which enabled childcare consultations to become more qualified.

Health care for homosexual women: discourses of Primary Health Care nurses

Health care for homosexual women: discourses of Primary Health Care nurses

Family caregivers' itineraries of preschool children who survived leukemia: implications for primary healthcare nursing.

to analyze the path taken by family caregivers of preschool children who survived leukemia and discuss the implications for primary healthcare nursing. the narrative interview guided by a talking map and body knowledge was used with family members of children who survived leukemia, living in Rio de Janeiro (capital) and São Paulo (countryside). Conversation analysis was applied to the data. five family groups (seven people) of five children started their journey in the professional subsystem of private services; four were assisted in the private sector since the onset of the illness; one was assisted in public and private services. Living conditions reduced barriers to accessing supplementary health, facilitating coordination, and listening to a reference professional. the itinerary was marked by attentive listening to family caregivers by reference professionals, favoring early diagnosis, initiation of treatment, and resolution of leukemia with the cure of children.

Importance and efficacy of health promotion by primary care nurses

The core of many countries' primary care strategies has been increasing community engagement in primary care, greater efforts in preventive illnesses and promoting health, and greater harmony and synergy of current services in accordance with the community's needs. Primary care nurses have a lot of opportunity to provide strategies for health promotion and prevention, and prior research has revealed the multitude of functions that nurses can play, such as managing complex medical problems. Nurses employed in general practices have been observed to be effective in providing a number of preventative initiatives, including smoking cessation. It has been seen that though nurses who work in this environment are eager to counsel patients about physical exercise but have major deficiencies in their understanding of existing recommendations, suggesting a dearth of training preparation for such tasks. Very often, primary health care nurses' ability to undertake health promotion is restricted by the general practice environment, their skillset, and general practitioners' perspectives toward nurses' participation in health promotion activities. Primary care nurses may be able to bridge the gap between societal expectations of this field and how patients view prevention in the context of general practice. Primary care nurses have a lot of room to grow in their ability to collaborate with other healthcare providers and work outside the confines of general practice settings. In primary care settings, nursing appears to be underused despite its potential to be working more successfully in HPP. The effectiveness of present primary health care changes depends on identifying and addressing the enablers and hurdles to health promotion and prevention among primary care nurses.

Impact of the Empathic Understanding of People and Type D Personality as the Correlates of Social Skills of Primary Health Care Nurses: A Cross-Sectional Study.

Efficient functioning at work depends on social skills. The aim of this study was to assess the relationship among empathy, type D personality traits, and the level of social skills among Primary Health Care (PHC) nurses. A cross-sectional study was carried out involving 446 PHC nurses. In the multidimensional model, after taking into account disruptive variables (age, place of residence, postgraduate education and self-assessment of health), as in one-dimensional models, respondents with a higher level of empathic understanding of other people were found to have a higher level of social skills (b = 0.76; SE = 0.11; p < 0.001), while a lower level of social skills was observed among respondents with traits which are characteristic of type D personality (b = −11.86; SE = 2.28; p < 0.001). The results of the study show that personal predispositions, such as empathy or type D personality, may support or hinder the shaping of social skills of nurses. Therefore, it is essential to create an individualised approach when nurses are undergoing social skills training.

The effects of antiretroviral stockout on primary health care nurses in the Ethekwini and Ilembe districts, KwaZulu-Natal

Background: Nurses face challenges of antiretroviral therapy (ART) stock out when rolling out, leading to drug resistance, poor compliance and decreased viral suppression. Poor viral suppression leads to higher morbidity and mortality rates, hence a need to strengthen supply chain principles in order to achieve equal distribution of resources amongst clinics. Nurses also need to have relevant guidelines available to prevent treatment failure. The study aimed to describe the effects of ART stockouts on primary health nurses rolling out ART in clinics in KwaZulu Natal. Methods: The study followed a qualitative approach, using a descriptive design. Two primary healthcare clinics in Ilembe and Ethekwini districts were selected for the study. The population comprised of 8 purposively selected participants. In-depth interviews and focus groups were conducted to describe the experiences of primary health care nurses rolling out antiretroviral therapy regarding stockout and how it was managed. Data collection and analysis followed Yates, Partridge and Bruce steps. Ethics and trustworthiness were maintained. Results: The singular theme of inconsistent availability of treatment emerged, as well as sub-themes of means used to manage treatment stockout and supply change management issues. Conclusions: An adequate supply of ART through an efficient supply chain management strategy, ongoing training in primary health care and nurse-initiated management of antiretroviral therapy and the availability of treatment guidelines should be enforced.

Training needs of professional nurses in primary health care in the Cape Metropole, South Africa

The African Journal of Primary Health & Family Medicine welcomes submissions that encourage scholarly exchange between family medicine and primary health care researchers and practitioners across Africa and the developing world, whilst providing a contextual and holistic view of family medicine as practiced across the continent.

"Talking on the Phone Is Very Cold"-Primary Health Care Nurses' Approach to Enabling Patient Participation in the Context of Chronic Diseases during the COVID-19 Pandemic.

Strengthening patient participation is considered a crucial element of primary health care (PHC) nurses' practice when working with chronically ill patients. The COVID-19 pandemic had extraordinary effects on PHC nursing routines and how chronically ill patients' could be involved in their own care. This study investigates the adaptation of Spanish PHC nurses' approaches to supporting the participation of patients living with chronic illness during the COVID-19 pandemic. To reach this goal, we interviewed 13 PHC nurses who practiced in PHC centers in Spain. The interviews were analyzed using thematic coding. Three themes emerged from the descriptions of the nurses: (1) High COVID-19-related workload, decreasing health promotion, and chronic care, (2) Emphasis on patients' and families' self-responsibility, (3) Expanded digital and telephone communication with fewer in-person consultations. Nurses felt especially challenged to uphold the support for vulnerable groups, such as older people or patients without family support. Future research should focus on how the participation of the most vulnerable chronic patients can be supported in the context of the growing relevance of remote care.

Primary Healthcare Nurses' Views on Digital Healthcare Communication and Continuity of Care: A Deductive and Inductive Content Analysis.

Primary healthcare in the Western world faces significant functional challenges, resulting in the implementation of digital communication tools. Nurses are key professionals in primary care and focusing on the impact of digital communication and continuity of care in primary care organisations is important. This qualitative descriptive study explores digital communication and continuity of care from primary healthcare nurses' perspective. Data from individual semi-structured interviews with 12 nurses were collected; deductive and inductive content analyses were performed. Three descriptive categories emerged from the deductive (digital communication as interpersonal, information, and management continuities) and inductive ('digital care does not suit everyone', 'new technology is contextually intertwined with daily work', and 'patient-positive aspects of digital information') phases. Additionally, a structural risk of obscuration of patients' needs by the contextual conditions emerged. To ensure digital communication-aligned continuity of care, compatible information technology systems should be developed. Allowing nurses to provide high-quality care based on their own values would enhance person-centred patient care.

Job satisfaction among primary health care nurses

This study aimed to analyze the job satisfaction of nurses in primary health care facilities. This study employed a quantitative descriptive design. The research used a cross-sectional approach. This study involved 226 nurses who worked in 15 inpatients primary health care. The sampling technique uses a proportionate simple random sampling technique. Nurse job satisfaction instruments assessed context factors and content factors. Nurse job satisfaction on context factor was in a good category by a big responsibility for nurse's work (55.2%), progress in work developed well (63.4%), nurses had the opportunity to achieve achievement (54.5%), nurses got great recognition for performance (58.6%) and felt their work is valuable (65.5%). Job satisfaction was supported by policy indicators, supervision, salary, interpersonal relationships, and good working conditions. On the other hand, nurses' job satisfaction on the content factor still needs to be optimized. This is supported by the job satisfaction of nurses on the indicators of responsibility, achievement, performance recognition that has not reached 60%. Therefore, job satisfaction among nurses in inpatient primary health care was quite good enough but still requires optimization on the content factor.

A scoping review of the healthcare provided by nurses to people experiencing domestic violence in primary health care settings.

Domestic and family violence is a significant and growing public health concern in many communities around the world. Nurses are often the first and sometimes only point of contact for people seeking healthcare following DFV incidents and are therefore well placed to identify and support these vulnerable people. The aim of this scoping review is to examine the English language studies of healthcare provided by nurses in primary healthcare settings to people experiencing domestic and family violence. A scoping review of the following databases was undertaken between March-June 2021: CINAHL, Medline, and PubMed. Primary studies were included if written in English, published from 2000 onwards, and focused on the care provided by primary healthcare nurses to people experiencing DFV. A critical appraisal of included studies was conducted using the Mixed Methods Appraisal Tool (MMAT). Results were synthesised narratively. Six studies were included, from the United States (n=2), United Kingdom (n=1), Sweden (n=2), and Brazil (n=1). Five studies were quantitative and one qualitative. A fundamental aspect of the healthcare provided by nurses, reported by all studies, was the screening of DFV. Other healthcare provided includes physical and mental health assessment and referral to other services, including sexual assault clinics, social supports, and law enforcement agencies. Findings suggest the level of DFV screening conducted by nurses is limited. Nurses' knowledge of how to support people experiencing DFV was also reportedly limited. Two studies reported that nurses were unfamiliar with DFV practice guidelines and the existence and availability of support networks for people experiencing DFV. Findings suggest inconsistency in primary healthcare nurses' level of education, skill and knowledge, and detection of people experiencing DFV. As the largest healthcare professional discipline, nurses have frequent contact with people experiencing DFV. There is an urgent need for nurses to be better educationally prepared and more organisationally supported in order to adequately respond and provide healthcare to people experiencing DFV. Given that the number of people experiencing DFV has increased due to the COVID-19 pandemic, it is ever more important for nurses to be well equipped to identify and respond appropriately.

Self-perception of primary health-care staff about physical activity on prescription: A qualitative semi-structured interview

ObjectiveThis study aimed to analyze the self-perception at primary health-care (PHC) nurses and general practitioners (GPs) toward PAP implementation in PHC centers. Material and methodsTwo semi-structured group interviews were performed separately, with five GPs and nurses working in the PHC system in the region of Madrid (Spain). An expert psychologist guided each semi-structured session. The interviews were transcribed verbatim and consensually analyzed using a content analysis. ResultsHalf of the PHC staff considered themselves physically active and were convinced that physically active staff behavior could facilitate PAP with patients. Both GPs and nurses showed a lack of knowledge of exercise prescription but were interested in PAP and motivational training courses, as well as leadership or to collaborate under a multidisciplinary or interdisciplinary PAP approach. Some of the most relevant self-perceived PAP barriers were a confident method to measure sedentary and physical activity levels. Besides lack of staff awareness, time of consultation, and improving local community relationships and PAP policies strategies. ConclusionsThere are some common self-perceptions, barriers, and facilitators among PHC nurses and GPs for PAP implementation. Following a socio-ecologic approach, this organizational data provides further insight to design a future cost-effective policy strategy to improve patient health and health-care system sustainability.

Primary Healthcare Nurse’s Barriers and Facilitators to Providing Sexual and Reproductive Healthcare Services of LGBTQI Individuals: A Qualitative Study

In most cases, we only hear Lesbians, Gays, Bisexuals, Transgender, Queer, and Intersex (LGBTQI) patients complaining about nurses being the reason for not accessing and utilizing healthcare services; for example, studies reports on the different attitudes of healthcare providers including nurses against LGBTQI patients. However, factors influencing the behavior of South African Primary Healthcare (PHC) Nurses toward LGBTQI patients are rarely reported. The study aimed to explore how PHC nurses experienced and perceived sexual and reproductive health services for LGBTQI individuals in Tshwane, Gauteng Province, South Africa. The study followed qualitative research using an exploratory design approach. The sample included 27 PHC nurses from Tshwane, Gauteng Province, South Africa. In-depth face-to-face interviews were coded and analyzed using Thematic Content Analysis (TCA) which included five interrelated steps. The results revealed three main themes: barriers to the provision of LGBTQI-related SRHS, facilitators for the provision of SRHS to LGBTQI individuals, and strategies to improve LGBTQI individuals' SRHS accessibility and availability. Common barriers were related to the institutions, PHC nurses, the general public, and LGBTQI patients themselves. Regardless of the challenges faced by PHC nurses, there were some enabling factors that pushed them to continue rendering SHRS to LGBTQI patients who came to their clinics. Almost all PHC nurses suggested the importance of awareness, transparency, collaboration, and the need for training related to LGBTQI healthcare issues.

Exploring Primary Healthcare Nurses’ Preparedness and Response toward COVID-19 Pandemic in Makkah, Saudi Arabia: A Cross-sectional Study

Background and aim: Nurses' responsibilities during this epidemic have broadened beyond simply caring for the ill to assisting them in their recovery. The main purpose of this study was to assess the primary healthcare nurses’ preparedness and response to COVID-19 pandemic in primary healthcare centers in Makkah- Saudi Aribia. Materials &amp; Methods: A quantitative cross-sectional design was conducted at primary healthcare centers in Makkah. The population of the current study consisted of nurses who are working in primary healthcare in Makkah during the period of COVID-19. The total number of study sample is 132. Self-administered questionnaire was used to collect data from the participants adopted from Al Baalharith &amp; Pappiya (2021). Results: The majority (92.4%) of participants have high knowledge, 4.5% of them have average knowledge, while 3.0% of them have weak knowledge. Moreover, the majority (93.9%) of nurses stated that health care workers explain the reason for triage/screening to patients and 92.4% of them stated that there was a designated screening area to check the temperature. Factors associated with nurses’ preparedness toward COVID-19 pandemic involve nurses’ knowledge of preparedness and nurses’ knowledge of preparedness and response. Conclusion: The nurses who participated in the study had a high level of awareness of pandemic preparedness and response. The level of readiness and preparation shown by nurses with regard to personal protective equipment is insufficient. Age, years of experience, and the setting in which nurses operate are all factors that influence their level of readiness knowledge.

Rehabilitation and primary care treatment guidelines, South Africa

The World Health Organization recognizes rehabilitation as an essential component of universal health coverage (UHC). In many countries, UHC builds on a standard benefits package of services that is informed by the country's essential medicines list, standard treatment guidelines and primary health care essential laboratory list. In South Africa, primary health care is largely provided and managed by primary health-care nurses and medical officers in accordance with primary health care standard treatment guidelines. However, rehabilitation is mostly excluded from these guidelines. This paper describes the 10-year process that led to rehabilitation referral recommendations being considered for inclusion in South Africa's primary health care standard treatment guidelines. There were five key events: (i)a breakthrough moment; (ii)producing a scientific evidence synthesis and formulating recommendations; (iii)presenting recommendations to the national essential medicines list committee; (iv)mapping rehabilitation recommendations onto relevant treatment guideline sections; and (v)submitting revised recommendations to the committee for final consideration. The main lesson learnt is that, by working together, rehabilitation professionals can be of sufficient number to make a difference, improve service delivery and increase referrals to rehabilitation from primary health care. A remaining challenge is the lack of a rehabilitation representative on the national essential medicines list committee, which could hamper understanding of rehabilitation and of the complexities of the supporting evidence.

An integrative review on the maternal health literacy among maternal and child workers.

This study aim to capture the most comprehensive evidence-based dimensions of maternal health literacy, including summarizing the definitions, theoretical frameworks, measuring instruments, and the association between maternal health literacy and health behaviours. Maternal health literacy has been recognized as an important approach to achieving high-quality maternal and child health; however, little is known about maternal health literacy comprehensively and scientifically. An integrative review retrieved articles from 11 databases, following the methodology of Whittemore and Knafl. Inductive content analysis and narrative synthesis were conducted, guided by the aim of this review. A total of 5580 articles were retrieved and 23 articles were finally identified. Existing definitions and theoretical frameworks took less consideration of maternal applicability and failed to summarize maternal health literacy from a dynamic and systematic perspective. Measurement instruments were set up with many items that make it difficult to quickly screen for poor maternal health literacy. Most articles proved the association between maternal health literacy and health behaviours through correlation analysis or regression analysis but less explored the influence pathways between them. The definition and theoretical framework need to focus on maternal applicability and explain the process of individual mothers acquiring and understanding health knowledge and skills from a dynamic and systematic perspective. A rapid instrument for maternal health literacy should be developed and high-quality empirical research was conducted to understand the associated mechanisms between maternal health literacy and health behaviours. It is necessary to strengthen maternal and child health education of primary health care nurses and enhance their ability to help perinatal women use maternal and child health information effectively.

Adaptación y validación de un instrumento de evaluación de la competencia del consejo breve para dejar de fumar. BTI-Prof©

ObjectiveAdaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. DesignCross-sectional study of adaptation and psychometric validation of a criterion-referenced test. SettingPrimary Health Care. ParticipantsOne hundred fifty-five general practitioners and nurses working at Primary Health Care. InterventionsThree clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. Main measuresCompetence in brief tobacco intervention measured by the BTI-Prof©. ResultsResults related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test–retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734–0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676–0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76–0.928), p<0.0001. ConclusionsThe BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.

Work time allocation at primary health care level in two regions of Albania.

Although well-performing workforce is essential to equitable and efficient health service delivery, few countries have systematically addressed performance improvements. How health workers use their work time and what tasks they accomplish is here an important starting point. Therefore, a time motion study was conducted to assess the work time allocation patterns of primary health care doctors and nurses in two regions of Albania. We used observation tool to record the time allocation along eight predefined main categories of activities. Conditional to presence at work, 48 health workers were continuously observed in early 2020 before start of the Covid-19 pandemic over five consecutive working days. The observed health workers spent 40.7% of their overall working time unproductively (36.8% on waiting for patients and 3.9% on breaks), 25.3% on service provision to users, 18.7% on administrative activities, 12.7% on outreach activities, 1.6% on continuous medical education and 1% on meetings. The study found variations in work time allocation patterns across cadres, with nurses spending more time unproductively, on administrative activities and on outreach and less on all other activities than doctors. Further, the work time allocation patterns were similar between urban and rural settings, except for nurses in rural settings spending less time than those in urban settings on administrative work. This study found that primary health care workers in Albania devote a substantial amount of work time to unproductive, service provision to users and administrative activities. Consequently, there is possibility for productivity, respectively efficiency gains in how health workers use their time.