Primary Health Care Personnel Research Articles

Primary healthcare in the aftermath of the COVID-19 pandemic: a qualitative interview study in Sweden

ObjectiveTo explore how primary healthcare workers in Sweden experienced and perceived the long-term impact of the pandemic on their work.DesignThis is a descriptive qualitative study with individual semistructured interviews conducted...

Work Motivation and Job Satisfaction among Primary Healthcare Workers in Georgia

Motivation is defined as human effort, striving, stimulation process for successful work, and achievement of organizational goals. The purpose of the research is to study the factors determining the motivation and job satisfaction of primary healthcare personnel in Georgia. The relevance of the issue is indicated by the poorly development of the primary healthcare system in Georgia, which is confirmed by the fact that the number of referrals to outpatient medical institutions is 3.6 per capita per year, while it reaches 7.5 in European countries. A quantitative study was conducted in this research. As a result of the research, it was determined that motivation and job satisfaction are complex constructs. The following main factors that influence the job satisfaction of employees in primary care organizations were identified: individual characteristics, financial and non-financial incentives, organizational structures and processes, including supervision, leadership, fairness, and responsibility for the distribution of resources, staff dynamics, and team cohesion, relationships with colleagues and management, relationships with patients, intellectual stimulation, opportunities for continuing medical education. A family physician’s and family nurse practitioner’s job satisfaction significantly improves the services and has a positive impact on the patient’s well-being. Health policymakers and managers need to critically analyze the importance of providing additional incentives. In order to improve the job satisfaction of primary health care workers, in addition to salary, special emphasis should be placed on supporting family life, creating decent living conditions, adequate free time, educational prospects, and better opportunities for professional development and promotion.

Challenges in Type 2 Diabetes Prevention among Senior High School Students: A Qualitative Study.

Schools, a place where students spend much more time than home, play an important role in preventing the nation's future generation from type 2 diabetes mellitus (T2DM). This study aimed to explore challenges in T2DM prevention among senior high school students. The study was conducted in Riau Province, Indonesia, from June to August 2023 using a qualitative content analysis. 31 respondents, determined by data saturation, were recruited using purposeful sampling. They were public senior high schools' principals, vice principals, school health services staff, school canteen tenants, students, parents, and primary health care personnel in six districts. Data were collected through semi-structured face-to-face interviews and document review. Graneheim and Lundman's content analysis method was used to analyze the data in Nvivo version 11 software. The Lincoln and Guba Qualitative research criteria for trustworthiness were used to ensure the rigor of the study. The main concepts obtained from the data were classified into three themes entitled, "Nonoptimal existing diabetes prevention programs in schools", "Inadequate knowledge of school community on T2DM", and "Inadequate policies to prevent diabetes in schools". An evidence-based, well-organized, and systematic school-based diabetes prevention program is fundamental to help overcome challenges and prevent future T2DM incidence. It requires relevant stakeholders' high level of awareness, strong collaborations with the school community, and effective school policies.

Assessing public health service capability of primary healthcare personnel: a large-scale survey in Henan Province, China

BackgroundThe public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement.MethodsWe used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences.ResultsThe total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones.ConclusionsThe public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

Trends in the mobility of primary healthcare human resources in underdeveloped regions of western China from 2000 to 2021: Evidence from Nanning

ObjectiveThis research aimed to identify the fundamental and geographic characteristics of the primary healthcare personnel mobility in Nanning from 2000 to 2021 and clarify the determinants that affect their transition to non-primary healthcare institutions.MethodsThrough utilizing the Primary Healthcare Personnel Database (PHPD) for 2000–2021, the study conducts descriptive statistical analysis on demographic, economic, and professional aspects of healthcare personnel mobility across healthcare reform phases. Geographic Information Systems (QGIS) were used to map mobility patterns, and R software was employed to calculate spatial autocorrelation (Moran’s I). Logistic regression identified factors that influenced the transition to non-primary institutions.ResultsPrimary healthcare personnel mobility is divided into four phases: initial (2000–2008), turning point (2009–2011), rapid development (2012–2020), and decline (2021). The rapid development stage saw increased mobility with no spatial clustering in inflow and outflow. From 2016 to 2020, primary healthcare worker mobility reached its peak, in which the most significant movement occurred between township health centers and other institutions. Aside from their transition to primary medical institutions, the primary movement of grassroots health personnel predominantly directs towards secondary general hospitals, tertiary general hospitals, and secondary specialized hospitals. Since 2012, the number and mobility distance of primary healthcare workers have become noticeably larger and remained at a higher level from 2016 to 2020. The main migration of primary healthcare personnel occurred in their districts (counties). Key transition factors include gender, education, ethnicity, professional category, general practice registration, and administrative division.ConclusionsThis study provides evidence of the features of primary healthcare personnel mobility in the less developed western regions of China, in which Nanning was taken as a case study. It uncovers the factors that impact the flow of primary healthcare personnel to non-primary healthcare institutions. These findings are helpful to policy refinement and support the retention of primary healthcare workers.

The personnel maintenance of primary health care physicians in condition of challenges from menaces to population health

In condition of challenges from menaces to health due to COVID-19 the role of primary health care physicians increases that requires development of management decisions at the regional level. The purpose of the study. On the basis of analysis of medical demographic indicators and data concerning provision of primary health care personnel in the Russian Federation, proposals were made related to reforming of primary health care system in conditions of implementation of general medical practice with purpose to counteract menaces to population health. The analytical and statistical methods were applied. The official statistics data from the Minzdrav of the Russian Federation and Rosstat, results of original researches with content analysis and interpretation were used. The COVID-19 pandemic negatively impacted population health. The indicator of newly detected morbidity in the Russian Federation in 2020 decreased as compared to 2019 from 78024.3 to 75989.7‰oo (by 2.6%). This is the result of decreasing of dispensary and preventive activities among population. In next COVID-19 year (2021), as compared to 2020, indicator of primary morbidity increased to 85531.6‰oo that 12.6% higher than in 2020. The increase occurred in all classes of diseases that caused necessity of rehabilitation of these patients. The COVID-19 morbidity increased up to 2.4 times i.e. from 3391.1 in 2020 to 8085.7‰oo in 2021. The provision of physicians in the Russian Federation was 37.7‰o in 2021. Across the Federal Okrugs differences in indicators made up to 1.3 times and in subjects of the Russian Federation - up to 2.7 times. In conditions of COVID-19 significance of menaces to population health worsened. The situation requires both enhancement of primary health care and implementation of physicians of new formation - general practitioners responsible for patient health. The general practice (GP) widely developed in Russia in the 1990s during last ten years loses its significance in most subjects of the Russian Federation. In 2021, provision of general practitioners in the Russian Federation made up to 0.67‰o. In the Federal Okrugs, difference between indicators made up to 5.6 times. In the subjects of the Russian Federation the difference is enormous - 141.5 times. The article presents and scientifically substantiates prospective functional organizational models of general practice. The established situation with COVID-19 infection requires development of management decisions and measures at the regional level concerning improvement of organization of primary health care and implementation of general practice in conditions of counteracting risks of menaces to population health and health preservation.

A resilience perspective on healthcare personnels’ experiences of managing the COVID-19 pandemic: a qualitative study in Norwegian nursing homes and home care services

BackgroundThe COVID-19 pandemic led to new and unfamiliar changes in healthcare services globally. Most COVID-19 patients were cared for in primary healthcare services, demanding major adjustments and adaptations in care delivery. Research addressing how rural primary healthcare services coped during the COVID-19 pandemic, and the possible learning potential originating from the pandemic is limited. The aim of this study was to assess how primary healthcare personnel (PHCP) working in rural areas experienced the work situation during the COVID-19 outbreak, and how adaptations to changes induced by the pandemic were handled in nursing homes and home care services.MethodThis study was conducted as an explorative qualitative study. Four municipalities with affiliated nursing homes and homecare services were included in the study. We conducted focus group interviews with primary healthcare personnel working in rural nursing homes and homecare services in western Norway. The included PHCP were 16 nurses, 7 assistant nurses and 2 assistants. Interviews were audio recorded, transcribed and analyzed using thematic analysis.ResultsThe analysis resulted in three main themes and 16 subthemes describing PHCP experience of the work situation during the COVID-19 pandemic, and how they adapted to the changes and challenges induced by the pandemic. The main themes were: “PHCP demonstrated high adaptive capacity while being put to the test”, “Adapting to organizational measures, with varying degree of success” and “Safeguarding the patient’s safety and quality of care, but at certain costs”.ConclusionThis study demonstrated PHCPs major adaptive capacity in response to the challenges and changes induced by the covid-19 pandemic, while working under varying organizational conditions. Many adaptations where long-term solutions improving healthcare delivery, others where short-term solutions forced by inadequate management, governance, or a lack of leadership. Overall, the findings demonstrated the need for all parts of the system to engage in building resilient healthcare services. More research investigating this learning potential, particularly in primary healthcare services, is needed.

Vaccination Approaches of Primary Healthcare Personnel and Their Communication Levels with Parents Having Childhood Vaccine Hesitancy

Vaccines have saved more lives than any other health development in the 20th century. One of the most cost-effective programs for reducing infant/child morbidity and mortality is the vaccination of children against common vaccine-preventable diseases. Türkiye is one of the countries that has managed to achieve a significant reduction in the incidence of vaccine-preventable diseases by increasing immunization rates. Currently, 13 different antigens are included in the vaccination calendar of the Ministry of Health of the Republic of Türkiye, and all vaccines to be administered (vaccination calendar) are determined and continuously updated by the Immunization Advisory Board of the Ministry of Health of the Republic of Türkiye. Our study is a cross-sectional descriptive study. A total of 410 family physicians and family health workers were included in the study. An interactive training meeting on vaccines, vaccine hesitancy, communication, and counseling was organized in 18 groups (including the study participants) in May-June 2019. A questionnaire form consisting of 24 topics was applied to the participants before the training presentation. When comparisons between groups were analyzed according to the answers given by the participants to some questions, it was found that 57.1% of the group with a good average of knowledge, attitude and behavior score reflecting the level of communication with parents with vaccine hesitancy had received training on vaccines and their characteristics, while 43.6% of the group with a poor average had received this training, and the difference was statistically significant (p=0.008). Parents with vaccine refusal were most hesitant about Measles-Mumps-Rubella (MMR) vaccine (87.7%). Healthcare professionals play a very important role in the provision of healthcare services and in the decision-making of families about vaccination with the counseling they provide all over the world. To reduce vaccine hesitancy, continuous education activities on vaccination for health professionals, the creation of educational materials for public education, the use of mass media, and legal regulations can be made.

Prevention of caries and obesity in children with immigrant background in Norway- a study protocol for a cluster randomized controlled trial

BackgroundImmigrants are known to experience greater socioeconomic stress and poorer well-being and to suffer more from lifestyle- and diet-related disorders than native populations. There is also evidence that children of immigrant parents are at greater risk of diverse health problems than their host country cohorts. The aim of this study is to apply and evaluate the efficacy of an early life intervention program among parents/children with immigrant background to prevent childhood caries and obesity, thereby improving the children’s general health, oral health, and quality of life.MethodsThis is a study protocol for a cluster randomized controlled intervention follow-up study. In phase I of the study, the primary care health centers in the municipality of Bergen, Norway were randomly allocated to intervention or control groups. The intervention was carried out using the motivational interviewing technique and the common risk factor approach. The intervention group received guidance on diet/oral hygiene and the control group received standard care information. Parental knowledge and children at age 3 and 5 years old will be assessed in a prospective phase II follow-up study compared to native Norwegian controls. The primary outcome will be evaluation of change on parental oral health related knowledge and attitudes. The secondary outcome will assess the impact of the intervention on children’s caries -, body mass index- and oral health related quality of life.DiscussionCollaboration between dental public health and primary health care personnel on the common risk approach motivational intervention offers opportunities to address key dietary behaviors that may prevent obesity and dental caries. Providing sustainable preventive measures decreases the burden of diseases and consequently reduces health inequalities, particularly among at-risk children.Trial RegistrationThe study is registered as a clinical trial (ClinicalTrials.gov Identifier: NCT05758454: 7 March 2023). Ethical approval has already been granted by the Regional Ethical Committee (REK) (2015/ 27,639 /REK vest) and Sikt – Norwegian Agency for Shared Services in Education and Research (Reference number 778825).

Relationship between honesty-credit, specialty identity, career identity, and willingness to fulfill the contract among rural-oriented tuition-waived medical students of China: a cross-sectional study.

The fulfillment of contractual obligations by rural-oriented tuition-waived medical students (RTMSs) to work in rural medical institutions after graduation directly impacts the improvement of rural health quality. This study aimed to not only quantitatively measure the direct impact of honesty-credit, specialty identity, and career identity on willingness to fulfill the contract of RTMSs but also to quantify the intermediary role of specialty identity and career identity between honesty-credit and willingness to fulfill the contract. The research results provided recommendations for the rural-oriented tuition-waived medical education (RTME) program to achieve its goal of training rural primary healthcare personnel. From March to May 2022, 1162 RTMSs were selected as the research objects. The honesty-credit, specialty identity, career identity, and willingness to fulfill the contract were quantitated using a self-completed questionnaire. Pearson's correlation analysis and structural equation modeling were used for statistical analysis and mediating effect evaluation. A total of 455 (42.3%) RTMSs had high willingness to fulfill the contract, and honesty-credit had a significant direct positive effect on willingness (β = 0.198, P < 0.001), specialty identity (β = 0.653, P < 0.001), and career identity (β = 0.180, P < 0.001). In the intermediary path between honesty-credit and willingness, career identity [95% confidence interval (CI): 0.007-0.051] had significant mediating effects. Career identity (95% CI: 0.030-0.149) also had significant mediating effects between specialty identity and willingness, and specialty identity (95% CI: 0.465-0.760) had significant mediating effects between honesty-credit and career identity. These results strongly confirmed that honesty-credit, specialty identity, and career identity are early and powerful predictors of the willingness to fulfill the contract of RTMSs. The honesty-credit of RTMSs can predict their willingness to fulfill the contract early, significantly and positively. For the students who fail to pass the credit assessment for many times and have a strong tendency to default, their training qualifications should be canceled in time, so that students who are truly willing to serve rural areas can enter the project, and finally achieve the policy goal of "strengthening the rural primary medical and health system".

AWARENESS OF DENTAL CARIES PREVENTION IN INFANTS AND YOUNG CHILDREN AMONG DENTAL STUDENTS AND DENTAL INTERNS

Introduction. Promoting a commitment to dental caries prevention in young children plays a vital role in establishing healthy lifestyle habits that ward off dental diseases. The initial dental visit is as a cornerstone for fostering parental motivation in preventing dental issues and providing optimal conditions for the development of healthy eating habits, oral care practices, and the use of fluoride toothpaste. The foundation of dental knowledge, habits, and skills is laid within the family as children emulate adult behavior. Pediatric dentists, pediatricians, and primary healthcare personnel should serve as the primary and reliable sources of knowledge. As the determinants of dental caries are influenced by family-related risk factors, such as oral hygiene practices, the use of fluoride toothpaste, and sugar and carbohydrate consumption from an early age, parents bear the responsibility for creating an environment conducive to effective prevention. Dental professionals act as key information sources for oral health within the population and primary healthcare workers.&#x0D; Objective. This study aims to analyze the awareness of senior dental students and interns regarding the prevention of dental caries in infants and young children.&#x0D; Materials and Methods. A questionnaire was designed to assess awareness of dental caries prevention in infants and young children. The questionnaire, consisting of 13 questions with multiple answer options, was distributed to senior dental students and dental interns using an online Google form. It focused on evaluating knowledge of dental disease prevention, including the relationship between dental caries and behavioral risk factors such as nutrition, recommendations for oral care in children, and the use of fluoride-containing toothpaste.&#x0D; Results. Analysis of the questionnaire responses revealed that all participants were aware of the cariogenic nature of sugar, with 82.5% recognizing the caries-causing potential of fruit juices. However, knowledge regarding the cariogenicity of other products, such as fruits (8.8%) and dietary carbohydrates (25.4%), was limited. While the benefits of breastfeeding for a growing child are well-known, only 25.4% of senior dental students and interns recognized that prolonged, unregulated breastfeeding beyond one year contributes to early childhood caries. Moreover, 38.6% believed that bottle-feeding with milk formula can lead to tooth decay. Recommendations for feeding children from a spoon and cup after the eruption of the first milk tooth were not provided by any respondents. Only two individuals (1.8%) acknowledged that co-sleeping with the mother can pose a risk factor for childhood caries. Regarding oral hygiene recommendations for parents, only 12.3% of senior dental students and medical interns suggested the use of toothpaste and a brush, while guidance on selecting appropriate toothpaste for infants and young children was disregarded by all respondents. Additionally, the quantity of toothpaste to be applied and the age at which children should start brushing their teeth were not considered, with 53.5% of respondents believing that brushing with a toothbrush alone is sufficient.&#x0D; Conclusion. The survey exposed insufficient knowledge among senior dental students and medical interns regarding risk factors and evidence-based methods for preventing dental caries in infants and young children.

Reforming China's Secondary Vocational Medical Education: Adapting to the Challenges and Opportunities of the AI Era.

China's secondary vocational medical education is essential for training primary health care personnel and enhancing public health responses. This education system currently faces challenges, primarily due to its emphasis on knowledge acquisition that overshadows the development and application of skills, especially in the context of emerging artificial intelligence (AI) technologies. This article delves into the impact of AI on medical practices and uses this analysis to suggest reforms for the vocational medical education system in China. AI is found to significantly enhance diagnostic capabilities, therapeutic decision-making, and patient management. However, it also brings about concerns such as potential job losses and necessitates the adaptation of medical professionals to new technologies. Proposed reforms include a greater focus on critical thinking, hands-on experiences, skill development, medical ethics, and integrating humanities and AI into the curriculum. These reforms require ongoing evaluation and sustained research to effectively prepare medical students for future challenges in the field.

Mental health among patients with chronic musculoskeletal pain and its relation to number of pain sites and pain intensity, a cross-sectional study among primary health care patients

BackgroundChronic musculoskeletal pain (CMP) is characterised by pain related to the muscles or the joints with a duration of three months or more and is associated with high symptomatic burden in patients in primary health care. CMP is commonly associated with impaired mental health, which may affect the rehabilitation process. The primary aim of this study was to compare symptoms of anxiety, depression, fatigue, and insomnia in patients in primary health care with and without CMP. The secondary aim was to assess difference in mental health symptoms related to number of pain sites and pain intensity.MethodsThis cross-sectional study was conducted in Trondheim, Norway. All patients aged 21–58 from randomly selected general practitioners (GPs) were invited to participate. Participants were classified into two groups according to presence of CMP. Symptoms of anxiety, depression, fatigue, and insomnia were assessed by the Hospital Anxiety and Depression Scale (HADS), Chalder Fatigue Questionnaire (CFQ), and Insomnia Severity Index (ISI), respectively, using an online survey system.ResultsFrom the patient lists of six GPs, we included 969 patients. Mean age 46 years (SD: 10.1), and 517 reported CMP. CMP patients reported higher mean symptom score for anxiety (5.4 vs 3.7), depression (3.4 vs 2.0), fatigue (14.2 vs 11.2), and insomnia (8.1 vs 4.4), all p < 0.01 compared to no-CMP patients. Symptoms of impaired mental health increased with increasing number of pain sites and pain intensity (p < 0.001).ConclusionsPrimary health care patients with CMP reported significantly more symptoms of anxiety, depression, fatigue, and insomnia than patients without CMP. The higher number of pain sites and pain intensity, the more mental health symptoms, especially of anxiety. Primary health care personnel have to address mental health issues when treating patients with CMP.Trial registrationClinicaltrials.gov (NCT02020772, 25/12/2013).

Factors associated with the uptake of national essential public health service package for hypertension and type-2 diabetes management in China's primary health care system: a mixed-methods study

China launched the primary health care (PHC) system oriented National Essential Public Health Service Package (NEPHSP) in 2009, to combat health challenges including the increasing burden from hypertension and type-2 diabetes (T2DM). In this study, the PHC system was assessed to understand factors influencing the uptake of the NEPHSP for hypertension and T2DM management. A mixed-methods study was conducted in seven counties/districts from five provinces across the mainland of China. Data included a PHC facility level survey and interviews with policy makers, health administrators, PHC providers, and individuals with hypertension and/or T2DM. The facility survey used the World Health Organisation (WHO) service availability and readiness assessment questionnaire. Interviews were thematically analysed using the WHO health systems building blocks. A total of 518 facility surveys were collected with over 90% in rural settings (n=474). Forty-eight in-depth individual interviews and 19 focus-group discussions were conducted across all sites. Triangulating the quantitative and qualitative data found that China's continuous political commitment to strengthening the PHC system led to improvements in workforce and infrastructure. Despite this, many barriers were identified, including insufficient and under-qualified PHC personnel, remaining gaps in medicines and equipment, fragmented health information systems, residents' low trust and utilization of PHC, challenges in coordinated and continuous care, and lack of cross-sectorial collaborations. The study findings provided recommendation for future PHC system strengthening, including improving the quality of NEPHSP delivery, facilitating resource-sharing across health facilities, establishing integrated care systems, and exploring mechanisms for better cross-sectorial engagement in health governance. The study is supported by National Health and Medical Research Council (NHMRC) Global Alliance for Chronic Disease funding (APP1169757).

Immune response against SARS-CoV-2 of primary healthcare personnel in a commune of Santiago, Chile: follow-up at 6 months

Immune response against SARS-CoV-2 of primary healthcare personnel in a commune of Santiago, Chile: follow-up at 6 months

Prevalence and Management of Outpatients with Asymptomatic Microscopic Hematuria in a University Hospital

Background: There has never been any report regarding the prevalence of asymptomatic microscopic hematuria (AMH) in the patients in the Southern part of Thailand. Additionally, there is also no data regarding clinical management for this kind of health condition. Objective: To document the prevalence and management of AMH in outpatient departments of the region. Materials and Methods: A cross-sectional descriptive study was conducted to analyze the clinical data of 511 patients, attending 10 outpatient departments of the hospital between January 2012 and May 2020. AMH was defined, according to the American Urology Association (AUA), as urine red blood cells in urine specimens greater than three per high power field, with no associated urinary symptoms. Results: Among the 511 studied samples recruited for analysis, 73.0% of the AMH identified patients were female. The most common age and gender group was 56 to 65 years at 9.0% in males and at 24.7% in females, or about one-third of all age and gender groups. The patients from four departments, which usually send routine patient urinary examinations, including, General practice, the Primary care unit, Premium checkup, and Health care personnel surveillance, constituted of more than one-half at 56.4%, of all AMH patients from all departments. The most common investigation was repeated urinary analysis at 445/484 (91.9%), followed by urinary system imaging at 375/484 (77.5%). The most common management combination was repeated urine analysis and urinary system imaging, with urologist consultation at 225/484 (46.5%). Conclusion: AMH is a common health condition in outpatient settings, and the patients were well managed for further investigation, according to AUA guidelines. Keywords: Asymptomatic; Microscopic, Hematuria, Prevalence, Management, Investigation, Red blood cell

Assessing the impact of mental health capacity building of Primary Health Care (PHC) personnel

Introduction COVID-19 poses an immense challenge to health systems and societies, associated with a burden of mental health in the population. The pandemic is uncovering treatment gaps in mental health systems, especially in Low and Middle-Resource Countries, as Georgia. The high burden calls for renewed efforts to integrate mental health into Primary Health Care (PHC) to address increased mental health needs of the population. The capacity building of PHC personnel is ongoing since October 2020, according to mhGAP algorithm. Family doctors (FD) are trained in identification and management in priority mental conditions.ObjectivesThe overall aim of the study was to assess the impact of capacity building of PHC personnel. This was an implementation research seeking to understand how effective was the offered capacity building process and what could be lessons learnt.MethodsWe employed a mixed-methods process evaluation design utilising a series of instruments specifically designed to provide data for the domains as training/capacity building, service delivery and user satisfaction.ResultsFD were able to identify the most prevalent conditions - Anxiety (74%) and Depression (39%); in 22.8% the comorbidity was recognized. The psychoeducation was the most common method of management used by 72%. In 39.4% FD were able to recommend at least one medicine to their patients. 83.3% of patients reported improved conditions.ConclusionsThe family doctors are able to identify and manage certain mental health conditions after proper trainings and regular supervision. This study has simultaneously identified targets for change within the broader mental health system.DisclosureNo significant relationships.

INFLUENCE OF LIFESTYLE ON STRESS MANAGEMENT IN PUBLIC SECTOR HEALTH WORKERS IN SEMI-URBAN AREA – A PRELIMINARY STUDY

Introduction: This research set out to evaluate the effects lifestyle has on stress in primary health care personnel’s working in the public Health sector in a semi urban region of Rivers State, Nigeria, and if possible understand how diet as well as other intrinsic factors might help in the management of stress. Method: The Holmes and Rahe stress scale was administered, as well as other questions in a self-administered questionnaire to test for how Age, diet, food type, physical activity and sleep affected stress on the stress scale. The questionnaire was administered to 53 individuals (8 males and 45 females), with ages between 24-60 and data was evaluated based on several different criteria. Result: A low level stress was found to be higher (37.7%) in the age groups 25-34 and 35-44 (60.0% and 68.8% respectively). Men (87.5%) were found to have moderate to high level stress than the women (57.8%). Respondents with moderate to high levels stress had 50% - 80% chance of major health breakdown within the next 2 years according to the Holmes and Rahe statistical predictor model which saw 35.7% of respondents who slept less than 7 hours a day had high levels of stress than does who slept more than 9 hours at night (28.6%). Regarding exercise, respondents who were inactive (30.8%) to low (43.5%) in terms of minutes per week of physical activity as well as those who were inconsistent (45.5%) with physical activities (in terms of number of times per week) had high levels of stress. Regarding body mass index (BMI) and stress, the risk for health breakdown within 2 years were observed as overweight/obese (64.5%) individuals had moderate to high levels of stress compared to normal (59.1%). Concerning dietary pattern, moderate to high levels stress were observed in semi vegetarian (100%), lacto-Ovo vegetarians (66.9%) and non-vegetarians (61.1%). Blood group was found to influence the way individuals dealt with the stress - with type O positive (68.7%) being the most sensitive, and type AB positive the least sensitive. Conclusion: Effectively knowing and practicing how to eliminate the negative factors of stress and modifying lifestyle especially sleep hours, food, physical activities in male population and the active age group can assure one of better health outcomes by reducing the chances of major health breakdown within 2 years. KEY WORDS: Sleep hours, Exercise, Physical activity, blood group, Diet, stress, Primary Health Workers.

Seven lessons from the coronavirus pandemic for primary health care: A qualitative study of registered and assistant nurses in Sweden.

AimThe aim of this study was to explore lessons from the pandemic by registered and assistant nurses in Swedish primary health care (PHC) of potential relevance for the future operation of PHC.MethodsTwenty‐one semi‐structured interviews were conducted with registered and assistant nurses. We used a purposeful sampling strategy to achieve a diverse sample with regard to size and location of PHC centres. Data were analysed using qualitative content analysis.ResultsAnalysis yielded two categories: lessons from the pandemic pertaining to PHC personnel and patient behaviours (adaptability of the personnel; importance of hygiene and maintaining physical distance; and importance of being attentive to illness symptoms) and lessons from the pandemic related to primary healthcare work routines (effectiveness of digital job meetings; advantages of digital patient consultations; importance of keeping infectious patients separate from other patients; and the need to allow only pre‐booked patient appointments).ConclusionsThe seven sub‐categories represent seven lessons from the pandemic. The lessons generated both instrumental knowledge, which the nurses could apply in work‐related decisions, and conceptual knowledge which yielded improved understanding of problems and potential solutions for PHC.

Development of Warfarin Safety Monitoring System at Primary Health Care grounded on Chronic Care Model

Warfarin, an anticoagulant with high risk on the fatal adverse effects, the safety monitoring system in primary health care is needed for patients in the community. This study aimed to investigate problems of warfarin use, to discover factors related to the blood clotting, and to develop a safety monitoring system for warfarin. A mixed method was conducted in two phases. Phase one consisted of home visit for 104 patients with warfarin which aimed to investigate use problems. Phase two; the focus groups included all stakeholders were done which aimed to develop a community-based system grounded on the Chronic Care Model (CCM). The warfarin monitoring system was implemented for a month and briefly evaluated the stakeholders’ satisfaction on it. The results revealed that: Phase one, 38.5% patients with warfarin at home had missed their treatment appointments. Their warfarin compliance was 91.1+21.3%. 53.5% had unused warfarin at home; 37.4% had inappropriate warfarin storage; 13.1% suffered the side effect of minor bleeding; 17.3% potentially had warfarin-herb interactions; 61.3% experienced drug-warfarin interaction. Two factors significantly affecting on the International Normalized Ratio (INR) and %Time in Therapeutic Range (%TTR) were inappropriate warfarin dosages and taking other medications. %TTR was influenced by warfarin compliance. Stage two, the safety monitoring system and protocol were created using CCM. The developed system composed of six elements that were joint operation of primary health care personnel and inter-professional team of the hospital. This promoted the continuity of services from hospital to community. After one-month implementation by an inter-professional team, all three groups of stakeholders were satisfied with its results. We concluded that the main problem afflicting warfarin patients was missed treatment appointments. Receiving extra medicines from other services, inappropriate dosage, and non-compliance. The developed warfarin monitoring system covered patients in primary health care, and all stakeholders were satisfied on its outcomes.