IntroductIon: The care work of general practice receptionists has received limited research attention, despite receptionists position at the beginning of patients' journeys in many health care systems. We examine receptionists' perceptions of their work and the opportunities and constraints they experience in caring for patients while providing administrative support to practices.Methods: Data were collected in focus group interviews with 32 receptionists from urban and rural general practices in the Auckland and Northland regions of New Zealand. We employed tools from inductive thematic analysis and Straussian grounded theory in interpreting the data. FIndIngs:We found that the way receptionists identified with a caring role strongly challenged the pejorative view of them in public discourse. Receptionists provide care in two key ways: for the practice and for patients. The juggling they do between the demands of the practice and of patients creates considerable work tensions that are often invisible to other staff members.conclusIon: Receptionists have a critical role as the first step in the patient care pathway, bridging health care system and community. For general practice to be patient-centred and improve accessibility for the most vulnerable, the care work of receptionists must be considered core.
Social workers form part of many healthcare teams. The roles of social workers in health care can involve in-depth conversations with clients, along with home visits. These encounters can reveal a variety of sensitive information, not all of which may be known, or accessible to, other members of the healthcare team.Most modern healthcare systems employ shared care records, which are populated by, and accessible to, multiple members of the healthcare team.Shared care records are valued for their capacity to enhance inter-professional communication and, thus, improve patient care. But this very capacity may increase the underlying tension for health records between privacy and efficient and effective care. Ethical tensions can arise for health social workers between comprehensive documentation to ensure provision of appropriate and beneficial care, and protecting client privacy by limiting access to privileged information obtained in the context of a social work encounter.This qualitative empirical ethics study investigated health social workers' experiences of tensions between protecting client privacy and maintaining complete records, and how they thought the tension should be resolved. Eleven social workers from a range of health settings across New Zealand's North Island were interviewed. We adopted a pragmatist approach to ethical theory, in which everyday experiences and modes of reasoning are valid foundations for theory. Participant testimony provided the basis for developing an account of the principles that should govern decisions about recording sensitive information in shared care records. Three overarching principles were identified: necessity, accuracy, and neutrality. Participants' reports of moral concerns about some decisions regarding recording indicate that ethical tensions can occur. The identified principles offer a starting point for managing such tensions.
Background: The International Classification of Functioning, Disability and Health (ICF) aims to comprehensively describe the ways in which a person's health condition affects their life. This study aimed to contribute to the development of an ICF core set for gout through patient opinion derived from focus groups and interviews. Methods: We conducted a secondary qualitative analysis of data from three studies investigating the patient experience of gout. In total there were 30 individual interviews and 2 focus groups (N = 17) comprising 47 participants. We conducted thematic analysis of the textual data to extract meaning units, which were then linked to the ICF. Results: A large number of ICF categories were relevant to patients with gout. Participants mentioned 93 third level categories, 17 of which were mentioned by more than 50% of patients. The most references for a single category was for b280, Sensation of pain, followed by personal factors (not yet categorised by the ICF). The most participants mentioned the environmental factor e355, Health professional support, followed by b280, Sensation of pain. Conclusion: The categories identified in this study as relevant to patients with gout highlight the severe pain associated with this disease, the impact on mobility and corresponding life areas. The roles of health professional support, medication, and personal attitudes to disease management are also reflected in the data. These results will contribute to the development of the ICF core set for gout.
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