Factors influencing inquiry about patients’ alcohol consumption by primary health care physicians: qualitative semi-structured interview study

Aira, Marja; Kauhanen, Jussi; Larivaara, Pekka; Rautio, Pertti

doi:10.1093/fampra/cmg307

Cited by 137 publications

(171 citation statements)

References 18 publications

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“…Interviewing one's peers is considered both a strength and a limitation. Prior topic knowledge and associated professional cultures enables a thorough exploration of the subject without explanation seeking and terminology clarification; 14,15 in addition, solidarity between professionals may encourage disclosure, 16 particularly in research addressing sensitive areas, including sickness certification. However, prior subject knowledge may prevent researchers from finding novel insights within their data 17 and being interviewed by a colleague may induce cautious responses for fear of judgement.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Exploration of GPs' views and use of the fit note: a qualitative study in primary care

Welsh

Mallen²,

Wynne‐Jones³

et al. 2012

Br J Gen Pract

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BackgroundSickness certification constitutes daily clinical practice for GPs. In April 2010, the UK sickness certification system changed to reflect the evidence that work is generally good for health and a new Statement of Fitness for Work -the 'fit note' -was introduced. Sickness certification is a contentious topic among GPs and the proposed fit note generated mixed reviews. AimTo explore GPs' views and use of the fit note during its first year of operation. Design and settingQualitative interview study of GPs based in different geographical locations across the UK. MethodGPs (n = 15), who were recruited from a national sample, participated in semi-structured telephone interviews which were subject to constant comparative analysis. ResultsOverall, the fit note was well received. GPs recognised that work is generally good for health and felt the fit note facilitated using an earlier return to work as a negotiation tool. GPs perceive employers as the major obstacle to early return to work. There were reports of scepticism towards the system that negatively impacted on some GPs' operation of sickness certification. Feedback over the fit note's impact on employer behaviour and the return of a mechanism that enables GPs to request early independent assessments would be welcomed. ConclusionA revised approach is needed to address the scepticism towards the sickness certification system that persists among some GPs. New strategies need to be designed to engage employers in facilitating an early return to work and to enable the objectives of the medical statement reforms to be achieved.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Exploration of GPs' views and use of the fit note: a qualitative study in primary care

Welsh

Mallen²,

Wynne‐Jones³

et al. 2012

Br J Gen Pract

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“…Esto es coherente con los resultados de otros estudios donde la negación de un consumo problemático o la no intención de realizar cambios en el patrón de consumo se menciona como una característica propia de aquellas personas a los que se le detecta un consumo problemático o dependencia de alcohol, actuando como barreras para la búsqueda de tratamiento o inicio de cambios (Aira, Kauhanen, Larivaara, & Rautio, 2003;Arborelius & Damström Thakker, 1995;Beich, Gannik, & Malterud, 2002;Grant, 1997;Morse & Flavin, 1992;Wells et al, 2007). En este sentido, la negación es un factor cognitivo en los pacientes con dependencia teniendo un papel defensivo para éstos, tal y como referencian Sawayama et al (2012), pudiendo ser a su vez un indicador de falta de motivación para el cambio (Miller, 1983).…”

Section: Resultsunclassified

Número Completo/Full Number

Rodríguez¹

2015

HAAJ

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“…[25][26][27] SEEK provides the necessary tools, enabling HPs to meet the goals of Bright Futures. 9 This study shows how the SEEK model of pediatric primary care offers a practical approach to helping address serious and prevalent psychosocial problems that jeopardize children's health, development and safety.…”

Section: Discussionmentioning

confidence: 99%

The Safe Environment for Every Kid Model: Impact on Pediatric Primary Care Professionals

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:It is well established that risk factors such as maternal depression are prevalent and jeopardize children's health and development. Pediatric primary care offers an opportunity for helping address such psychosocial problems that are connected with child abuse and neglect. WHAT THIS STUDY ADDS:Results of this study indicate that the Safe Environment for Every Kid model helps pediatric health professionals address targeted psychosocial problems. The study is one of the first to examine change in pediatric private practices concerning the management of psychosocial problems. abstract OBJECTIVE: To examine whether the Safe Environment for Every Kid (SEEK) model of enhanced primary care would improve the attitudes, knowledge, comfort, competence, and behavior of child health care professionals (HPs) regarding addressing major risk factors for child maltreatment (CM). METHODS:In a cluster randomized controlled trial, 18 private practices were assigned to intervention (SEEK) or control groups. SEEK HPs received training on CM risk factors (eg, maternal depression). The SEEK model included the parent screening questionnaire and the participation of a social worker. SEEK's impact was evaluated in 3 ways: (1) the health professional questionnaire (HPQ), which assessed HPs' attitudes and practice regarding the targeted problems; (2) observations of HPs conducting checkups; and (3) review of children's medical records. RESULTS:The 102 HPs averaged 45 years of age; 68% were female, and 74% were in suburban practices. Comparing baseline scores with 6-, 18-, and 36-month follow-up data, the HPQ revealed significant (P Ͻ .05) improvement in the SEEK group compared with controls on addressing depression (6 months), substance abuse (18 months), intimate partner violence(6and18months),andstress(6,18,and36months),andintheircomfort level and perceived competence (both at 6, 18, and 36 months). SEEK HPs screened for targeted problems more often than did controls based on observations 24 months after the initial training and the medical records (P Ͻ .001). CONCLUSIONS:The SEEK model led to significant and sustained improvement in several areas. This is a crucial first step in helping HPs address major psychosocial problems that confront many families. SEEK offers a modest yet promising enhancement of primary care.

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Factors influencing inquiry about patients’ alcohol consumption by primary health care physicians: qualitative semi-structured interview study

Abstract: There still exist many barriers to initiating discussions about alcohol in the consultation room. Changing the frame of reference of the concept of alcohol drinking from an addictive disease to a general lifestyle risk factor could overcome many of these barriers.

Cited by 137 publications

References 18 publications

Exploration of GPs' views and use of the fit note: a qualitative study in primary care

Exploration of GPs' views and use of the fit note: a qualitative study in primary care

Número Completo/Full Number

The Safe Environment for Every Kid Model: Impact on Pediatric Primary Care Professionals

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