“What do you mean I can’t have a doctor? This is Canada!” – A Qualitative Study of the Myriad Consequences for Unattached Patients Awaiting Primary Care Attachment

Abstract

Access and attachment to primary healthcare (PHC) is foundational to stronger healthcare systems and healthier populations yet has declined over time. We explore consequences of unattachment employing a realist-informed qualitative study with unattached patients in Nova Scotia, Canada. Semi-structured interviews with nine participants were conducted. The framework method was used to structure analysis, guided by Donabedian’s model of assessing healthcare access and quality. Five key findings noted: participants used creative strategies to attempt to gain attachment to a PHC provider; and to address their health needs in the absence of a regular PHC provider; participants experienced negative feelings about themselves and the healthcare system; stress related to the added work of being unattached, and health consequences from lost care. These findings may underestimate unattachment consequences for further at-risk populations not represented in the data. Consequences of unattachment could be mitigated by interventions, such as enhanced centralized waitlists promoting attachment.

Coping Strategies for Patients with Pleural Effusion

“…CHN should advise patients with pleural effusion about the important lifestyle changes suitable for condition, such as the use of proper body mechanics during routine activities, maintaining ideal body weight, stop smoking, sleep on the side affected with a pleural effusion, try to sleep in a semisitting position when feeling short of breath, maintain good ventilation at home, avoid heavy lifting. The CHN can also teach the patients with pleural effusion coping strategies and encourage to use strategies which help the patients to promote adjustment with pain/ condition, improve outcome, restoration of function within family, society, and work (Marshall et al, 2021;Taylor et al, 2021).…”