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Rengasamy ER, Hiscock H, Newlove-Delgado T, Mughal F. Optimising access to primary care services for young people: lessons from England and Australia. Br J Gen Pract 2024; 74:440-442. [PMID: 39327087 PMCID: PMC11441614 DOI: 10.3399/bjgp24x739461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024] Open
Affiliation(s)
- Emma R Rengasamy
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Harriet Hiscock
- Department of Paediatrics, The University of Melbourne; Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia
| | | | - Faraz Mughal
- School of Medicine, Keele University; Department of General Practice and Primary Care, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
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Chen X, Zhang Y, Qin W, Yu Z, Yu J, Lin Y, Li X, Zheng Z, Wang Y. How does overall hospital satisfaction relate to patient experience with nursing care? a cross-sectional study in China. BMJ Open 2022; 12:e053899. [PMID: 35039296 PMCID: PMC8765024 DOI: 10.1136/bmjopen-2021-053899] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To determine how patient experience with nursing care influence patient satisfaction with overall hospital services. DESIGN This was a cross-sectional study. SETTING Inpatients were consecutively recruited at the national hospital (with 2000 beds) in Shanghai, China. PARTICIPANTS The inclusion criteria were as follows: (1) hospitalised for 2 days or more; (2) able to read and understand Chinese; and (3) aged 18 years old or above. Patients with mental health problems were excluded. 756 patient surveys distributed among 36 wards were analysed. The mean age of participants in the study was 57.7 (SD=14.5) and ranged from 18 to 80 years. Most participants were men (61.5%) and ever married (94.6%). PRIMARY AND SECONDARY OUTCOME MEASURES Patient experience with nursing care, meaning the sum of all interactions between patients and nurses, was measured using the self-designed questionnaire, which was developed by patient interviews, literature analysis and expert consultation. The overall patient satisfaction question was measured with a 10-point response option ranging from 1 to 10. RESULTS A linear relationship between the patient experience with nursing care and overall patient satisfaction was observed. The patient experience with nursing care was significantly associated with overall satisfaction in the crude model and in the adjusted models. Even after adjusting for six sociodemographic and three disease-related factors, the patient experience with nursing care explained 34.9% of the variation in overall patient satisfaction. CONCLUSIONS This study showed that patient experience with nursing care was an important predictor for overall patient satisfaction.
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Affiliation(s)
- Xiao Chen
- Department of Nursing, Zhongshan Hospital Fudan University, Shanghai, China
| | - Yuxia Zhang
- Department of Nursing, Zhongshan Hospital Fudan University, Shanghai, China
| | - Wei Qin
- Department of Nursing, Zhongshan Hospital Fudan University, Shanghai, China
| | - Zhenghong Yu
- Department of Surgery, Zhongshan Hospital Fudan University, Shanghai, China
| | - JingXian Yu
- Department of Liver Disease, Zhongshan Hospital Fudan University, Shanghai, China
| | - Ying Lin
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai, China
| | - XiaoRong Li
- Department of Internal Medicine, Zhongshan Hospital Fudan University, Shanghai, China
| | - Zheng Zheng
- Department of Respiratory, Zhongshan Hospital Fudan University, Shanghai, China
| | - Ying Wang
- Department of Internal Medicine, Zhongshan Hospital Fudan University, Shanghai, China
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Grigoroglou C, Munford L, Webb RT, Kapur N, Ashcroft DM, Kontopantelis E. Prevalence of mental illness in primary care and its association with deprivation and social fragmentation at the small-area level in England. Psychol Med 2020; 50:293-302. [PMID: 30744718 PMCID: PMC7083582 DOI: 10.1017/s0033291719000023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 12/21/2018] [Accepted: 01/03/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND We aimed to spatially describe mental illness prevalence in England at small-area geographical level, as measured by prevalence of depression, severe mental illness (SMI) and antidepressant prescription volume in primary care records, and how much of their variation was explained by deprivation, social fragmentation and sociodemographic characteristics. METHODS Information on prevalence of depression and SMI was obtained from the Quality and Outcomes Framework (QOF) administrative dataset for 2015/16 and the national dispensing dataset for 2015/16. Linear regression models were fitted to examine ecological associations between deprivation, social fragmentation, other sociodemographic characteristics and mental illness prevalence. RESULTS Mental illness prevalence varied within and between regions, with clusters of high prevalence identified across England. Our models explained 33.4-68.2% of variability in prevalence, but substantial variability between regions remained after adjusting for covariates. People in socially cohesive and socially deprived areas were more likely to be diagnosed with depression, while people in more socially fragmented and more socially deprived areas were more likely to be diagnosed with SMI. CONCLUSIONS Our findings suggest that to tackle mental health inequalities, attention needs to be targeted at more socially deprived localities. The role of social fragmentation warrants further investigation, and it is possible that depression remains undiagnosed in more socially fragmented areas. The wealth of routinely collected data can provide robust evidence to aid optimal resource allocation. If comparable data are available in other countries, similar methods could be deployed to identify high prevalence clusters and target funding to areas of greater need.
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Affiliation(s)
- Christos Grigoroglou
- Division of Population Health, Health Services Research and Primary Care, NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
| | - Luke Munford
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- Division of Population Health, Health Services Research and Primary Care, Centre for Health Economics, University of Manchester, Manchester, UK
| | - Roger T. Webb
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, University of Manchester, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
| | - Nav Kapur
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
- Division of Psychology and Mental Health, Centre for Suicide Prevention, University of Manchester, Manchester, UK
- Greater Manchester Mental Health Trust
| | - Darren M. Ashcroft
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
- Faculty of Biology, Medicine and Health, Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Evangelos Kontopantelis
- Division of Population Health, Health Services Research and Primary Care, NIHR School for Primary Care Research, Centre for Primary Care, University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
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Viktorsson L, Yngman-Uhlin P, Törnvall E, Falk M. Healthcare utilisation and health literacy among young adults seeking care in Sweden: findings from a cross-sectional and retrospective study with questionnaire and registry-based data. Prim Health Care Res Dev 2019; 20:e151. [PMID: 31813392 PMCID: PMC7003531 DOI: 10.1017/s1463423619000859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/29/2019] [Accepted: 09/29/2019] [Indexed: 01/27/2023] Open
Abstract
AIM The objective of this study was to examine young adults' healthcare utilisation and its possible association with health literacy. BACKGROUND Many countries struggle with insufficient accessibility at emergency departments (EDs) and primary healthcare centres (PHCs). Young adults, aged 20-29 years old, account for a substantial number of unnecessary doctor visits where health literacy could be an explanatory factor. METHOD This study incorporated a combined retrospective and cross-sectional study design with analysis of registry data, including all registered outpatient doctor visits between 2004 and 2014 (n = 1 086 432), and strategic sample questionnaire data (n = 207), focusing on socio-demographics, symptoms and information-seeking behaviour. Mean differences between first-year and last-year doctor visits for each age group were calculated using registry data. Fischer's exact test was applied to questionnaire data to analyse group differences between ED and PHC visitors as well as between patients with sufficient health literacy and insufficient health literacy. Binary logistic regression was used to investigate covariation. FINDINGS Healthcare utilisation has increased among young adults during the past decade, however, not comparatively more than for other age groups. ED patients (n = 49) compared to PHC patients (n = 158) were more likely to seek treatment for gastrointestinal symptoms (P = 0.001), had shorter duration of symptoms (P = 0.001) and sought care more often on the recommendation of a healthcare professional (P = 0.001). Insufficient/problematic health literacy among young adults was associated with having lower reliance on the healthcare system (P = 0.03) and with a greater likelihood of seeking treatment for psychiatric symptoms (P = 0.002). CONCLUSION Young adults do not account for the increase in healthcare utilisation during the last decade to a greater extent than other age groups. Young adults' reliance on the healthcare system is associated with health literacy, an indicator potentially important for consideration when studying health literacy and its relationship to more effective use of healthcare services.
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Affiliation(s)
- Lisa Viktorsson
- Research and Development Unit, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Pia Yngman-Uhlin
- Research and Development Unit, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Eva Törnvall
- Management Department, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Magnus Falk
- Primary Health Care Center Kärna, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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van Til JA, Groothuis-Oudshoorn CGM, Vlasblom E, Kocken PL, Boere-Boonekamp MM. Primary care in five European countries: A citizens' perspective on the quality of care for children. PLoS One 2019; 14:e0224550. [PMID: 31710618 PMCID: PMC6844459 DOI: 10.1371/journal.pone.0224550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022] Open
Abstract
Objective As part of the Models of Child Health Appraised (MOCHA) project, this study aimed to answer the following research questions: 1) How do European citizens perceive the quality of primary health care provided for children? And 2) What are their priorities with respect to quality assessment of primary health care aimed at satisfying children’s needs? Methods Nine potential attributes of quality of primary care were operationalized in 40 quality aspects. An online survey was used to elicit opinions in a representative sample of citizens of Germany, the Netherlands, Poland, Spain, and the United Kingdom. Data collection comprised: background characteristics; perceived quality of primary health care for children; and priority setting of quality aspects. Descriptive analysis was performed and differences between groups were tested using Chi-Square test and ANOVA. Results Valid results were obtained from 2403 respondents. Mean satisfaction with quality of primary care ranged from 5.5 (Poland) to 7.2 (Spain). On average, between 56% (Poland) and 70% (Netherlands) of respondents had a positive perception of the primary health care system for children in their country. The ability of a child to limit their parents’ access to the child’s medical records was judged most negatively in all countries (average agreement score 28%, range 12–36%). The right of a child to a confidential consultation was judged most differently between countries (average agreement score 61%, range 40–75%). Overall top-10 priorities in ensuring high quality primary care were: timeliness (accessibility); skills/competences, management, facilities (appropriateness); no costs (affordability); information, dignity/respect (continuity); and swift referrals, collaboration (coordination). Discussion Between countries, significant differences exist in the perceived quality of primary care and priorities with regard to quality assessment. Taking into account the citizens’ perspective in decision-making means that aspects with low perceived quality that are highly prioritized warrant further action.
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Affiliation(s)
- Janine A. van Til
- University of Twente, Technical Medical Centre, Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, the Netherlands
- * E-mail:
| | - Catharina G. M. Groothuis-Oudshoorn
- University of Twente, Technical Medical Centre, Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, the Netherlands
| | - Eline Vlasblom
- TNO, Department of Child Health, Leiden, The Netherlands
| | - Paul L. Kocken
- TNO, Department of Child Health, Leiden, The Netherlands
- Public Health and Primary Care Department of LUMC, Leiden, The Netherlands
| | - Magda M. Boere-Boonekamp
- University of Twente, Technical Medical Centre, Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, the Netherlands
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Perspectives of vaccinators on the factors affecting uptake of meningococcal ACWY vaccine amongst school leavers in London. Public Health 2018; 164:128-133. [DOI: 10.1016/j.puhe.2018.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/09/2018] [Accepted: 08/03/2018] [Indexed: 11/17/2022]
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Soanes L, Gibson F. Protecting an adult identity: A grounded theory of supportive care for young adults recently diagnosed with cancer. Int J Nurs Stud 2018; 81:40-48. [DOI: 10.1016/j.ijnurstu.2018.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 12/15/2022]
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Eating disorder behaviours amongst adolescents: investigating classification, persistence and prospective associations with adverse outcomes using latent class models. Eur Child Adolesc Psychiatry 2017; 26:231-240. [PMID: 27341841 PMCID: PMC5183523 DOI: 10.1007/s00787-016-0877-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 05/31/2016] [Indexed: 12/18/2022]
Abstract
Diagnostic criteria for eating disorders (ED) remain largely based on clinical presentations, but do not capture the full range of behaviours in the population. We aimed to derive an empirically based ED behaviour classification using behavioural and body mass index (BMI) indicators at three time-points in adolescence, and to validate classes investigating prospective associations with adverse outcomes. Adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC) provided data on ED at age 14 (n = 6615), 16 (n = 5888), and 18 years (n = 5100), and had weight and height measured. Psychological and behavioural outcomes were assessed at 15.5/16 and 17.5/18 years. We fit gender- and age-stratified latent class models, and employed logistic regression to investigate associations between classes and later outcomes. One asymptomatic and two symptomatic (largely representing higher and lower frequency ED behaviours) classes were observed at each time-point, although their relative prevalence varied by age and gender. The majority of girls in symptomatic classes remained symptomatic at subsequent assessments. Girls in symptomatic classes had higher odds of subsequent anxiety and depressive disorders, binge drinking, drug use, and deliberate self-harm. Data analyses were underpowered amongst boys. The presence of two symptomatic classes (characterised by different ED behaviour frequency) and their prospective association with adverse outcomes suggest a need to refine diagnostic thresholds based on empirical data. Despite some instability of classes, particularly in mid-adolescence, evidence that half of girls in symptomatic classes remained symptomatic suggests persistence of ED behaviours in adolescence, and highlights a need for early identification to reduce chronicity.
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Desborough J, Phillips C, Banfield M, Bagheri N, Mills J. Impact of nursing care in Australian general practice on the quality of care: A pilot of the Patient Enablement and Satisfaction Survey (PESS). Collegian 2015; 22:207-14. [DOI: 10.1016/j.colegn.2014.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rowlands IJ, Loxton D, Dobson A, Mishra GD. Seeking Health Information Online: Association with Young Australian Women's Physical, Mental, and Reproductive Health. J Med Internet Res 2015; 17:e120. [PMID: 25986630 PMCID: PMC4468597 DOI: 10.2196/jmir.4048] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 03/17/2015] [Accepted: 03/23/2015] [Indexed: 01/25/2023] Open
Abstract
Background Relatively little is known about the extent to which young adults use the Internet as a health information resource and whether there are factors that distinguish between those who do and do not go online for health information. Objective The aim was to identify the sociodemographic, physical, mental, and reproductive health factors associated with young women’s use of the Internet for health information. Methods We used data from 17,069 young women aged 18-23 years who participated in the Australian Longitudinal Study on Women’s Health. Multivariable logistic regression was used to estimate the association between sociodemographic, physical, mental, and reproductive health factors associated with searching the Internet for health information. Results Overall, 43.54% (7433/17,069) of women used the Internet for health information. Women who used the Internet had higher odds of regular urinary or bowel symptoms (OR 1.44, 95% CI 1.36-1.54), psychological distress (very high distress: OR 1.24, 95% CI 1.13-1.37), self-reported mental health diagnoses (OR 1.16, 95% CI 1.09-1.23), and menstrual symptoms (OR 1.25, 95% CI 1.15-1.36) than women who did not use the Internet for health information. Internet users were less likely to have had blood pressure checks (OR 0.85, 95% CI 0.78-0.93) and skin cancer checks (OR 0.90, 95% CI 0.84-0.97) and to have had a live birth (OR 0.74, 95% CI 0.64-0.86) or pregnancy loss (OR 0.88, 95% CI 0.79-0.98) than non-Internet users. Conclusions Women experiencing “stigmatized” conditions or symptoms were more likely to search the Internet for health information. The Internet may be an acceptable resource that offers “anonymized” information or support to young women and this has important implications for health service providers and public health policy.
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Affiliation(s)
- Ingrid Jean Rowlands
- Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Brisbane, Australia.
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Davey A, Asprey A, Carter M, Campbell JL. Trust, negotiation, and communication: young adults' experiences of primary care services. BMC FAMILY PRACTICE 2013; 14:202. [PMID: 24373254 PMCID: PMC3880848 DOI: 10.1186/1471-2296-14-202] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 12/27/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Young adulthood is an important transitional period during which there is a higher risk of individuals engaging in behaviours which could have a lasting impact on their health. Research has shown that young adults are the lowest responders to surveys about healthcare experiences and are also the least satisfied with the care they receive. However, the factors contributing to this reduced satisfaction are not clear. The focus of our research was to explore the needs and experiences of young adults around healthcare services with an aim of finding out possible reasons for lower satisfaction. METHODS Twenty young adults were interviewed at GP surgeries and at a local young adult advice agency, exploring their experiences and use of primary care services. Interviews were analysed using thematic analysis. RESULTS The use of primary care services varied amongst the young adult interviewees. Many interviewees reported positive experiences; those who did not linked their negative experiences to difficulties in negotiating their care with the health care system, and reported issues with trust, and communication difficulties. Most of the interviewees were unaware of the use of patient surveys to inform healthcare planning and delivery and were not inclined to take part, mainly because of the length of surveys and lack of interest in the topic area. CONCLUSIONS In order to effectively address the health needs of young adults, young adults need to be educated about their rights as patients, and how to most efficiently use primary care services. GPs should be alert to effective means of approaching and handling the healthcare needs of young adults. A flexible, varied approach is needed to gathering high quality data from this group in order to provide services with information on the changes necessary for making primary care services more accessible for young adults.
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Affiliation(s)
- Antoinette Davey
- Primary Care Research Group, University of Exeter Medical School, St Lukes Campus, Smeall Building, Magdalen Road, Exeter EX1 2 LU, UK
| | - Anthea Asprey
- Primary Care Research Group, University of Exeter Medical School, St Lukes Campus, Smeall Building, Magdalen Road, Exeter EX1 2 LU, UK
| | - Mary Carter
- Primary Care Research Group, University of Exeter Medical School, St Lukes Campus, Smeall Building, Magdalen Road, Exeter EX1 2 LU, UK
| | - John L Campbell
- Primary Care Research Group, University of Exeter Medical School, St Lukes Campus, Smeall Building, Magdalen Road, Exeter EX1 2 LU, UK
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