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Your search keyword '"Qualitative design and methods"' showing total 2 results
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2 results on '"Qualitative design and methods"'

1. Implementation of Primary Palliative Care in five Belgian regions: A qualitative study on early identification of palliative care needs by general practitioners

Author

Isabelle Aujoulat, Marlène Karam, Johan Wens, Bert Leysen, Olivier Schmitz, Bart Van den Eynden, and UCL - SSS/IRSS - Institut de recherche santé et société

Subjects
Adult, Male, Palliative care, Family medicine, education, general practice/family medicine, qualitative designs and methods, 03 medical and health sciences, 0302 clinical medicine, Palliative and terminal care, Nursing, Belgium, General Practitioners, otorhinolaryngologic diseases, Care pathway, Medicine, Humans, 030212 general & internal medicine, Qualitative Research, Aged, lcsh:R5-920, Health Services Needs and Demand, Primary Health Care, business.industry, 030503 health policy & services, Palliative Care, Continuity of Patient Care, Focus Groups, Middle Aged, Qualitative design and methods, Identification (information), Health care organisation and management, general, health care organisation and management, Female, Original Article, Human medicine, 0305 other medical science, business, lcsh:Medicine (General), Family Practice, General practice, Qualitative research, Research Article
Abstract

Background To deliver optimal palliative care, a Care Pathway for Primary Palliative Care (CPPPC) was developed. This CPPPC was implemented by general practitioners (GPs) in territories of five Belgian palliative care networks (2014–2016). Belgian doctors have much therapeutic freedom, and do not commonly follow guidelines. Objectives To assess how palliative care was provided by GPs before the CPPPC and its implementation project were presented publicly. Methods Between 2013 and 2015, seven focus groups with GPs were conducted. Participants included 15 GPs in three French-speaking focus groups and 26 GPs in four Dutch-speaking focus groups, with diversity for age, gender, palliative care experience and practice context. Some GPs implemented the CPPPC later. Results GPs considered each palliative care case unique and disliked strict protocols. However, they expressed a need for peer review and reflective frameworks. GPs felt it is important to identify palliative care patients ‘timely’, but found this difficult. Screening methods help, but are not widely used. GPs struggled most with identifying palliative care needs in non-oncological patients. Bad news breaking was considered difficult. Continuity of care was considered very important. However, advance care planning seemed more widely practised by Dutch-speaking GPs than by French-speaking GPs. The taboo of palliative care provoked emotional discussions. Conclusion Palliative care frameworks which help GPs to deliver ‘tailor-made’ care have more chance to be adopted than strict protocols. GPs should be given education for bad news breaking. Palliative care and advance care planning practices differ locally: guideline dissemination plans should respect these local differences.

Published
2020

2. Why do GPs continue inappropriate hospital prescriptions of proton pump inhibitors? A qualitative study.

Author

Wermeling M, Himmel W, Behrens G, and Ahrens D

Subjects
Attitude of Health Personnel, Clinical Competence, Female, General Practitioners standards, Health Knowledge, Attitudes, Practice, Hospitals, Humans, Interviews as Topic, Male, Physicians standards, Physicians statistics & numerical data, Practice Patterns, Physicians' standards, Primary Health Care standards, Primary Health Care statistics & numerical data, Proton Pump Inhibitors administration & dosage, General Practitioners statistics & numerical data, Inappropriate Prescribing statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data, Proton Pump Inhibitors therapeutic use
Abstract

Background: Inappropriate prescriptions of Proton pump inhibitors (PPIs) initiated in hospitals are frequently continued in primary care. No research has explored why general practitioners (GPs) continue or discontinue inappropriate drug therapy., Objectives: This study aims to describe factors and motives associated with the continuation of inappropriate prescriptions of PPIs in primary care., Methods: Semi-structured qualitative interviews on basis of a purposive sampling of five GPs who often continued inappropriate prescriptions and five GPs who frequently discontinued inappropriate drug therapy with PPIs (10 GPs total, of which four were female and six male)., Results: Although all GPs enrolled in the study were enthusiastic about the effectiveness of PPIs, differences between the continuing and discontinuing GPs exists in three areas: The two groups varied ( 1 ) in awareness of indications and general attitudes towards prescribing ( 2 ) in perception of the hospital physicians' competence in prescribing and ( 3 ) appreciation of general prescribing conditions in hospitals., Conclusion: Differences between the continuing and discontinuing GPs were found in their level of knowledge and their perceptions of the hospital physicians' competence and the threshold to prescribing in hospitals. Financial pressure and possible adverse effects demand a more balanced and evidence-based prescribing of PPIs. Attempts to change behaviour should focus on the GPs' awareness of indications for PPIs, NSAID risks, and prescribing approaches in hospitals. Default prescribing in hospital demands critical examination.

Published
2014
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