The aim of this study is to describe the rollout of nursing activities during the pilot project’s first 12 months (2019–2021), especially relating to what was initially planned in the nurses’ job description.

To provide more comprehensive services and reinforce primary care, a pilot implementation study assessed the integration of nursing activities into eight general practitioners’ (GPs’) practices. The study evaluated how new types of activities were integrated and rolled out over the first year.

A mixed-methods observational study collected quantitative data on nursing activities and duration and qualitative data via five interviews with nurses and patients and one focus group with six GPs. Investigators combined quantitative and qualitative data in discussions about their results.

New nursing activities were rolled out progressively, especially follow-up activities with chronically ill patients, with a median time dedicated/month of 21h58 (range: 9h25 to 64h50) at six months and 48h43 (range: 11h01 to 59h51) at 12 months. One-off clinical activities are more easily integrated: the median time dedicated/month was 40h01 (range: 13h44 to 74h53) at six months and 40h30 (range: 9h38 to 76h51) at 12 months. Three elements were crucial in the implementation of nursing activities. The nurse’s previous professional experience influenced the scope of activities developed. GPs’ willingness to refer patients to the nurses enabled the latter to carry out follow-up activities with care plan. Lastly, the implementation of nursing activities was also made possible by patients’ acceptance of being cared for by nurse instead of a GP.

Implementation of nursing activities increased progressively, although more slowly for activities with chronically ill patients and within care plans, principally due to the overall change faced by GPs and nurses.

This study aimed to assess the impact of oral Fe+2 iron preparations on weight, body composition, metabolic, and appetite parameters in adults undergoing treatment for iron deficiency.

In this observational prospective study, a total of 119 patients, aged 18–45, initiating Fe+2 iron therapy for iron deficiency within the last month at Family Medicine Outpatient Clinic, were included. Data on sociodemographic variables, health, dietary habits, anthropometric measurements, metabolic parameters, and appetite scores were collected. The Power of Food (PFS), Visual Analogue Scale (VAS), and Three-Factor Eating Questionnaire (TFEQ) were utilized for appetite assessment.

After three months of iron treatment, a statistically significant increase was found in the mean values of Hb, Hct, MCV, ferritin, iron, and transferrin saturation; anthropometric measurements displayed a significant reduction in body weight, body mass index (BMI), fat percentage, waist circumference, hip circumference, and waist/hip circumference ratios post-treatment. Notably, VAS scores for certain food items decreased, while carbonated drinks VAS score increased. Appetite-related factors, as per PFS, exhibited a significant decrease in PFS factor 1 (food available), PFS factor 2 (food present).

In conclusion, our findings indicate that oral Fe+2 iron preparations positively influence the treatment of iron deficiency anaemia by improving haematological parameters and concurrently leading to a significant reduction in body weight, BMI, and appetite scores related to specific food items. The study underscores the multifaceted impact of iron supplementation on both physiological and behavioural aspects, providing valuable insights for optimizing iron deficiency anaemia management.

Primary healthcare units (PHCUs) in Austria play a crucial role in providing regionally tailored, high-quality care through interprofessional teams. Barriers, such as limited training and unclear roles, hinder effective interprofessional collaboration (IPC). Additionally, healthcare and social professionals (HCSPs) in primary healthcare (PHC) face a rise in patients with non-communicable diseases and increasing climate-related challenges, underscoring the need for education addressing IPC and sustainability to build resilient healthcare.

This paper presents the protocol of the REALISE study, which aims to evaluate the effectiveness of a didactic concept integrating collaborative, digital, and sustainability skills within multimodal training modules (including simulations).

In this prospective trial, HCSPs working in PHC and students in their final year of education in related professions are recruited to participate in interprofessional training modules, which take place on four days within a month in person and with additional e-learning elements between those days. The modules consist of didactic elements on IPC and sustainability, simulation scenarios with acting patients, and immersive virtual reality scenarios. The primary outcomes assess IPC by utilizing the Teamwork Assessment Scale, the Interprofessional Socialization and Valuing Scale (9a/9b), and the Interprofessional Collaborative Competency Attainment Survey. Secondary outcomes focus on sustainability and environmental awareness, as well as the organization and structure of the training modules.

The findings of this study will demonstrate the effect of proprietary training modules on IPC and will inform on the integration of respective modules into standard curricula and continuing educational programmes at the Salzburg University of Applied Sciences.

The aim of this study was to develop an up-to-date system of Structural Indicators for the Strength of Primary Care (SiSPC) to enable comparisons of primary care systems across countries.

Indicators are needed for international research into the development of primary care and to support countries in monitoring improvements in access, responsiveness and efficiency of their primary care services. International comparisons with use of identical indicators for the strength of primary care offer policymakers opportunities to learn lessons from abroad.

Our point of departure was the Primary Health Care Activity Monitor Europe (PHAMEU), that effectively measured the strength of primary care at the beginning of this century. We went through the following steps: (1) Reduction, refining and tuning of the PHAMEU indicator system (2) comparison with the European Primary Health Care, Impact, Performance and Capacity Tool (PHC-IMPACT) (3) addition of topics from other frameworks (4) identification of topical issues from the literature. The resulting draft indicator system was discussed at meetings and received feedback from experts from 25 countries.

SiSPC consists of three care-related domains: Structure of Primary Care, Systemic Aspects of Facility Management and Systemic Aspects of Care Delivery. SiSPC also contains a domain on the Context of Primary Care. Care processes that vary between care providers, were not included as a domain at the system level.

To investigate factors influencing the recruitment and retention of adult community nurses.

The recruitment and retention of community nurses is a growing global challenge, exacerbated by aging populations and increasing demand for primary and home-based care. Across Europe, nurse shortages threaten healthcare sustainability, with high attrition rates linked to workplace pressures, inadequate staffing, and emotional exhaustion. Despite efforts to strengthen retention, many European countries struggle to maintain adequate staffing levels, particularly in community nursing.

An exploratory qualitative approach was used with semi-structured interviews. The interview schedule was shaped by the study’s aims, a prior integrative literature review, and the ‘causal model of turnover for nurses’. Questions explored participants’ experiences of recruitment into community nursing and factors influencing retention. The study focused on registered nurses and service managers within adult community nursing organizations across diverse geographical areas.

The study identified eight main themes influencing recruitment and retention: the perfect job, finding true self and fulfilment, alignment with organizational values, prior development and transitional experience, job dissatisfaction, shift in traditional practices, lack of compassionate leadership, and family commitments. Key factors included workplace flexibility, professional identity, job security, and organizational culture. However, challenges such as staffing shortages, lack of career progression, and increased administrative tasks were significant barriers to retention.

This study highlights the multifaceted challenges surrounding community nurse recruitment and retention, emphasizing the need for targeted strategies that go beyond traditional hospital-focused approaches. While salary improvements remain crucial, broader systemic changes including workplace flexibility, compassionate leadership, and career development opportunities are essential to fostering a sustainable workforce. By addressing these factors through co-designed solutions and evidence-based policy adjustments, healthcare organizations can enhance job satisfaction, reduce attrition, and ultimately strengthen the future of community nursing.

Written referrals and follow-up correspondence between referring general practitioners (GPs) and psychiatrists is a medico-legal responsibility and integral part of caring for patients with mental illness. Objective: To describe expectations and practices that GPs and psychiatrists have when exchanging correspondence concerning patients with mental health problems.

In this observational, declarative, and cross-sectional study, two surveys were used to evaluate the expectations, frequency, and content of correspondence exchanged between GPs and psychiatrists. The questionnaire was based on the National College for the Quality of Psychiatric Care 2010 recommendations. Conducted in a regional setting in France between 2014 and 2016, the study involved 2754 GPs and 575 psychiatrists.

Overall, we achieved a positive response rate of 33% (189/575) of psychiatrists and 23% (628/2754) of GPs, which was similar in each local region. Regarding the correspondence from GPs to psychiatrists, 478 (75%) GPs declared having written a referral for an initial consultation and 84 (44%) psychiatrists declared having received a referral. Regarding the correspondence from psychiatrists to GPs, 144 (76%) psychiatrists declared having written at least one letter after the initial consultation or during follow-up and 160 (25%) GPs declared having received return correspondence. The GPs would like to be better informed about psychotherapeutic or long-term management, leave of absence from work, surveillance measures, prognosis, and division of specialist roles. The psychiatrists would like to receive more information about previous medication trialed, the level of willingness the patient has to consult a psychiatrist and any allergies or intolerances to medication.

This study highlights the need to improve the disparity between expected and received correspondence from GPs and psychiatrists concerning patients with mental health problems.

To understand patterns of cannabis use and self-management experiences in patients with chronic disease during the post-legalization period in Thailand and to quantify such experiences and perceptions.

Patients with chronic disease are a population in which disease self-management is potentially involved with the use of complementary and alternative medicines (CAMs). The recent changes in cannabis regulation in Thailand have allowed retail selling and home cultivation. Cannabis is a medicinal herb in many traditional Thai recipes and is often adopted as a CAM in the chronic disease population. The adoption of cannabis products as part of CAM could lead to changes in chronic disease outcomes.

Exploratory-sequential mixed methods were used in this study. A descriptive qualitative study was conducted to acquire a basic understanding of the patients’ experiences. Semi-structured in-depth interviews were conducted, and thematic analysis was applied. Subsequently, a cross-sectional study was conducted to quantify the patterns of cannabis use and self-management experience in patients with diabetes and/or hypertension.

Eleven patients were interviewed, and 124 patients participated in the cross-sectional study. Most of the participants were male, married, and identified as Buddhist. Many patients believed that cannabis could improve their health, while fewer considered it a threat to their health. In general, the patients viewed cannabis as a way to enhance their quality of life and treat chronic diseases. Some patients embraced the principles of CAM. They primarily used cannabis tea daily to manage diabetes or hypertension, with their approaches being more complementary than alternative. However, only one-third (34.7%) were aware of potential drug interactions with their concurrent medications.

Primary care serves as the foundation of a well-functioning healthcare system and is critical for ensuring equitable access, early disease management, and cost-effective service delivery. In China, reforming primary-level healthcare institutions has become a national priority to achieve universal health coverage. Understanding the service users’ perspectives is essential to align primary care services with population health needs and improving trust in grassroots healthcare providers.

To evaluate satisfaction and unmet service needs among primary care users in Jiangsu Province, China.

A cross-sectional survey using structured questionnaires was given to 424 residents in urban and rural Jiangsu Province to measure satisfaction with primary hospitals, doctors, service preferences, and perceived gaps. Data was analyzed using descriptive statistics and chi-square tests to identify regional differences.

The primary care utilisation rate among respondents was 73.3%. While 75.2% reported satisfaction with medical expenses at primary-level facilities, significant urban-rural and regional differences were observed in service awareness, health policy knowledge, and perceived quality of doctor-patient communication. Primary care doctors received the highest ratings for using “easy-to-understand language”(mean score 4.13 ± 0.821) but lower scores for “professional competence” and “treatment effectiveness” (both 3.91). Rural inhabitants expressed high demand for services like management of common diseases (65.8%) and routine health examinations (52.4%), but highlighted shortages in advanced diagnostic tools (e.g., CT scans, endoscopy). Most inhabitants (67.2%) felt that primary care providers require improvement, particularly in clinical competency and communication.

The findings highlight areas for targeted policy interventions to improve primary care service delivery and capacity-building of primary care doctors in Jiangsu Province.

To explore factors shaping social prescribing (SP) link workers (LWs) experiences of their job, and how they influence decisions about whether or not to leave it.

LWs support healthcare delivery by listening to patients’ non-medical concerns and social or relational difficulties, connecting them to ‘community assets’ (groups, organizations, charities) when relevant to help. LWs try to assist people with often complex emotional and/or social issues. This can affect how they feel in their job.

As part of a mixed methods project on LW retention, a qualitative study was conducted. It involved 20 LWs, purposively selected from respondents to a questionnaire; variation in the sample was sought in terms of self-efficacy in the role, length of time in it, intention to leave or not, employing organization, where they worked in the UK and gender. Semi-structured interviews, conducted via Microsoft Teams, were audio-recorded and transcribed verbatim. Prior to interviews, we asked participants to take photographs of: a typical part of their working day; something that gave them confidence in their role; an unexpected part of their role. These photographs were discussed at the start of the interview. Thematic analysis was used to interpret data (the computer programme NVIVO supported this); this involved coding and clustering codes to develop analytical themes.

We produced four themes from the data; 1) Disconnection through place and space: straddling different organizational spheres; 2) Delivery ambiguity: vagueness around the link worker role; 3) Job misalignment and realignment: navigating identity and boundaries; 4) Clouded by instability: uncertainty around career advancement and sustainability. This led to the development of an overarching theme of LWs inhabiting a liminal space as they entered and undertook the role. Findings highlight the importance of training, supervision and other support to ensure LWs do not experience a prolonged liminal state.

In South Africa, community health workers (CHWs) provide home-based care and health promotion for patients with chronic conditions like hypertension. However, their views on patients’ poor blood pressure control remain unclear. Understanding CHWs’ perspectives could inform future community-level strategies for improving blood pressure management.

To explore CHWs’ experiences about factors contributing to uncontrolled hypertension among adults living in a South African District.

A qualitative exploratory design, based on 22 face-to-face, semi-structured interviews with CHW. Data was transcribed and analysed manually using thematic analysis.

Four themes emerged: (1) adequate knowledge about blood pressure and hypertension. However, lack of comprehension about the physiological concept of blood pressure and hypertension, (2) interventions used for hypertension control were contextualized and very simple, (3) contextual barriers to hypertension control included financial, personal, systemic, medication as well as cultural and traditional factors, (4) strategies to improve hypertension control included improved team work, awareness creation, holistic healthcare, improved access to clinic facilities, system-related improvements and patient initiatives.

Community health workers (CHWs) demonstrated sufficient knowledge of hypertension, highlighting the need to strengthen and standardize their training, supervision, and support. Their patient advice was practical and context-specific. To address barriers and stigma around hypertension, CHWs should lead awareness campaigns and engage in community-based exercise and support groups, with help from rehabilitation teams. Collaborating with local police and community leaders to address violence, alcohol, and crime, along with initiatives like community gardens, multidisciplinary teamwork, and more frequent home visits, could further improve hypertension control.

This review explored whether and how prescribers modify their prescribing behaviour for older people (≥65) with hearing, visual or dual impairment (hereafter referred to as sensory impairment) in primary care settings and identified what evidence sources exist to inform prescribing for these specific patient populations.

Older people with sensory impairment may experience substantial challenges with medicines management compared with older people without sensory impairment. The prevalence of sensory impairment and medicine use increases with age, as such, practitioners may need to consider how to modify their prescribing behaviour to improve the safe and effective use of medicines.

This study was conducted to reflect the Joanna Briggs Institute [JBI] methodology for scoping reviews. Electronic databases were searched: MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google, and Google Scholar. Qualitative and quantitative studies were included if published between January 2012 and April 2023. Grey literature sources, including Google and Google Scholar, were also searched. Studies were eligible for inclusion if they focussed on prescribing behaviour for older people with sensory impairment in primary care settings. Independent duplicate data extraction was undertaken of details about the participants, concept, context, study methods, outcomes, and key findings relevant to the review question.

A total of 3,590 records were identified through database searching and 10 full text articles were retrieved. Grey literature identified a further 61 records. On examination, none of the articles fulfilled the inclusion criteria for this review.

This review has highlighted a gap in the evidence regarding prescribing for these high risk patient populations. There may be a need for the development of resources, such as evidence based guidelines, to support the safe and effective use of medicines for these specific patient populations.

Rehabilitation with removable complete dentures (RCDs) involves navigating public dental systems that often present barriers like long wait times and limited access. While clinical outcomes are often known, patient experiences with service delivery remain underexplored. Understanding these experiences is key to improving denture care in public settings.

This study aimed to explore and gain a comprehensive understanding of the service delivery experiences of patients rehabilitated with RCDs through the public dental health system in the State of Tasmania in Australia with the goal of informing improvements to the patient journey and overall service quality.

A qualitative study using a Constructivist Grounded Theory (CGT) approach was undertaken. Twenty-five adult participants who received RCDs between 2017 and 2022 were purposively selected from public dental clinics. Data were collected through in-depth, semi-structured, face-to-face interviews. Analysis followed CGT principles, including iterative coding, constant comparison, memo writing, and the co-construction of meaning with participants.

Participants reported emotional distress linked to prolonged waiting times and limited continuity of care. Despite valuing the professionalism and empathy of individual practitioners, many expressed a need for improved communication, more coordinated interdisciplinary care, and greater system responsiveness. Good service was characterised by accessibility, affordability, approachability, friendly staff, and high-quality care. Suggestions for improvement included moving services close to patients, better integration with other health sectors, and the use of visual aids to support understanding and self-management.

Patient narratives reveal a pressing need to address delays, communication gaps, and fragmented care in the public denture service pathway. System-level changes adopting a more holistic approach such as patient-centred approach, improving interprofessional collaboration, decentralising service provision, and enhancing health communication may significantly improve the denture rehabilitation experience and patient outcomes.

The influence of severity of migraine-like symptoms on different levels of executive functions is not well established. In this study, we investigate the impact of severity of migraine-like symptoms on the relationship between core-level executive functions (attention and memory) and fluid intelligence.

A cross-sectional study was conducted on university students (n = 427, age = 20.7 + 1.8 years). Participants completed self-report measures of Migraine Screen Questionnaire (MS-Q), single-item visual analogue scales (VASs) each for the subjective accounts of problems in core-level executive functions (attention and memory), and a single-item VAS for problems in fluid intelligence (PFI), and sociodemographics tool. The mediation effect model was used to determine the relationship.

The study found a correlation between i) attention problems and severity of migraine-like symptoms (b = 0.109, standard error (SE) = 0.026, p < 0.001), ii) severity of migraine-like symptoms and memory problems (b = 0.318, SE = 0.076, p < 0.001), and iii) severity of migraine-like symptoms – PFI (b = 0.243, SE = 0.083, p < 0.003), with an indirect effect of attention problems on memory problems and PFI and no correlation between severity of migraine-like symptoms and PFI.

Self-reported accounts of problems in core-level executive functions and fluid intelligence are correlated. Severity of migraine-like symptoms may mediate the inter-relationship between some core-level and higher-level executive functions.

In this systematic review, we identify and critically appraise randomised controlled trials of effectiveness of available educational, behavioural, cognitive, and self-management support interventions for individuals with chronic migraine.

Non-pharmacological interventions have the potential to help people living with chronic migraine. Little is known about their true effectiveness.

We searched Cochrane, Embase, Medline, PsychINFO, Scopus, and Web of Science for randomised controlled trials assessing the effectiveness of educational, behavioural, cognitive, and self-management support interventions, compared to usual care, for adults with chronic migraine. Our outcomes of interest were headache frequency, headache-related disability, quality of life, pain intensity, medication consumption, and psychological wellbeing at baseline and follow-up.

We included six randomised controlled trials (713 participants) whose interventions met our inclusion criteria: two educational, two psycho-educational, and two behavioural interventions. Trial heterogeneity precluded statistical pooling. Several small trials reported some between-group differences. One trial (N = 177) found more people had ≥50 reduction in headache frequency at 12 months following a psychological (mindfulness-based) intervention added to acute medication withdrawal in people with medication overuse headache: 43/89 (48%) control vs. 69/88 (78%) intervention, p < 0.001. However, the largest included study (N = 396) had effectively excluded the possibility that their intervention had a worthwhile effect on headache-related disability at 12 months; mean difference in Headache Impact Test (HIT-6) 0.7 (95% Confidence Interval −0.65 to 1.97). Current evidence does not support the use of educational, behavioural, cognitive, and self-management support interventions for individuals with chronic migraine to improve headache-related symptoms and quality of life. Very limited evidence suggests they may contribute towards headache frequency reduction.

Diabetes mellitus is a prevalent chronic illness worldwide and largely impacts migrants who have settled in developed countries. In diabetes care, patients play a central role and are natural partners in self-care education for improving health. Upon reviewing the literature, no studies were found that evaluated culturally adapted education models led by a nurse and delivered by a multi-professional team from the perspective of migrants in a group setting. Therefore, this study aims to explore patients’ evaluation of the content and implementation of a person-centred, group-based diabetes education model for migrants with type 2 diabetes led by a nurse and delivered by a multi-professional team.

Qualitative exploratory study, using semi-structured interviews in focus groups and individually to collect data. Eleven migrants who had participated in an intervention testing the education model aged 45–70, who had been living in Sweden between 4–32 years participated. Inductive qualitative content analysis of data was undertaken.

Participants gave a positive picture of their experiences concerning the content and organisation of the person-centred, group-based, culturally adapted diabetes education model. The education sessions were described as providing new and evidence-based knowledge. The multi-professional education staff and the interpreter were perceived as having a professional and familiar approach. They wanted to recommend the education model to others.

The study revealed a well-functioning diabetes education model tailored to individual beliefs and cultural aspects. It improved perceived knowledge about type 2 diabetes among migrants, thus increasing self-care behaviour and health. In today’s multicultural society, the study offers insights into migrants’ feelings, ideas, concerns, knowledge, and experience regarding the content, structure, and outcome of a group-based, culturally adapted diabetes education model that can improve self-care behaviour to promote health and prevent illness. As a result, the education model can be used in primary healthcare as a central and natural partner in self-care education to improve health.

To investigate how to recruit patients rigosrously in general practice for trials based on symptoms as predefined inclusion criteria rather than a well-defined diagnosis. We used persistent physical symptoms (PPS) as a target condition.

Conducting randomized controlled trials (RCTs) in general practice is crucial for evidence-based decision-making and treatment in frontline healthcare. However, recruitment is often challenged in general practice because many patients have vaguely defined conditions, such as PPS.

We used qualitative semi-structured interviews to explore the perspectives of general practitioners (GPs) on different recruitment scenarios, while paying particular attention to the logistics and feasibility in routine care. A total of 11 GPs from seven clinics were strategically recruited. The GPs were presented with one recruitment scenario (pre-consultation screening) and encouraged to suggest other scenarios. We conducted a thematic framework analysis of the interview material.

To ensure valid intervention research, one predefined scenario was discussed, and three additional scenarios were co-created during the interviews: (1) opportunistic screening, (2) pre-consultation screening, (3) audit (retrospective and prospective), and (4) random sample screening of the practice population. These scenarios differ with respect to logistical complexity, comparability to daily clinical practice, and entailed selection bias. Every scenario requires individual adaptation and implementation support to be feasible in routine care in general practice. The present study provides approaches for rigorous primary care research based on RCTs for frequent and vaguely defined conditions, but it also highlights a need to develop research methods better suited to frontline healthcare interventions.