To assess the impact of a person-centred culturally sensitive approach in primary care on the recognition and discussion of mental distress in refugee youth.

Refugee minors are at risk for mental health problems. Timely recognition and treatment prevent deterioration. Primary care is the first point of contact where these problems could be discussed. However, primary care staff struggle to discuss mental health with refugees.

Guided by the needs of refugees and professionals we developed and implemented the Empowerment intervention, consisting of a training, guidance and interprofessional collaboration in four general practices in the Netherlands.

This mixed-method study consisted of a quantitative cohort study and semi-structured interviews. The intervention was implemented in a stepped wedge design. Patient records of refugee youth and controls were analysed descriptively regarding number of contacts, mental health conversations, and diagnosis, before and after the start of the intervention.

Semi-structured interviews on experiences were held with refugee parents, general practitioners, primary care mental health nurses, and other participants in the local collaboration groups.

Findings:

A total of 152 refugees were included. Discussions about mental health were significantly less often held with refugees than with controls (16 versus 38 discussions/1000 patient-years) but increased substantially, and relatively more than in the control group, to 47 discussions/1000 patient-years (compared to 71 in the controls) after the implementation of the programme.

The intervention was much appreciated by all involved, and professionals in GP felt more able to provide person-centred culturally sensitive care.

Person-centred culturally sensitive care in general practice, including an introductory meeting with refugees, in combination with interprofessional collaboration, indeed results in more discussions of mental health problems with refugee minors in general practice. Such an approach is assessed positively by all involved and is therefore recommended for broader implementation and assessment.

The new adoption law, which was introduced in Greece in 2018, brought radical changes in adoption.

This presentation aimed to investigate the emotions of the prospective stepparents, based on the changes which were effectuated by the new law of adoption.

This survey was conducted through mixed methodology. Quantitative research was addressed to investigate the emotions of the to prospective stepparents. Qualitative research was addressed to social workers and its goal was to depict their opinion about the new law and the prospective stepparents’ expressed emotions.

The findings of the survey have demonstrated that the stepparents had a variety of emotions that changed throughout the adoption process. The dominant feelings of parents at the first visit with the social worker were stress and anxiety. However, at the end of the training process, these feelings were replaced by confidence and impatience. This emotional rotation of prospective stepparents was confirmed in the social workers’ interviews. In addition, social workers interviews highlighted the importance of the amendment of the old law of adoption’s process.

To sum up, this research has shown the importance of the new law and therefore the significance of its right application from all children’s placements in Greece. Nevertheless, it seems that due to the recent application of the new law, many placements have not yet complied with it and therefore there is urgent need for reinforcement of its application, according to the guidelines of the European Union that demanded gradual deinstitutionalization using the alternative types of child care.

No significant relationships.

Portugal has a Dementia Strategy that endorses care coordination in the community, but the strategy is not implemented despite there being a network of multidisciplinary primary care clinics that could support it. Recent research into barriers to dementia management in primary care has focused essentially on general practitioners’ (GPs) factors and perspectives. A comprehensive triangulated view on the barriers to dementia management emphasising teamwork is missing.

To explore the barriers to the implementation of the Portuguese Dementia Strategy by primary care teams, from the perspectives of service users and professionals.

Purposive sampling was used to recruit 10 GPs, 8 practice nurses, 4 social workers, 8 people with dementia and 10 family carers from 6 practices in different social contexts within the Lisbon metropolitan area. The analytical framework combined codes derived from the transcripts with codes from the available literature. Themes focused on the access to professionals/community services, care coordination within healthcare teams, and between health and community services.

Several system barriers were identified (undefined roles/coordination within teams, time constraints, insufficient signposting to community services) along with individual barriers (limited competence in dementia, unrecognised autonomy, limited views on social health and quality of life (QoL)), hindering users access to dementia services.

Enhanced competence in dementia, and nurse-led systematic care of people with dementia and their carers, are necessary. They can be effective in improving the QoL in dementia, but only if associated with better community support.