cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.30638979.v1
title: Advanced practice nurses and their potential in home care for frail patients in rural France: A qualitative study

description: The ageing population in Europe, particularly in rural areas, creates new health challenges, including patients with multiple comorbidities and difficult access to care. Advanced Practice Nurses (APNs) could play a key role in improving access and care for frail older patients in France’s rural areas, although how to achieve this remains unclear. This study aimed to identify the healthcare needs of frail patients living at home in rural areas and those of their healthcare providers to assess the potential role of APNs in addressing these needs. This interpretive descriptive qualitative study was conducted from June to September 2023, using focus groups (FGs). Three FGs with 20 participants, including healthcare providers and frail older people, were conducted in two French rural areas. Data were analysed using thematic analyse to identify key needs and potential APN contributions. The healthcare needs identified were: improving access to care, maintaining human interactions, and providing coordinated, preventive care. Participants emphasised the importance of interprofessional collaboration and the central role of APNs, whose expanded skillset enables them to coordinate care with caregivers and professionals. However, challenges remain, including a lack of understanding of the APN’s skills and concerns about their integration within the care team. APNs could support access to person-centred, coordinated home care in rural areas by acting as key references for patients, caregivers, and teams. However, limited awareness of their role and concerns from other professionals remain barriers to their integration. Frail older adults in rural areas need better access to home care, social connection, and coordinated services. APNs can enhance care and collaboration through advanced skills, addressing rural healthcare challenges. Limited awareness of APN roles hinders integration, making education essential for their acceptance and effective use.
DOI: 10.6084/m9.figshare.30582338
title: Experiences of supporting primary and community healthcare workers affected by domestic abuse in the United Kingdom: A cross-sectional survey

description: Healthcare workers are expected to identify and respond to domestic abuse among patients. However, research has neglected healthcare workers’ own experiences of domestic abuse. Focusing on UK primary and community healthcare workers with formal support roles (e.g. line managers, human resources, employee assistance professionals), this exploratory study aimed to illustrate workplace support offered to healthcare colleagues affected by domestic abuse. We used an online cross-sectional survey with closed and qualitative free-text questions, advertised via mailing lists and social media, targeting healthcare workers. Our mixed methods embedded design involved quantitative descriptive analysis with content analysis of qualitative free text to explain and interrogate results. Sixty-two people in healthcare roles supporting colleagues responded, mostly from community hospitals, dentistry, and general practice. Few workplaces had staff domestic abuse policies. Support measures were limited. Emotional support, signposting, and adjusted working hours were the most common types of support available. Training on supporting affected colleagues was rare. Few environments had specialist domestic abuse advocates who supported staff. Along with needing policies, training, and in-house support, respondents indicated a need for a cultural shift to address myths about domestic abuse and hierarchical power, particularly regarding healthcare workers who perpetrate abuse. Despite several limitations, including substantial missing data, our work highlights that primary and community healthcare workplaces should explore the implementation of practical and emotional support measures; healthcare-based domestic abuse advocates with staff support; and training on supporting colleagues. Further pan-European comparative research should surface good practice and foster cross-learning.
DOI: 10.6084/m9.figshare.30582338.v1
title: Experiences of supporting primary and community healthcare workers affected by domestic abuse in the United Kingdom: A cross-sectional survey

description: Healthcare workers are expected to identify and respond to domestic abuse among patients. However, research has neglected healthcare workers’ own experiences of domestic abuse. Focusing on UK primary and community healthcare workers with formal support roles (e.g. line managers, human resources, employee assistance professionals), this exploratory study aimed to illustrate workplace support offered to healthcare colleagues affected by domestic abuse. We used an online cross-sectional survey with closed and qualitative free-text questions, advertised via mailing lists and social media, targeting healthcare workers. Our mixed methods embedded design involved quantitative descriptive analysis with content analysis of qualitative free text to explain and interrogate results. Sixty-two people in healthcare roles supporting colleagues responded, mostly from community hospitals, dentistry, and general practice. Few workplaces had staff domestic abuse policies. Support measures were limited. Emotional support, signposting, and adjusted working hours were the most common types of support available. Training on supporting affected colleagues was rare. Few environments had specialist domestic abuse advocates who supported staff. Along with needing policies, training, and in-house support, respondents indicated a need for a cultural shift to address myths about domestic abuse and hierarchical power, particularly regarding healthcare workers who perpetrate abuse. Despite several limitations, including substantial missing data, our work highlights that primary and community healthcare workplaces should explore the implementation of practical and emotional support measures; healthcare-based domestic abuse advocates with staff support; and training on supporting colleagues. Further pan-European comparative research should surface good practice and foster cross-learning.
DOI: 10.6084/m9.figshare.30418653
title: Does one have to be queer to care for queer patients? A qualitative interview study with general practitioners in Germany

description: LGBT* (lesbian, gay, bisexual, trans, others) individuals are known to experience poorer health and restricted access to healthcare compared to cisgender-heterosexual individuals. As General Practitioners (GPs) are a patient’s first point of contact with the healthcare system in Germany, this study examines GPs’ perspectives on LGBT healthcare. In this qualitative study, we conducted 19 semi-structured episodic interviews with GPs in urban and rural areas of Germany. The interviews were analysed using framework analysis. Our study shows LGBT* doctors feel more responsible for LGBT* healthcare than their cis-heterosexual colleagues. There is a perceived lack of knowledge and learning opportunities on LGBT* health needs for most interviewees. Cis-heterosexual GPs often feel unprepared to provide specific healthcare interventions to LGBT* patients and believe they lack the resources to improve their education on the topic. LGBT*-specific primary healthcare seems to be delivered by a small number of GP practices and primarily by LGBT* doctors. These LGBT* doctors recommend more widespread knowledge of LGBT* primary care and lives, to allow their colleagues to provide better care for these patients. There is a lack of knowledge on LGBT health needs and challenges among GPs in Germany, which needs to be addressed through structured training in medical school, and on a postgraduate level. This lack of knowledge leads to cis-heterosexual GPs feeling more insecure in providing care to LGBT* patients and LGBT* GPs providing a bigger share of LGBT* healthcare than their cis-heterosexual colleagues. LGBT* or queer GPs feel more responsible and equipped in providing care to LGBT* patients than cis-heterosexual GPs. Cis-heterosexual GPs often feel unprepared to provide specific healthcare interventions like gender affirming hormone therapy to LGBT* patients. While many cis-heterosexual GPs believed their number of LGBT* patients to be too low for it to be worth the time to educate themselves on caring for them, structured medical training is needed to allow all GPs to care for all members of their communities.
DOI: 10.6084/m9.figshare.30418653.v1
title: Does one have to be queer to care for queer patients? A qualitative interview study with general practitioners in Germany

description: LGBT* (lesbian, gay, bisexual, trans, others) individuals are known to experience poorer health and restricted access to healthcare compared to cisgender-heterosexual individuals. As General Practitioners (GPs) are a patient’s first point of contact with the healthcare system in Germany, this study examines GPs’ perspectives on LGBT healthcare. In this qualitative study, we conducted 19 semi-structured episodic interviews with GPs in urban and rural areas of Germany. The interviews were analysed using framework analysis. Our study shows LGBT* doctors feel more responsible for LGBT* healthcare than their cis-heterosexual colleagues. There is a perceived lack of knowledge and learning opportunities on LGBT* health needs for most interviewees. Cis-heterosexual GPs often feel unprepared to provide specific healthcare interventions to LGBT* patients and believe they lack the resources to improve their education on the topic. LGBT*-specific primary healthcare seems to be delivered by a small number of GP practices and primarily by LGBT* doctors. These LGBT* doctors recommend more widespread knowledge of LGBT* primary care and lives, to allow their colleagues to provide better care for these patients. There is a lack of knowledge on LGBT health needs and challenges among GPs in Germany, which needs to be addressed through structured training in medical school, and on a postgraduate level. This lack of knowledge leads to cis-heterosexual GPs feeling more insecure in providing care to LGBT* patients and LGBT* GPs providing a bigger share of LGBT* healthcare than their cis-heterosexual colleagues. LGBT* or queer GPs feel more responsible and equipped in providing care to LGBT* patients than cis-heterosexual GPs. Cis-heterosexual GPs often feel unprepared to provide specific healthcare interventions like gender affirming hormone therapy to LGBT* patients. While many cis-heterosexual GPs believed their number of LGBT* patients to be too low for it to be worth the time to educate themselves on caring for them, structured medical training is needed to allow all GPs to care for all members of their communities.
DOI: 10.6084/m9.figshare.30903179
title: How far on the road? The role of family medicine/general practice in 10 Central and Eastern European countries: A mixed-method study

description: Central and Eastern European (CEE) countries began healthcare reforms in the late twentieth century, adopting Family Medicine/General Practice (FM/GP) models. The FATMEE (Family Medicine After Transformation in Middle and Eastern Europe) study in 2012 found this process advanced but incomplete. This study (FATMEE-2) examines current FM/GP development in the CEE region that follows recent social changes and healthcare challenges. A mixed-methods approach combined literature and dataset review with a Key Informant-based survey using the updated FATMEE questionnaire, exploring the FM/GP role in primary care. FM/GP is recognised as a separate medical speciality in all countries with robust legal frameworks. Care comprehensiveness varies, with some systems maintaining separate paediatric and adult services, and a lack of gynaecology and obstetrics services in many. Weighted capitation remains the dominant funding model, supplemented by pay-for-performance and fee-for-service schemes. Electronic medical records and teleconsultations are common. Compared to the previous FATMEE study, changes include increased use of digital tools and diversified financing. Primary care structure and professional roles changed little. While the legal and technological foundations of family medicine in CEE countries have strengthened, comprehensiveness and service integration have limitations. There is a visible progress in infrastructure and digitalisation, but the structural and organisational challenges identified in 2012 largely remain. This may indicate that sustained political commitment and systemic reform – beyond legal acknowledgement and technological improvements – are essential for successful transformation. However, the examples of Estonia and Slovenia prove that under a supportive policy, such a transformation is achievable.
DOI: 10.6084/m9.figshare.30903179.v1
title: How far on the road? The role of family medicine/general practice in 10 Central and Eastern European countries: A mixed-method study

description: Central and Eastern European (CEE) countries began healthcare reforms in the late twentieth century, adopting Family Medicine/General Practice (FM/GP) models. The FATMEE (Family Medicine After Transformation in Middle and Eastern Europe) study in 2012 found this process advanced but incomplete. This study (FATMEE-2) examines current FM/GP development in the CEE region that follows recent social changes and healthcare challenges. A mixed-methods approach combined literature and dataset review with a Key Informant-based survey using the updated FATMEE questionnaire, exploring the FM/GP role in primary care. FM/GP is recognised as a separate medical speciality in all countries with robust legal frameworks. Care comprehensiveness varies, with some systems maintaining separate paediatric and adult services, and a lack of gynaecology and obstetrics services in many. Weighted capitation remains the dominant funding model, supplemented by pay-for-performance and fee-for-service schemes. Electronic medical records and teleconsultations are common. Compared to the previous FATMEE study, changes include increased use of digital tools and diversified financing. Primary care structure and professional roles changed little. While the legal and technological foundations of family medicine in CEE countries have strengthened, comprehensiveness and service integration have limitations. There is a visible progress in infrastructure and digitalisation, but the structural and organisational challenges identified in 2012 largely remain. This may indicate that sustained political commitment and systemic reform – beyond legal acknowledgement and technological improvements – are essential for successful transformation. However, the examples of Estonia and Slovenia prove that under a supportive policy, such a transformation is achievable.
DOI: 10.6084/m9.figshare.29212961
title: Long-term prognosis of adults with moderately severe SARS-CoV-2 lower respiratory tract infection managed in primary care: Prospective cohort study

description: Information about the incidence of persisting symptoms after COVID-19 and its impact on patients treated in primary care are scarce. To determine differences in health-related quality of life (HRQoL) and symptomatology between adults with and without SARS-CoV-2 moderately severe lower respiratory tract infection (LRTI) in the 12 months following their primary care visit. Prospective cohort study in 35 Dutch practices. Individuals aged ≥18 years who presented to their general practitioner (GP) with a moderately severe LRTI during the first COVID-19 waive in The Netherlands (March–June 2020, <i>n</i> = 277; 268 (97%) with complete follow-up) were included between September and December 2020, then underwent serology testing (participants, GPs and study personnel remained blinded for serology outcomes during study conduct) and completed baseline and follow-up questionnaires. Main outcome measures: (1) SF-36 scores, and (2) risk of persisting symptoms during 12 months follow-up. The change in SF-36 PSC (<i>p</i> = 0.13), MCS (<i>p</i> = 0.30) during 12 months follow-up did not differ between SARS-CoV-2 serology positive and negative participants after adjusting for sex, age, BMI, diabetes, and chronic pulmonary conditions. The risk of any persisting symptom during 12 months follow-up did not significantly differ between the groups (aHR 0.61, 95% CI 0.33–1.15), nor did the risk of individual symptoms. In the 12 months following their moderately severe LRTI, primary care patients with and without confirmed SARS-CoV-2 infection had a comparable HRQoL profile. A substantial proportion of participants reported persisting symptoms, indicating that persisting symptoms can occur following LRTIs irrespective of causative pathogen.
DOI: 10.6084/m9.figshare.29212961.v1
title: Long-term prognosis of adults with moderately severe SARS-CoV-2 lower respiratory tract infection managed in primary care: Prospective cohort study

description: Information about the incidence of persisting symptoms after COVID-19 and its impact on patients treated in primary care are scarce. To determine differences in health-related quality of life (HRQoL) and symptomatology between adults with and without SARS-CoV-2 moderately severe lower respiratory tract infection (LRTI) in the 12 months following their primary care visit. Prospective cohort study in 35 Dutch practices. Individuals aged ≥18 years who presented to their general practitioner (GP) with a moderately severe LRTI during the first COVID-19 waive in The Netherlands (March–June 2020, <i>n</i> = 277; 268 (97%) with complete follow-up) were included between September and December 2020, then underwent serology testing (participants, GPs and study personnel remained blinded for serology outcomes during study conduct) and completed baseline and follow-up questionnaires. Main outcome measures: (1) SF-36 scores, and (2) risk of persisting symptoms during 12 months follow-up. The change in SF-36 PSC (<i>p</i> = 0.13), MCS (<i>p</i> = 0.30) during 12 months follow-up did not differ between SARS-CoV-2 serology positive and negative participants after adjusting for sex, age, BMI, diabetes, and chronic pulmonary conditions. The risk of any persisting symptom during 12 months follow-up did not significantly differ between the groups (aHR 0.61, 95% CI 0.33–1.15), nor did the risk of individual symptoms. In the 12 months following their moderately severe LRTI, primary care patients with and without confirmed SARS-CoV-2 infection had a comparable HRQoL profile. A substantial proportion of participants reported persisting symptoms, indicating that persisting symptoms can occur following LRTIs irrespective of causative pathogen.
DOI: 10.6084/m9.figshare.29425418
title: General Practice-led urgent care practice vs. emergency room – satisfaction of ambulatory patients with low urgency medical problems

description: Emergency room (ER) utilisation by ambulatory patients with low urgency medical problems leads to ER-capacity use and long waiting times. Establishing General Practice (GP)-led urgent care practices (UCP) adjacent to ERs allows to triage patients from the ER to the UCP. However, patients may perceive themselves as ER-cases and expect ER-treatment including extensive diagnostics. To assess UCP-patients’ satisfaction compared to ambulatory ER-patients. Sub-analysis (11/2019–01/2020) of a prospective, monocentric observational study at the University Medical Centre Hamburg-Eppendorf ER and co-located UCP focusing on patient survey data including demographics, waiting time and diagnoses. Satisfaction, uncertainty and appropriateness of waiting time was assessed with 4-point Likert-scales. Analysing 1196 UCP- and 597 ER-patients, patient satisfaction correlated positively with perceived appropriate waiting time in both groups. But more UCP-patients deemed their waiting time appropriate (76.7% vs. 70.4%; <i>p</i> = 0.004) and reported to be very satisfied with the treatment (64.7% vs. 55.8%; <i>p</i> &lt; 0.001). Time until the first physician contact was nearly equal, but the entire length of stay was shorter in the UCP (104 ± 88.0 min vs. 179 ± 301 min; <i>p</i> &lt; 0.001). In both groups, satisfaction was reduced by on-going uncertainty after the visit, but uncertainty was higher among UCP-patients (32% vs. 25%; <i>p</i> = 0.003). Age, gender or diagnosis had no influence on patients’ satisfaction. More UCP-patients stated that today’s problem could have been treated by a GP (57% vs. 15%; <i>p</i> &lt; 0.001) and were advised to follow up in an outpatient setting. Treating patients in an UCP does not lead to overall dissatisfaction. Emergency room (ER)- and urgent care practice (UCP)-patients’ satisfaction correlated positively with a perceived appropriate waiting time, but more UCP-patients stated that their waiting time was appropriate. Satisfaction correlated negatively with on-going uncertainty after the visit; uncertainty was higher among UCP-patients. Age, gender or diagnosis had no influence on patients’ satisfaction.
DOI: 10.6084/m9.figshare.29425418.v1
title: General Practice-led urgent care practice vs. emergency room – satisfaction of ambulatory patients with low urgency medical problems

description: Emergency room (ER) utilisation by ambulatory patients with low urgency medical problems leads to ER-capacity use and long waiting times. Establishing General Practice (GP)-led urgent care practices (UCP) adjacent to ERs allows to triage patients from the ER to the UCP. However, patients may perceive themselves as ER-cases and expect ER-treatment including extensive diagnostics. To assess UCP-patients’ satisfaction compared to ambulatory ER-patients. Sub-analysis (11/2019–01/2020) of a prospective, monocentric observational study at the University Medical Centre Hamburg-Eppendorf ER and co-located UCP focusing on patient survey data including demographics, waiting time and diagnoses. Satisfaction, uncertainty and appropriateness of waiting time was assessed with 4-point Likert-scales. Analysing 1196 UCP- and 597 ER-patients, patient satisfaction correlated positively with perceived appropriate waiting time in both groups. But more UCP-patients deemed their waiting time appropriate (76.7% vs. 70.4%; <i>p</i> = 0.004) and reported to be very satisfied with the treatment (64.7% vs. 55.8%; <i>p</i> &lt; 0.001). Time until the first physician contact was nearly equal, but the entire length of stay was shorter in the UCP (104 ± 88.0 min vs. 179 ± 301 min; <i>p</i> &lt; 0.001). In both groups, satisfaction was reduced by on-going uncertainty after the visit, but uncertainty was higher among UCP-patients (32% vs. 25%; <i>p</i> = 0.003). Age, gender or diagnosis had no influence on patients’ satisfaction. More UCP-patients stated that today’s problem could have been treated by a GP (57% vs. 15%; <i>p</i> &lt; 0.001) and were advised to follow up in an outpatient setting. Treating patients in an UCP does not lead to overall dissatisfaction. Emergency room (ER)- and urgent care practice (UCP)-patients’ satisfaction correlated positively with a perceived appropriate waiting time, but more UCP-patients stated that their waiting time was appropriate. Satisfaction correlated negatively with on-going uncertainty after the visit; uncertainty was higher among UCP-patients. Age, gender or diagnosis had no influence on patients’ satisfaction.