Primary Health Care Research and Development

This study aimed to examine the association between cardiopulmonary function, health-related quality of life (HRQOL) and cognitive function among nursing home residents aged 80 years and over.A nursing home-based, cross-sectional study was implemented among 677 aged over 80 years in Shanghai, China. A total of 197 participants underwent effective cardiopulmonary function examinations. Mini-Mental Status Examination (MMSE) and Short Form-36 scales (SF-36) were used to assess cognitive function and HRQOL, respectively.Decline in left ventricular ejection fractions (LVEF) [adjusted odds ratio (AOR), 1.98; 95% confidential interval (CI), 1.03-3.81)] and vital capacity (VC) (AOR, 2.08; 95%CI, 1.07-4.04) was associated with cognitive impairment. After adjusting confounding factors, relationships between cognitive function and physical functioning (PF) (AOR, 0.98; 95%CI, 0.97-0.99) still existed.Healthcare professionals should pay more attention to cardiopulmonary health and HRQOL in the nursing home residents. Actions of public health strategies focus on the improvement of cardiopulmonary function, and PF among older nursing home residents with cognitive impairment is required.

Zhitong Zhou

Longbing Ren

Ziyan Zhang

Xiaoting Sun

Yongtao Zheng

Yijun Gu

Hengjing Wu

Jue Li

Lijuan Zhang

Primary Health Care Research & Development

Association between cardiopulmonary function, health-related quality of life and cognitive impairment among the older nursing home residents in Shanghai, China

上海市老年护理院居民心肺功能、健康相关生活质量和认知障碍之间的关联

Health visiting in England is a universal service that aims to promote the healthy development of children aged under five years and safeguard their welfare. We consulted stakeholders about their priorities for research into health visiting and also used these consultations and a literature review to generate a logic model. Parents wanted research to explore how health visiting teams can provide a caring, responsive, accessible service (the mechanisms of change). Policymakers, commissioners, and clinical service leads wanted descriptions and evaluations of currently implemented and 'gold standard' health visiting. The challenges to evaluating health visiting (data quality, defining the intervention, measuring appropriate outcomes, and estimating causal effects) mean that quasi-experimental studies that rely on administrative data will likely underestimate impact or even fail to detect impact where it exists. Prospective and experimental studies are needed to understand how health visiting influences infant-parent attachments, breastfeeding, childhood accidents, family nutrition, school readiness, and mental health and well-being.

Katie Harron

Sally Kendall

Catherine Bunting

Rebecca Cassidy

Julie Atkins

Amanda Clery

Eirini-Christina Saloniki

Francesca Cavallaro

Helen Bedford

Louise Mc Grath-Lone

Mengyun Liu

Jenny Woodman

How should policymakers, funders, and research teams mobilize to build the evidence base on universal early years services?

政策制定者、资助者及研究团队应如何动员以建立关于全民早期服务的证据基础？

Abstract Aim: This position paper focuses on healthy ageing for the frailest and institutionalized older adults in the context of the recent pandemic. The paper aims to identify and discuss hindering and promoting factors for healthy ageing in this context, taking both health safety and a meaningful social life into account, in a pandemic situation and beyond. Background: The recent COVID-19 pandemic has highlighted the vulnerability of frail older adults residing in long-term care institutions. This is a segment of the older population that does not seem to align well with the recent policy trend of healthy and active ageing. The need for healthy ageing in this population has been voiced by professionals and interest organizations alike, alluding to inadequate support systems during the pandemic, conditioned by both previous and newly emerging contextual factors. Supporting healthy ageing in older adults in nursing homes and other residential care settings calls for attending to meaningful social life as well as to disease control. Methods: Findings and early conclusions leading up to the position paper were presented with peer discussions involving healthcare professionals and researchers at two joint EFPC PRIMORE workshops 2021 and 2022, as well as other international research seminars on long-term care. The following aspects of long-term care and COVID-19 were systematically discussed in those events, with reference to relevant research literature: 1. Long-term care policies, 2. pre-COVID state of long-term care facilities and vulnerability to the pandemic, 3. factors influencing the extent of spread of infection in long-term care facilities, and 4. the challenge of balancing between strict measures for infection control and maintaining a meaningful social life for residents and their significant others. Findings: A policy shift towards ageing at home and supporting the healthiest of older adults seems to have had unwarranted effects both for frail older adults, their significant others, and professional care staff attending to their needs. Resulting insufficient investment in primary health care staff and in the built environment for frail older adults in nursing homes were detrimental both for the older adults living in nursing homes, their significant others, and staff. More investment in staff and in physical surroundings might improve the quality of care and the social life of older adults in nursing homes in a non-pandemic situation and be a resource for primary health care staff ensuring both protection from health hazards and a meaningful social life for frail older adults in a pandemic or epidemic situation. As for investing in the physical surroundings, smaller nursing homes are advantageous, with singular resident rooms and for developing out-and indoor spaces for socializing and for meeting with families and other visitors. Regarding investment in staff, there is a documented need for educated staff in full-time positions. Use of part-time or temporary staff should be limited.

Frode F Jacobsen

Stinne Glasdam

Heidi Haukelien

Maria E T C van den Muijsenbergh

Gudmund Ågotnes

Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic: a position paper

长期护理中的健康老龄化？从COVID-19大流行中吸取的教训：立场文件

Abstract Aim: This article outlines the implementation and deployment strategy defined by the Catalan healthcare system which sought to promote a plan to strengthen and transform primary care in order to provide high-quality healthcare services whilst making an optimal use of resources across the Catalan region. Background: Following the COVID-19 pandemic, the Catalan healthcare system initiated a plan to enhance primary care services. The Lean methodology has been used extensively in other sectors for process improvement. More recently, it has been adopted in large hospitals, showing good results, so Lean was selected as the most appropriate method to achieve this project’s goal. The Process Office of the Catalan Health System, which is made up of experts in Lean methodology, has been involved in defining and deploying the strategy to all 374 Primary Care Teams (PCTs) within the Catalan healthcare system. Methods: The deployment strategy was executed in four phases (each consisting of a number of sessions): (1) explaining the project’s goals and training the professionals in the methodology; (2) assessing the current status regarding the processes with the various PCTs; (3) identifying and implementing improvement projects; and (4) defining key performance indicators to monitor the impact of the projects. Findings: As a conclusion, this project has allowed to successfully define and implement a standard at a strategic and deployment level of a project for primary care improvement that may be replicated in other regions. The key elements to ensure success have been the following: leadership, implementation of an improvement methodology, standardization of sessions, and involvement and training of front-line professionals.

Marc Sales Coll

Sara Manjón

Jeroni Salabert

Clara Pladevall

Daniel Algar

Alba Benaque

Júlia Soler

Anna Ochoa de Echagüen Aguilar

A plan to transform primary and community care at Catalonia based on a process improvement methodology

基于过程改进方法的加泰罗尼亚初级和社区护理转型计划

Abstract Background and Objective Early and collaborative interventions are desirable to prevent long-term sick leave and promote sustainable return-to-work (RTW). The aim of this study was to evaluate if the use of the Capacity Note – a brief intervention promoting early and structured communication between general practitioners (GPs), patients, and employers – had an impact on length of sick leave in patients with common mental disorders (CMDs) in primary healthcare. Method In a pragmatic trial, GPs at eight primary healthcare centres were randomized to provide the intervention or control and recruited eligible patients: employed women and men, 18-64 years, who visited a GP due to CMD and became or were (&lt;4 months) full- or part-time sick-listed. Patients in the intervention group (n=28) used the Capacity Note in addition to usual care. Patients in the control group (n=28) received usual care. Outcomes of interest were time until full RTW, sick leave status at end of follow-up (17 months), number of sick leave episodes during follow-up, and number of sick leave days at 6, 12, and 17 months of follow-up. Results The proportion of patients with full RTW at the end of follow-up was 79.2% in the intervention group and 84.6% in the control group. Time until full RTW was 102 and 90 days (median) in intervention and control group, respectively. We found no statistically significant differences between the groups for any of the outcomes. Discussion Despite efforts to increase the number of participants, the study ended up with a small sample. This prohibited us from drawing any final conclusions about the effect of the intervention. Obstacles to recruitment of patients and use of the intervention are discussed.

Paula Nordling

Chioma Nwaru

Lena Nordeman

Ingmarie Skoglund

Maria E H Larsson

Cecilia Björkelund

Gunnel Hensing

Early structured communication between general practitioner, sick-listed patient, and employer: Results and lessons learned from a pragmatic trial in the Capacity Note project

全科医生、病假患者与雇主之间的早期结构化沟通：能力笔记项目实用试验的结果与经验教训

Abstract Background: The COVID-19 pandemic has impacted patient’s visits to general practitioners (GPs). However, it is unclear what the impact of COVID-19 has been on the interaction among the local primary care clinics, the GP Department within the hospital and specialists. Methods: The interaction among GPs referring to hospital-based specialists and specialists to local doctors was determined, comparing pre-pandemic 2019 and 2020 during the pandemic. Results: Reduced referrals from GPs to specialists were consistent with the reduction in specialist referrals back to the local doctors, which dropped by approximately 50% in 2020, particularly in the two most common chronic conditions (hypertension and diabetes mellitus). Discussion: Reduced referral of patients from local clinics to Tongren Hospital is probably due to the extensive online training provided to the local GPs to become more competent in handling local patients via telehealth. Our data provide some insight to assist in combatting the pandemic of COVID-19, offering objective evidence of the impact of COVID-19 on patient management by GPs.

Zhongqing Xu

Jingchun Fan

Dandan Shi

Jingjing Ding

Jun Zhou

Xianzhen Feng

Brett D Hambly

Kun Tao

Shisan Bao

The impact of COVID-19 on referrals among general practitioners and specialists in Shanghai, China

COVID-19对中国上海全科医生和专科医生转诊的影响

Abbreviation	Prim Health Care Res Dev
Journal Impact	1.68
Quartiles(Global)	PRIMARY HEALTH CARE(Q3)

ISSN	1463-4236, 1477-1128
h-index	35

Publication Information	Publisher: Cambridge University Press，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2000，Proportion of original research papers: 89.33%，Self Citation Rate:0.00%， Gold OA Rate: 100.00%
Average review cycle	网友分享经验：33 Weeks

Primary Health Care Research and Development

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Association between cardiopulmonary function, health-related quality of life and cognitive impairment among the older nursing home residents in Shanghai, China

How should policymakers, funders, and research teams mobilize to build the evidence base on universal early years services?

Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic: a position paper

A plan to transform primary and community care at Catalonia based on a process improvement methodology

Early structured communication between general practitioner, sick-listed patient, and employer: Results and lessons learned from a pragmatic trial in the Capacity Note project

How should policymakers, funders, and research teams mobilize to build the evidence base on universal early years services?

Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic: a position paper

A plan to transform primary and community care at Catalonia based on a process improvement methodology

Early structured communication between general practitioner, sick-listed patient, and employer: Results and lessons learned from a pragmatic trial in the Capacity Note project

The impact of COVID-19 on referrals among general practitioners and specialists in Shanghai, China