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Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 13586

Special Issue Editor

Prof. Dr. Filipe Prazeres

E-Mail Website
Guest Editor
1. Faculdade de Ciências da Saúde, Universidade da Beira Interior, 6200-506 Covilhã, Portugal
2. Family Health Unit Beira Ria, 3830-596 Gafanha da Nazaré, Portugal
Interests: multimorbidity; chronic diseases; family medicine; primary care; quality of life; geriatrics; public health

Special Issue Information

Dear Colleagues,

We can all agree that we are living in unique and challenging times, not only for patients but also for primary healthcare workers (doctors, nurses, community pharmacists, psychologists, dentists, and so many others who work in teams providing primary care). In this uncertainty that we are currently experiencing, as a primary healthcare worker, I am finding work much more challenging than I had anticipated. Primary care services have changed due to the pandemic, with increases in online bookings and remote consultations, after which new scenarios of war are now increasing the risk of infectious diseases and threatening the lives of several people. Primary care services play an important role in preventing ill health, both physically and mentally, not only of our patients and their families but also of migrants and refugees,. The purpose of this Special Issue, “Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the face of adversity” of the International Journal of Environmental Research and Public Health, is to gather recent research that shows the importance of primary care services for surpassing current health challenges. We look forward to submissions that include theory-based investigations in the form of experimental studies, observational designs with follow-up measurements, or systematic reviews. This Special Issue plans to answer the following questions (although similar research questions may be considered): How do patients access primary care services nowadays? Does digital technology promote health equality in primary care services? What are the new strategies for primary care services in adapting to current adversities? Are primary care teams resilient enough? Have the roles of the primary healthcare workers (doctors, nurses, community pharmacists, psychologists, dentists, and all others who work in teams providing primary care) changed? How can primary care teams increase patients’ safety? Do we need to change the future training of primary healthcare workers and address how to face adversity?

Prof. Dr. Filipe Prazeres
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • primary care
  • family medicine
  • adversity
  • resilience
  • health equality
  • patient access
  • role of the primary healthcare workers
  • patients’ safety
  • training of primary healthcare workers
  • teamwork
  • doctors
  • nurses
  • community pharmacists
  • psychologists
  • dentists

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Published Papers (6 papers)

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Research

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12 pages, 441 KiB  
Article
Chronic Care in Primary Care: Exploring the Role and Impact of General Practice Pharmacists in Managing Long-Term Conditions in Northern Ireland
by Ahmed Abuelhana, Petra Garlone Clark, Aaron Courtenay, Heather Coleman, Nermeen Ali and Kingston Rajiah
Int. J. Environ. Res. Public Health 2025, 22(2), 292; https://doi.org/10.3390/ijerph22020292 - 16 Feb 2025
Cited by 1 | Viewed by 613
Abstract
The role of General Practice Pharmacists (GPPs) has expanded in response to increasing demands on primary care services, particularly in managing chronic conditions. While GPPs are recognised for their contributions to medication optimisation and patient care, challenges such as role clarity, workload pressures, [...] Read more.
The role of General Practice Pharmacists (GPPs) has expanded in response to increasing demands on primary care services, particularly in managing chronic conditions. While GPPs are recognised for their contributions to medication optimisation and patient care, challenges such as role clarity, workload pressures, and confidence in clinical decision-making remain underexplored. This study aims to investigate the tasks, professional identity, confidence levels, and challenges faced by GPPs in Northern Ireland. A mixed-methods design was employed, incorporating a questionnaire distributed to GPPs across Northern Ireland. The questionnaire comprised 20 multiple-choice questions and 5 open-ended questions, focusing on demographics, tasks, confidence levels, role clarity, and professional challenges. Quantitative data were analysed using descriptive and inferential statistics, while qualitative responses underwent thematic analysis using NVIVO software. A total of 44 GPPs participated, with a majority being female and aged 34–39 years. Most participants had 4–6 years of experience as GPPs. Quantitative findings revealed significant correlations between clinical confidence and factors such as years of experience, age, and employment type. Qualitative analysis revealed key themes: clinical confidence was enhanced by training and experience, but workload pressures often limited time for patient care. Variability in role integration and the lack of public awareness were highlighted as barriers to maximising the GPP role. This study highlights the key challenges of workload distribution and role ambiguity in the GPP role. Delegating administrative tasks and developing clear frameworks for role integration could address these barriers. Additionally, targeted training programs and public education campaigns are essential to enhance the impact of GPPs in primary care. Full article
(This article belongs to the Special Issue Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity)
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16 pages, 304 KiB  
Article
Relational Coordination at the Primary–Secondary Care Interface: Insights from a Cross-Sectional Survey in the South Tyrolean Healthcare System
by Christian J. Wiedermann, Verena Barbieri, Adolf Engl and Giuliano Piccoliori
Int. J. Environ. Res. Public Health 2024, 21(4), 425; https://doi.org/10.3390/ijerph21040425 - 30 Mar 2024
Cited by 6 | Viewed by 2280
Abstract
Understanding the dynamics of teamwork and communication among healthcare professionals is crucial in the face of evolving healthcare challenges. This study assessed relational coordination among healthcare professionals in the South Tyrolean healthcare system in Italy, focusing on communication and teamwork dynamics in a [...] Read more.
Understanding the dynamics of teamwork and communication among healthcare professionals is crucial in the face of evolving healthcare challenges. This study assessed relational coordination among healthcare professionals in the South Tyrolean healthcare system in Italy, focusing on communication and teamwork dynamics in a cross-sectional survey. Using the validated Relational Coordination Survey (RCS) instrument and 525 completed online responses, the questionnaire aimed to understand the implications of different levels of relational coordination ratings by general practitioners, hospital physicians, nurses, and administrative personnel (response rate 26%). The demographics of the participants revealed a predominance of female professionals (64%), with an average age of 50 and 18 years of service. The resulting RCS scores varied significantly across professional groups, with nurses reporting the highest within-group scores, indicating moderate coordination, and administrators reporting the lowest scores, reflecting areas of weak coordination. Between-group relational coordination was generally perceived as weak across professional groups, with the least weakness observed between general practitioners and nurses. German or Italian language and health district affiliation emerged as significant factors influencing relational coordination ratings, highlighting the need for differentiated understanding and strategies in multilingual and diverse regional settings. Assessments of interdisciplinary feedback and referral practices highlight the variation in teamwork and communication weaknesses and underscore the need for targeted interventions to improve relational coordination. This study provides insights into the complexity of relational dynamics in health care settings. This suggests that improving relational coordination through tailored strategies could significantly improve team effectiveness, quality of patient care, and overall system efficiency. Full article
(This article belongs to the Special Issue Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity)
16 pages, 353 KiB  
Article
Accreditation of Quality in Primary Health Care in Chile: Perception of the Teams from Accredited Family Healthcare Centers
by Juan Coss-Mandiola, Jairo Vanegas-López, Alejandra Rojas, Pablo Dubó, Maggie Campillay-Campillay and Raúl Carrasco
Int. J. Environ. Res. Public Health 2023, 20(3), 2477; https://doi.org/10.3390/ijerph20032477 - 30 Jan 2023
Cited by 1 | Viewed by 2579
Abstract
This study aimed to investigate the perception of the health teams belonging to the Family Healthcare Centers (CESFAMs) that are accredited, regarding the process of implementation and the achievement of accreditation. A qualitative approach was applied, with contributions from grounded theory, through the [...] Read more.
This study aimed to investigate the perception of the health teams belonging to the Family Healthcare Centers (CESFAMs) that are accredited, regarding the process of implementation and the achievement of accreditation. A qualitative approach was applied, with contributions from grounded theory, through the technique of individual in-depth interviews and focus groups. The interviews were carried out in nine accredited CESFAMs. For the presentation, organization and analysis of the data, Atlas.ti V9 software was used. From the results, derived from the open phase of the analysis, obtained from the opinions of the participants, a total of 26 categories emerged relating to the facilitating and hindering factors of the process. From the axial phase, it was possible to establish central categories that were related to quality management policies, the structure of Primary Health Care (PHC), participation and co-construction, and leadership and change management. In conclusion, the discourse of the teams reveals the need to have necessary conditions for the accreditation process, which are mainly related to training, characteristics of the types of leadership and teamwork in harmony with the process. Finally, the study reveals a gap in the community participation in this process, which suggests continuing this line of research. Full article
(This article belongs to the Special Issue Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity)
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10 pages, 949 KiB  
Article
The Effects of Monetary Incentives on Physicians’ Effort and Patient Satisfaction: Understanding the Links between Monetary Incentives and Physicians’ Effort
by Chenhao Yu, Xiaoyan Li, Huigang Liang, Zhiruo Zhang and Dong Fang
Int. J. Environ. Res. Public Health 2022, 19(20), 13075; https://doi.org/10.3390/ijerph192013075 - 11 Oct 2022
Cited by 4 | Viewed by 2581
Abstract
How monetary incentives promote physicians’ job performance in terms of patient satisfaction has been widely discussed. The incentive dilemma debate concerns whether monetary incentives reduce physicians’ intrinsic motivation at work and even lead to moral hazard. This study investigated monetary incentive policies in [...] Read more.
How monetary incentives promote physicians’ job performance in terms of patient satisfaction has been widely discussed. The incentive dilemma debate concerns whether monetary incentives reduce physicians’ intrinsic motivation at work and even lead to moral hazard. This study investigated monetary incentive policies in a hospital and analyzed how monetary incentives affect performance and behavior. By means of income composition grouping, a treatment group and control group were established, and the identification of the effect on performance was implemented using the difference-in-difference (DiD) method. The mechanism analysis was implemented using the event-study approach (ESA) and path analysis. The study found that (1) monetary incentives promote physicians to improve patient satisfaction, and the average effect is a two-point increment (p < 0.0001); (2) the effects are short-term; and (3) in contrast to many criticisms, the improvement in patient satisfaction was mainly from the effort in working during the monetary incentive policy. The results of this study contribute empirical evidence regarding the effects of monetary incentives and their mechanism and can help hospital management formulate incentive plans. Full article
(This article belongs to the Special Issue Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity)
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Review

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14 pages, 304 KiB  
Review
Why Do Primary Care Patients Change Their Physicians: An Overview of the Literature
by Mariana Cardoso Ribeiro, Elisa Martins and Filipe Prazeres
Int. J. Environ. Res. Public Health 2025, 22(2), 285; https://doi.org/10.3390/ijerph22020285 - 14 Feb 2025
Viewed by 645
Abstract
Primary healthcare has an important role in a patient’s long-term health. While patients in most countries are free to change their family physician, fragmented care leads to higher healthcare costs, more preventable hospitalizations, and an increased likelihood of deviation from clinical best practice. [...] Read more.
Primary healthcare has an important role in a patient’s long-term health. While patients in most countries are free to change their family physician, fragmented care leads to higher healthcare costs, more preventable hospitalizations, and an increased likelihood of deviation from clinical best practice. This review aims to identify the main reasons patients change family doctors, summarize the factors influencing these decisions, and highlight areas in healthcare that can be improved to increase patient satisfaction and design better services. An electronic search of the literature was conducted in March 2023 in PubMed and Embase databases for articles in English, French, Portuguese, or Spanish published from 1980 to March 2023. A thematic synthesis approach was applied to the included studies, involving systematic analysis of their findings to identify and categorize analytical themes. Nineteen relevant studies were identified. The following themes were identified as reasons to change family physicians: doctor–patient relationship; consultation schedule and convenience; referrals and positive references; medication and treatment issues; practice management and cost; personal preferences and physician characteristics; and accessibility and distance. The identified themes can serve as valuable targets for developing interventions aimed at enhancing the quality of care provided to patients. Full article
(This article belongs to the Special Issue Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity)
35 pages, 1500 KiB  
Review
Management of Rheumatoid Arthritis in Primary Care: A Scoping Review
by Francesco Inchingolo, Angelo Michele Inchingolo, Maria Celeste Fatone, Pasquale Avantario, Gaetano Del Vecchio, Carmela Pezzolla, Antonio Mancini, Francesco Galante, Andrea Palermo, Alessio Danilo Inchingolo and Gianna Dipalma
Int. J. Environ. Res. Public Health 2024, 21(6), 662; https://doi.org/10.3390/ijerph21060662 - 22 May 2024
Cited by 5 | Viewed by 3542
Abstract
Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the [...] Read more.
Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the approach to RA in the PC setting. PubMed, Scopus, and Web of Science were searched using the MESH terms “rheumatoid arthritis” and “primary care” from 2013 to 2023. The search strategy followed the PRISMA-ScR guidelines. The 61 articles selected were analyzed qualitatively in a table and discussed in two sections, namely criticisms and strategies for the management of RA in PC. The main critical issues in the management of RA in PC are the following: difficulty and delay in diagnosis, in accessing rheumatological care, and in using DMARDs by GPs; ineffective communication between GPs and specialists; poor patient education; lack of cardiovascular prevention; and increase in healthcare costs. To overcome these criticisms, several management strategies have been identified, namely early diagnosis of RA, quick access to rheumatology care, effective communication between GPs and specialists, active patient involvement, screening for risk factors and comorbidities, clinical audit, interdisciplinary patient management, digital health, and cost analysis. PC appears to be the ideal healthcare setting to reduce the morbidity and mortality of chronic disease, including RA, if a widespread change in GPs’ approach to the disease and patients is mandatory. Full article
(This article belongs to the Special Issue Research on the Primary Care Services, Patients Safety and Primary Healthcare Workers Training in the Face of Adversity)
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