Background: Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. Aim: To understand the experiences of European PCPs working during the first peak of the COVID-19 pandemic. Design and Setting: An exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece and Sweden, between April and July 2020. Method: Interviews were audio recorded, transcribed and analysed using a combination of inductive and deductive thematic analysis techniques. Results: Eighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and deal with uncertainty. Conclusion: PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions will facilitate easy and coordinated access to practical information on how to adapt services, ongoing training and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.
The recommended rifabutin doses for use with lopinavir-ritonavir may be inadequate in many patients. Monitoring of plasma concentrations is recommended.
With aid of a brief standardized questionnaire, women can accurately assess their UI type. This suggests women could be educated about UI via good-quality Internet health sites and choose appropriate conservative management options.
Background: Minimising primary care professionals' (PCPs) risk of SARS-CoV-2 infection is crucial to ensure their safety as well as functioning health care system. PCPs' perspectives on the support they needed in the early stages of a public health crisis can inform future preparedness.Aim: To understand PCPs' experiences of providing care during the COVID-19 pandemic, with focus on personal risk from COVID-19 and testing.Design and Setting: Qualitative study using semi-structured interviews with PCPs in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece and Sweden, between April and July 2020.Method: Interviews were analysed using a combination of inductive and deductive thematic analysis techniques.Results: Eighty interviews were conducted, showing that PCPs tried to make sense of their risk of both contracting and severity of COVID-19 by assessing individual risk factors and perceived effectiveness of Personal Protective Equipment (PPE). They had limited access to PPE yet continued providing care as their “duty.” Some PCPs felt that they were put in high-risk situations when patients or colleagues were not flagging symptoms of COVID-19. Not having access to testing in the initial stages of the pandemic was somewhat accepted but when available, was valued.Conclusion: Access to adequate PPE and testing, as well as training for staff and education for patients about the importance of ensuring staff safety is crucial. Given PCPs' varied response in how they appraised personal risk and their tolerance for working, PCPs may benefit from the autonomy in deciding how they want to work during health emergencies.
Background: Physical distancing measures (e.g., keeping a distance of two metres from others, avoiding crowded areas, and reducing the number of close physical contacts) continue to be among the most important preventative measures used to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID -19). Therefore, it is important to understand barriers and facilitators of physical distancing to help inform future public health campaigns. Methods: The current study aimed to qualitatively explore barriers and facilitators of physical distancing in the context of the COVID-19 pandemic using a qualitative interpretative design. Semi-structured one-to-one phone interviews were conducted with 25 participants aged 18+ years and living in the Republic of Ireland between September and October 2020. A purposive sampling strategy was used to maximise diversity in terms of age, gender, and socioeconomic status. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Results: Analysis resulted in the development of six main themes related to barriers and facilitators of physical distancing: (1) Maintaining and negotiating close relationships; (2) Public environments support or discourage physical distancing; (3) Habituation to threat; (4) Taking risks to maintain well-being; (5) Personal responsibility to control the “controllables”; and (6) Confusion and uncertainty around government guidelines. Conclusions: Our study found that physical distancing measures are judged to be more or less difficult based on a number of internal and external psychosocial factors, including maintaining and negotiating close relationships, habituation to threat, risk compensation, structure of public environments, personal responsibility, and confusion or uncertainty around government guidelines. Given the diversity in our sample, it is clear that the identified barriers and facilitators vary depending on context and life stage. Messaging that targets sub-groups of the population may benefit from considering the identified themes in this analysis.
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