Holding the complex whole: Generalist philosophy, priorities and practice that facilitate whole-person care

Sturman, Nancy; Thomas, Hayley; Askew, Deborah; Lynch, Johanna

doi:10.31128/ajgp-01-23-6686

Cited by 4 publications

(1 citation statement)

References 46 publications

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“… 15 Health systems should promote holistic care for the population, especially the population with SMI, taking into account the context, culture, meaning, and subjective internal experience, including the strengths and deepest fears of the person. This change could be implemented by utilising medical care models, such as the Co-Work-Care model, 42 in order to improve communication and facilitate active dialogues between GPs, psychiatrists, caregivers, and the patients themselves.…”

Section: Discussionmentioning

confidence: 99%

Patients with severe mental illness and their carers’ expectations for GPs’ communication skills: a qualitative approach in Spain

Ramos-Ruiz,

Pérez-Milena,

Noguera-Cuenca

et al. 2023

BJGP Open

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BackgroundEffective Communication with General Practitioners (GPs) provides higher rates of satisfaction and adherence to treatment plans. People with Severe Mental Illness (SMI) and their caregivers present unique characteristics that present difficulties in the GP-carer-patient communication process.AimTo explore SMI patients and their caregivers’ expectations for GPs’ Communication Skills (CS) in primary care (PC) consultations.Design & settingFace-to-face interviews using focus group methodology surveyed in southern Spain.Method42 participants in 21 paired semi-structured interviews with an average duration of 19±7.2 minutes. Information was audio-recorded and transcribed literally. Qualitative content analysis, obtaining a codification in categories by means of triangulation.ResultsThe ability of GPs to use a language that was colloquial and adapted to each person was perceived as a determinant of the quality of care provided. An empathetic attitude, low reactivity and efficient time management were the most valued CS. The telephone consultation was perceived as a useful tool to care for people with SMI. Video consultation was valued as a requirement in isolated rural areas. The caregiver was considered by the patients as an allie who improves the clinical interview. Finally, the continuity of care, defined by a low turnover of GPs, determined the quality perceived by those who require care.ConclusionThemes emerging from this study suggest that people suffering from SMI require an inclusive, collaborative and personalised approach in the care they receive from the public health system. Improved communication between general practitioners and patients with SMI is an essential requirement for quality medical care.

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Section: Discussionmentioning

confidence: 99%

Patients with severe mental illness and their carers’ expectations for GPs’ communication skills: a qualitative approach in Spain

Ramos-Ruiz,

Pérez-Milena,

Noguera-Cuenca

et al. 2023

BJGP Open

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Development of a Generalist Competency Framework for Medical Education Leaders in Longitudinal Integrated Curricula (LILIC)

Gullo,

Cho,

Szarek

et al. 2024

Med.Sci.Educ.

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Recent shifts in health professions education have prompted significant curriculum reforms toward multidisciplinary, longitudinally integrated courses during the pre-clinical and clinical years of medical school curricula. Faculty who are accustomed to managing discipline-specific courses must now be trained to meet the challenges of implementing new integrated courses. Skills and competencies for Leaders in Longitudinal Integrated Curricula (LILIC) must be identified for faculty development efforts and to assist administrators in recognizing the attributes of well-qualified course/curriculum directors for their appointment/hiring decisions. Drawing on the collective expertise of faculty from multiple medical schools, we developed a framework to meet this new need. Herein, we present a shared mental model, a framework, and higher-level attributes important for the development of these curricular leaders. A proposed development process and future directions for this framework are also presented, underscoring its potential impact on faculty development and the broader educational landscape in health professions.

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Promoting physical activity among cancer survivors through general practice: a realist review

Sugiarto,

Jabbour,

Uebel

et al. 2024

Family Practice

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Background Multiple studies have shown that physical activity improves cancer survivorship, by decreasing risk of second primary cancers and chronic conditions. However, cancer survivor physical activity levels remain low. General practice presents more opportunities for lifestyle interventions, such as increasing physical activity. We conducted a realist review of physical activity interventions relevant to general practice. Methods A total of 9728 studies were obtained from a systematic search of the CINAHL, Embase, PsycINFO, PubMed, and SPORTDiscus databases from the inception of the electronic database to 21 June 2024. We focussed on intervention studies that improved physical activity among cancer survivors and were relevant to general practice. Data extraction focussed on: what makes physical activity interventions effective for cancer survivors (what works) and what factors promote physical activity for cancer survivors (for whom it works). Results Thirty-seven studies were used to generate themes on the components of physical activity interventions that are likely to work and for whom; these studies facilitated goal setting, action planning, self-monitoring, social support, and shaping of knowledge; through delivering tailored motivational support, evoking a teachable moment, and promoting the use of self-monitoring tools. Interventions that were cost-effective and easily implementable improved sustainability, deployability, and uptake by cancer survivors. Cancer survivor psychological and physical factors, such as baseline motivational levels and post-treatment symptoms, influenced the uptake of physical activity interventions. Conclusion Our realist review has highlighted opportunities for general practices to promote physical activity among cancer survivors through collaborative goal setting, action planning, self-monitoring, social support, and shaping of knowledge.

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Holding the complex whole: Generalist philosophy, priorities and practice that facilitate whole-person care

Cited by 4 publications

References 46 publications

Patients with severe mental illness and their carers’ expectations for GPs’ communication skills: a qualitative approach in Spain

Patients with severe mental illness and their carers’ expectations for GPs’ communication skills: a qualitative approach in Spain

Development of a Generalist Competency Framework for Medical Education Leaders in Longitudinal Integrated Curricula (LILIC)

Promoting physical activity among cancer survivors through general practice: a realist review

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