CUMG.NET \ nouvelle version \ Journal Club Journal Club cumg UCL 24th June 2005 Valérie Dory Jean-Marc Feron.

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Presentation transcript:

CUMG.NET \ nouvelle version \ Journal Club Journal Club cumg UCL 24th June 2005 Valérie Dory Jean-Marc Feron

CUMG.NET \ nouvelle version \ Journal Club Aims For GPs and lecturers, to get the best out of the literature for their patients and students For researchers, to learn how published studies are built and reported, and how to criticize them.

CUMG.NET \ nouvelle version \ Journal Club Today Patients’ and health professionals’ views on primary care for people with serious mental illness: focus group study BMJ april 2005 GP treatment decisions for patients with depression: an observational study Brit J Gen Pract april 2005 First an intuitive critic, and then a reading framework

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Introduction Prevalence of schizophrenia, bipolar disorder and recurrent depression up to 3 % in UK Considerable workload for GPs and higher risk of poorer physical health GPs do not perceived themselves as involved in mental health or overall care of people with serious mental illness Little research has sought …

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Objective To explore the changing experience of providing and receiving primary care from the dual perspectives of primary care health professionals and patients with serious mental illness respectively

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Design: Qualitative study consisting of 6 patients groups (N total: 45), 6 health professionals (39 GPs and 8 nurses) and 6 combined focus groups Setting: 6 Primary Care Trusts in the West Midlands, selected according to differing levels of deprivation (Townsend score) and population density

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Patients’ recruitment: through existing community based user networks – snowballing technique Timing: 18 focus groups from May 2002 to January 2003, publication April 2005; 3 researchers

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Procedure Topic guide piloted with 6 patients and 6 health professionals FG in non clinical settings Always the same facilitator No patient registered at a GP’s practice About the half participated, usually 1 week later, to a combined FG

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Analysis FG, data collection and analysis were concurrent, and FG continued until saturation All FG audiotaped and transcribed Software, thematic framework

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Results (1/3) Most of professionals felt that care for people with serious mental illness was too specialised for them Most patients viewed Primary Care as the cornerstone of their health care and prefer to consult their own GP Patients' arguments: being listened, swift access

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Results (2/3) Patients exaggerate their symptoms to get urgent appointment to the GP GPs exaggerate patients’ symptoms to facilitate admission to secondary care All participants felt that interpersonal and longitudinal continuity was vital for good quality care

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Results (3/3) Professionals perceived serious mental illness as a lifelong condition Patients emphasised the importance of optimism in treatment and hope for recovery Both thought that structured reviews for people with serious mental illness (for example: annual check-up) is a good concept

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Discussion Combined FG = a strength Patient – GP hierarchy ? Seems that not. Only 8 % of invited professionals agreed to participate Very important study for the health care system

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Intuitive critic

CUMG.NET \ nouvelle version \ Journal Club Patients’ and health professionals’ views on primary care for people with serious mental illness: Reading framework Validity: appropriateness of the chosen method, purposeful sampling, triangulation, respondent validation Reliability: analysis and interpretation, theoretical models Relevance Reflexivity Transferability