General practitioners’ knowledge, preparedness, and experiences of managing COVID-19 in Australia

Author(s): Cristina Sotomayor-Castillo , Dr, PhD ^a ^, ^b , Shizar Nahidi , Dr, PhD ^a ^, ^b , Cecilia Li , Dr, PhD ^a ^, ^b , Charlotte Hespe , MBBS (Hons) ^c , Penelope L. Burns , BMed MPHTM ^d ^, ^e , Ramon Z. Shaban , BSc (Med) BN GradCertInfCon PGDipPH&TM MEd MCommHealthPrac (Hons1) PhD RN FACIPC FCENA FACN CICP-E ^a ^, ^b ^, ^f ^, ^g ^, ^∗

Publication date (Electronic): 18 February 2021

Journal: Infection, Disease & Health

Publisher: Australasian College for Infection Prevention and Control. Published by Elsevier B.V.

Keywords: COVID-19, general practitioners, personal protective equipment, primary health care, outbreaks

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Abstract

Background

COVID-19 has brought unprecedented demands to general practitioners (GPs) worldwide. We examined their knowledge, preparedness, and experiences managing COVID-19 in Australia.

Methods

A cross-sectional online survey of GPs members of the Royal Australian College of General Practitioners (RACGP) was conducted between June and September 2020.

Results

Out of 244 survey responses, a majority of GPs (76.6%) indicated having good knowledge of COVID-19, relying mostly on state/territory department of health (84.4%) and the RACGP (76.2%) websites to source up-to-date information. Most felt prepared to manage patients with COVID-19 (75.7%), yet over half reported not receiving training in the use of PPE. The majority were concerned about contracting SARS-CoV-2, more stressed than usual, and have heavier workloads. Their greatest challenges included scarcity of PPE, personal distress, and information overload.

Conclusions

Access to PPE, training, accurate information, and preparedness are fundamental for the successful role of general practices during outbreaks.

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Most cited references 33

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Three approaches to qualitative content analysis.

Hsiu-Fang Hsieh, Sarah Shannon (2016)

Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.

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The behaviour change wheel: A new method for characterising and designing behaviour change interventions

Susan Michie, Maartje M. van Stralen, Robert H. West (2012)

Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Conclusions Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.

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Quality of primary health care in China: challenges and recommendations

Xi Li, Harlan M. Krumholz, Winnie Yip … (2020)

Summary China has substantially increased financial investment and introduced favourable policies for strengthening its primary health care system with core responsibilities in preventing and managing chronic diseases such as hypertension and emerging infectious diseases such as coronavirus disease 2019 (COVID-19). However, widespread gaps in the quality of primary health care still exist. In this Review, we aim to identify the causes for this poor quality, and provide policy recommendations. System challenges include: the suboptimal education and training of primary health-care practitioners, a fee-for-service payment system that incentivises testing and treatments over prevention, fragmentation of clinical care and public health service, and insufficient continuity of care throughout the entire health-care system. The following recommendations merit consideration: (1) enhancement of the quality of training for primary health-care physicians, (2) establishment of performance accountability to incentivise high-quality and high-value care; (3) integration of clinical care with the basic public health services, and (4) strengthening of the coordination between primary health-care institutions and hospitals. Additionally, China should consider modernising its primary health-care system through the establishment of a learning health system built on digital data and innovative technologies.

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Author and article information

Contributors

Cristina Sotomayor-Castillo: Role: Postdoctoral Research Fellow

Shizar Nahidi: Role: Research Administrative Officer

Cecilia Li: Role: Postdoctoral Research Fellow

Charlotte Hespe: Role: A/Professor, General Practitioner

Penelope L. Burns: Role: A/Professor, General Practitioner

Ramon Z. Shaban: Role: Professor, Clinical Chair of Infection Prevention and Disease Control

Journal

Journal ID (nlm-ta): Infect Dis Health

Journal ID (iso-abbrev): Infect Dis Health

Title: Infection, Disease & Health

Publisher: Australasian College for Infection Prevention and Control. Published by Elsevier B.V.

ISSN (Print): 2468-0451

ISSN (Electronic): 2468-0869

Publication date PMC-release: 18 February 2021

Publication date (Electronic): 18 February 2021

Affiliations

[a ]Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney. Camperdown. NSW, Australia

[b ]Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia

[c ]General Practice and Primary Care Research, School of Medicine, The University of Notre Dame Australia, Sydney, NSW, Australia

[d ]Academic Unit of General Practice, Australian National University Medical School, The Australian National University, Canberra, ACT, Australia

[e ]Department of General Practice, School of Medicine, Western Sydney University, Campbelltown, NSW, Australia

[f ]Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead. NSW, Australia

[g ]New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia

Author notes

[∗ ]Corresponding author. University of Sydney and Western Sydney Local Health District Office: 0.4.20, Westmead Institute for Medical Research 176 Hawkesbury Road, Westmead NSW 2145. Australia. Tel.: +61 2 8627 3117. Mobile: +61 0478 312 668.

Article

Publisher Item ID: S2468-0451(21)00004-3

DOI: 10.1016/j.idh.2021.01.004

PMC ID: 7891055

PubMed ID: 33676878

SO-VID: f0f96c59-770e-4988-9ea1-b8b20b16c110

License:

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

History

Date received : 11 January 2021

Date revision received : 25 January 2021

Date accepted : 26 January 2021

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General practitioners’ knowledge, preparedness, and experiences of managing COVID-19 in Australia

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Abstract

Background

Methods

Results

Conclusions

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 33

Three approaches to qualitative content analysis.

The behaviour change wheel: A new method for characterising and designing behaviour change interventions

Quality of primary health care in China: challenges and recommendations

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