General Practice

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The Discipline of General Practice is part of the School of Population Health and Clinical Practice

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Browsing General Practice by Author "Aertgeerts, B."

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    GP's reasons for referral of patients with chest pain: a qualitative study
    (BioMed Central Ltd., 2009) Bruyninckx, R.; Van den Bruel, A.; Hannes, K.; Buntinx, F.; Aertgeerts, B.
    Background: Prompt diagnosis of an acute coronary syndrome is very important and urgent referral to a hospital is imperative because fast treatment can be life-saving and increase the patient's life expectancy and quality of life. The aim of our study was to identify GPs' reasons for referring or not referring patients presenting with chest pain. Methods: In a semi-structured interview, 21 GPs were asked to describe why they do or do not refer a patient presenting with chest pain. Interviews were taped, transcribed and qualitatively analysed. Results: Histories of 21 patients were studied. Six were not referred, seven were referred to a cardiologist and eight to the emergency department. GPs' reasons for referral were background knowledge about the patient, patient's age and cost-benefit estimation, the perception of a negative attitude from the medical rescue team, recent patient contact with a cardiologist without detection of a coronary disease and the actual presentation of signs and symptoms, gut feeling, clinical examination and ECG results. Conclusion: This study suggests that GPs believe they do not exclusively use the 'classical' signs and symptoms in their decision-making process for patients presenting with chest pain. Background knowledge about the patient, GPs' personal ideas and gut feeling are also important.
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    Obstacles to the implementation of evidence-based physiotherapy in practice: A focus group-based study in Belgium (Flanders)
    (Psychology Press, 2009) Hannes, K.; Staes, F.; Goedhuys, J.; Aertgeerts, B.
    Over the past few years concerns have been rising about the use of Evidence-Based Practice (EBP). We explored obstacles among Belgian physiotherapists to the implementation of EBP in clinical work. We used a qualitative research strategy based on five focus groups, organised between October 2004 and May 2005. Purposeful sampling was used to recruit 43 participants from diverse geographical regions in Flanders, working in different settings and with a variety of interest and expertise in EBP. Data collection and analysis were concurrent and guided by “grounded theory approach.” A problem tree was developed. Important obstacles to the implementation of EBP include physiotherapists’ lack of autonomy and authority to decide on patients’ treatments or to negotiate with government. In addition, the lack of evidence, inaccessibility and inapplicability of scientific evidence, the economic parameters influencing government and physicians, the expectations from patients and a lack of motivation hamper the implementation of EBP. The problem tree developed reveals direct links between the lack of autonomy from physiotherapists and the dominant position from physicians in the Belgian health care system, which further impacts the boundaries between both professions and the weight of physiotherapists in governmental advisory boards. Direct access to physiotherapy has not yet been considered in Belgium. However, it could have major advantages for physiotherapists who are in favour of a more autonomous, professional status.