How do general practitioners use 'safety netting' in acutely ill children?

Background: 'Safety netting' advice allows general practitioners (GPs) to cope with diagnostic uncertainty in primary care. It informs patients on 'red flag' features and when and how to seek further help. There is, however, insufficient evidence to support useful choices regarding 'safety netting' procedures. Objectives: To explore how GPs apply 'safety netting' in acutely ill children in Flanders. Methods: We designed a qualitative study consisting of semi-structured interviews with 37 GPs across Flanders. Two researchers performed qualitative analysis based on grounded theory components. Results: Although unfamiliar with the term, GPs perform 'safety netting' in every acutely ill child, guided by their intuition without the use of specific guidelines. They communicate 'red flag' features, expected time course of illness and how and when to re-consult and try to tailor their advice to the context, patient and specific illness. Overall, GPs perceive 'safety netting' as an important element of the consultation, acknowledging personal and parental limitations, such as parents' interpretation of their advice. GPs do not feel a need for any form of support in the near future. Conclusion: GPs apply 'safety netting' intuitively and tailor the content. Further research should focus on the impact of 'safety netting' on morbidity and how the advice is conveyed to parents

How do general practitioners use 'safety netting' in acutely ill children?

'Safety netting' advice allows general practitioners (GPs) to cope with diagnostic uncertainty in primary care. It informs patients on 'red flag' features and when and how to seek further help. There is, however, insufficient evidence to support useful choices regarding 'safety netting' procedures.peerreview_statement: The publishing and review policy for this title is described in its Aims & Scope. aims_and_scope_url: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=igen20status: publishe

Implementation of the ars moriendi model in palliative home care: a pilot study

Background: Assessing the spiritual well-being of palliative patients is often perceived as difficult by professional caregivers. Previous research has shown that general practitioners would appreciate a directive for spiritual conversations, if this tool were not too structured and not too religious, and provided it proved to be useful in clinical practice. Aim: To investigate the experiences of professional caregivers and patients with the ars moriendi model as a directive for spiritual conversations in palliative home care. Method: Qualitative semi-structured interview pilot study in Flanders Results: All professional caregivers (n = 7) experienced the ars moriendi model as a useful directive to talk about spirituality at the end of life. They stressed the importance of adjusting the questions to each patient, and of spreading the spiritual conversation over several contacts. The palliative patients (n = 4) appreciated the conversation and advised the caregivers to show an open attitude, to spend enough time on their spiritual well-being, and to follow them in their spiritual process. Both caregivers and patients emphasized the importance of a trusting relationship to establish spiritual conversations. Conclusion: Flemish professional caregivers experienced the ars moriendi model as useful for supporting spiritual conversations, provided that the model is used in a spontaneous and intuitive way, according to the needs of the patient. Palliative patients are stimulated by the questions in the model to think about their spiritual needs and resources. © W. S. Maney & Son Ltd 2013.status: publishe