What do we know about who does and does not attend general health checks? Findings from a narrative scoping review

Background: General and preventive health checks are a key feature of contemporary policies of anticipatory care. Ensuring high and equitable uptake of such general health checks is essential to ensuring health gain and preventing health inequalities. This literature review explores the socio-demographic, clinical and social cognitive characteristics of those who do and do not engage with general health checks or preventive health checks for cardiovascular disease. Methods: An exploratory scoping study approach was employed. Databases searched included the British Nursing Index and Archive, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE), EMBASE, MEDLINE, PsycINFO and the Social Sciences Citation Index (SSCI). Titles and abstracts of 17463 papers were screened; 1171 papers were then independently assessed by two researchers. A review of full text was carried out by two of the authors resulting in 39 being included in the final review. Results: Those least likely to attend health checks were men on low incomes, low socio-economic status, unemployed or less well educated. In general, attenders were older than non-attenders. An individual's marital status was found to affect attendance rates with non-attenders more likely to be single. In general, white individuals were more likely to engage with services than individuals from other ethnic backgrounds. Non-attenders had a greater proportion of cardiovascular risk factors than attenders, and smokers were less likely to attend than non-smokers. The relationship between health beliefs and health behaviours appeared complex. Non-attenders were shown to value health less strongly, have low self-efficacy, feel less in control of their health and be less likely to believe in the efficacy of health checks. Conclusion: Routine health check-ups appear to be taken up inequitably, with gender, age, socio-demographic status and ethnicity all associated with differential service use. Furthermore, non-attenders appeared to have greater clinical need or risk factors suggesting that differential uptake may lead to sub-optimal health gain and contribute to inequalities via the inverse care law. Appropriate service redesign and interventions to encourage increased uptake among these groups is required

Service use and the prevention of emergency hospital admissions: a comparison of the views of older people and health and social care professionals

This paper presents a comparison of the perceptions of health and social care professionals and older people on the prevention of emergency hospital admissions and the use of care services. Whereas older people viewed emergency admission as an inevitable part of ageing, professionals attributed many emergency admissions to the social isolation of older people. Professionals reported that the majority of services were not designed to minimise isolation in older age. Older people listed quality of life, boosted by socialising and support during periods of good health, as their first priority. Older people and professionals presented differing arguments why some health and social care services were underutilised. Older people explained that they deliberately avoided using some services because they believed these would undermine their independence and level of activity. Professionals reasoned that low uptake of services was associated with service providers’ lack of knowledge and trust as well as problems with the accessibility of services. This shows that service users and providers differ in their assessment of need and service delivery. Hence, it is argued that both professional and patient perspectives are required to inform service development that meets the needs of older people and health and social care staff

Professional perceptions of joint working in primary care and social care services for older people in Scotland

The purpose of this paper is to report health and social care professionals’ perceptions on joint working for the care of older people in Scotland. Semi-structured interviews were conducted with 34 primary care and social care professionals. These professionals emphasised that joint working requires a fundamental change in thinking and a scrutiny of professional roles and identities and is influenced by the given geographical and organisational infrastructure. In order to facilitate sustained joint working knowledge and models of care bespoke to joint working need to be developed. This requires health and social care organisations to focus on the co-creation and generation of new knowledge by health and social care professionals as well as the communication and exchange of existing knowledge between services. However, joint working also needs to be based on patient views to guarantee a whole systems perspective

Safeguarding children in primary health care

Safeguarding children from harm has, until recently, been driven primarily by social work practitioners. With current shifts in child care and protection practice and policy, combined with an overwhelming message of 'working together', primary health care professionals have an increasingly central part to play. There is a strong argument that cases of suspected child abuse and neglect should warrant the same level of urgent response as any potentially fatal childhood illness. This book provides an overview of the challenges primary health care professionals now face in recognising and responding to concerns about a child's safety from abuse and neglect. It provides practical accounts and perspectives from a range of frontline practitioners working with children, parents and carers, backed up by theoretical insights from leading academics in the field. Issues explored include: media coverage of child abuse and neglect cases, inter-professional collaboration, competing professional priorities and resources, practical workload decisions and personal experiences and anxieties. Safeguarding Children in Primary Health Care is a useful training and development resource for all primary health care practitioners, such as paediatricians, community nurses and midwives, community psychiatric nurses, health visitors, dentists, general practitioners and allied health professionals

Decay, transformation, and growth: meaning-making processes of patients with acute leukemia within the first year after diagnosis or relapse

Purpose/Objectives: To explore the processes through which patients construct their meanings of acute leukemia (AL).
 Research Approach: An exploratory design was employed using serial, in-depth interviews, guided by Smith’s Interpretative Phenomenological Analysis approach.
 Setting: Two inpatient hematology clinics in the United Kingdom.
 Participants: 10 adult patients with AL. 
 Methodologic Approach: Two serial interviews were conducted with each participant, two to four weeks apart, within the first year of diagnosis or post-relapse.
 Findings: AL creates a state of imbalance, which may initiate a search for new equilibrium. Patients’ journeys toward making sense of their illness may involve three interchangeable processes: decay, transformation, and growth. As patients learned of their diagnosis and their treatment commenced, a sense of decay dominated their lives. Running in parallel, signs of transformation started to become more evident as time elapsed. Within growth, reprioritizing values was prominent. 
 Conclusions: Findings of this contextually and methodologically novel study highlight the complex nature of sense-making for patients experiencing AL.
 Interpretation: Nurses can take valuable lessons on how to manage the invisibility of AL, enhance trust in healthcare professionals, address the impact of isolation, and facilitate the making-sense processes of patients in ways that favor their short- and long-term psychosocial adjustment

Safeguarding children in primary health care

Safeguarding children from harm has, until recently, been driven primarily by social work practitioners. With current shifts in child care and protection practice and policy, combined with an overwhelming message of 'working together', primary health care professionals have an increasingly central part to play. There is a strong argument that cases of suspected child abuse and neglect should warrant the same level of urgent response as any potentially fatal childhood illness. This book provides an overview of the challenges primary health care professionals now face in recognising and responding to concerns about a child's safety from abuse and neglect. It provides practical accounts and perspectives from a range of frontline practitioners working with children, parents and carers, backed up by theoretical insights from leading academics in the field. Issues explored include: media coverage of child abuse and neglect cases, inter-professional collaboration, competing professional priorities and resources, practical workload decisions and personal experiences and anxieties. Safeguarding Children in Primary Health Care is a useful training and development resource for all primary health care practitioners, such as paediatricians, community nurses and midwives, community psychiatric nurses, health visitors, dentists, general practitioners and allied health professionals