Primary Health Care Theory and Practice

by Greenhalgh, Trisha

• ISBN13: 9780727917850
• ISBN10: 0727917854
• Edition: 1st
• Format: Paperback
• Copyright: 2007-09-11
• Publisher: BMJ Books

Summary

General practitioners and other primary care professionals have a leading role in contemporary health care, which Trisha Greenhalgh explores in this highly praised new text. She provides perceptive and engaging insights into primary health care, focussing on: - its intellectual roots - its impact on the individual, the family and the community - the role of the multidisciplinary team - contemporary topics such as homelessness, ethnic health and electronic records. Concise summaries, highlighted boxes, extensive referencing and a dedicated section on effective learning make this essential reading for postgraduate students, tutors and researchers in primary care. ___ From the foreword by Julian Tudor Hart "Trish Greenhalgh, in her frequent columns in the British Medical Journal...more than any other medical journalist spoke to her fellow GPs in the language of experience, but never without linking this to our expanding knowledge from the whole of human science. When I compare the outlines of primary care so lucidly presented in this wonderful book, obviously derived from rich experience of real teaching and learning, with the grand guignol theatre of London medical schools when I was a student 1947-52, the advance is stunning." ___ "Trish Greenhalgh is one of the international stars of general practice and a very clever thinker. This new book is a wonderful resource for primary health care and general practice. Every general practice registrar should read this book and so should every general practice teacher and primary care researcher." Professor Michael Kidd, Head of the Department of General Practice, University of Sydney and Immediate Past President of The Royal Australian College of General Practitioners "This important new book by one of primary care's most accomplished authors sets out clearly the academic basis for further developments in primary health care. Health systems will only function effectively if they recognise the importance of high quality primary care so I strongly recommend this book to students, teachers, researchers, practitioners and policy makers." Professor Martin Marshall, Deputy Chief Medical Officer, Department of Health, UK

Author Biography

Trisha Greenhalgh Department of Primary Care and Population Sciences, University College London, UK.

Author of bestselling How to Read a Paper and Diffusion of Innovations in Health Service Organisations (Blackwell Publishing BMJ Books).

Table of Contents

Acknowledgements	p. ix
Preface	p. xi
Foreword	p. xvii
Introduction	p. 1
What is primary (health) care?	p. 1
What is academic study?	p. 13
What are theories - and why do we need them?	p. 19
The 'ologies' (underpinning academic disciplines) of primary health care	p. 23
Biomedical sciences	p. 24
Epidemiology	p. 26
Psychology	p. 32
Sociology	p. 34
Anthropology	p. 36
Literary theory	p. 41
Philosophy and ethics	p. 43
Pedagogy	p. 50
Research methods for primary health care	p. 57
What is good research in primary health care?	p. 58
Qualitative research	p. 63
Quantitative research	p. 66
Questionnaire research	p. 72
Participatory ('action') research	p. 74
Research data - and analysing it	p. 75
Critical appraisal of published research papers	p. 80
Systematic review	p. 83
Multi-level approaches to primary care problems	p. 85
The person who is ill	p. 90
The sick role	p. 91
The illness narrative	p. 94
Lifestyle choices and 'changing behaviour'	p. 98
Self-management	p. 102
Health literacy	p. 108
The primary care clinician	p. 115
The role of the generalist	p. 116
Clinical method I: rationalism and Bayes' theorem	p. 118
Clinical method II: humanism and intuition	p. 124
Clinical method III: the patient-centred method	p. 129
Influencing clinicians' behaviour	p. 133
The 'good' clinician	p. 137
The clinical interaction	p. 146
The clinical interaction I: a psychological perspective	p. 147
The clinical interaction II: a sociolinguistic perspective	p. 151
The clinical interaction III: a psychodynamic perspective	p. 156
The clinical interaction IV: a literary perspective	p. 160
The interpreted consultation	p. 164
The family - or lack of one	p. 175
Family structure in the late modern world	p. 176
The mother-child relationship (or will any significant other do these days?)	p. 185
Illness in the family - nature, nurture and culture	p. 191
Homelessness	p. 194
The population	p. 202
Describing disease in populations	p. 202
Explaining the 'causes' of disease	p. 204
Detecting disease in populations	p. 209
'Risk': an epidemiological can of worms?	p. 216
The community	p. 225
Unpacking health inequalities I: deprivation	p. 225
Unpacking health inequalities II: social networks and social capital	p. 229
Unpacking health inequalities III: life course epidemiology and 'risk regulators'	p. 232
Developing healthy communities I: community oriented primary care	p. 237
Developing healthy communities II: participatory approaches	p. 240
Complex problems in a complex system	p. 248
Illness in the twenty-first century: chronicity, comorbidity and the need for coordination	p. 248
Coordinating care across professional and organisational boundaries	p. 254
The electronic patient record: a road map for seamless care?	p. 258
The end of an era?	p. 263
Quality	p. 273
Defining and measuring quality	p. 274
A rational biomedical perspective: evidence-based targets, planned change and criterion-based audit	p. 279
A narrative perspective: significant event audit	p. 282
A social learning perspective: peer review groups and quality circles	p. 287
A phenomenological perspective: the patient as mystery shopper	p. 290
A sociological perspective: Quality Team Development as organisational sensemaking	p. 293
Index	p. 305
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