Participation by patients with chronic diseases under primary health care requires more attention to achieve effective disease management and better health outcomes. In 2016, China proposed accelerating the establishment of a system of family doctors (FDs) and strengthening doctor-patient communication to better meet residents’ health service needs. This study aimed to describe perceived participation in primary health care among patients with chronic diseases in northeastern China and explore the impact of FD contract services and patient’s trust on patients’ perceived participation. A cross-sectional survey of 847 patients with chronic diseases in 16 primary healthcare institutions was conducted in Jilin Province, China. Among all participants, 453 patients reported signing up for FD contract services (62.93%). The perceived participation of patients with chronic diseases was at a low level (mean = 6.71 and SD = 3.35). After controlling for sociodemographic variables and health-related variables, FD contract services directly and indirectly influenced patients’ perceived participation. The patient’s trust was a mediator in the relationship between FD contract services and perceived participation. This study confirmed the valuation of family doctor contract services and provided a theoretical basis for the formulation of primary health service policies. Health organizations should continue to enhance the capacity of primary health services and attract more chronic disease patients to contract with FD teams, thereby enhancing doctor-patient trust and increasing patient’s participation in primary health care.

Xinru Li

Jinghua Li

Weiya Shao

Jingyu Ma

Angdi Zhou

Yiwen Song

Li Zhang

The Relationship between Family Doctor Contract Services Policy and Perceived Participation in Primary Health Care among Chronic Disease Patients in China: The Mediating Role of the Patient Trust

This study explores the palliative care capacity of social workers in Flanders. First, it examines the frequency with which social workers in Flanders are currently performing palliative care tasks. Second, this study assesses their attitudes and competencies regarding the performance of these tasks. Third, as contextual factors also influence this performance, this study explores the level of appreciation experienced by social workers in Flanders. To achieve these objectives, a mixed-methods explanatory sequential design was used. Quantitative data were collected by distributing electronic survey questionnaires on QUALTRICS© to a theoretical sample of social workers in Flemish hospitals, community health clinics, nursing homes, home care, and health insurance services. A total of 499 social workers completed the survey in April and May 2021, of whom 352 met the eligibility criteria and were retained for analysis. Qualitative data were collected based on online focus groups between June and September 2021, in which a total of 24 social workers discussed the main survey results. Transcripts from the focus groups were analysed by using the framework method. The results indicate that the current palliative care capacity of responding social workers in Flanders is limited to tasks related to client assessment and referral, while their potential role extends beyond these tasks. With an expanded role, social workers would be better able to address the social dimensions of care, engage in politicising work, and, in turn, contribute to a holistic and multidimensional approach to palliative care. However, this study illustrates the need to increase the competencies and actual involvement of social workers in tasks associated with this expanded role.

Brent Taels

Kirsten Hermans

Chantal Van Audenhove

Joachim Cohen

Koen Hermans

Anja Declercq

A Mixed-Method Study on the Palliative Care Capacity of Social Workers in Flanders (Belgium): A Call to Expand Their Role

This cross-sectional study examined the experiences of people accessing Emergency Food Relief (EFR) in the regional city of Ballarat, Victoria, Australia, including determinants, impacts of food insecurity, and service delivery recommendations. The forty-one item survey examined demographics, food security status (six-item adult US-Household Food Security Survey Module), food acquisition, use of charitable food services, and self-rated health. Adults n = 100 accessing meal programs and/or EFR services from three EFR organisations in 2018 were surveyed. Ninety-seven percent of participants received government social security payments. Food insecurity prevalence was 92% (USDA-HFSSM 6 item); of these, 63% were experiencing very low food security. Over half (54%) of households with children (n = 26) reported being sometimes unable to feed their children balanced meals and 50% indicated that they were not eating enough. Participants (47%) relied on EFR services for food between one and five years. Poor self-rated dental health was expressed by over 50% of participants and 97% indicated the importance for services to provide healthy food. Food insecurity prevalence was high and chronic among adults receiving EFR services in a large regional Australian city. Recipients’ poor dental health, chronicity of use of services for food assistance, and calls for healthier food suggest more was needed to secure pathways out of food insecurity. The chronicity of reliance on EFR is a concern. The results of this study are likely to be of interest to providers and funders of EFR, policy makers, academics, and client advocates. Whilst the provision of EFR is not a sustainable solution to the problem of food insecurity, scope exists to improve service delivery to uphold principles of dignity, choice, and access to nutritious food. Furthermore, this highlights that the key strategies to mitigate food insecurity lie beyond simply feeding people.

Sue Kleve

Deborah Greenslade

Melissa Farrington

Sarah Funston

Benjamin S. David

Jessica Xi

Chloe Swiney

Emily Clarke

Christina M. Pollard

Sue Booth

Perspectives of Food Insecurity and Service Delivery amongst Emergency Food Relief Clients in a Regional City in Victoria, Australia

Loneliness is considered to be a global public health challenge, impacting a range of physical and mental health conditions. Social prescribing, whereby service users are signposted into community-based activities and social groups by a community link worker, has been suggested as one mechanism to reduce service users’ loneliness and social isolation. This paper reflects on service users’ experiences of accessing a national social prescribing scheme. Drawing on qualitative findings from interviews with service users who were receiving support through a social prescribing programme between October 2017 and December 2018 (n = 26, with n = 12 interviewed a second time), we reflect on their experiences of the programme. We consider some of the complexities of providing short-term support with a focus on signposting people into local activities, when many service users prefer the companionship of their link worker. Furthermore, we highlight some of the difficulties in ending short-term support. Crucially, we highlight the importance of considering the intersection of the social determinants of health. We suggest that social prescribing schemes may exacerbate inequalities if consideration is not given to the ways in which people are (dis)advantaged in accessing the social capital necessary for their initial and continued involvement.

Jill Thompson

Eleanor Holding

Annette Haywood

Alexis Foster

Service Users’ Perspectives of a National Social Prescribing Programme to Address Loneliness and Social Isolation: A Qualitative Study

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Health and Social Care in the Community&nbsp;is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health&nbsp;economy, primary health care and the promotion of health.

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Health and Social Care in the Community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health.

Health & Social Care in the Community