The Impact and Wider Implications of Remote Consultations for General Practice in Norway: Qualitative Study Among Norwegian Contract General Practitioners.

Background: The digital shift toward remote consultations in general practice needs ongoing monitoring to understand its impact on general practice organizations and the wider health care system.

Objective: This study aimed to explore how remote consultations impact on contracted general practitioner (GP) practices and how GPs perceive the implications of this uptake for the overall health care system.

Methods: In total, 5 focus groups were conducted with a total of 18 GPs from all 4 health regions of Norway in 2022.

Medical encounters with young unaccompanied refugees: a qualitative study among general practitioners and physicians in migrant health clinics in Norway and Denmark.

Objective: This study examines the experiences of clinical encounters with young unaccompanied refugees in Norway and Denmark among both general practitioners (GPs) and physicians in migrant health clinics (MHC physicians), and it identifies important aspects that should be taken into consideration for improving the quality of healthcare for these patients.

Methodology: Ten individual in-depth interviews with physicians in Norway and Denmark were conducted and analysed using interpretative phenomenology. Axel Honneth's theory of recognition was our theoretical lens.

Navigating weight, risk and lifestyle conversations in maternity care: a qualitative study among pregnant women with obesity.

Background: Pregnant women with obesity face heightened focus on weight during pregnancy due to greater risk of medical complications. Closer follow-up in maternety care may contribute to reduce risk and promote health in these women. The aim of this study was to gain a deeper insight in how pregnant women with obesity experience encounters with healthcare providers in maternity care.

Weight development from childhood to motherhood-embodied experiences in women with pre-pregnancy obesity: a qualitative study.

Background: Pre-pregnancy obesity increases the risk of perinatal complications. Post-pregnancy is a time of preparation for the next pregnancy and lifestyle advice in antenatal care and postpartum follow-up is therefore recommended. However, behavioral changes are difficult to achieve, and a better understanding of pregnant women's perspectives and experiences of pre-pregnancy weight development is crucial.

Primary care gatekeeping during the COVID-19 pandemic: a survey of 1234 Norwegian regular GPs.

Background: In the Nordic healthcare systems, GPs regulate access to secondary health services as gatekeepers. Limited knowledge exists about the gatekeeper role of GPs during public health crises seen from the perspective of GPs.

Aim: To document GPs' gatekeeper role and organisational changes during the initial COVID-19 lockdown in Norway.

'They never mentioned this in medical school!' A qualitative analysis of medical students' reflective writings from general practice.

Objective: The aim of the study was to identify final-year medical students' experiences with thought-provoking and challenging situations in general practice.

Design Setting And Subjects: We conducted a qualitative analysis of 90 reflective essays written by one cohort of Norwegian final-year medical students during their internship in general practice in 2017. The students were asked to reflect upon a clinical encounter in general practice that had made a strong impression on them.

Adverse childhood experiences and pre-pregnancy body mass index in the HUNT study: A population-based cohort study.

Objective: Investigate the association between adverse childhood experiences and pre-pregnancy body mass index (BMI) in a population-based cohort in Trøndelag county, Norway.

Materials And Methods: We linked data from the third (2006-2008) or fourth (2017-2019) survey of the Trøndelag Health Study (HUNT) and the Medical Birth Registry of Norway for 6679 women. Multiple logistic regression models were used to examine the association between adverse childhood experiences and pre-pregnancy BMI.

General Practitioners' Experiences With Potentials and Pitfalls of Video Consultations in Norway During the COVID-19 Lockdown: Qualitative Analysis of Free-Text Survey Answers.

Background: The use of video consultations (VCs) in Norwegian general practice rapidly increased during the COVID-19 pandemic. During societal lockdowns, VCs were used for nearly all types of clinical problems, as in-person consultations were kept to a minimum.

Objective: This study aimed to explore general practitioners' (GPs') experiences of potentials and pitfalls associated with the use of VCs during the first pandemic lockdown.

Prescription of potentially addictive medications after a multilevel community intervention in general practice.

Objective: To evaluate the long-term effects of a multilevel community intervention to improve the quality of prescription practice of potentially addictive medications (PAMs).

Design: We conducted a retrospective study, using anonymized data from the Norwegian prescription registry.

Setting: Based on an initiative from the GPs in Molde Municipality in Norway, a multilevel community intervention was initiated by the municipal chief physician in 2018.

The impact of clinical experience on working tasks and job-related stress: a survey among 1032 Norwegian GPs.

Background: General practice is a generalist discipline fraught with complexity. For inexperienced physicians, it may be demanding to get to grips with the clinical challenges. The purpose of this article is to describe possible differences in the range of tasks between inexperienced and experienced general practitioners (GPs), and the extent to which clinical experience affects the way in which GPs perceive their daily work.

Perceptions of the medical relevance of patients` stories of painful and adverse life experiences: a focus group study among Norwegian General Practitioners.

Purpose: Adverse life experiences increase the risk of health problems. Little is known about General Practitioners' (GPs') thoughts, clinical concepts, and work patterns related to eliciting, including, or excluding their patients' stories of painful and adverse life experiences. We wanted to explore GPs' perceptions of the medical relevance of stories of painful and adverse life experiences, and to focus on what hinders or facilitates working with such stories.

Trends in absolute and relative educational inequalities in health during times of labour market restructuring in coastal areas: The HUNT Study, Norway.

Background: Restructuring labour markets offers natural population-level experiments of great social epidemiological interest. Many coastal areas have endured substantial restructuring of their local labour markets following declines in small-scale fishing and transitions to new employment opportunities. It is unknown how educational inequalities in health have developed in formerly fishery-dependent communities during such restructuring.

The Craft of Generalism clinical skills and attitudes for whole person care.

Rationale, Aims And Objectives: Generalists manage a broad range of biomedical and biographical knowledge as part of each clinical encounter, often in multiple encounters over time. The sophistication of this broad integrative work is often misunderstood by those schooled in reductionist or constructivist approaches to evidence. There is a need to describe the practical and philosophically robust ways that understanding about the whole person is formed.

Beyond multimorbidity: What can we learn from complexity science?

Multimorbidity - the occurrence of two or more long-term conditions in an individual - is a major global concern, placing a huge burden on healthcare systems, physicians, and patients. It challenges the current biomedical paradigm, in particular conventional evidence-based medicine's dominant focus on single-conditions. Patients' heterogeneous range of clinical presentations tend to escape characterization by traditional means of classification, and optimal management cannot be deduced from clinical practice guidelines.

Suitability of Video Consultations During the COVID-19 Pandemic Lockdown: Cross-sectional Survey Among Norwegian General Practitioners.

Background: The COVID-19 pandemic imposed an acute, sharp rise in the use of video consultations (VCs) by general practitioners (GPs) in Norway.

Objective: This study aims to document GPs' experiences with the large-scale uptake of VCs in the natural experiment context of the pandemic.

Methods: A nationwide, cross-sectional online survey was conducted among Norwegian GPs during the pandemic lockdown (April 14-May 3, 2020).

Adverse life experiences among patients with morbid obesity.

Background: The association between highly stressful life experiences and morbid obesity is well documented internationally, but this knowledge is not incorporated to any great extent in Norwegian clinical practices. We have studied the reports of previous life stresses from a sample of Norwegian patients under assessment for morbid obesity at a centre where the topic of life experiences was included during the recording of patient histories.

Material And Method: In the summer of 2018, an invitation to participate in the study was distributed to the last 200 patients to have been examined at the Regional Centre for Morbid Obesity in Bodø.

Complex issues in general practice - a prevalence study.

Background: The contract GP scheme in Norway has been a success, but the scheme's sustainability has been weakened. In summer 2017, the so-called Trønder rebellion arose among GPs who wished to analyse the situation. In order to obtain a better understanding of their total daily workload, all GPs in Norway were invited to record all their activity on a typical day in their practices.

Use of pregnancy ultrasound before the 19th week scan: an analytical study based on the Icelandic Childbirth and Health Cohort.

Background And Aim: Use of ultrasound scans early in pregnancy is increasing, but we have limited knowledge about the actual prevalence, associated decision-making and impact on expectant women/couples in a general population. The aim of this study was to document the use of, and experiences related to, foetal scanning before the recommended 19th week scan among pregnant women in Iceland.

Population And Methods: The data come from the Icelandic Childbirth and Health Cohort Study 2009-11.

Does 'existential unease' predict adult multimorbidity? Analytical cohort study on embodiment based on the Norwegian HUNT population.

Objectives: Multimorbidity is prevalent, and knowledge regarding its aetiology is limited. The general pathogenic impact of adverse life experiences, comprising a wide-ranging typology, is well documented and coherent with the concept allostatic overload (the long-term impact of stress on human physiology) and the notion embodiment (the conversion of sociocultural and environmental influences into physiological characteristics). Less is known about the medical relevance of subtle distress or unease.

Are persons with fibromyalgia or other musculoskeletal pain more likely to report hearing loss? A HUNT study.

Background: Leading theories about the pathogenesis of fibromyalgia focus on central nervous dysregulation or sensitization, which can cause altered perception. There is growing evidence that fibromyalgia involves altered perception not only of pain, but also other sensory stimuli. On this basis, we investigated whether individuals with fibromyalgia are more likely to report subjective loss of hearing, adjusted for audiometrically measured loss of hearing, compared to persons without any musculoskeletal pain disorders.

History of violence and subjective health of mother and child.

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child's health.

Setting And Subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5-6 months after delivery.