ABSTRACT Background Burnout among healthcare practitioners is a growing global concern. Interventions typically focus on organisational change or individual resilience. An additional approach is to address factors within the clinical consultation, where expectations around managing complex disease and behaviour change may contribute to burnout. Aim To evaluate the acceptability, adoption and implementation of a health coaching skills course for general practitioners, and to explore its impact on practitioner burnout and flourishing. Methods An online health coaching skills course was implemented and evaluated using a convergent parallel mixed‐methods design. Quantitative data were collected using validated pre‐ and post‐intervention surveys, including the Maslach Burnout Inventory and the Flourishing Scale. Qualitative data were obtained through focus groups and individual interviews. Quantitative and qualitative data were analysed separately and integrated to provide a comprehensive understanding of outcomes. The RE‐AIM framework informed evaluation of the intervention. Qualitative data were analysed using reflexive thematic analysis, and quantitative data using descriptive and non‐parametric inferential statistics. Results Eleven female general practitioners completed the course. Qualitative findings suggested reductions in perceived burnout were associated with perceived reductions in consultation burden and improved effectiveness. Quantitative findings indicated improvements in Maslach Burnout Inventory subscale scores, while changes in Flourishing Scale scores were modest. Conclusion This pilot study suggests that learning and applying health coaching skills in general practice consultations may influence burnout by decreasing perceived consultation burden and enhancing practitioner effectiveness. Wider dissemination of health coaching skills training may support practitioner well‐being while maintaining patient‐centred care. Further research is needed to confirm these findings.
ABSTRACT Healthcare systems are undergoing swift transformations driven by rapid advances in artificial intelligence (AI) and digital health, due to which the role of a doctor is being reshaped. This essay explores whether doctors will remain central to care in the next generation while drawing on examples from different healthcare systems and the experiences of an individual patient. It argues that while technology could reshape the delivery of care, the doctor's role remains essential.
ABSTRACT Background and Objective Rising demand and patient complexity challenge primary health care sustainability, prompting interest in group medical visits (GMVs). Although GMVs have been widely studied, heterogeneous evidence hinders synthesis. This umbrella review aimed to summarize evidence from systematic reviews (SRs) on GMVs in improving cardiometabolic disease indicators compared with usual primary care. Methods SRs of GMVs targeting cardiometabolic risk factors in adults were included. A comprehensive search (July 2025) preregistered in PROSPERO was conducted without restrictions. Study overlap, quality, and risk of bias were assessed using validated tools. Findings were synthesized with the direction‐of‐effect approach. Results The search identified 4837 records, of which nine SRs met the inclusion criteria, collectively encompassing 120 nonoverlapping primary studies. A moderate overlap of primary studies was observed (9.4%). The target populations were patients seeking weight loss (n = 1), with diabetes (n = 4) or chronic cardiometabolic diseases in general (n = 4). Approximately 80% of the evidence informing reviews on chronic cardiometabolic diseases was from primary studies on diabetes. Nearly half of the reviews demonstrated moderate methodological quality (4/9), and most exhibited low risk of bias (8/9). The most consistent and favorable outcomes were observed for HbA1c (6/7) and blood pressure (BP) (6/8). Results for blood lipids were mixed, ranging from equivalence (4/8) to superiority (4/8). GMVs were generally equivalent to traditional care for weight (4/7) and body mass index (4/6) outcomes. Self‐efficacy and self‐management were improved following GMVs (6/6), suggesting potential mechanisms through which GMVs may influence outcomes. GMVs were also often proven effective in improving lifestyle (3/5). Conclusion GMVs represent an effective alternative to traditional primary care for managing HbA1c and BP, particularly among patients with diabetes. Further research should explore their effectiveness in individuals with a broader range of cardiometabolic conditions.
ABSTRACT Primary care waiting rooms represent a valuable environment for health promotion. Current literature specifically focused on physical activity (PA) promotion in this setting is limited, necessitating exploration of the wider evidence base on general health promotion. Subsequently this scoping review aimed to map the existing peer‐reviewed literature regarding health promotion interventions in primary care waiting rooms. Five databases were searched, yielding seventeen studies for inclusion. Studies were eligible if health promotion interventions were delivered within primary care waiting rooms. The reach, effectiveness, adoption, implementation and maintenance (RE‐AIM) checklist was applied to evaluate the impact, scalability and sustainability of health promotion interventions. The findings suggest that exposure to health education materials may be associated with short‐term improvements in patient recall, knowledge and behavioural intentions. However, there is a lack of strong evidence showing that these short‐term improvements translate into tangible behaviour change. Health education materials were widely used in general practices, yet these resources were often underutilised by both patients and general practitioners (GPs). RE‐AIM analysis revealed substantial gaps in reporting, particularly regarding representativeness, cost‐effectiveness and long‐term maintenance. These findings suggest that the current evidence base remains exploratory and that further research is needed to assess the full impact of these interventions by incorporating longitudinal follow‐up and explicitly measuring behavioural outcomes. The insights gained from this scoping review may directly inform future research into the design and implementation of PA promotion interventions in health care waiting rooms.
ABSTRACT Background Nigeria's rapidly growing older population faces increasing mobility challenges. However, these limitations are often examined using either self‐reported outcomes or selected psychological factors in isolation, with limited attention to how mobility‐related psychological factors relate simultaneously to both self‐reported and performance‐based physical function. Aim This study aimed to examine the relationships between selected mobility‐related psychological factors and both self‐reported and performance‐based physical function among community‐dwelling older adults in Nigeria and to explore whether these factors are associated differently across the two functional measures. Methods A cross‐sectional study of 210 community‐dwelling older adults (mean age 67.9 ± 7.4 years) assessed self‐reported and performance‐based physical function using the Barthel Index and the Short Physical Performance Battery (SPPB), respectively. Psychological factors were measured using the Falls Efficacy Scale–International (FES–I), the Activities‐specific Balance Confidence (ABC) Scale, and the Attitude Toward Own Aging (ATOA) Scale. Spearman correlations and hierarchical regressions examined associations. Results Participants showed high functional independence (Barthel Index: 98.6 ± 5.1) and moderate physical performance (SPPB: 8.1 ± 2.8). Balance confidence was strongly negatively correlated with fear of falling (FOF) (ρ = −0.60, p < 0.001). Age was the only significant predictor of performance‐based physical function (β = −0.38, p < 0.001). In contrast, self‐reported physical function was predicted by higher balance confidence (β = 0.30, p = 0.002) and lower FOF (β = −0.24, p = 0.013), whereas ATOA was not a significant predictor. Item‐level analysis showed that confidence in complex tasks, such as walking in a crowd or navigating ramps, was strongly associated with perceived functional independence. Conclusion Performance‐based physical function was primarily associated with age, whereas self‐reported physical function was more strongly associated with mobility‐related psychological factors such as balance confidence and FOF. We recommend incorporating psychological assessment alongside physical performance evaluation when assessing functional ability in older adults.
