Chest Radiography: General Practitioners’ Compliance with Recommendations

Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.

The quality of older adults'involvement in clinical communication with general practitioners:evidence from rural towns in Australia

Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health intake visits.Methods:It was a cross-sectional study between January 2021 and April 2022.The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software.This online survey was administered by sending an email request to the Renmark Rotary Club,which actively promoted this study across five rural towns in South Australia.121 participants completed the surveys.Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes,specifically initiation of information,active participation,and emotional expression.We employed different methods including t-tests,ANOVA,and leaner regressions to analyse data.Results:The demographic profile of participants characterised by a female predominance(58.7%,71/121),a majority falling within the 65-<70 age bracket(47.1%,57/121),and a high level of educational attainment(58.7%had completed high school or higher,71/121).Additionally,35%of the participants predominantly spoke a language other than English at home.Regarding the initiation of information with GPs,the mean sum-score was(20.5+3.7),indicating a marginally above-average level of engagement.Contrarily,the active participation was suboptimal,as suggested by a mean sum score of(35.9±6.3).Furthermore,the emotional expression was relatively low,with a mean score of(13.9±1.8).Substantial variations were discerned in the quality of patient-GP communication,contingent upon factors such as educational background,language spoken at home,health literacy,and preparatory measures for clinical visits.Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs(P<0.o01).Higher educational attainment was positively correlated with increased active participation(P<0.001).Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation(P<0.001).Conclusion:Meaningful engagement through recognition,empowerment,and support(health literacy programs)for older rural adults is suggested for improving their quality of involvement in communication with GPs.

Knowledge about the Management of Anti-Epileptic Drug Treatment among General Practitioners in Brazzaville, Congo

Background: Epilepsy is a chronic brain disorder. It often leads to disabilities and handicaps. In Africa, epilepsy is almost exclusively treated by general practitioners (GPs) because of a shortage of epilepsy specialists. It is therefore important to know the level of knowledge about epilepsy among GPs in order to improve their skills. Objectives: To assess the level of knowledge about the management of anti-epileptic drug treatment among GPs in Brazzaville;to investigate the relationship between demographic factors and GPs’ knowledge. Methods: This was a cross-sectional analytical study. It was conducted from 20 July to 1 September 2021. It focused on GPs working in public hospitals and private care centers in Brazzaville. Information on treatment aspects was collected through a standardized 11-item questionnaire. Results: Among the 137 participants, there were 84 (61.3%) men and 53 (38.7%) women. Of these participants, 36 (26.3%) were trained in Congo versus 101 (73.7%) in other countries. Only 21 (15.3%) GPs had good knowledge about the management of anti-epileptic drug treatment. The overall average knowledge score among GPs was low (31.4%). No significant associations were found between low and good levels of knowledge and gender (OR = 1.03;95% CI = 0.40 - 2.68;p = 1.000), age groups (OR 0.05), training country (OR = 0.62;95% CI = 0.19 - 1.98;p = 0.591), practice hospital (OR = 0.40;95% CI = 0.05 - 3.20;p = 0.695) and duration of professional experience (OR 0.05). Conclusion: The study population has insufficient knowledge about the management of anti-epileptic drug treatment. Demographic factors have no impact on GPs’ knowledge. Epilepsy education programs are needed to improve GPs’ knowledge and skills.

Management of erectile dysfunction: barriers faced by general practitioners

Aim: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED). Methods: This was a qualitative analysis of focus group discussions and in-depth inter views involving 28 Malaysian GPs. Results: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impoteneet drugs. Cardiovascular side effects and cost were two most important drug barriers. Conclusion: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patients and drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients.

Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

Sexually transmitted infection (STI) management is considered rudimentary among rural medical practitioners (RMPs) in Bangladesh. We sought to understand the level of knowledge and skills in STI management and to assess the impact of a two-day training orientation among RMPs in Tangail district. Data were collected through a baseline survey of 225 practicing RMPs in the study area and a three-month follow-up survey of 99 RMPs who participated in a two-day STI/HIV orientation training. The level of formal training among RMPs ranged from none (22.7%), to paramedical training (14.7%) and local medical assistant training (62.6%). The baseline survey revealed a low level of STI/HIV knowledge and misconceptions about the transmission of STI/HIV among RMPs. RMPs mostly prescribed first line antibiotics for treatment of common reproductive tract infections (RTIs) including STIs, but they rarely prescribed the correct dosages according to the national RTI/STI management guidelines. Only 3% of RMPs were able to correctly answer all four HIV transmission (unprotected sexual intercourse, blood transfusion, needle sharing and mother to child transmission) questions at baseline, while 94.9% of RMPs answered all four correctly at three months following the training (p = 0.001). Only 10% of RMPs reported suggesting the recommended drug (azithromycin) and only 2% mentioned about the recommended dosage (2 gm single dose) for the treatment of urethritis/cervicitis;compared to 49.5% suggested azithromycin at follow-up with 39.4% mentioned the recommended 2 gm single dose (p = 0.001). Our study found low level of knowledge and poor practices related RTI/STI management among RMPs. Short orientation training and education intervention shown promise to increase knowledge and management skills for RTIs/STIs.

The Influence of E-Commerce on Marketing Practitioners and Consumers

The paper sets out to examine the influence of e-commerce on marketing practitioners and consumers. This researcher found out that e-commerce brings about a new experience for both consumers and marketing practitioners as both groups try to achieve their different goals that end in an online relationship between the duo. This posses a lot of challenges for marketers who have to adapt and modify their offline marketing strategies to suite and meet the demands of e-commerce bringing about the whole concept and execution of e-marketing. The issue of the benefits as well as trust for online transactions based on the fear of insecurity from the consumers＇ perspective was also discussed. In all, the authors concluded that it＇s important for organizations engaging in e-commerce to come up with proper strategies to address these issues and build consumer trust in e-commerce; aiding it to further adapt to the ever changing needs of the business world.

Role of Community Health Practitioners in National Development: The Nigeria Situation

This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunity of the community to prevent transmission of disease pathogen to cause a disease. Community Health Practitioners are the frontline Primary Health Care Professionals charged with the responsibility of implementation of immunization programmes in Nigeria and therefore contributing significantly to the prevention and control of targeted vaccine preventable diseases in Nigeria Health System. Our findings on factors militating against Community Health Practitioners’ Roles in National Development as elicited in this paper may form basis for empirical studies to determine the level of significance of each of these factors. In conclusion, it is when the Community Health parameters are adequately addressed that we can ensure sustainable National Development and we can say we have succeeded in our various strategic agenda of government at whatever level that makes up the complex whole. This brings to fore, the importance of the roles of Community Health Practitioners in health care delivery to National Development in the context of our country, Nigeria.

Knowledge of General Practitioners in Cotonou about Systemic Lupus Erythematosus

Introduction: Patients with Systemic Lupus Erythematosus (SLE) are seen late in specialized medical consultation in Benin. The objective of this work was to assess general practitioners’ knowledge in Cotonou about SLE. Materials and Methods: This work was a cross-sectional study that was led in the city of Cotonou from July 1 to September 30, 2017. In the study population, we have general practitioners who practice in the city. Data collection was set in response to a self-questionnaire. Result: The survey involved 209 general practitioners. The average age was 27.5 years with a minimum of 22 and a maximum of 34. Most of them practiced in private clinics. Besides, 17 doctors (8.1%) reported that they never heard of lupus. Among the 192 remaining, only one had an average knowledge of lupus, while the others had insufficient knowledge. Conclusion: From this study, we got that SLE is still little known by the general practitioner. Increasing the knowledge of general practitioners’ knowledge of lupus is compulsory to improve the screening rate.

Participation of private general practitioners in disease management of malaria in Myanmar

Objective:Myanmar has been trying to improve the disease management of malaria through public health services. The involvement of private general practitioners(GPs) is recognized as one of the key contributory issues in malaria control,but no one has yet made an attempt to study the efficiency of their role.This study aimed to assess the participation of GPs in improvement of disease management.Methods:The study was conducted with all 32 GPs practicing at three randomly selected townships with high malaria load situated in Upper Myanmar from June 2006 to March 2007 using a pretest-posttest design to assess their knowledge of the disease management prior to and after intervention.The intervention package consisted of a one-day workshop on diagnosis and treatment of malaria and the supply of facilities for microscopy.Questionnaires filled in before and after tests were compared to assess the change of knowledge after the intervention.Diagnosis and treatment practice during the study period was analysed by review of registers kept by GPs,together with a follow-up survey of their patients for the reliability of data.Results:An overall improvement of knowledge was observed and significant changes were apparent for three variables:the criteria for referral of severe malaria,the effect of incomplete treatment and recommended treatment of Plasmodium vivax.Pre-test results showed that only 65.6%of GPs perceived microscopy or Rapid Diagnostic Test kits(RDTs) for confirmation of malaria necessary,while only 15.6%and 40.6%of the GPs knew the recommended treatments of falciparum and vivax malaria,respectively. However,after intervention 92%of the patients were diagnosed as malaria by RDTs and 3%by microscopy throughout the study.The GPs prescribed artemisinin-based combination therapy(ACTs) to 95%of confirmed falciparum cases and treated 82.4%of RDT confirmed falciparum negatives with chloroquine and primaquine.Concurrent with our study,an international NGO,Population Service International,supplied GPs with RDTs and ACTs at subsidized rate which was helpful.Conclusion:The study suggests that participation of GPs may help improve the disease management of malaria and thus assist in the country’s effort to control ma- laria.

Meta-Analysis the Quality of General Practitioners Management for Elderly Patients with Hypertension in China

Background: Among Chinese adults aged 35 - 75 years, nearly half have hypertension and the prevalence of hypertension is increased with age. But older patients with high systolic pressure and high pulse pressure could not be cured, and will have greater cardiovascular morbidity. This study aims to evaluate the effectiveness of general practitioners (GP) management for Chinese elderly hypertension, and explore reasonable and effective blood pressure management pattern. Methods: We searched the published literature for randomized controlled trials designed to improve blood pressure with community care management delivered by general practitioners or nurses, compared with usual care. Major outcome measures were systolic and diastolic blood pressure;the percentage of patients whose blood pressures are under control with community care management and Revman 5.3 was used in this study. Results: Pooled data from all 13 researches showed a lower outcome diastolic blood pressure (SMD = &minus;0.95, 95% CI (&minus;1.23, &minus;0.67)) and systolic blood pressure (SMD = &minus;1.17, 95% CI (&minus;1.52, &minus;0.81)) respectively in favor of community management. Pooled data from all 11 researches showed a higher percentage of patients with blood pressure under control in favor of community management (OR = 3.85, 95% CI (1.58, 9.37)) and the difference between treatment group and control group on blood pressure control ratio had statistical significance (Z = 2.97, P Conclusions: General practitioners’ management in Chinese elderly hypertension is effective, and complies with the advanced hypertension management guidelines. The multi-patterns are supposed to adopt community blood pressure monitoring and team-based general practitioners.

Clinical Audit Project Report —Audit of the Palliative Care Practitioners’ Adherence to WHO Guidelines in Managing Patients’ Pain at Cancer Diseases Hospital, Lusaka, Zambia

Appropriate adherence to World Health Organisation (WHO) pain management guidelines is vital in palliative care centres as it promotes the comfort of patients who are experiencing pain and it improves their quality of life. WHO (1996) highlighted the use of the WHO analgesic ladder guideline. This “analgesic ladder” proposes that after proper assessment with an appropriate pain assessment tool, patients in mild pain should be given non-opioids plus or minus adjuvants (including anticonvulsants and steroids);patients in moderate pain should be given weak opioids plus or minus non-opioids plus or minus adjuvants;and patients in severe pain should be given strong opioids plus or minus non-opioids plus or minus adjuvants as per the WHO pain ladder. The audit project was focused on assessing the palliative care practitioners’ (PCPs) adherence to WHO guidelines in managing their patients’ pain at Cancer Diseases Hospital (CDH). 15 participants were involved in the study and the data collection method used was a cross-sectional study in which the auditor observed PCPs, with an observation checklist comparing practice with WHO analgesic ladder guidelines. The result revealed that most of the PCPs were not meeting 80% of the standard set in the specific objectives for the audit. 7 (47%) PCPs were scoring the pain level before analgesia administration, whereas 8 (53%) PCPs were not scoring the pain level before analgesia administration. On the other hand, 47% (7 PCPs) were adhering to the WHO ladder of pain management, but 53% (8 PCPs) were not adhering to the WHO ladder of pain management. Therefore, effective adherence to the WHO analgesic ladder practice is still lacking in the PCPs at CDH. The percentage of PCPs who were not scoring the pain and not adhering to the WHO pain ladder guidelines was high, which is 8 (53%). Therefore, a re-audit is recommended to find out if levels of adherence have improved or not.

Personal and professional influences on practitioners’ attitudes to traditional and complementary approaches to health in the UK

Objective:To explore primary care practitioners’personal and professional beliefs about traditional and complementary approaches(TCA)to health and the influence of professional socialization in the UK.Methods:As part of a larger study on child TCA use in a multi ethnic community,semi-structured,one on one,face-to-face interviewswith 30 primary care practitioners(GPs,nurses and health visitors)explored experience,knowledge and attitudes regarding TCA.Framework analysiswas used.This paper explores the key emergent issues of personal and professional beliefs and professional socialization resulting from the qualitative data obtained during the interviews.Results:Personal factors(ethnicity and personal use)influence attitudes,but professional factors appear to dominate,including biomedical theory,evidence basedmedicine,safety and treatment choice.Curbing of personal views and experience may be due to caution and conformity from increasing regulatory power.Inter-and intra-professional group differences also emerged,likely due to variation in training,status and professional role.Conclusions:Practitioners need to understand patients’diverse health beliefs and practices and discuss TCAwith families,despite regulatory and organizational constraints,to fulfil their professional duty to patients,particularly regarding safety.Further research is needed to verify the professional socialization process and the influence of specific regulation on training.

Positive attitudes towards priority setting in clinical guidelines among Danish general practitioners: A web based survey

Aims: Increasing focus on improvement and optimisation of the treatment in primary care and reduction of healthcare costs emphasize the need to understand which factors determines adherence and non-adherence to clinical guidelines. In the present study, we examined attitudes towards clinical guidelines in Danish general practitioners (GPs). Methods: We conducted a survey among Danish GPs from all five regions of Denmark. In total, 443 GPs answered the web-based questionnaire that contained questions about attitudes and barriers to clinical guidelines. Results: More than 90% of the GPs reported that they have good knowledge of the guidelines and in general follows the guidelines. A majority of the GPs (81%) found it acceptable that economic considerations are part of the guidelines. The most important factors for non- adherence to guidelines were “need of adjustment to clinical practice” and “lack of confidence in guidelines”. The attitudes to clinical guidelines were not significantly associated with practice characteristics such as gender, years of experience, practice organisation and localisation. Conclusions: Our findings show that clinical guidelines are an integrated or internalised part of everyday practice among GPs in Denmark. Furthermore, the findings indicate that Danish GPs are positive towards applying priority setting in their practice. This is decisive in the light of rising healthcare costs due to development of new expensive technologies and ageing populations that puts pressure on the healthcare system in general and primary healthcare in particular.

Being Reflective Practitioners In the Professional Development

More then ever before,English language teaching focuses on learners’communicative competence.That is to say,English language teachers nowadays are not only to teach their students linguistic knowledge but also to cultivate their competence to use the language.So it’s self evident that drawing language out of students instead of cramming them in,duck stuffing,as our idiom has it,calls for more time effort and a better command of the language on the part of teachers.In other words,better trained teachers are urgently needed in order to accomplish the goals of English language teaching today.This paper just points out that being reflective practitioners is a workable and effective way leading to both the improvement of teaching in classroom and their own development as professtional practitioners.

Drug Prescribing Trends among Consultants and General Practitioners in Sharjah-UAE

Background: Inappropriate prescribing can lead to errors in dispensing medications and serious problems for patients. Objectives: Prescription analysis can identify such drawbacks of prescribing, increase awareness of prescribers of rational prescribing and consequently lead to proper delivery of pharmaceutical care and enhance therapeutic outcomes. Methods: In the present study, prescriptions issued by consultants from a hospital and by general practitioners from private practice in Sharjah-United Arab Emirates were analyzed using indicators suggested by World Health Organizations. These include information with regard to prescriber, patient and the medication prescribed. We also determined the average number of drugs/encounter and % of prescriptions with antibiotics and those with injections. Data were collected and analyzed using Microsoft Excel and expressed in terms of both counts and percentages. Results: Almost all prescriptions were handwritten with easily readable ones being 65% for consultants and 46% for general practitioners. Average number of drugs/encounter was 2.1 and 2.8 for consultants and general practitioners, respectively. Antibiotics were prescribed in 27% and 44%;generic prescribing was 5% and 10% by consultants and general practitioners respectively and 8% of prescriptions by consultants contained injections. Variable results were obtained on information regarding the patient but consultants seem to be better in documenting patient’s age and gender. Consultants and general practitioners tend to prescribe 3 drugs and more in 35% and 25% respectively. The most commonly prescribed therapeutic classes for both groups of prescribers were NSAIDs and antibiotics with ibuprofen and amoxicillin-clavulanic acid combination being the most commonly prescribed drugs of each class. Conclusion: To improve prescription writing, interventions must include, among others, incorporation of topics on prescription writing in medical curriculum and programs of continuing medical education.

Knowledge, Attitudes and Practices Survey in Management of Type 2 Diabetes by General Practitioners in Dakar

Introduction: Considering the global burden of diabetes and lack of specialist in diabetology in our subsaharian area, general practitioners (GPs) play a major role as first referent for care of diabetic people. The aim of this work was to describe knowledge, attitudes and practices of GPs related to management of type 2 diabetes. Patients and Methods: It was about a transversal and descriptive survey held between July 14, 2015 and November 1st, 2015 in the medical districts and public corporations of health of Dakar in Senegal. Results: The population of study was made of 107 males and 40 females GPs. The majority (82.8%) was graduated since less than five years. Hygienic and dietetic measures (HDM) were known and commonly recommended by 77.60% of GPs in their daily practice. The caloric intakes were known by 21.1%. The 30 min of physical activity per day three times in the week was advised by 91.20%. Monotherapy with metformine associated with HDM was prescribed by 76.90%. Bitherapy with metformine and sulfonylureas associated to HDM were prescribed by 39.50%. Concerning insulin therapy, mixed insulin twice daily associated with rapid insulin before lunch was prescribed by 49.7%. Use of rapid acting insulin with three injections before each meal was prescribed by 36.10%. Treatment of the other cardiovascular risk factors was addressed by 97.30%. Smoking cessation was advised by 37.40%. Use of sweetened drink and intravenous glucose were most adopted in case of hypoglycemia, and use of glucagon was adopted by 23.10%. To improve the diabetic retinopathy 61.2% of GPs recommended tight control of other cardiovascular risk factors. Rigorous glycemic control and regular physical activity were recommended for painful neuropathy beside analgesics. Smoking cessation was also recommended by 61.90% for that. Against obstructive arterial disease of the lower extremities, tight control of blood pressure was recommended by 69.40% Conclusion: It comes out from these results the need for reinforcing post graduate trainings on diabetes for our GPs. Moreover, there’s an urgent need to elaborate and disseminate adapted guidelines and recommendations for improving efficient and standardized strategies for day to day management of type 2 diabetic people in our country.

Nurses Perception of Advance Nurse Practitioners Roles in Public Hospitals: A Qualitative Study

Aim: To explore the nurses’ perceptions about the advanced nurses’ practitioner’s role in public hospitals in Saudi Arabia. Background: Advanced nurse practitioners are one of the leading professionals who contribute to health promotion, disease prevention, health counseling and patient education. However, misunderstandings of their roles may have an impact on the performances of the function that limits their access and the use of significant resources that can help patients to obtain treatment. Methods: This is a qualitative exploratory study conducted on nurses working in three public hospitals. Semi-structured interviews were conducted among fourteen nurses between October-January 2020. The three public hospitals were based in Eastern (1) and Central (2) Saudi Arabia regions. Data analysis was conducted through thematic analysis utilizing inductive and deductive coding. Results: The study found that the role of Advanced Practice Nurses will enhance, motivate, and sustain the status of nurses in Saudi Arabia. Findings indicated that advanced practitioners’ educational preparedness, organizational, and contextual factors are important factors that need to be addressed to promote their role and to improve nurse’s perception about the APN role in clinical practice. Conclusion: This research provided new evidence to support the need to raise understanding of the role of advanced nurse practitioners among nurse members, advanced nurses and clinical nurse specialists who wish to enhance quality healthcare delivery and job satisfaction in the Kingdom of Saudi Arabia. Recognizing the factors that comprise the function and status of APNs will assist health-care officials to make informed decisions when designing a national policy and a plan for the implementation and the development of the role of APNs.

Think upon Cultivating Domestic High-class Practitioners of Industrial Embedded Software Development

Domestic situation of embedded software practitioners in the industry field is analyzed in this paper,based on which the new requirements for personnel working for embedded software R&D are proposed.Then reform notions in higher education system upon cultivating high-class practitioners are presented.

Tendency and foci of nurse practitioners:bibliometric analysis based on the CiteSpaceV

Objective:Nurse practitioners(NPs)have drawn significant attention recently and played a major role in healthcare.We aim to find the evaluation of NPs through published studies and then visualize the research status and hotspots in this field.Methods:All data came from the Web of Science Core Collection,and the data were counted and entered into Excel 2016.The key documents nodes were excavated by analyzing the knowledge network map using Cite Space V software.In this study,these nodes of“author,country,institution,keyword,co-citation(referencecited-authorcited-journal),and grant”were harvested for analysis and comparison.Results:A total of 4912 records,which were published between 2007 and 2018 and pertained to NPs,were retrieved from the Web of Science Core Collection database(Wo SCC)from a diversity of languages.The total and the annual number of publications and citations of these continually increased over time.Most publications were in 2018(618 records).This study involved 8241 authors located in 98 countries and 4557 institutions totally.The United States(2737 records)and the University of Michigan(90 records)dominated in publication frequency.There are 902 journals and 2449 articles with funding support that have been analyzed.Most articles were from JAMA:The Journal of the American Medical Association(1386,IF=47.661),followed by the Journal of Advanced Nursing(1359,IF=2.267),and The New England Journal of Medicine(1109,IF=79.258).The reference“The Role of Nurse Practitioners in Reinventing Primary Care”was co-cited most frequently,which revealed it as the highest landmark article in NP.The top-ranked keyword was“Care,”other than“Nurse practitioner,”which has an ultra-high frequency.Some of the high-frequency keywords represent the significant direction of NPs.Conclusions:NPs are at the crux of health-care delivery and play an important role in providing high-quality nursing.Publications on NPs in Wo SCC have increased notably during the recent years,and have appeared in some journals that have a high impact factor.Research frontiers and developmental trends were revealed by the analysis in this study,which can be used to forecast future research developments in NPs and taken as a reference to choose the right directions by subsequent researchers who wish to use these results.However,the grant support from administration or research institutions is still in need of improvement and the scope of research in NPs should be broadened in the future.