Primary Health Care: Theory and Practice Book

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