Welcome to the 26th WONCA Europe Virtual Conference Programme Scheduling

Abstract Body

Background: General Practice (GP) seems to be perceived as less attractive throughout Europe. Most of the policies on the subject focused on negative factors. An EGPRN research team from eight participating countries was created in order to clarify the positive factors involved in appeal to the profession and staying in clinical work as a GP throughout Europe. The objective was to explore the positive factors supporting the satisfaction of General Practitioners (GPs) in clinical practice

throughout Europe.

Method: Qualitative study, employing face-to-face interviews and focus groups using a phenomenological approach. The setting was primary care in eight European countries: France, Belgium, Germany, Slovenia, Bulgaria,

Finland, Poland and Israel. A thematic qualitative analysis was performed following the process described by Braun and Clarke. Codebooks were generated in each country. After translation and back translation of these codebooks, the team clarified and compared the codes and constructed one international codebook used for further coding.

Results: A purposive sample of 183 GPs, providing primary care to patients in their daily clinical practice, was interviewed across eight countries. The international codebook included 31 interpretative codes and six themes.

Five positive themes were common among all the countries involved across Europe: the GP as a person, special skills needed in practice, doctor-patient relationship, freedom in the practice and supportive factors for work-life

balance.

Conclusion: This study identified positive factors which give GPs job satisfaction in their clinical practice. This description focused on the human needs of a GP. They need to have freedom to choose their working

environment and to organize their practice to suit themselves. In addition, they need to have access to professional education so they can develop specific skills for General Practice, and also strengthen doctor-patient relationships.

Stakeholders should consider these factors when seeking to increase the GP workforce.

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OBJECTIVES:

To evaluate the effectiveness of an educational intervention in residents of Family Medicine and Community Care (physicians and nurses) to improve empathy. The intervention was designed to acquire or improve personal skills mediating in the processes of physical and mental well-being that could have an influence on burnout and, conversely, on empathy.

METHODOLOGY:

Experimental intervention study during specialized training for residents of Multiprofessional Teaching Unit (UDM), from two Spanish Health Regions, promotions 2020, 2021 and 2022, family physicians and community nurses.

The controls will be their peers of the UDM from a different Health Region. All residents of these promotions who want to participate in the study will be recruited.

The specifically planned training intervention consists of 3 annual face-to-face workshops per promotion vs online training vs control group (expected Face-to-face 90/ Online 70/ Control 180). REDCap (Research Electronic Data Capture) will be used for data management.

The main result will be the variation in level of self-perceived empathy measured by Interpersonal Reactivity Index (IRI), as well as the difference in burnout measured by the Copenhagen questionnaire (CBI). The secondary outcomes will be: locus of control, resilience (Connor-Davidson), Orientation to Life Questionnaire (OLQ-13), social support (Oslo-3) and its influence on burnout, adjusted for age, sex, personality (TIPISP v2), Hospital Anxiety and Depression Scale (HADS) and other organizational factors.

For statistical analysis, GLM and GAM models will be used.

DISCUSSION

Our troubles with recruitment and Covid-19 pandemic will be discussed. Any help to overcome them will be welcomed.

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In 2015, the IMA surveyed Israeli physicians regarding health practices and status, since it is well known that physicians who practice a healthy lifestyle will be healthier and more likely to promote healthy behavior to their patients.
The survey was sent to 25,000 physicians; 4,832 responded.

The survey revealed that most Israeli physicians do not practice a healthy lifestyle. Over one-third of respondents noted exercising fewer than 150 minutes a week. Only half eat breakfast or sit down to lunch. Only one-third eat a Mediterranean diet, drink enough water, and eat five pieces of fruit and vegetables daily. Less than half had normal BMI. 8.5% of respondents were smokers, lower than the Israeli general population but higher than rates of physicians who smoke in America (4%) and Canada (3.3%).

In light of the results, the IMA established a Forum of experts to facilitate change in physicians' health behaviors. The group was divided into teams, each focusing on a separate issue: exercise, burnout and stress, nutrition, smoking, personal care, and raising awareness. The workgroup formulated practical ideas, some of which have already been implemented.

Conclusion: Most Israeli physicians do not practice a healthy lifestyle.

The innovative activities of The Israeli forum for physician's health and wellbeing are showing a promising move towards improving the health status of Israeli physicians.

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How Empowerment Contributes to GP’s Health and Well-Being. What we Learned by a European Multicentre Delphi Study.

Previous studies have demonstrated a positive relationship between empowerment and job satisfaction. Moreover, the job satisfaction level is a vital factor concerning workers' health and is most strongly related to mental and psychological health conditions, such as burnout, self-esteem, depression, and anxiety.

This study examines the factors contributing to GPs' health and well-being by empowering them in their clinical practice. We focus on a European multicentre Delphi study conducted to identify the factors that affect GPs in making a timely diagnosis of cancer in their patients.

The Delphi process, which included three rounds, allowed us to construct an anonymous panel of geographically distant European GPs from 21 European countries-members of the Örenäs Research Group. Panellists assessed the clinical relevance in a Primary Health Care setting of each of the 52 factors we had given them using a 9-point Likert scale. Finally, 53 panellists (78%) of the 68 who took part in the first round completed all three Delphi rounds. The result was a list of 12 factors that satisfied the selection criteria at the end of the third round. The majority of the selected factors were related to communication with secondary health care, working conditions (workload, bureaucracy), and established healthcare procedures, such as rapid access pathways and screening programmes.

We expect that the outcomes of this study will identify priorities and specific actions to help increase GPs’ empowerment in their clinical practice and contribute to GPs' health and well-being primarily as a consequence of improved performance and greater job satisfaction.

Abstract Body

Background:

2020-2021 brought a rapid escalation in the rate of change in workload and work practices for family physicians (FPs) and general practitioners (GPs) across Europe because of a pandemic. Changes in communication, lack of face-to-face care and less continuity brings more uncertainty to the work of a GP practice team. Challenges arise from coordination of care, access to services and the need to maintain trust with patients and colleagues.

Aim and learning objectives:

Participants who attend this workshop can expect to:

(1) watch a video compilation on the sources of stress in general practice in 2021 in Europe.

(2) hear presentations from a panel of speakers from different countries in Europe who share information on supports and innovations of WONCA Europe Member Organisations for the benefit of GPs / FPs during 2020-21 pandemic.

Breakout for interactive small group work OR discuss in a Q&A session with the panel of speakers for additional solutions to these stresses.

Methods

0-5 min. Introduction to the interactive section

5-15 min. VIDEO The covid pandemic and stress at work for the medical practice team

15-25 min. PANEL: Supports for GPs/FPs from member organisations in Europe

25-30 min. Introduction to group work 1

30-45 min. Group work 1

45-55 min. Short summary group work 1

55-60 min. Introduction to group work 2

60-75 min. Group work 2

75-85 min. Short summary group work 2

85-90 Concluding remarks

(Proposed) Results / Conclusions

Participants will identify a range of practical actions/activities to promote healthy workplace environments and educational resources for building resilient family medicine practices.