{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:15:56Z","timestamp":1783682156684,"version":"3.55.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004144","name":"Liverpool John Moores University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004144","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore how primary and community-based healthcare professionals (HCPs) experience supporting adults with congenital heart disease (ACHD) in generalist healthcare settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative interpretive study was conducted with 18 UK primary care HCPs, including general practitioners and advanced clinical practitioners. Semi-structured interviews were analysed using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      An overarching theme,\n                      <jats:italic toggle=\"yes\">balancing knowledge, care and constraint<\/jats:italic>\n                      , captured how HCPs supported adults with ACHD while navigating uncertainty, relational responsibility and fragmented systems. Three interconnected themes were identified:\n                      <jats:italic toggle=\"yes\">navigating uncertainty<\/jats:italic>\n                      , reflecting limited ACHD knowledge and infrequent exposure;\n                      <jats:italic toggle=\"yes\">sustaining relationships<\/jats:italic>\n                      , highlighting the role of continuity and familiarity in maintaining care; and\n                      <jats:italic toggle=\"yes\">working around the system<\/jats:italic>\n                      , describing how participants adapted to unclear pathways, inconsistent communication and organisational constraints. Despite limited condition-specific knowledge, participants described recognising concerns, coordinating care and sustaining continuity across fragmented services.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As increasing numbers of adults with ACHD receive care beyond specialist centres, primary and community-based HCPs play a crucial role in recognising concerns, coordinating care and maintaining continuity. Participants\u2019 accounts highlight the often-unseen relational and coordinating work required to keep patients connected to appropriate care despite uncertainty and organisational constraints. Strengthening ACHD care therefore requires more than condition-specific education; it depends on healthcare systems that facilitate communication, collaboration and shared responsibility across specialist and generalist services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319261466432","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:15:31Z","timestamp":1783491331000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Caring for Adults with Congenital Heart Disease in Primary Care: A Qualitative Study of Generalist Health Care Professionals\u2019 Experiences"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0354-265X","authenticated-orcid":false,"given":"S.","family":"Ellison","sequence":"first","affiliation":[{"name":"Liverpool John Moores University, Faculty of Health, Innovation, Technology and Science, Tithebarn Street, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8609-4516","authenticated-orcid":false,"given":"Philip","family":"Moons","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, KU Leuwen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3081-0069","authenticated-orcid":false,"given":"I. D.","family":"Jones","sequence":"additional","affiliation":[{"name":"Liverpool John Moores University, Faculty of Health, Innovation, Technology and Science, Tithebarn Street, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4305-0513","authenticated-orcid":false,"given":"Robyn","family":"Lotto","sequence":"additional","affiliation":[{"name":"Liverpool John Moores University, Faculty of Health, Innovation, Technology and Science, Tithebarn Street, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.03.085"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(19)30402-X"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-318246"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.12968\/bjca.2023.0083"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.008396"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab422"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.019552"},{"key":"e_1_3_8_9_2","volume-title":"Medical care of adults with congenital heart diseases: Present and future","author":"Neidenbach R","year":"2019","unstructured":"Neidenbach R, Achenbach S, Andonian C, et al. Medical care of adults with congenital heart diseases: Present and future. Herz; 2019."},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2022.100012"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1474515120923785"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2023-002420"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjcpc.2022.10.002"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-69909-7_3470-2"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.NAJ.0000512204.85973.04"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14776"},{"issue":"1","key":"e_1_3_8_19_2","article-title":"Enhancing Nurse Moral Agency: The Leadership Promise of Doctor of Nursing Practice Preparation","volume":"23","author":"Grace P","year":"2018","unstructured":"Grace P. Enhancing Nurse Moral Agency: The Leadership Promise of Doctor of Nursing Practice Preparation. Online Journal of Issues in Nursing. 2018;23(1).","journal-title":"Online Journal of Issues in Nursing"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/socsci13050237"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1353\/ken.2010.a413519"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/icon\/moac002"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.21037\/cdt-20-825"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab388"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7425.1219"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4080-7"},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.886"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319261466432","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501319261466432","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319261466432","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T10:48:10Z","timestamp":1783680490000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501319261466432"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":26,"alternative-id":["10.1177\/21501319261466432"],"URL":"https:\/\/doi.org\/10.1177\/21501319261466432","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"21501319261466432"}}