Barriers and enablers to providing evidence-based in-hospital urinary continence care: A cross-sectional survey informed by the Theoretical Domains Framework

AIMS

To identify the barriers and enablers perceived by hospital-based clinicians to providing evidence-based continence care to inpatients.

DESIGN

This was a cross-sectional study of inpatient clinicians using a questionnaire.

METHODS

Acute care and rehabilitation clinicians from 15 wards that admit patients after stroke at 12 hospitals (NSW = 11, Queensland =1, metropolitan = 4, regional = 8) were invited to complete an online questionnaire. The 58 questions (answered on a 5-point Likert scale) were aligned to 13 of the 14 domains of the Theoretical Domains Framework. Results were dichotomized into 'strongly agree/agree' and 'unsure/disagree/strongly disagree' and proportions were calculated. Data collection occurred between January 2019 and March 2019.

RESULTS

The questionnaire was completed by 291 participants with 88% being nurses. Barriers were found in nine domains including knowledge; skills; memory attention and decision making; emotion; environmental context and resources; behavioural regulation; social professional role; intensions, social influences; and beliefs about capabilities. Enablers were found in seven domains including goals; social influences; knowledge; skills; social, professional role and identity; reinforcement and beliefs about consequences.

CONCLUSION

This multi-site, multi-professional study that included predominantly nurses highlights the barriers and enablers to inpatient continence care. Future implementation studies in inpatient continence management should address these identified barriers and enablers to improve effectiveness of implementation of evidence-based care.

IMPLICATIONS FOR THE PROFESSION

This study highlights that although there are many barriers to ward nurses providing evidence-based continence care, there are also several enablers. Both should be addressed to improve practice.

REPORTING METHOD

We adhered to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) (Supplementary File 1).

RELEVANCE TO CLINICAL PRACTICE

Establishing barriers to practice gives a broader understanding of why practice does not occur and establishes areas where researchers and clinicians need to address in order to change behaviour.

Perceptions, Satisfaction, and Barriers to Telemedicine Use: A Community-Based Study From Jeddah, Saudi Arabia

Background Telemedicine has expanded significantly, driven by technology and the necessity for accessible healthcare. However, users' knowledge, attitudes, and perceived barriers determine its application. This study aimed to assess these factors among patients in Jeddah, Saudi Arabia. Methodology We conducted a cross-sectional study on 403 participants from Ministry of Health centers in Jeddah from February to May 2023. A structured questionnaire was used for data collection, and subsequent analysis was performed using SPSS version 28.0 (IBM Corp., Armonk, NY, USA). Results Most participants (93.1%) agreed that telehealth services have improved healthcare accessibility and expressed willingness to participate in future telemedicine consultations. However, 73.7% felt potential embarrassment or discomfort due to camera and equipment presence. Remarkably, 76.2% of participants believed telemedicine suits all medical conditions, and 95% recommended its use. Barriers to telemedicine use were identified, including the need to travel to access healthcare services in the absence of telemedicine and the associated inconvenience and cost. The overall satisfaction score was 4.56 ± 0.78, with the highest satisfaction reported for the ability to talk freely over telemedicine (4.64 ± 0.76) and the ease of registration/scheduling (4.63 ± 0.82). Significant differences (p < 0.001) in satisfaction scores were found across various age groups, gender, nationality, employment status, and education level. Patients aged >55 years and those who used telemedicine services for the first time were associated with a significantly increased risk of poor satisfaction (odds ratio (OR) = 8.068, p = 0.011 and OR = 8.919, p = 0.005, respectively). Conclusions The findings suggest high satisfaction and positive attitudes toward telemedicine services in Jeddah, Saudi Arabia, despite identifiable barriers such as potential discomfort from camera presence. Patient age and familiarity with telemedicine services significantly influenced satisfaction levels, indicating areas that require attention for the successful implementation and expansion of telemedicine in Saudi Arabia.

Evaluating Psychometric Properties of the Sultan Bin Abdulaziz Humanitarian City (SBAHC) Nurses' Electronic Handover Tool

INTRODUCTION

Handover is crucial during the transfer of patient care between healthcare professionals.Successful handover maintains patients' safety and high-quality care. The electronic handover of patients' information is achievable, feasible, and potentially improves the quality of patient care. However, the introduction of the electronic handover is relatively recent and challenging for healthcare providers, especially nurses.

OBJECTIVES

Since Sultan Bin Abdulaziz Humanitarian City (SBAHC) has recently implemented an electronic handover system among nurses, the main aim of the current study was to develop a tool to assess the perception and barriers to electronic handover systems among nurses working at SBAHC and evaluate its psychometric properties.

METHODS

The tool content and face validity were assessed by the content validity ratio (CVR). Exploratory and confirmatory factor analysis were used as validity methods, while the test-retest and inter-item consistency were used as reliability measures. The sample size was planned as five times the number of questions and a total of 200 nurses participated in the study.

RESULTS

The criteria required for factor analysis were met as indicated by the results of the Kaiser-Mayer-Olkin test and Bartlett's test of sphericity. The reliability results showed a Cronbach's alpha coefficient ranging from 0.858 to 0.910 for the perception subscale and from 0.564 to 0.789 for the barrier subscale, and an overall interclass correlation of 0.986, p<0.001.

CONCLUSIONS

The developed SBAHC electronic handover tool was valid and reliable, and it is advisable to consider it at the initial stages of implanting an electronic handover system to identify obstacles that are faced by the staff to be considered and addressed by the higher management.

Comfort levels in discussing tobacco smoking among hospital staff in a children's hospital

INTRODUCTION

Hospital staff discussing smoking with children and their families can impact tobacco control, which is crucial in reducing the harmful effects of tobacco smoke exposure. Our study aims to assess staff comfort level in discussing smoking with patients or their families, and coworkers, after the implementation of a hospital-wide tobacco control policy.

METHODS

This cross-sectional study included 2340 staff members who completed an anonymous online survey in a large urban children's hospital in 2019. The main outcomes of interest were the comfort level in discussing smoking with patients or their families, and co-workers. We used multivariable logistic regression to identify whether the comfort level varied by sex, age, job type, and smoking status.

RESULTS

Most of the respondents (83.8%) were female, 41.2% were aged 18-35 years, 57.6% worked as clinical staff, and 15.5% were ever smokers. Compared to males, females were less likely to feel very comfortable in asking patients or their families about their smoking tobacco (adjusted odds ratio, AOR=0.72; 95% CI: 0.56-0.92) or talking to co-workers about the health risks associated with their smoking (AOR=0.71; 95% CI: 0.54-0.93). Staff who were non-smokers were less likely to feel very comfortable in talking to co-workers about the health risks associated with their smoking (AOR=0.60; 95% CI: 0.45-0.78). The odds of feeling very comfortable in discussing smoking were consistently lower among those aged 18-35 years than their older counterparts. Clinical staff were more likely than non-clinical staff to feel very comfortable in discussing with patients and their parents about smoking, but there was no difference when talking to co-workers.

CONCLUSIONS

We found differences in staff comfort level in discussing smoking with patients or their families, and coworkers, by sex, age, job type, and smoking status. These results can guide training and identify potential barriers and improve tailored tobacco control training programs and policies for hospital staff.

Medication Administration Error Perceptions Among Critical Care Nurses: A Cross-Sectional, Descriptive Study

Purpose

This study aimed to investigate the medication administration error perceptions among Jordanian critical care nurses.

Methods

A cross-sectional, descriptive design was used among Jordanian critical care nurses. The total number of completed questionnaires submitted for analysis was 340. Data were collected between July and August 2022 in two health sectors (governmental hospitals and educational hospital) in the middle and north region in Jordan through a self-administered questionnaire on medication administration errors which includes 65 items with three parts.

Results

Nurses showed negative perceptions toward medication administration errors. The majority of participants agreed that "The packaging of many medications is similar" (76.7%), followed by "different medications look alike" (76.2%), as the main reasons for medication error occurrence. Two thirds of participants agreed that "when med errors occur, nursing administration focuses on the individual rather than looking at the systems as a potential cause of the error" (74.1%). Similarly, 73.5% of them believed nurses were blamed if something happens to the patient as a result of the medication error was the main reason for underreporting of MAEs. The highest reported levels of medication errors were in a range between 41% and 70%, for both types intravenous (IV) medication errors and non-intravenous (non-IV) medication errors.

Conclusion

Implement interventions centered on MAEs in particular among critical care nurses, owing to the proven significance of it in foretelling their crucial role in delivering safe care to patients, which will lead to quantifiable returns on both patient outcomes and nurse health, as well as the overall efficiency and image of the organization.

Awareness and Perceptions of "Age-Friendly": Analyzing Survey Results from Voices in the United States

The term "age-friendly" is widely used to describe cities, communities, health systems, and other environments. However, little is known about how this is interpreted or what the term means to the public. To investigate the public's familiarity with the term and gain insights into its relevance to older adults, we utilized data generated by a survey of 1000+ adults aged 40 and above. We employed a 10-question survey, distributed online in the US from 8 to 17 March 2023 via a third-party vendor, that captured awareness and perceptions of age-friendly designations by exploring awareness of the term, contextual understanding, and influence on decision making. The resultant aggregate data was analyzed using Microsoft Excel and straightforward summary statistical analyses. The majority of respondents (81%) were aware of the term "age-friendly." Older adults (ages 65+) lagged in the self-described extreme or moderate level of awareness compared to adults aged 40-64. In the surveyed population, the term "age-friendly" was most often understood to apply to communities (57%), followed by health systems (41%) and cities (25%). Most people believed "age-friendly" refers to all ages, even though age-friendly health systems are designed to meet the unique needs of older adults. These survey results provide the age-friendly ecosystem field with insights into the awareness and perceptions of the term "age-friendly," highlighting opportunities to bolster understanding.

Perceptions of Cross-Cultural Challenges and Successful Approaches in Facilitating the Improvement of Equine Welfare

Projects that aim to improve the welfare of equids worldwide usually involve people from different countries and cultures working together. Given that professionals involved with multi-stakeholder projects often work cross-culturally, this study examined their experiences regarding the challenges involved in, and their reflections on, how to work in a culturally sensitive way. Semi-structured interviews were conducted with 14 participants working in a total of 29 countries and analysed using thematic analysis. Key response themes emerged from the responses to questions covering the areas of perceptions of animal welfare, challenges working cross-culturally and embracing cultural sensitivity. The overriding theme regarding perceptions of animal welfare was that of barriers to animal welfare, under which emerged the subthemes of limited financial and material resources, limited understanding of the tenets of animal welfare, and attachment to traditional medicines and practices. Exploring the key challenges resulted in two themes: challenges regarding the local context and etiquette, and those regarding working with different stakeholders. Considering cultural sensitivity, again, two themes emerged: the importance of trust and respect, and of working with local partners. Previous works have highlighted the importance of shared linguistic knowledge, interpersonal skills and cultural knowledge, and these elements also emerged in this research. As well as providing insights into the challenges of working cross-culturally, the findings of this study have enabled the development of suggestions for how this work could be taken forward in a practical way to be of use to professionals in this sector.

Prevalence of Obesity and the Factors Associated with Low Obesity Awareness among Urban Adolescents in Harare, Zimbabwe

Obesity is a global health problem. In developing countries such as Zimbabwe, obesity is both an emerging health problem and a grey area, particularly among adolescents. This study assessed the prevalence of obesity and factors associated with low obesity awareness among adolescents.

METHOD

A cross-sectional survey was performed using an interviewer-administered questionnaire. The participants were 423 adolescents aged 14-19 years recruited from 10 schools in Harare using a stratified random sampling technique. Data were analyzed using SPSS software (version 23) and binary logistics regression was used to examine the factors associated with low obesity awareness. The level of significance was set at p < 0.05.

RESULTS

The median± IQR age was 16 (14-18) years, and overweight and obesity affected 15.8% of the participants with higher proportions among girls (73.1%, p = 0.002). Low obesity awareness was observed in 27.1% of the adolescents with a higher proportion among girls (67.0%, p = 0.001), 14-16-year-olds (51.3%, p = 0.317), and obese adolescents (56.7%, p = 0.001). Significant factors associated with low obesity awareness were household heads lacking formal education [OR = 9.41 (2.20-40.36), p = 0.003] and inadequate (poor) food habits [OR = 2.58 (1.33-5.01), p = 0.005].

CONCLUSIONS

Our study showed that adolescents had different obesity awareness levels and diverse perceptions in terms of obesity causes, and a range of potential solutions. Obesity awareness and nutrition education should address adolescents' poor eating habits while taking cognizance of the different education levels of household heads.

Evaluation of Attitudes and Perceptions in Students about the Use of Artificial Intelligence in Dentistry

BACKGROUND

The implementation of artificial intelligence brings with it a great change in health care, however, there is a discrepancy about the perceptions and attitudes that dental students present towards these new technologies.

METHODS

The study design was observational, descriptive, and cross-sectional. A total of 200 dental students who met the inclusion criteria were surveyed online. For the qualitative variables, descriptive statistical measures were obtained, such as absolute and relative frequencies. For the comparison of the main variables with the type of educational institution, sex and level of education, the chi-square test or Fisher's exact test was used according to the established assumptions with a level of statistical significance of p < 0.05 and a confidence level of 95%.

RESULTS

The results indicated that 86% of the students surveyed agreed that artificial intelligence will lead to great advances in dentistry. However, 45% of the participants disagreed that artificial intelligence would replace dentists in the future. In addition, the respondents agreed that the use of artificial intelligence should be part of undergraduate and postgraduate studies with 67% and 72% agreement rates respectively.

CONCLUSION

The attitudes and perceptions of the students indicate that 86% agreed that artificial intelligence will lead to great advances in dentistry. This suggests a bright future for the relationship between dentists and artificial intelligence.

Examining the Relationship Between Existing Community Resources and Community Leaders' Perceptions of Resilience and Rural Health During COVID-19

This study explored the relationship between existing community resources and community leaders' perceptions of resilience and rural health during COVID-19. Observational data of material capitals (e.g., grocery stores and physical activity resources) present in five rural communities involved in a health promotion project were collected and compared with key informant interviews of perceived community health and resilience during the COVID-19 pandemic. The analysis compares the differences in community leaders' perceptions of resilience during the pandemic to the actual material capitals of the community. While these rural counties were average in terms of available physical activity and nutritional resources, the onset of the pandemic led to varying degrees of disruption in access due to structural closures of mainstay resources, as well as residents perceiving that they cannot or should not access available resources. In addition, county coalition progress was stalled as individuals and groups could not gather together to complete projects, such as building playground equipment. This study demonstrates that existing quantitative instruments, such as NEMS and PARA, fail to take into account perceived access and utility of resources. Therefore, practitioners should consider multiple ways to evaluate resources, capacity, and progress on a health intervention or program and consider community voice to ensure feasibility, relevance, and sustainability-especially when faced with a public health emergency like COVID-19.

An Analysis of Psychological Perceptions of Survivors of Sexual Assault

INTRODUCTION

 Sexual assault, although not limited to females, is predominantly a form of male-on-female oppression and a form of torture and trauma, both physical as well as psychological, and may have longstanding and lasting effects. It includes any sexual behavior or act which is threatening, violent, forced, coercive, or exploitative and to which a person has not given consent or was not able to give consent. The impact of victimization is utterly profound and there is a wide range of responses a person may have to sexual assault. Some last a few days, others a few weeks, but most can entrench far longer.

METHODS

 A detailed analysis was conducted on the data of each case using a standardized form and guided interview of 206 survivors who had experienced alleged sexual offenses and met the specified criteria, seeking examination at the Department of Forensic Medicine & Toxicology in a tertiary level teaching hospital in India over a period of two years. Designed as a cross-sectional observational qualitative study, relying on interviews with the survivors. The inclusion criteria encompassed survivors of alleged rape cases, kidnapping cases, and anal sex ("sodomy") cases who presented to the department during the study period. Certain cases were excluded from the study, including those requiring only an "Ossification test" and cases involving prostitution.

RESULTS

The experiences of 206 survivors were analyzed and we found that in the majority of cases, the assailants were known to the survivors. Reasons for this included proximity, familiarity, and taking advantage of trust and faith bestowed upon them by the victim. Up to 75.24% of the offenses were committed with consent, while 24.76% were committed without consent. The causes of consensual and forceful sex acts were explored, with the majority of consensual sex acts being attributed to false promises to marry and love affairs. The majority of non-consensual sexual offenses were forcefully committed with ill intent, with only a small number being influenced by alcohol or drug intoxication. The study also found that almost equal numbers of cases were reported by survivors and their parents, and that survivor statements were valuable for investigating cases, although there were instances where they differed from their initial statements.

CONCLUSION

Mental and psychological status varied among survivors, with responses related to the elapsed time period from the occurrence of the assault.

The Relationship Between Air Quality, Health Outcomes, and Socioeconomic Impacts of the COVID-19 Pandemic in the US

COVID-19 lockdowns caused significant improvements in air quality in US states where traffic emissions are the main pollution source. In this study, we investigate the socioeconomic impacts of the COVID-19-related lockdowns in states which experienced the greatest changes in air quality, especially among different demographic populations and those with contraindications to health. We administered a 47-question survey and collected 1,000 valid responses in these cities. Our results show that 74% of respondents within our survey sample had some level of concern regarding air quality. In agreement with previous literature, perceptions of air quality were not significantly correlated with measured air quality criteria but rather seemed to be influenced by other factors. Respondents in Los Angeles were the most concerned about air quality followed by Miami, San Francisco, and New York City. However, those from Chicago and Tampa Bay expressed the least amount of concern about air quality. Age, education, and ethnicity were all factors affecting peoples' concerns about air quality. Respiratory conditions, living in proximity to industrial areas, and financial impacts from the COVID-19 lockdowns influenced concerns about air quality. About 40% of the survey sample reported greater concern for air quality during the pandemic, while approximately 50% stated that the lockdown didn't affect their perception. Furthermore, respondents seemed concerned about air quality in general, not a specific pollutant, and are willing to adopt additional measures and more stringent policies to improve air quality in all investigated cities.

Age-Old Dilemma of Pregnancy During Residency: A Cross-Sectional Study From Central India on Perceptions and Experiences of Female Medicos

Introduction The integration of family and career poses a significant problem for women in the medical profession. Balancing residency program demands with burgeoning family issues has always been a dilemma for female medicos. Lack of support and sometimes hostility from life partners, program administrators, teachers, and other residents have been reported. The present study is an attempt to assess perceptions and experiences of female medicos regarding pregnancy during residency. Methods The present descriptive cross-sectional study was carried out in a government medical college and hospital, which is a tertiary care center as well as a public sector teaching and training institute located in central India. Data were collected by interview technique using a predesigned and pretested questionnaire. Data were analyzed using the statistical software Epi Info version 7.2.5 (CDC, Atlanta, Georgia). Mean and standard deviations were calculated for continuous variables and the chi-square test was applied for categorical variables. Results Of the 612 study subjects, 409 (66.8%) belonged to the clinical disciplines and 203 (33.2%) were from nonclinical and paraclinical disciplines. A total of 66 (32.5%) subjects from the paraclinical and nonclinical sides had experienced pregnancy during residency, whereas only 54 (13.2%) from the clinical side were pregnant during residency. Positive influences for pregnancy during residency were concerns about age and fertility, pressure from in-laws and parents, desire for family and pregnancy, etc., all with a mean score of 3.5 and above on a five-point Likert scale. Tight schedules, availability of childcare arrangements, support from faculty and other residents, etc. were relatively negative influences with a mean score of less than 3.5. Around 66% of those from nonclinical and paraclinical groups had conceived before 26 years of their age, whereas only 30% of residents from clinical departments had experienced pregnancy before that age. Thus, the age at conception was relatively lower in residents from nonclinical and paraclinical disciplines as compared to their counterparts from clinical disciplines, and this difference was found to be statistically significant (p < 0.001). The complications during pregnancy were more in clinical residents than in those from the nonclinical and paraclinical side. Conclusions This study concludes that concerns about age and fertility, pressure from in-laws and parents, desire for family and pregnancy, and enjoying children are relatively positive influences on the occurrence of pregnancy, whereas tight schedule, availability of childcare arrangements, support from faculty and other residents, and timing professionally are relatively negative influences.

The Influence of Perceptions of Competence on Motor Skills and Physical Activity in Middle Childhood: A Test of Mediation

The mediating effect of perceptions of physical competence (PPC) on the relationship between motor competence and physical activity levels is documented in adolescence. However, it is unclear at what age this begins. In this study, we examined whether PPC mediated the relationship between moderate-vigorous physical activity (MVPA) or sedentary behaviour and motor competence in middle childhood. The participants were 129 children (mean age = 8.3 years) from eight elementary schools. MVPA and sedentary behaviour were measured using Actigraph accelerometers, and motor competence was assessed using the Test of Gross Motor Development, Second Edition. The Pictorial Scale of Perceived Competence and Social Acceptance for Young Children and The Self-Perception Profile for Children were used to assess PPC. In this study, PPC did not predict either MVPA or engagement in sedentary behaviours. Further, structural equation modelling revealed that PPC did not mediate the relationship between motor competence and MVPA or between motor competence and sedentary behaviour. These results suggest that at 8 years of age, children's perceptions do not influence their participation in physical activities. It is possible that factors influencing PPC, such as peer comparisons and performance outcomes, have more impact in later childhood or adolescence. In turn, those perceptions may affect children's or adolescents' choices to opt in or out of physical activities.

Assessment of Awareness, Perceptions, and Opinions towards Artificial Intelligence among Healthcare Students in Riyadh, Saudi Arabia

Background and Objective: The role of the pharmacist in healthcare society is unique, since they are providers of health information and medication counseling to patients. Hence, this study aimed to evaluate Awareness, Perceptions, and Opinions towards Artificial intelligence (AI) among pharmacy undergraduate students at King Saud University (KSU), Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional, questionnaire-based study was conducted between December 2022 and January 2023 using online questionnaires. The data collection was carried out using convenience sampling methods among senior pharmacy students at the College of Pharmacy, King Saud University. Statistical Package for the Social Sciences version 26 was used to analyze the data (SPSS). Results: A total of one hundred and fifty-seven pharmacy students completed the questionnaires. Of these, most of them (n = 118; 75.2%) were males. About 42%, (n = 65) were in their fourth year of study. Most of the students (n = 116; 73.9%) knew about AI. In addition, 69.4% (n = 109) of the students thought that AI is a tool that helps healthcare professionals (HCP). However, more than half 57.3% (n = 90) of the students were aware that AI would assist healthcare professionals in becoming better with the widespread use of AI. Furthermore, 75.1% of the students agreed that AI reduces errors in medical practice. The mean positive perception score was 29.8 (SD = 9.63; range-0-38). The mean score was significantly associated with age (p = 0.030), year of study (p = 0.040), and nationality (p = 0.013). The gender of the participants was found to have no significant association with the mean positive perception score (p = 0.916). Conclusions: Overall, pharmacy students showed good awareness of AI in Saudi Arabia. Moreover, the majority of the students had positive perceptions about the concepts, benefits, and implementation of AI. Moreover, most students indicated that there is a need for more education and training in the field of AI. Consequently, early exposure to content related to AI in the curriculum of pharmacy is an important step to help in the wide use of these technologies in the graduates' future careers.

A Systematic Review of the Determinants of Implementation of a Locomotor Training Program Using a Powered Exoskeleton for Individuals with a Spinal Cord Injury

BACKGROUND

Wearable powered exoskeletons represent a promising rehabilitation tool for locomotor training in various populations, including in individuals with a spinal cord injury. The lack of clear evidence on how to implement a locomotor powered exoskeleton training program raises many challenges for patients, clinicians and organizations.

OBJECTIVE

To report determinants of implementation in clinical practice of an overground powered exoskeleton locomotor training program for persons with a spinal cord injury.

DATA SOURCES

Medline, CINAHL, Web of Science.

STUDY SELECTION

Studies were included if they documented determinants of implementation of an overground powered exoskeleton locomotor training program for individuals with spinal cord injury.

DATA EXTRACTION

Eligible studies were identified by two independent reviewers. Data were extracted by one reviewer, based on constructs of the Consolidated Framework for Implementation Research, and validated by a second reviewer.

RESULTS

Sixty-three articles were included. 49.4% of all determinants identified were related to the intervention characteristics, 29.6% to the individuals' characteristic and 13.5% to the inner setting. Recurrent barriers identified were the high prevalence of adverse events (e.g., skin issues, falls) and device malfunctions. Adequate training for clinicians, time and resource available, as well as discussion about patients' expectations were identified as facilitators.

CONCLUSIONS

Powered exoskeleton training is a complex intervention. The limited information on the context and the implementation process domains may represent a barrier to a successful transition from knowledge to action.

Perceptions of telehealth among older U.S. adults during the COVID-19 pandemic: A national survey

INTRODUCTION

COVID-19 necessitated a shift from in-person to virtual care for all patients, particularly older adults. It is unknown how older individuals' views of telehealth changed during this time and how this may affect their future use of telehealth services.

METHODS

We used data from a cross-sectional online survey of a nationally representative sample of 2074 U.S. adults ages 50-80 who were participants in the National Poll on Healthy Aging. We performed a descriptive and multivariable analysis of individuals' perspectives on past and future telehealth visits, sociodemographics, and health status.

RESULTS

Before March 2020, 5.8% of respondents had used telehealth, compared to 32.0% by June 2020. Of telehealth users, 36.1% indicated their most recent telehealth visit used audio-only (i.e., without video) technology. In multivariable analysis, those who never used video technology compared to those who were "very comfortable" (average marginal effect (AME) 49%, 95% CI: 36-63), identified as Hispanic (AME 19% vs White, non-Hispanic, 95% CI: 5-32), or were female (AME 9%, 95% CI: 1-17) were more likely to report audio-only use. Concerns remained about the inability to conduct physical exams (75%) and telehealth quality of care (67%), though most (64%) older adults indicated an interest in future telehealth visits.

DISCUSSION

Telehealth use increased substantially among older U.S. adults during the early months of the COVID-19 pandemic; however, many reported using audio-only telehealth, an important consideration for policymakers and providers. Addressing older adults' concerns about and barriers to telehealth visits is needed to ensure telehealth does not exacerbate disparities in their care.

The Impact of Leadership Program Formatting on Perceived Development Within Pharmacy Cohorts

Objective. To assess the impact of variable leadership development program formats on perceived participant growth.Methods. In 2020, the Phi Lambda Sigma national office began offering national Leader Academies to members, while University of South Florida Health Taneja College of Pharmacy simultaneously offered a Leader Academy program to its Phi Lambda Sigma students. Both programs used virtual leadership development tools from GiANT Worldwide, but differed in meeting frequency, content focus, and participant diversity. A 17-question pre- and postsurvey was developed from the Emotional Intelligence Leadership Inventory. Descriptive and inferential statistics were used to compare the cohorts.Results. Twenty-two respondents in the national cohort (66.7% response rate) and 15 in the single-institution cohort (100% response rate) were included. There was more diversity in age, ethnicity, and previous education in the national cohort. Significant improvements in perceived growth were noted in almost all areas. The only decrease noted was the national cohort response to "I strive to improve myself." The overall change in mean response values was generally higher for the single-institution cohort. Qualitative data supported these results and showed more notable references to emotional intelligence in the national cohorts (∼50%) as compared to the single-institution cohort (<25%).Conclusion. Study results suggest that participation in a longitudinal leadership development program, regardless of cohort format, leads to perceived participant improvement in three categories. However, perceived benefit within each of these categories may vary depending on the cohort. Future studies are needed to further evaluate specific leadership arenas and validate the leadership assessment tool.

A Qualitative Description of Direct Care Workers of Lesbian, Gay, Bisexual, Transgender Older Adults

Purpose: The aim of the study was to examine direct care worker (DCW) perceptions of lesbian, gay, bisexual, transgender (LGBT) older adults living in long-term care, assisted living, and home health settings. DCWs provide the closest interaction with LGBT older adults in these settings. The perceptions DCWs have toward LGBT older adults is important because the quality of care can be influenced by negative attitudes. Methodology: Qualitative description was used to synthesize what is known about DCWs' perceptions toward LGBT older adults. Results: The overarching theme, "Care is Different, but Not my Care," was supported by the categories Cues of Stereotyping, Cues of Prejudice, and DCWs' Social System and Reported Care. Application: Specific implications for practice (i.e., training, recruitment, retention strategies) and policy (i.e., mandated staffing ratios, pay) are explicated to guide future interventions to ensure equitable, quality care in health care.

Food for thought on eating while meeting virtually

This study examines observers' perceptions of employees eating during virtual work meetings. Using a 2 × 3 experimental design, participants (N = 842) were randomly assigned to one of three eating conditions including no one eating, target eating, and everyone eating where they rated either a male or female target. While existing research has demonstrated positive consequences of sharing food in the traditional workplace, our findings demonstrate that individuals who eat during virtual work meetings are perceived as less professional, less competent, and less likely to experience career success. Observers' perceptions of the eater's professionalism are negatively impacted, regardless of whether the target is the only one eating or whether everyone is eating. We offer practical suggestions for HRM professionals working to help managers and employees understand the nuances of videoconferencing.

Developing Emotional Intelligence through Physical Education: A Systematic Review

The development of Emotional Intelligence (EI) has gained importance in the context of goals to spur a new generation of people intent upon improving human health. Physical education (PE) is a suitable curriculum subject in which to train EI. Therefore, our aim in this review is to summarize existing literature pertaining to EI within PE, while seeking particular guidance on how to best teach EI. We systematically reviewed PubMed, ERIC, Education Database, Scopus, SPORTDiscus, Cochrane, and FECYT (i.e., Web of Sciences, CCC, DIIDW, KJD, MEDLINE, RSCI, and SCIELO) databases up to January 24, 2022. From 248 studies initially located, 28 were included in a final qualitative synthesis. These 28 studies were sub-divided into (i) correlation and (ii) intervention studies with an intervention group, possibly a control group, and with pre-test and post-test outcome measures. There was a clear correlation between EI-motivation and EI-psychological needs, and there emerged the following types of educational programs for developing EI within PE: (a) pedagogical models based on corporal expression and relaxation, (b) Cooperative Learning (e.g., the Sport Education Model), (c) community engagement interventions (e.g., Social-Emotional Learning, the Teaching Personal and Social Responsibility model, and Service Learning), and (d) augmented reality games. Most successful EI programs included themes of collaborative work, concern for others, and social welfare. Including EI as a PE goal will require developing students' personality and encouraging PE teachers to focus on EI within pedagogical models based on community engagement.

Knowledge, Attitude, Awareness, and Perceptions among Physicians toward Antibiotic Resistance in Hospitals in South Palestine

Background  Antibiotic resistance is a global problem, and the World Health Organization has made this problem one of its priorities for solving. Therefore, a survey was carried out to investigate the knowledge, attitude, awareness, and perceptions of antibiotic resistance among physicians and to assess the correlation between the knowledge of antibiotic resistance and their years of experience in some Palestinian hospitals.

Methods  This was a cross-sectional study that targeted physicians who are working in different healthcare facilities in Hebron and Bethlehem governorates. We used a questionnaire for data collection. The questionnaire consists of 42 questions to measure the knowledge, attitudes, awareness, and perceptions of antibiotic use and resistance.

Results  The response rate was 91.33% (137 of 150 physicians completed the questionnaire). The participants' ages ranged from 25 to 56 years, and the majority were males ( n  = 116, 84.7%) working in governmental hospitals ( n  = 83, 60.6%). Of physicians, 69.3% ( n  = 95) perceived antibiotic resistance as a very important worldwide problem, while 54.7% ( n  = 75) perceived a very important problem in the country, 54.0% ( n  = 74) a very important problem in their hospital, and 59.1% ( n  = 81) a very important problem in their departments. Methicillin-resistant Staphylococcus aureus was the most known antibiotic-resistant bacteria followed by extended-spectrum beta-lactamases. Only 47 physicians (34.3%) think that antibiotics are not used appropriately in their department. Respondents' physicians showed that the development of antibiotic resistance was due to various factors that include self-medication n= (92, 67.2%), overuse of antibiotics ( n  = 83, 60.6%), and uncompleted treatment (n= 87, 63.5). Senior specialists/consultants were found to be more knowledgeable about antibiotic resistance.

Conclusion  In our survey, physicians showed variable knowledge and perceptions of antibiotic resistance. Introducing educational programs is necessary to improve their understanding and perceptions of antibiotic resistance, as well as their attitude toward antibiotic use.

Knowledge, perceptions, and readiness of telepharmacy (KPR-TP) questionnaire among pharmacists: Development and psychometric evaluation

INTRODUCTION

The pandemic increased pressure on healthcare services and forced limited care in all health facilities to ensure the care of all patients. Telepharmacy appears as an alternative to the remote pharmacy practice approach through information and communication technologies, but there are no comprehensive tools to measure pharmacists' knowledge, perception, and readiness to implement telepharmacy. This study developed and validated a questionnaire version of the Knowledge, Perceptions, and Readiness of Telepharmacy (KPR-TP) for pharmacists.

METHODS

The KPR-TP assessed three domains: knowledge, perception, and readiness. Its factor structure, reliability, and validity were assessed using 7730 pharmacists from 34 Indonesian provinces. The validity of the model's three-factor structure was assessed using confirmatory factor analysis. Cronbach's alpha and composite reliability were used to validate the consistency of our factors, whereas convergent and discriminant validity established significant relationships between them.

RESULTS

The goodness-of-fit index indicated that the model was economical and reasonable. Furthermore, the correlation between the three domains revealed a significant positive relationship. KRP-TP is a viable instrument for assessing pharmacists' perceptions of telepharmacy in Indonesia.

CONCLUSION

Overall, we discovered that our questionnaire contains critical constructs for assessing a pharmacist's knowledge, perception, and level of readiness to implement telepharmacy. This study will help pharmacists identify appropriate strategies for skill improvement.

Electronic Cigarette Usage Patterns and Perceptions in Adult Australians

Despite their increasing popularity, and Australia's unique regulatory environment, how and why Australian adults use e-cigarettes and their perceptions of their safety, efficacy and regulation have not been extensively reported before. In this study, we screened 2217 adult Australians with the aim of assessing these questions in a sample of current or former e-cigarette users. A total of 505 out of 2217 respondents were current or former e-cigarette users, with only these respondents completing the full survey. Key findings of this survey included the high proportion of respondents who indicated they were currently using e-cigarettes (307 out of 2217 = 13.8%), and the high proportion of current e-cigarette users that were also smokers (74.6%). The majority of respondents used e-liquids containing nicotine (70.3%), despite it being illegal in Australia without a prescription, and the majority bought their devices and liquids in Australia (65.7%). Respondents reported using e-cigarettes in a variety of places, including inside the home, inside public places (where it is illegal to smoke tobacco cigarettes), and around other people-which has implications for second and third hand exposures. A significant proportion of current e-cigarette users (30.6%) thought that e-cigarettes were completely safe to use long-term, although in general, there was a large amount of uncertainty/ambivalence with respect to perceptions of e-cigarette safety and efficacy as smoking cessation tools. This study shows that e-cigarette use is common in Australia, and that appropriate dissemination of unbiased research findings on their safety and efficacy in smoking cessation is urgently required.

Awareness and Perceptions of the Impact of Tonsillectomy on the Level of Immunity and Autoimmune Diseases among the Adult Population in Abha City, Kingdom of Saudi Arabia

The widespread misconception that tonsillectomy leads to a decrease in immunity may lead to fear and avoidance of the operation. This can result in a deterioration of the situation, such as sleep-related breathing issues, frequent infections, and an increase in complications. The current research was conducted to assess the awareness and perception with respect to the impact of tonsillectomy on the immune system and to assess the awareness and perception of the relationship between autoimmune diseases and tonsillectomy. This 6-month descriptive cross-sectional online questionnaire survey was conducted among individuals who were 18 years and above living in Abha city, Saudi Arabia. Out of the 800 study subjects, 104 (13%) had undergone tonsillectomy. Statistically significant associations were found between age group, education, income, and occupation among those who had undergone tonsillectomy. Multivariate logistic regression analysis showed that ages 18-30 years and 31-40 years (OR: 2.36, 95% CI: 1.18-4.71, and OR: 1.46, 95% CI: 0.53-3.97) and education levels of high school, bachelors, and above (OR: 8.30, 95% CI: 3.05-22.58 and OR: 10.89, 95% CI: 4.23-28.05) were found to be associated with tonsillectomy status of the subjects. On the contrary, income levels of 5000-9000 and >9000 (OR: 0.65, 95% CI: 0.36-1.17 and OR: 0.78, 95%CI: 0.42-1.42) and male gender (OR: 0.79, 95% CI: 0.52-1.19) were found to be associated with non-tonsillectomy status of subjects. Almost 36% of study subjects thought that tonsillectomy affects immunity. Only 18% of study subjects thought that there is a relationship between tonsillectomy and autoimmune diseases. About one-third of the respondents had received this information from community members and social media. A small number of study subjects relied on public awareness programs. Therefore, social media can play a vital role in the community to remove misconceptions regarding tonsillectomy and its effect on immunity and autoimmune disease. Further educational interventional studies are required to see the correction to the public perception of tonsillectomy and its effect on immunity and autoimmune diseases.

Perceptions of Knowledge, Disease Impact and Predictive Genetic Testing in Family Members at Risk to Develop Early-Onset Alzheimer's Disease (EOAD) and Their Levels of Suicidal Ideation: A Mixed Study

Early-onset Alzheimer's disease (EOAD) is an autosomal dominantly inherited disease, in which a founder effect has been described for A431E mutation in the PSEN1 gene, with most of the affected patients being residents of a small town in the state of Jalisco in Mexico. To date, no studies have been performed in order to know the impact of the disease on this population. Therefore, the objective of this study was to investigate the perceptions in the knowledge, the impact of the disease and the intention to take the predictive genetic testing in the population at genetic risk of Jalisco. For this objective, we performed a mixed study that included a qualitative methodology (semi-structured interviews), and, in addition, we measured suicidal ideation, stress and depression with quantitative instruments in order to compare them with a control group. Of the 28 invited individuals, 9 accepted to participate, from which, 5 (55.56%) participants did not know their genetic risk to develop the disease and 5 (55.56%) would want to take the predictive genetic testing in order to be prepared to face the disease; however, among those who did not want to know, 2 individuals (22.22%) mentioned that they would consider suicide if they were positive for the pathogenic variant. On the impact of the disease, we detected that the adaptation to the familiar's needs was the most frequent answer, including changes in their lifestyle (being responsible since very young, changes in social life and familiar dynamic), this being their main stressor, followed by changes in plans for the future and contemplating the possibility of being affected. Although no differences in stress and depression between groups were observed, we detected that suicidal ideation was significantly higher in the group of cases. These results highlight the importance to involve all the family in genetic counseling in order to clarify any doubts and also to attend to them psychologically to prevent suicidal ideation and attempts.

"I Crave a Blunt, I Don't Crave a Cigarillo": A Focus Group Study on Perceptions of Nicotine and Addiction among US Adults Who Currently Smoke Little Cigars or Cigarillos

While the US Food and Drug Administration (FDA)'s proposal to reduce the nicotine content in cigarettes is gaining traction, it is still undetermined whether the policy will also include other combustible tobacco products, such as little cigars and cigarillos (LCCs), and how such a policy should be communicated given the patterns of use and perceptions around LCCs. This study examined perceptions of nicotine and addiction related to LCC use and involved data collection from eight semi-structured virtual focus groups conducted in Summer 2021 in the US. Participants were adults who reported past-30-day use of LCCs, consisting of African American males (n = 9), African American females (n = 9), white males (n = 14), and white females (n = 11). Participants discussed their perceptions of nicotine and addiction in general and in relation to LCC use. Inductive thematic analysis of transcripts was conducted. Differences across race and sex groups were examined. Participants did not consider nicotine to be a characterizing feature of LCCs; rather, they generally associated nicotine with cigarettes. Participants' views of nicotine and addiction related to LCCs were discussed along four dimensions: context of use, frequency of use, the presence of cravings, and whether a product is modified (e.g., by adding marijuana). Social and infrequent use, a lack of cravings, and the use of LCCs for marijuana were considered indicative of a lack of addiction and reasons not to be concerned about nicotine in LCCs. Because perceptions of nicotine and addiction related to LCCs differ from those of cigarettes, communications about a reduced nicotine policy that includes LCCs should consider these differences to ensure the policy is understood by people who currently use LCCs and to prevent people who use cigarettes from switching to LCCs.

Knowledge, Perceptions, and Practices on Risks and Disasters Among Medical Students. A Multicenter Cross-Sectional Study in 9 Latin American and Caribbean Countries

PURPOSE

The objective of this study was to describe the level of knowledge, perceptions, and practices in relation to risks and disasters in medical schools in Latin America and the Caribbean.

PARTICIPANTS AND METHODS

Multicenter, observational, analytical, non-probabilistic convenience sample study with 2546 medical students in 9 countries of Latin America and the Caribbean. An online survey was conducted between October 2020 and November 2020, using an instrument validated in each country to assess knowledge, perceptions, and practices regarding risk and disaster prevention measures. Frequencies, percentages, mean and standard deviation (SD) were used for descriptive analysis. Differences resulting from the relationship between the variables studied and the level of knowledge were obtained using the Chi-square test. P-value <0.05 was accepted as statistically significant for all analyses.

RESULTS

The highest proportion of responses came from women, third-semester students, and those studying in public universities. Students from Colombia and Honduras had the highest percentage of high levels of knowledge about disasters, while Peruvian students had the highest percentage of low levels of knowledge. Women and students from public universities showed a higher proportion of high levels of knowledge. 52.7% considered that they live in a country with a medium risk of natural disasters, while 91.2% said that Latin American and Caribbean countries are not prepared to face natural disasters. Only 43.6% believe they are prepared to help in the event of a natural disaster.

CONCLUSION

Most of medical students from Latin America and Latin America and the Caribbean have high and medium level of knowledge in risks and disasters. However, the implementation of disaster training programs for medical students has the potential to improve the preparedness, knowledge, and skills that are important for medical personnel to improve their self-confidence, and their ability to respond, resulting in more effective systems.

Assessment of Stakeholder Perceptions and Attitudes Toward Health Data Governance Principles in Botswana: Web-Based Survey

BACKGROUND

The use of information and communication technologies for health-eHealth-is described as having potential to improve the quality of health care service delivery. Consequently, there is an increased global trend toward adoption of eHealth interventions by health care systems worldwide. Despite the proliferation of eHealth solutions, many health care institutions especially in transitioning countries are struggling to attain effective data governance approaches. The Ministry of Health in Botswana is an exemplar institution continually seeking better approaches to strengthen health data governance (HDG) approaches following the adoption of eHealth solutions. Recognizing the need for a global HDG framework, the Transform Health coalition conceptualized HDG principles that are structured around 3 interconnected objectives: protecting people, promoting the value of health, and prioritizing equity.

OBJECTIVE

The aim of the study is to solicit and evaluate perceptions and attitudes of health sector workers in Botswana toward the HDG principles by Transform Health and derive any future guidance.

METHODS

Purposive sampling was used to select participants. A total of 23 participants from various health care organizations in Botswana completed a web-based survey and 10 participated in a follow-up remote round-table discussion. The aim of the round-table discussion was to gain further insight into participants' responses from the web-based survey. Participants were from the following health care cadres: nurses, doctors, information technology professionals, and health informaticians. Both validity and reliability testing were performed for the survey tool before sharing it with study participants. An analysis of participants' close-ended responses from the survey was performed using descriptive statistics. Thematic analysis of open-ended responses from the questionnaire and the round-table discussion was achieved using the Delve software and the widely accepted principles of thematic analysis.

RESULTS

Although some participants highlighted having measures in place similar to the HDG principles, there were some who either did not know or disagreed that their organizations already had in place mechanisms similar to the proposed HDG principles. Participants further expressed relevance and importance of the HDG principles in the context of Botswana. However, some modifications to the principles were also suggested.

CONCLUSIONS

This study highlights the necessity of data governance in health care particularly toward meeting the requirements for Universal Health Coverage. The existence of other health data governance frameworks calls for a critical analysis to assess the most appropriate and applicable framework in the context of Botswana and similar transitioning countries. An organization-centered approach may be most appropriate, as well as strengthening of existing organizations' HDG practices with the Transform Health principles.

Breast Cancer and Screening Prevention Programmes: Perceptions of Women in a Multicultural Community in Southern Thailand

BACKGROUND

Breast cancer is a leading cause of morbidity and mortality among women worldwide and in Thailand.

OBJECTIVE

To explore perceptions of breast cancer and screening prevention programmes among a group of at-risk women in a multicultural setting in southern Thailand.

METHODS

Semi-structured in-depth interviews were used for data collection with 30 at-risk group women. Women from Muslim and Buddhist backgrounds were purposively included in this study. The thematic analysis method was used to analyse the data.

RESULTS

Four themes were identified from our data: perceptions of breast cancer, being diagnosed with breast cancer and anxiety, stigma: effects of breast cancer, and breast self-screening and prevention of breast cancer. The participants had some knowledge about the risk factors for breast cancer. However, participants perceived that breast cancer could occur to individual women at any time and that it was not possible to entirely prevent the disease, even when following a breast self-examination programme. However, most participants perceived that whether one would be afflicted by breast cancer depended also on Allah and their own karma. All participants were encouraged to attend breast self-screening training by healthcare providers of local health centres, but they had no confidence to perform self-screening soon after finishing the training programme. This became the reason for a lack of regular self-screening with responsibility left to health practitioners. Although participants were aware that breast self-screening should be their routine practice, there were multiple barriers to this, including accurate knowledge about breast cancer, belief, self-awareness, screening skills and healthcare facilities. Breast self-screening was recognised as an important means of early detection. However, most women did not perform this regularly, which could increase their risk of developing breast cancer.

CONCLUSIONS

Public health providers need to be more concerned about the perceptions, beliefs and practices regarding breast cancer and develop prevention practices that work better for women living in more diverse cultural locations so that they may be able to follow preventive practices and reduce their vulnerability to breast cancer.

Knowledge- and Experience-Based Perceptions of Radiation Therapists during the COVID-19 Outbreak

Objective: To assess the perceived risks and impact of the COVID-19 outbreak on radiation therapists in Saudi Arabia. Methods: A questionnaire was distributed to all radiation therapists in the country. The questionnaire contained questions about demographic characteristics, the extent of the pandemic's impact on hospital resources, risk perception, work-life, leadership, and immediate supervision. The questionnaire's reliability was assessed using Cronbach's alpha; >0.7 was considered adequate. Results: Out of the 127 registered radiation therapists, 77 (60.6%) responded; 49 (63.6%) females; and 28 (36.4%) males. The mean age was 36.8 ± 12.5 years. Nine (12%) of the participants had a past experience with pandemics or epidemics. Further, 46 (59.7%) respondents correctly identified the mode of transmission of COVID-19. Approximately, 69% of the respondents perceived COVID-19 as more than a minor risk to their families and 63% to themselves. COVID-19 had an overall negative impact on work at the personal and organizational levels. However, there was a positive attitude toward organizational management during the pandemic in general; positive responses ranged from 66.2% to 82.4%. Ninety-two percent considered protective resources and 70% considered the availability of supportive staff to be adequate. Demographic characteristics were not significantly associated with the perceived risk. Conclusions: Despite the high perception of risk and negative impact on their work, radiation therapists conveyed a positive overall perception regarding resource availability, supervision, and leadership. Efforts should be made to improve their knowledge and appreciate their efforts.

Undergraduate student perceptions of cognitive behavioral therapy, aerobic exercise, and their combination for depression

OBJECTIVE

Both aerobic exercise and Cognitive Behavioral Therapy (CBT) improve depression, but perceptions of their credibility and efficacy are underexplored. These perceptions can contribute to treatment seeking and outcome. A previous online sample ranging in age and education rated a combined treatment higher than individual components and underestimated their efficacy. The current study is a replication exclusively focused on college students.

PARTICIPANTS

Undergraduates (N = 260) participated during the 2021-2022 school year.

METHODS

Students reported impressions of each treatment's credibility, efficacy, difficulty, and recovery rate.

RESULTS

Students viewed combined therapy as potentially better, but also more difficult, and underestimated recovery rates, replicating previous work. Their efficacy ratings significantly underestimated both meta-analytic estimates and the previous sample's perceptions.

CONCLUSIONS

Consistent underestimation of treatment effectiveness suggests that realistic education could prove especially beneficial. Students might be more willing than the broader population to accept exercise as a treatment or adjunct for depression.

Nurses' and midwives' perceptions and strategies to cope with perinatal death situations: A systematic literature review

AIM

The aim of this paper is to describe the strategies used by nurses and midwives to cope with experiences of dealing with perinatal death and maintain their satisfaction at work.

DESIGN

Systematic literature review, in accordance with the PRISMA Declaration.

DATA SOURCES

(2000-2021) Web of Science, PubMed, Scopus, CINALH and Dialnet, for articles in English and Spanish from the period between January 2000 and March 2021.

REVIEW METHODS

The outcome of the review was the perceptions of nurses and midwives who have cared for people in a situation of perinatal loss.

RESULTS

Thirteen studies were identified that evaluated the attitudes, experiences and needs of these healthcare professionals. The combined size of all samples was 2196 participants.

CONCLUSIONS

The negative effects on these professionals' satisfaction with their situation at work could be mitigated by covering their needs for knowledge, experience, and emotional and technical skills to deal with such events.

IMPACT

As potential protective factors against dissatisfaction in nurses and midwives during perinatal death experiences, we identified older age and experience in perinatal care and coping strategies based on communicating one's feelings to peers, empathetic listening to the families cared for, training and institutional support. No Patient or Public Contribution.

Greek dental students' perceptions of treating older patients

BACKGROUND AND AIM

The oral problems of the older population are largely undertreated because of various barriers, including negative perceptions and ageist stereotypes, among care providers. The aim of this study was to record the perceptions of Greek dental students of treating older patients.

MATERIALS AND METHODS

An anonymous written questionnaire including two open-ended questions about the positive and negative issues when treating older patients was administered to clinical dental students. A content analysis was conducted to identify the main themes.

RESULTS

A total of 135 students responded to the questionnaire (response rate 88.23%). Five key themes were identified for the facilitating factors and six for the barriers/challenging factors. The facilitating factors of treating older people were the promotion of the patients' health and quality of life, the good interaction and communication with older patients, the dentist's intrinsic reward treating older people, the positive feedback from the patients and the improvement of professional dental competences when treating complex cases. The barriers included communication and cooperation problems, treatment challenges related to disease and disability, patients' negative beliefs about oral health, barriers to accessing dental care, complex and time-consuming treatment plans, and communication and cooperation problems with the patients' carers.

CONCLUSION

A range of facilitating and challenging factors influence dental students' perceptions of treating older patients. More research is necessary on the methods that will enhance their geriatric knowledge and skills, help them overcome the challenges they detected and improve their attitudes and behaviours towards treating older patients.

A rapid evidence assessment of sickle cell disease educational interventions

AIMS AND OBJECTIVES

To assess the impact of educational interventions on the knowledge and attitude of healthcare professionals (HCPs) regarding sickle cell disease (SCD) pain management in the UK.

BACKGROUND

Variations and inadequate pain management due toHCPs' lack of knowledge and negative attitude is still an ongoing global concern for SCD patients despite availability of effective treatment and evidence-based guidelines. Several international studies have implemented interventions aimed at improving knowledge, attitude, and pain management. No review on the effectiveness of these interventions was found. Also, no previous intervention done in the UK was found from the thorough search of research databases. However, there are estimated 240,000 genetic carriers with about 12,500-15,000 estimated people living with SCD in the UK.

DESIGN

Rapid Evidence Assessment of existing evidence.

METHODS

A rapid evidence assessment was conducted between March 2021-January 2022 following the PRISMA 2020 guidelines. Included papers must have an educational intervention about SCD or related symptom management where the learners were HCPs. Excluded papers were those not published in English or before 2010. The following databases were searched: CINAHL, MEDLINE, PubMed America and Europe, Scopus, PsycINFO and Web of Science. Data quality was assessed using the Mixed Methods Assessment Tool (MMAT) and analysed using a narrative approach.

RESULTS

Ten studies were included in the final review. Overall, they reported improved outcomes in six main themes: knowledge, attitude, perception, adoption, satisfaction and efficiency. Five studies reported statistically significant improvement in at least one outcome, four studies reported positive improvement, and two studies reported no significant improvement in knowledge and attitude. These heterogeneous studies were implemented once, and all designs were prone to bias; this makes it difficult to state how effective interventions are for SCD.

CONCLUSION

Current evidence of positive improvement in HCPs' knowledge and attitude is insufficient for generalisation and recommendation for adoption. However, we believe that implementing validated educational interventions remains essential for effective acute SCD pain management and patient-centred care. Further research is needed to find a suitable educational intervention that can be replicated.

RELEVANCE TO CLINICAL PRACTICE

Quality SCD education, timely crisis management and reduced patient stigma are crucial in reducing the risk of rapid clinical decompensation to avoid developing life-threatening complications. Understanding SCD can also support the building of therapeutic relationships between the patient and practitioner.

TRIAL REGISTRATION

This review was not registered.

Opportunities to Increase Well-Child Care Engagement for Families Affected by Maternal Opioid Use Disorder: Perceptions of Mothers and Clinicians

OBJECTIVE

Previous research suggests gaps in well-child care (WCC) adherence, quality, and effectiveness for children impacted by parental opioid use disorder (OUD). The objective of this study was to gather in-depth information regarding maternal and clinician-reported factors that enhance ("facilitators") or hinder ("barriers") WCC engagement as well as mothers' experiences during WCC visits.

METHODS

Thirty mothers who were in treatment for OUD and 13 clinicians working at a pediatric primary care clinic participated in this qualitative study. All participants completed one data collection telephone session which involved a brief questionnaire followed by a semi-structured interview. Thematic analyses of the interview transcripts were conducted using an inductive approach.

RESULTS

Three broad themes were identified as facilitators of WCC by mothers and clinicians, including: 1) continuity in care, 2) addressing material needs, and 3) clinician OUD training and knowledge. Themes identified as barriers to WCC included: 1) stigma toward mothers with OUD, 2) gaps in basic parenting knowledge, 3) competing specialized health care needs, and 4) insufficient time to address all concerns.

CONCLUSION

WCC programs or clinical pathways designed for families affected by maternal OUD should consider these barriers and facilitators of WCC engagement and affect experiences of WCC for mothers and clinicians.

Low-Frequency Noise: Experiences from a Low-Frequency Noise Perceiving Population

Although low-frequency noise (LFN) is associated with various complaints, there is still much unknown about this phenomenon. This research aims to provide an extensive description of (1) LFN perceptions, (2) LFN-related complaints, and (3) the characteristics of LFN complainants. In an explorative observational cross-sectional survey study, a sample of Dutch adults reporting to experience LFN (n = 190) and a group not experiencing LFN (n = 371) completed a comprehensive questionnaire. Descriptions of LFN perceptions varied individually and were dependent on different circumstances, although some common patterns were observed. Complaints were wide-ranging and individual, with a reported high impact on daily living. Common complaints included sleeping difficulties, fatigue, or annoyance. Societal consequences were described regarding housing, work, and relationships. Attempts to stop or escape the perception were manifold but often unsuccessful. The LFN sample differed regarding sex, education level, and age from the Dutch adult population, indicating more frequent inability to work, less full-time work, and less years lived in their homes. No further differences in occupational or marital status or living circumstances were found. Although this research supports some previous findings and identifies common patterns, it also highlights the individual nature of LFN-related experiences and the heterogeneity of this group. It is advised to pay attention to the complaints of affected individuals, to inform concerned authorities, and to conduct more systematic and multidisciplinary research using standardized and validated measuring instruments.

Factors contributing to nurse resignation during COVID-19: A qualitative descriptive study

AIMS

To explore and describe registered nurses' perceptions and experiences of work well-being extending from what inspired them to join the healthcare organization, what created a great day at work for them, through to what may have supported them to stay.

DESIGN

Qualitative descriptive study.

METHODS

Thirty-nine Australian nurses who resigned in 2021 from two metropolitan healthcare organizations in Victoria were interviewed in 2022, each for 30-60 min. The semi-structured interview transcripts were transcribed verbatim and analysed inductively and thematically.

RESULTS

Four themes were constructed for each of the key research questions. Inspiration to join the organizations transpired through organizational reputation, recruitment experiences, right position and right time, fit and feel. A great day at work was created through relationships with colleagues, experiences with managers, adequate resourcing and delivering quality care. Factors contributing to nurses resigning included COVID-19, uncertainty of role, workload and rostering, and finally, not feeling supported, respected and valued. Factors that may have supported the nurses to stay included flexible work patterns and opportunities, improved workplace relationships, workload management and support, and supportive systems and environments. Cutting across these themes were five threads: (1) relationships, (2) communication, (3) a desire to learn and develop, (4) work-life balance and (5) providing quality patient care.

CONCLUSIONS

Novel ways of working and supporting individuals, teams and organizations are needed to maintain and sustain nurses. The nurses' inspiration, what created a great day at work, and support needed to stay highlighted the importance of workplace initiatives to build nursing career pathways, provide equitable opportunities for professional development, workload and roster flexibility and implement professional relationship-enhancing actions to foster authentic civility.

IMPACT

This study contributes an in-depth exploration of the perceptions and experiences of nurses who resigned from two healthcare organizations and provides a description of (1) what inspired these nurses to initially join the organization, (2) what they perceived created a great day at work for them, (3) the factors contributing to their resignation and (4) what may have supported them to stay. The reasons nurses resign from an organization were identified as complex and multi-factorial, with opportunities for promoting nursing career pathways, addressing equity in opportunities and implementing professional relationship-enhancing actions. These contributions add both context and opportunity to strengthen organizational initiatives to attract, sustain and retain nurses.

A corpus-assisted discourse study of Chinese university students' perceptions of sustainability

Education for sustainable development (ESD) in the higher education context plays a critical role in advancing the cause of sustainable development. However, previous research on university students' perceptions of sustainable development is limited. This study used a corpus-assisted eco-linguistic approach to investigate students' perceptions of sustainability issues and responsible actors to address these issues. This quantitative and qualitative study is based on a corpus of 501 collaborative essays on sustainability written by ~2,000 Chinese university students collected with their permission. The results show that the students had a comprehensive perception of the three dimensions of sustainable development. Environmental issues have received the most attention from students, followed by economic and social issues. With regard to perceived actors, students were inclined to view themselves as active participants in the cause of sustainable development, rather than as observers. They called for coordinated action of all relevant parties, such as the government, business sectors, institutions, and individuals. On the other hand, the author also noticed a tendency toward superficial green talk and anthropocentrism in students' discourse. This study aims to contribute to sustainability education by integrating findings into English as a foreign language (EFL) classes. Implications for sustainability education in the context of higher education are also discussed.

Differences in the Perception Regarding Inclusion Preparation among Teachers at Different Educational Stages

Inclusive education is fundamental, consisting of enabling all students, irrespective of their characteristics, to receive appropriate education and actively participate in school life. Teachers play an important role in this regard; thus, this study aims to analyze teachers' perceptions regarding their preparation for inclusion by assessing possible differences depending on the educational stage (early childhood, primary, or secondary education). A total of 1098 Spanish teachers, from Extremadura, responded to three dichotomic answers about their inclusive education preparation perception and the Evaluation of Teachers' Inclusion Readiness (CEFI-R) questionnaire, a 19-item tool composed of four dimensions: (1) conception of diversity, (2) methodology, (3) support, and (4) community participation. Pearson's chi-square test was used to assess differences between the dichotomous questions and educational stage; Kruskal-Wallis was used to determine whether the educational stage conditioned the CEFI-R dimensions responses, and the Spearman rho was used to test the association between age groups and the CEFI-R dimensions. Statistical differences were found between secondary education and preschool education and primary education teachers in the dimensions (1) conception of diversity, (2) methodology, and (3) support. Significant differences in dimension (4) community participation between preschool education teachers and secondary and primary education teachers were found.

Professor and Peer Perceptions of Requests for Academic Accommodations in College: An Examination of ADHD and Specific Learning Disorder

University students with attention-deficit/hyperactivity disorder (ADHD) and specific learning disorder (SLD) have higher rates of academic difficulty than their unaffected peers. Thus, some academic accommodations may be useful to them. However, research suggests that college students are hesitant to use their approved academic accommodations for fear of negative perceptions. The aim of the current study was to examine the perceptions of professors and fellow college students (i.e., peers) who were presented with a vignette depicting a fictitious student requesting an academic accommodation. It was hypothesized that professors and peers would have more negative impressions of students needing accommodations because of ADHD and SLD diagnoses, as compared to three other reasons (i.e., depression, a visual impairment, or collegiate athletics [specifically basketball]). In a sequence of two similar experiments, professors and then peers were presented with one of the five vignettes, and were asked to rate the student on various measures of academic ability and work ethic, among other things. Overall, our data suggested relatively positive perceptions of college students who request academic accommodations. However, contrary to the hypothesis, the fictitious basketball player received the most negative ratings. Implications and future directions are discussed.

The "secrets" of English private tutoring in China: Chinese students' experiences of study abroad test preparation in cram schools

English private tutoring, a.k.a. "shadow education" has been an important way that international students rely on for overseas test preparation. Despite the plethora of research on private tutoring in various countries and regions, scarce research focuses on the type of EPT that prepares students for overseas tests. Therefore, this study investigated the experience and perceptions of EPT in preparing for overseas writing tests of 187 Chinese students through retrospective interviews and questionnaires. The present study investigated Chinese students' experience in and perceptions of EPT for study abroad writing test preparation. The results showed that most students received EPT in writing in various ways at cram schools and they devoted themselves to EPT in cram schools intensively. They favored EPT in cram schools mainly because the test-taking strategies taught there could help them obtain a higher grade on the writing section in overseas tests. With respect to writing teaching in cram schools, the most frequent teaching activities included teaching test-taking strategies and providing writing templates. Although most students acknowledged the usefulness of EPT in writing in terms of preparing themselves for the writing test, it was not necessarily the case for improving their general writing abilities. The students believed that the writing instruction was test-oriented and had a ceiling effect in improving their general writing abilities. However, with enough long time in EPT, the cramming nature of cram schools can be less obvious.

Mobile Health Access and Utilisation in Uganda: Knowledge, Attitudes and Perceptions of Health and Veterinary Workers

Background: Despite its strong growth in many parts of the world, mobile health access is still limited in low- and middle-income countries. Among the many factors restricting implementation are the lack of information security, insufficient evidence base, low sensitization, and user acceptance. Limited evidence has been obtained on current practices, perceptions, and user acceptability in such settings. The aim of this study was therefore to evaluate the knowledge, attitude, and perceptions on mobile health use among health workers and veterinary officers in Uganda. Materials and Methods: A cross-section study was carried out, targeting health practitioners in both hospitals and veterinary laboratories/clinics. A structured questionnaire was used to collect data from the Central, Eastern, Northern, and Western representative regions. Interviews with selected health workers were also conducted as well as a focused group discussion. Results: Of the 120 health practitioners that were targeted, a total of 80 health workers and 7 veterinary practitioners participated in the study of which 46% were men and 54% women. Majority of the health workers had encountered m-health but had never used it, whereas the 15 practitioners who had used it before the survey did not use it for disease diagnosis in hospitals but used it for ordering medicine online, for patient consultations with the doctors, result interpretation, tracking women menstrual cycles, tuberculosis assessment. Discussion and Conclusion: Participants expressed significant interest in mobile health as it addresses key challenges including challenges with management of patient data, and long patient queues, which would ultimately improve service delivery. However, there is some skepticism about access as many rural facilities lack access to smartphones and stable internet.

Influence of Educational Specialty on Perceptions towards Corporal Expression of Prospective Teachers

Most educators overlook the importance of corporal expression, even though it has been shown to have various advantages for children of all ages. In the teaching-learning process, teacher views and beliefs are crucial because they have a significant impact on students. Therefore, the purpose of this research is to analyze the existing differences in the perceptions of future teachers towards corporal expression according to their gender and educational specialty. A total of 437 aspiring Spanish instructors participated in the sample, selected by the convenience sampling method, and answered the Questionnaire to Assess Perceptions of Corporal Expression in Future Spanish Teachers to gauge their understanding of and preparation for corporal expression via Google Forms. The Mann-Whitney U test was employed to evaluate the possible differences between the diverse items and factors according to gender and educational specialty. The results displayed good perceptions of corporal expression throughout the sample, finding significant differences in most items and all the dimensions when education specialty is considered. Nevertheless, gender variables did not seem to mediate those perceptions. Therefore, university degrees oriented to education must include the same amount of content related to corporal expression to ensure adequate initial training regardless of the stage of education at which the teachers develop their academic activity.

'Some of my patients only come to renew their prescriptions. They are not interested in any additional advice or support'. Physicians' perceptions on their roles in cardiovascular diseases risk reduction and management in Fiji

BACKGROUND

Primary health care (PHC) physicians' perceptions are vital to understand as they are the first-line health care providers in cardiovascular diseases (CVD) risk assessment and management. This study aims to explore PHC physicians' perceptions on their roles and their perceptions on management and risk reduction approaches on CVD risk reduction and management in Fiji.

METHODS

This is a qualitative study conducted in the Suva Medical area among 7 health centers from 1 August to 31 September, 2021. Purposive sampling was used to recruit physicians who worked in the Suva medical area as PHC physicians with at least 6 months' experience in the Special Outpatients Department clinics. In-depth interview were conducted using a semi-structured questionnaire over the telephone and recorded on a tablet device application. The interview content was then transcribed, and thematic analysis was done.

RESULTS

This study included 25 PHC physicians. From the thematic analysis, 2 major themes emerged with 6 subthemes. Theme 1 was CVD management skills with 3 subthemes including education, experience and trainings, beliefs and attitudes of physicians, self-confidence and effectiveness in CVD risk reduction and management. Theme 2 was roles and expectations with 3 subthemes including perceptions of effective treatment, perceptions of physicians' roles and perceptions of patients' expectations. Physicians generally see their role as central and imperative. They perceive to be important and leading toward combating CVDs.

CONCLUSIONS

Physicians' perceptions on their commitment to prevention and management of CVDs through their skills and knowledge, beliefs and motivation should be acknowledged. It is recommended that the physicians are updated on the current evidence-based medicine. Limitations include results that may not be the reflection of the entire physician and multidisciplinary community and the difficulties in face-to-face interviews due to the coronavirus diseases of 2019 pandemic.

Characterizing the use, preferences, and perceptions of flavors in cigars in pregnant women

BACKGROUND

Flavors contribute to the appeal of tobacco products, but less is known about flavors in cigar products. The current study is the first to focus on characterizing the use and perceptions of flavors in cigar products among pregnant women.

METHODS

Pregnant women (N = 124) reported their use, preferences (liking, attractiveness, smoothness, interest), perceptions of harm (general, pregnancy-specific, fetal), and postpartum intention to use eight flavor categories (menthol/mint, spices, fruit, chocolate, alcohol, other beverages, candy/sweet, tobacco). We utilized correspondence analysis of contingency tables to investigate clustering of preferences and perceptions of flavors across the sample, and examined how preferences and perceptions of flavors may differ based on history of cigar use (none vs. lifetime vs. prenatal).

RESULTS

Overall, 37% reported never trying cigars, 51% reported lifetime use, and 12% reported prenatal use. Fruit (37%), tobacco (36%), and alcohol (14%) were the most common cigar flavors participants reported ever trying. Correspondence analysis revealed clustering in preferences for alcohol, fruit, and candy flavors compared to other flavors, and revealed lower intentions to use menthol/mint and tobacco flavors compared to other flavors. Participants who reported prenatal cigar use also reported more positive perceptions and greater intentions to use (1) spice and alcohol flavors compared to those who reported lifetime use (ps < .05); and (2) spice, alcohol, fruit, and tobacco cigar flavors compared to participants reporting never using cigars (ps < .04).

CONCLUSIONS

Regulations to restrict the availability of flavors, especially fruit, spice, and alcohol, may reduce the appeal and use of cigar products in pregnant women.

Knowledge, Attitudes and Perceptions of Dental Hygiene and Dental Therapy Students towards End-stage Renal Disease: A pilot study

Purpose Chronic kidney disease is highly prevalent in the general population and can progress to end-stage renal disease (ESRD). The purpose of this pilot study was to assess dental hygiene and dental therapy students' knowledge, attitudes, and perceptions towards ESRD and evaluate the feasibility of a larger scale study.Methods A convenience sample (n=59) of dental hygiene (DH) and dual degree DH/dental therapy students were invited to participate in an electronic survey for the pilot study. The investigator designed survey consisted of a total of 37 items: demographics (4), perceived knowledge, confidence, importance and attitudes (14), knowledge of chronic kidney disease (18). The knowledge questions were adapted from the Chronic Kidney Disease Self-Management Knowledge Tool (CKD-SMKT) with permission. Descriptive statistics and the non-parametric two-sample Wilcoxon rank sum test were used to analyze the data.Results Twenty-five participants completed the survey for a 42% response rate. Fewer than half (36%) perceived having some knowledge regarding ESRD, its oral manifestations (28%) and mental health implications (12%). The importance of managing oral health for ESRD was rated by most respondents as "very important" or "extremely important" (76%). Respondent attitudes indicated high interest (68%) regarding employment in hospital settings to care for individuals with ESRD.Knowledge scores from the CKD-SMKT were low in the categories of general knowledge of ESRD and dental hygiene care modifications for individuals with ESRD.Conclusion Results of this pilot study indicate that using a validated instrument on a national sample is feasible to determine the knowledge, attitudes and perceptions of dental hygiene students regarding ESRD. Future research should include knowledge and awareness of hypertension, diabetes, and the role that management of chronic kidney disease plays in the prevention of ESRD.

Predictors of Abortion Attitudes in Medical Students After the Reversal of Roe v. Wade

Background On June 24, 2022, the United States (U.S.) Supreme Court ruled in Dobbs v. Jackson Women's Health that the Constitution does not grant women the right to abortion. This new ruling may have a profound impact on not only the attitudes of medical trainees but the nature in which they are trained when it comes to abortion practices, indications, or procedures. Some clinics where medical schools provide first-hand abortion experience have closed. As a surge of extreme restrictions on abortion has been seen in certain states in the U.S., medical schools and residency programs need to address these issues to ensure future physicians are adequately prepared. The purpose of this study was to assess factors that influence medical students' attitudes toward abortion, specifically knowledge about abortion, religiosity, and philosophical group affiliation regarding abortion (i.e., "pro-choice vs. "pro-life"). Methodology This cross-sectional study collected data from a convenience sample of 413 medical students between October and December 2022 via an online, anonymous questionnaire. Major study variables as depicted in the published literature led to the development of the Abortion Attitudes Questionnaire (AAQ) for medical students. The AAQ contained validated scales to assess the contribution of levels of abortion knowledge and religiosity as well as sample characteristics on attitudes about abortion in medical students. Speakman rank correlation and linear multivariate regression were used for hypothesis testing to explore the contributions of the dependent variables to attitudes about abortion in medical students. Results The mean age of the participants was 25.8 years (SD = 2.96; range = 21-45 years). Linear regression modeling indicated that religiosity, abortion knowledge, being a woman, and group affiliation regarding abortion ("pro-choice" or "pro-life") explained a significant amount of the variance (60%) in abortion attitudes scores in medical students. A significant regression equation was found, F(6,373) = 83.570, p < 0.0001, R² = 0.603, R² adjusted = 0.611). Less religiosity, greater abortion knowledge, being a woman, and identifying as "pro-choice" significantly contributed to more positive attitudes toward abortion in this sample of medical students. Interestingly, while moderately correlated with abortion attitudes (r = 0.436,p < 0.01), the single item regarding the importance of religion in one's life did not contribute to the model. Conclusions The present study is the first, to our knowledge, to identify medical student characteristics (i.e., sex, "pro-choice" vs. "pro-life" group affiliation, level of knowledge about abortion, and religiosity) as indicators of abortion attitudes. With the reversal of Roe v. Wade, attention must be given to the possible change in medical students' attitudes toward abortion (as well as any newly developed constraints on clinical training) and to ensure the provision of comprehensive education as U.S. states will determine the limits of these practices and procedures. While further research in this area is needed, findings from this study can help assess students' attitudes about abortion and guide medical education efforts to better prepare tomorrow's obstetrics and gynecology physicians.

Attitudes and practices related to smoking among university students in Thailand

Objective: To investigate attitudes and practices toward smoking among university students and to identify associated factors. Methods: A cross-sectional study was conducted among 1,299 students from five public universities in Thailand. Factor analysis and multiple regression were used for analysis. Results: A higher score of anti-smoking attitude was associated with female gender, majoring in science, living on campus, having a father with primary or secondary school, and those whose father was employed in the private sector. A more positive perceptions about smoking was associated with male gender, having a family income of 30,001-50,000 baht, and having a smoking friend. High positive preventive practice score was associated with those who came from rural areas, having a mother who was self-employed, and having a smoking family member. Conclusions: Although students showed strong anti-smoking attitudes, their preventive practices were poor. These findings should be taken into consideration when developing preventive smoking programs.