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Alshahrani NZ. Predictors of physical activity and public safety perception regarding technology adoption for promoting physical activity in Jeddah, Saudi Arabia. Prev Med Rep 2024; 43:102753. [PMID: 38798910 PMCID: PMC11127561 DOI: 10.1016/j.pmedr.2024.102753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/29/2024] Open
Abstract
Background This study aims to identify the predictors of levels of physical activity among the residents of Jeddah, Saudi Arabia. Additionally, it seeks to understand the public's safety perception regarding the adoption of technology for promoting physical activity. Method This is an analytical cross-sectional study using self-administered web-based survey. A stratified sampling technique was used to select participants from adult population in Jeddah and data collection took place from May 2023 to December 2023. Multivariable logistic regression models were applied to identify predictors of low-intensity (walking steps) and high-intensity physical activities. Result A total of 462 participated in the study. Gender significantly influenced walking habits, with males more likely to walk than females (AOR = 2.37; 95 % CI: 1.55-3.62; P < 0.001). Smoking status was also a predictor, with smokers more inclined to walk compared to non-smokers (AOR = 2.15; 95 % CI: 1.20-3.82; P = 0.010). High-intensity physical activity strongly correlated with increased walking, especially among those active 3-7 days per week (AOR = 3.03; 95 % CI: 1.91-4.78; P < 0.001). Chronic diseases negatively impacted walking frequency (AOR = 0.57; 95 % CI: 0.34-0.95; P = 0.031). Furthermore, males were likelier to engage in high-intensity activities compared to females (AOR = 1.61; 95 % CI: 1.04-2.50; P = 0.033). Those walking ≥ 10,000 steps weekly were more likely to participate in high-intensity activities (AOR = 3.07; 95 % CI: 1.95-4.82; P < 0.001). Excellent self-rated health was associated with higher participation in such activities (AOR = 2.00; 95 % CI: 1.30-3.06; P = 0.002). Most respondents (84.9 %) felt safe on public walkways, and 78.1 % indicated safety perceptions influenced their walkway use. Technology use was divided, with about half (49.1 %) using apps for tracking physical activity. The majority (90.9 %) supported adding motivational features to the 'Sehhaty' app, and 73.6 % favored financial rewards for walking. However, only 45.5 % believed that public walkways are designed to encourage walking. Conclusion The study highlights significant predictors of physical activity among general population in Jeddah. The study also revealed the impact of safety perceptions and technology use on physical activity, with strong support for motivational features in health apps. However, there is a need for improved design of public walkways to encourage walking.
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Affiliation(s)
- Najim Z. Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Azad CL, Beres LK, Wu AW, Fong A, Giladi AM. Developing a multimedia patient-reported outcomes measure for low literacy patients with a human-centered design approach. PLoS One 2024; 19:e0304351. [PMID: 38838037 DOI: 10.1371/journal.pone.0304351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/10/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION Almost all patient-reported outcomes measures (PROMs) are text-based, which impedes accurate completion by low and limited literacy patients. Few PROMs are designed or validated to be self-administered, either in clinical or research settings, by patients of all literacy levels. We aimed to adapt the Patient Reported Outcomes Measurement Information System Upper Extremity Short Form (PROMIS-UE) to a multimedia version (mPROMIS-UE) that can be self-administered by hand and upper extremity patients of all literacy levels. METHODS Our study in which we applied the Multimedia Adaptation Protocol included seven phases completed in a serial, iterative fashion: planning with our community advisory board; direct observation; discovery interviews with patients, caregivers, and clinic staff; ideation; prototyping; member-checking interviews; and feedback. Direct observations were documented in memos that underwent rapid thematic analysis. Interviews were audio-recorded and documented using analytic memos; a rapid, framework-guided thematic analysis with both inductive and deductive themes was performed. Themes were distilled into design challenges to guide ideation and prototyping that involved our multidisciplinary research team. To assess completeness, credibility, and acceptability we completed additional interviews with member-checking of initial findings and consulted our community advisory board. RESULTS We conducted 12 hours of observations. We interviewed 17 adult English-speaking participants (12 patients, 3 caregivers, 2 staff) of mixed literacy. Our interviews revealed two distinct user personas and three distinct literacy personas; we developed the mPROMIS-UE with these personas in mind. Themes from interviews were distilled into four broad design challenges surrounding literacy, customizability, convenience, and shame. We identified features (audio, animations, icons, avatars, progress indicator, illustrated response scale) that addressed the design challenges. The last 6 interviews included member-checking; participants felt that the themes, design challenges, and corresponding features resonated with them. These features were synthesized into an mPROMIS-UE prototype that underwent rounds of iterative refinement, the last of which was guided by recommendations from our community advisory board. DISCUSSION We successfully adapted the PROMIS-UE to an mPROMIS-UE that addresses the challenges identified by a mixed literacy hand and upper extremity patient cohort. This demonstrates the feasibility of adapting PROMs to multimedia versions. Future research will include back adaptation, usability testing via qualitative evaluation, and psychometric validation of the mPROMIS-UE. A validated mPROMIS-UE will expand clinicians' and investigators' ability to capture patient-reported outcomes in mixed literacy populations.
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Affiliation(s)
- Chao Long Azad
- The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, Maryland, United States of America
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Medicine, Baltimore, Maryland, United States of America
| | - Laura K Beres
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Albert W Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Allan Fong
- MedStar Health Research Institute, Hyattsville, Maryland, United States of America
| | - Aviram M Giladi
- The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, Maryland, United States of America
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Cheng Q, Xie J, Duan Y, Li J, She Z, Lu W, Chen Y. The psychological distress of gastrointestinal cancer patients and its association with quality of life among different genders. Support Care Cancer 2024; 32:329. [PMID: 38709308 DOI: 10.1007/s00520-024-08533-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Psychological distress is a prevalent unpleasant experience faced by many cancer patients. However, the psychological distress among gastrointestinal (GI) cancer patients is scarcely explored. Moreover, the association between psychological distress and quality of life in different genders has yet to be explored. AIMS To explore the psychological distress among GI cancer patients and examine its association with quality of life among different genders. METHODS This study was a cross-sectional study. A total of 237 gastrointestinal cancer patients completed the distress thermometer and the Functional Assessment of Chronic Illness Therapy-General. RESULTS The mean score of psychological distress of the participants was 3.04 (SD = 2.90). A greater proportion of female gastrointestinal cancer patients (52.8%) had clinically relevant psychological distress compared to males (35.9%). The quality of life was negatively associated with their psychological distress (B = - 1.502, 95%CI: - 2.759 to - 0.245, p = 0.019) among gastrointestinal cancer patients. Such association was stronger among males compared to females in gastrointestinal cancer patients (Interaction term, B = - 1.713, 95%CI: - 3.123 to - 0.303, p = 0.017). CONCLUSIONS These findings suggest that healthcare providers should attach their attention to gastrointestinal cancer patients' psychological distress, especially females. Longitudinal studies could adopted to track the changes in psychological distress and its association with quality of life over time among different genders. In future intervention studies, the focus of psychological interventions needs to be gender-specific.
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Affiliation(s)
- Qinqin Cheng
- Hunan Cancer Hospital, Changsha, Hunan, 410013, People's Republic of China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People's Republic of China
| | - Yinglong Duan
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People's Republic of China
| | - Juan Li
- Hunan Cancer Hospital, Changsha, Hunan, 410013, People's Republic of China
| | - Zhengdi She
- Hunan Cancer Hospital, Changsha, Hunan, 410013, People's Republic of China
| | - Wen Lu
- Hunan Cancer Hospital, Changsha, Hunan, 410013, People's Republic of China.
| | - Yongyi Chen
- Hunan Cancer Hospital, Changsha, Hunan, 410013, People's Republic of China.
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Delacruz NM, Anderson KL, Smith BS. Dental hygiene clinical faculty attitudes and likelihood of working during the COVID-19 pandemic. Int J Dent Hyg 2024; 22:313-320. [PMID: 37720993 DOI: 10.1111/idh.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To identify circumstances that influenced dental hygiene clinical faculty's likelihood of working during the COVID-19 pandemic, and to explore attitudes (responsibilities, personal issues, ethics, and policy statements) about working. METHODS This cross-sectional study used a purposive sample of dental hygienists (n = 1710) employed in academic clinical settings that held full-time, part-time, or adjunct appointments. The Health Care Workers' Attitudes to Working During a Pandemic survey was utilized. Likelihood scores were calculated based on respondents more or less likely to work under differing circumstances. Frequencies of agreement for attitudes were developed. Correlations were explored between likelihood scores and demographic data. Answers to the open-ended questions were categorized and described. RESULTS The response rate was 13.5% (225/1710). Only one-third of respondents had a likelihood score of 100%. Factors with the greatest impact on likelihood to work were personal protective equipment. Almost all respondents' attitudes of working indicated that their employer is responsible for providing PPE. Over 90% felt their main responsibility was to themselves/family. Correlation analyses resulted in no significant associations between likelihood scores and age, etc. Faculty are considering leaving their jobs because of pay cuts and/or not feeling safe. CONCLUSION Likelihood of working for dental hygiene faculty represents several personal and ethical decisions. Most respondents want employers to be responsible for their on-the-job safety. In addition, personal and work-related issues were causes of unease. The pandemic has had far-reaching implications on day-to-day work of dental hygiene clinical faculty as well as on the long-term trajectories and views on employment in higher education.
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Affiliation(s)
- Natalie M Delacruz
- Department of Dental Hygiene, Wichita State University, Wichita, Kansas, USA
| | - Kelly L Anderson
- Department of Dental Hygiene, Wichita State University, Wichita, Kansas, USA
| | - Barbara S Smith
- Department of Physical Therapy, Wichita State University, Wichita, Kansas, USA
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Miletic K, Servais M, Cardy JO, Denusik L. Do Caregiver Perceptions of the Virtual More Than Words® Program Differ Based on Autistic Children's Attributes? AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1127-1141. [PMID: 38381120 DOI: 10.1044/2024_ajslp-23-00278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
PURPOSE More Than Words® (MTW) is a caregiver-mediated intervention program led by a speech-language pathologist (SLP) who teaches caregivers strategies to support their autistic child's early social communication and play development. The program includes group sessions composed of multiple families with children of varying profiles. We explored whether caregiver experiences and perceived outcomes of the virtual MTW program differed depending on the child's age and social communication stage. METHOD As part of a program evaluation of virtual MTW delivered to over 2,000 families in Ontario, Canada, between 2020 and 2021, we randomly selected 31 families across four social communication stages and two age groups using stratified sampling (n = 4, in all but one subgroup). The Final Reflection and Evaluation form was analyzed both qualitatively and quantitatively, and a modified RE-AIM framework guided our analyses, including theme development. RESULTS Child attributes did not appear to impact caregivers' experiences, but perceived child skill improvements varied by children's social communication stage. The majority of caregivers reported changes in how they interact with their child. Four themes emerged: (a) perceived child skill improvements differed by social communication stage, (b) caregivers gained new knowledge and strategies regardless of child attributes, (c) SLPs effectively managed families' individual needs, and (d) program components were appropriate for a variety of families. CONCLUSIONS Findings suggest that the content taught in the MTW program was relevant for a variety of children, including those beyond the program's intended age of 5 years and under. Grouping families of children with varying profiles does not appear to negatively influence caregivers' experiences or perceived outcomes. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25237009.
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Affiliation(s)
| | - Michelle Servais
- University of Western Ontario, London, Canada
- Thames Valley Children's Centre, London, Ontario, Canada
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Bao X, Komesidou R, Hogan TP. A Review of Screeners to Identify Risk of Developmental Language Disorder. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1548-1571. [PMID: 38324341 DOI: 10.1044/2023_ajslp-23-00286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
PURPOSE This review aims to comprehensively summarize, compare, and evaluate screeners used to identify risk for developmental language disorder (DLD), a common learning disability that is underidentified. Screening for DLD is a cost-effective way to identify children in need of further assessment and, in turn, provides much needed supports. METHOD We identified 15 commercially available English language DLD screeners in North America. We then characterized each screener on 27 aspects in three domains, including (a) accessibility information (acronym, subtest, website, cost, materials included, publish year, examiner qualification, age range, administration time, and administration format), (b) usability features (dialect compatibility, progress monitoring function, actionable follow-up instruction, group assessment capability, and online administration availability), and (c) technical standards (the availability of a technical manual, conceptual definition, the sample size used in classification accuracy calculation, sample distribution, year of sample collection, outcome measure, sample base rate, cutoff score, sensitivity, specificity, positive predictive value, and negative predictive value). RESULTS We obtained sufficient accessibility information from 14 out of 15 (93%) screeners. In contrast, none of the screeners (0%) included comprehensive usability features. Ten screeners (67%) included a range of classification accuracy (70%-100% sensitivity and 68%-90% specificity). We provided areas of strength and weakness for each screener as a quick reference for users and generated screener recommendations for five practical scenarios. CONCLUSIONS Our findings presented some DLD screeners that meet most standards and highlight numerous areas for improvement, including improving classification accuracy and clarifying follow-up instructions for children who are identified with DLD risk. Screening for DLD is critical to provide timely early identification, intervention, and classroom support, which in turn facilitates student outcomes.
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Affiliation(s)
- Xue Bao
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA
| | - Rouzana Komesidou
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA
| | - Tiffany P Hogan
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA
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Norful AA, Dierkes A, de Jacq K, Brewer KC. Construct Validity Testing of the Provider Co-Management Index to Measure Shared Care in Provider Dyads. Nurs Res 2024; 73:248-254. [PMID: 38329959 DOI: 10.1097/nnr.0000000000000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND Co-management encompasses the dyadic process between two healthcare providers. The Provider Co-Management Index (PCMI) was initially developed as a 20-item instrument across three theory-informed subscales. OBJECTIVE This study aimed to establish construct validity of the PCMI with a sample of primary care providers through exploratory and confirmatory factor analyses. METHODS We conducted a cross-sectional survey of primary care physicians, nurse practitioners, and physician assistants randomly selected from the IQVIA database across New York State. Mail surveys were used to acquire a minimum of 300 responses for split sample factor analyses. The first subsample (derivation sample) was used to explore factorial structure by conducting an exploratory factor analysis. A second (validation) sample was used to confirm the emerged factorial structure using confirmatory factor analysis. We performed iterative analysis and calculated good fit indices to determine the best-fit model. RESULTS There were 333 responses included in the analysis. Cronbach's alpha was high for a three-item per dimension scale within a one-factor model. The instrument was named PCMI-9 to indicate the shorter version length. DISCUSSION This study established the construct validity of an instrument that scales the co-management of patients by two providers. The final instrument includes nine items on a single factor using a 4-point, Likert-type scale. Additional research is needed to establish discriminant validity.
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Daliri DB, Afaya A, Laari TT, Abagye N, Aninanya GA. Exploring the burden on family caregivers in providing care for their mentally ill relatives in the Upper East Region of Ghana. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003075. [PMID: 38626022 PMCID: PMC11020355 DOI: 10.1371/journal.pgph.0003075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 03/13/2024] [Indexed: 04/18/2024]
Abstract
Caring for the mentally ill involves numerous challenges, including financial difficulties, stigma, and psychosocial issues, among others. Unpaid family caregivers must endure these challenges as they continue their care for their relatives with mental illness. Despite these burdens and their concomitant effects on both the patients and their caregivers, there is no evidence of this burden in the Bolgatanga municipality. This study explored the burden on family caregivers providing care for mentally ill relatives in the Bolgatanga Municipality of the Upper East Region of Ghana. The study employed a phenomenological research design. Fifteen family caregivers were purposively sampled from two secondary-level health facilities. In-depth interviews were conducted, audio-recorded, and transcribed verbatim. NVivo 12 pro software was used for data analysis. Thematic analysis was conducted following Braun and Clarke's approach. The study identified three themes including social, physical, and psychological burdens. Under social burden, financial challenges and stigma were identified, weight loss was identified as a physical burden, and poor concentration as a psychological burden. These themes represent the challenges encountered by the family caregivers as they provided care for their mentally ill relatives. There is a need to provide support for family caregivers including respite, formation of support groups, and financial support to alleviate family caregivers of the burdens they endure. Additionally, it is imperative to integrate mental health services into the national health insurance scheme to alleviate the financial burden on family caregivers.
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Affiliation(s)
- Dennis Bomansang Daliri
- Presbyterian Psychiatric Hospital, Bolgatanga, Ghana
- Department of International and Global Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | | | - Nancy Abagye
- Department of Midwifery, School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana
| | - Gifty Apiung Aninanya
- Department of Health Services Policy Planning Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana
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Alassafi MO, Aziz W, AlGhamdi R, Alshdadi AA, Nadeem MSA, Khan IR, Bahaddad A, Altalbe A, Albishry N. Complexity reduction of oxygen saturation variability signals in COVID-19 patients: Implications for cardiorespiratory control. J Infect Public Health 2024; 17:601-608. [PMID: 38377633 DOI: 10.1016/j.jiph.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a respiratory illness that leads to severe acute respiratory syndrome and various cardiorespiratory complications, contributing to morbidity and mortality. Entropy analysis has demonstrated its ability to monitor physiological states and system dynamics during health and disease. The main objective of the study is to extract information about cardiorespiratory control by conducting a complexity analysis of OSV signals using scale-based entropy measures following a two-month timeframe after recovery. METHODS This prospective study collected data from subjects meeting specific criteria, using a Beurer PO-80 pulse oximeter to measure oxygen saturation (SpO2) and pulse rate. Excluding individuals with a history of pulmonary/cardiovascular issues, the study analyzed 88 recordings from 44 subjects (26 men, 18 women, mean age 45.34 ± 14.40) during COVID-19 and two months post-recovery. Data preprocessing and scale-based entropy analysis were applied to assess OSV signals. RESULTS The study found a significant difference in mean OSV during illness (95.08 ± 0.15) compared to post-recovery (95.59 ± 1.03), indicating reduced cardiorespiratory dynamism during COVID-19. Multiscale entropy analyses (MSE, MPE, MFE) confirmed lower entropy values during illness across all time scales, particularly at higher scales. Notably, the maximum distinction between illness and recovery phases was seen at specific time scales and similarity criteria for each entropy measure, showing statistically significant differences. CONCLUSIONS The study demonstrates that the loss of complexity in OSV signals, quantified using scale-based entropy measures, has the potential to detect malfunctioning of cardiorespiratory control in COVID-19 patients. This finding suggests that OSV signals could serve as a valuable indicator for assessing the cardiorespiratory status of COVID-19 patients and monitoring their recovery progress.
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Affiliation(s)
- Madini O Alassafi
- Department of Information Technology, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wajid Aziz
- Department of Computer Science and Information Technology, King Abdullah Campus, University of Azad Jammu and Kashmir, Muzaffarabad, AK, Pakistan
| | - Rayed AlGhamdi
- Department of Information Technology, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Abdulrahman A Alshdadi
- Department of Information Systems and Technology, College of Computer Science and Engineering, University of Jeddah, Saudi Arabia
| | - Malik Sajjad Ahmed Nadeem
- Department of Computer Science and Information Technology, King Abdullah Campus, University of Azad Jammu and Kashmir, Muzaffarabad, AK, Pakistan
| | | | - Adel Bahaddad
- Department of Information Technology, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali Altalbe
- Department of Information Technology, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nabeel Albishry
- Department of Information Technology, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
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Gamvrouli M, Karanikola MNK, Paschali A, Giannakopoulou M. Reliability of Moral Distress Scale, Secondary Traumatic Stress Scale, and Jefferson Scale of Empathy Among Greek Nurses: A Pilot Study. J Nurs Meas 2024; 32:18-27. [PMID: 37348889 DOI: 10.1891/jnm-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Background and Purpose: Moral distress (MD), secondary traumatic stress (STS), and empathy are of particular interest to the nursing profession. The availability of validated tools for the assessment of these parameters is of high importance. The primary aim of this pilot study was to evaluate the reliability of the Greek version of the MD Scale or the revised version (MDS-R), the Jefferson Scale of Empathy for Health Professionals (JSE-HP), and the STS Scale (STSS) in Greek nurses working in open and psychiatric wards. Methods: To assess the reliability of scales, internal consistency (coefficient alphas) and test-retest (interclass correlation coefficients [ICCs]) were calculated. Results: A total of 38 nurses took part in the study. All scales and subscales presented excellent stability (.876 ≤ ICC ≤ .963, p < .0001) and acceptable to excellent internal consistency reliability (first measurement, .796 ≤ coefficient alpha ≤ .959; second measurement, .794 ≤ coefficient alpha ≤ .956). Conclusions: The Greek version of MDS-R, STSS, and JSE-HP may be proposed for the assessment of relevant variables in Greek nursing staff.
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Affiliation(s)
- Maria Gamvrouli
- General Hospital of Nikaia-Piraeus "Agios Panteleimon" 20, Nikaia, Attica, Greece
| | - Maria N K Karanikola
- Associate Professor in Mental Health Nursing, Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Antonia Paschali
- Associate Professor in Health Psychology, Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Margarita Giannakopoulou
- Professor in Fundamentals of Nursing, Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
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Daliri DB, Aninanya GA, Laari TT, Abagye N, Dei-Asamoa R, Afaya A. Exploring the barriers to mental health service utilization in the Bolgatanga Municipality: the perspectives of family caregivers, service providers, and mental health administrators. BMC Health Serv Res 2024; 24:278. [PMID: 38443928 PMCID: PMC10916073 DOI: 10.1186/s12913-024-10567-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/05/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Mental health service utilization remains a challenge in developing countries, with numerous barriers affecting access to care. Albeit data suggest poor utilization of mental health services in the Bolgatanga Municipality in Ghana, no studies have explored the barriers to the utilization of mental health services. Therefore, this study explored the perspectives of family caregivers, service providers, and mental health service administrators on the barriers to mental health service utilization in the Bolgatanga Municipality, Ghana. METHODS A qualitative descriptive design was employed for the study. Nineteen participants were purposively sampled from two hospitals including fifteen family caregivers, two service providers, and two mental health administrators. Data were collected through individual in-depth interviews using a semi-structured interview guide. Audio-recorded interviews were transcribed verbatim and thematically analyzed using NVivo 12 pro software. RESULTS Five main themes emerged including individual-level barriers, interpersonal barriers, community-level barriers, organizational-level barriers, and policy-level barriers. At the individual level, lack of insight, poor treatment compliance, and financial challenges were prominent barriers. Interpersonal barriers included family pressure influenced by cultural and spiritual beliefs. At the community level, stigma and mental health illiteracy were identified as significant barriers. At the organizational level, barriers encompassed inadequate staffing, limited space, and staff attitudes. Policy-level barriers included the neglect of mental health in policies and the non-inclusion of mental health services in the National Health Insurance Scheme. CONCLUSION This study highlights the complexity of barriers to mental health service utilization and underscores the need for a comprehensive approach to address them. Collaborative efforts involving healthcare providers, policymakers, communities, and families are essential to mitigate these barriers. It is imperative to consider these barriers when developing strategies to improve the utilization of mental health services in Ghana.
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Affiliation(s)
- Dennis Bomansang Daliri
- Presbyterian Psychiatric Hospital, Bolgatanga, Ghana
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Gifty Apiung Aninanya
- Department of Health Services Policy Planning Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana
| | | | - Nancy Abagye
- Department of Midwifery, School of Nursing and Midwifery, University of Ghana, Legon, Ghana
| | - Richard Dei-Asamoa
- Department of Psychiatry, Korle-Bu Teaching Hospital, Accra, Ghana
- Department of Psychiatry, University of Ghana Medical School, Accra, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
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12
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Houben F, den Heijer CD, van Hensbergen M, Dukers-Muijrers NH, de Bont EG, Hoebe CJ. Behavioural determinants shaping infection prevention and control behaviour among healthcare workers in Dutch general practices: a qualitative study reflecting on pre-, during and post-COVID-19 pandemic. BMC PRIMARY CARE 2024; 25:72. [PMID: 38418938 PMCID: PMC10900587 DOI: 10.1186/s12875-024-02304-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/11/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Since the Coronavirus Disease 2019 (COVID-19) pandemic, awareness of infection prevention and control (IPC) has increased in primary care settings. This study aimed to examine behavioural determinants shaping IPC behaviour pre-, during, and post-pandemic among healthcare workers (HCWs) in general practices, to inform optimised IPC in primary care. METHODS For this qualitative study, semi-structured in-depth interviews were conducted during two study periods: (1) pre-COVID-19 pandemic: July 2019-February 2020, with 14 general practitioners (GPs) and medical assistants, and (2) during the COVID-19 pandemic: July 2022-February 2023, with 22 GPs and medical assistants. The design was informed by behaviour change theories. Data were analysed using thematic analysis. RESULTS Main themes were: (1) risk perception and IPC awareness, (2) attitudes towards IPC and professional responsibility, (3) decision-making process and risk considerations for IPC adherence, (4) social norm and social influence in GP practice team, and (5) environmental context and resource availability in GP practice. During the pandemic, risk perception and awareness of the importance of IPC increased compared to the pre-pandemic period. A consistent belief emerged that IPC is part of professional responsibility, while needing to be balanced with other aspects of patient care. Decision-making is dependent on the individual GP and mainly influenced by risk assessments and sustainability considerations. The social context in the practice team can reinforce IPC behaviours. GP practice building and layout, and limited IPC resource and material availability were reported as main barriers. CONCLUSIONS The theory-informed insights of this study can be used for targeted interventions to optimise IPC behaviour in general practices. Adopting multifaceted strategies to target the various determinants is recommended to sustain IPC, by implementing continuous education using tailored communication, integrating IPC in work routines and organisational workflows, refining existing IPC protocols by incorporating decision-making tools for HCWs, fostering a culture of IPC through knowledge-sharing and teamwork, and addressing GP practice physical environment and IPC resource barriers.
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Affiliation(s)
- Famke Houben
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands.
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands.
| | - Casper Dj den Heijer
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands
| | - Mitch van Hensbergen
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
| | - Nicole Htm Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Eefje Gpm de Bont
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Christian Jpa Hoebe
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, P.O. Box 33, Heerlen, 6400 AA, The Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands
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Carvajal B, Hancock A, Lewney K, Hagan K, Jamieson S, Cooke A. A global overview of midwives' working conditions: A rapid review of literature on positive practice environment. Women Birth 2024; 37:15-50. [PMID: 37648619 DOI: 10.1016/j.wombi.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/24/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND In the United Kingdom (UK), a critical shortage of midwives puts pressure on the already overworked midwives working in maternity services. Considering the challenges that midwives in the UK face, this rapid review was conducted to inform a larger-scale initiative to improve the working conditions of midwives in an acute NHS Trust in the Midlands area of the UK. OBJECTIVE To describe midwives' perceptions and experiences of positive practice environments. METHODS A search strategy to identify literature about midwives' perceptions and experiences of positive practice environments was conducted in Medline, CINAHL Plus and Embase databases. Literature screening was conducted independently in two steps using an eligibility tool. The articles' quality assessment was conducted using the Mixed Method Appraisal Tool. Data were extracted using the Job Quality framework and managed using NVivo12. RESULTS Seventy articles were included in this review. Midwives' working conditions can be improved in all seven areas of the Job Quality framework. Most articles in the review reported the negative aspects of midwives' working environments, making it challenging for the team to define a positive practice environment for midwives. Despite this, authors discuss that a positive practice environment is at least sustained by ensuring midwives' ability to provide care; providing good employment conditions; developing respectful organisations; and increasing team resources, such as those that improve team resilience. CONCLUSIONS Midwives' working conditions are universally challenging. Failure to address the situation will compromise recruitment and retention, increasing the shortage of midwives. Provision of safe and respectful care appears to be directly linked to midwives' safe and respectful working conditions.
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Affiliation(s)
- Bielka Carvajal
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK; Division of Nursing, Midwifery and Social Work, The University of Manchester, UK; Departamento de Promocion de la Salud de la Mujer y el Recien Nacido, Universidad de Chile, Chile.
| | - Angela Hancock
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK; Division of Nursing, Midwifery and Social Work, The University of Manchester, UK; School of Nursing and Midwifery, Keele University, UK
| | - Katharine Lewney
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK
| | - Karen Hagan
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK
| | - Sarah Jamieson
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK
| | - Alison Cooke
- Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands NHS Trust, UK; Division of Nursing, Midwifery and Social Work, The University of Manchester, UK; School of Nursing and Midwifery, Keele University, UK
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Al-jedai AH, Mayet AY, Khurshid F, Alsultan MS. Pharmacy practice in hospital settings in GCC countries: Pharmacists' medication therapy monitoring activities. Saudi Pharm J 2024; 32:101952. [PMID: 38283152 PMCID: PMC10820306 DOI: 10.1016/j.jsps.2024.101952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Purpose Our study aims to provide an overview of medication therapy monitoring practices carried out by pharmacists in hospitals across the Gulf Cooperation Council (GCC) countries. Methods This is a cross-sectional questionnaire-based study of hospitals located in the GCC. Questions were adopted from the American Society of Health-System Pharmacists (ASHP) national survey. Frequency analyses were used to examine the number and percentages of specific responses to the survey questions. Results A total of 64 hospitals participated in this survey, reflecting an overall response rate of 52.0%. Almost half of participating hospitals (48.4%) were from Saudi Arabia. Among the 64 participating hospitals, 54.7% monitored their patients daily, 40.6% assigned pharmacists to patient care units for at least eight hours per day, and 42.2% held pharmacists accountable for medication-related outcomes. Moreover, the criteria used to identify patients requiring monitoring, 35.9% relied on the list of high-risk medications, 26.5% relied on specific medical services, 21.9% relied on directions from the hospital committee, and 17.2% relied on lab abnormalities. The most frequently utilized method for monitoring adverse drug events (ADEs) was through notifications from nurses or physicians, observed in 60.9% of participating hospitals. Conclusion The survey emphasizes the need for hospitals in the GCC to promote increased pharmacist accountability for medication-related outcomes, explore technological solutions to enhance monitoring efficiency and extend the presence of pharmacists in patient care units beyond the current level.
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Affiliation(s)
- Ahmed H. Al-jedai
- Therapeutic Affairs, Ministry of Health, Riyadh, Saudi Arabia
- Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia
| | - Ahmed Y. Mayet
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box: 2457, Riyadh 11451, Saudi Arabia
| | - Fowad Khurshid
- Department of Pharmacy, Institute of Biomedical Education and Research, Mangalayatan University, Aligarh 202145, India
| | - Mohammed S. Alsultan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box: 2457, Riyadh 11451, Saudi Arabia
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Cham CQ, Ibrahim N, Kalaman CR, Ho MC, Visvalingam U, Ahmad Shahabuddin F, Abd Rahman FN, Halim MRTA, Harbajan Singh MK, Azhar FL, Yahya AN, Roslan S, Siau CS. Factors associated with depression, anxiety, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients: A cross-sectional study. Glob Ment Health (Camb) 2024; 11:e12. [PMID: 38390253 PMCID: PMC10882176 DOI: 10.1017/gmh.2024.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
Depression and anxiety are prevalent mental health issues worldwide, especially among parental caregivers. By expanding the family stress model, this cross-sectional study investigated the relevant factors associated with depressive symptoms, anxiety symptoms, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients. Data were collected through questionnaires (N = 207) across five major public hospitals through convenience sampling. Participants answered questionnaires measuring financial strain, caregiver burden, relationship quality, belief in mental illness, perceived COVID-19 stress, satisfaction with health services, depressive symptoms, anxiety symptoms and life satisfaction. Findings revealed that relationship quality among spouses, COVID-19 stress and caregiver burden were significantly correlated with anxiety symptoms, depressive symptoms and satisfaction with life. The multiple regression model also suggested that depressive symptoms (β = .613, p < .001), anxiety symptoms (β= .657, p < .001) and relationship quality among spouses (β = .264, p < .001) were the most influential predictors of anxiety symptoms, depressive symptoms and satisfaction with life respectively. By addressing the mental health needs of parental caregivers, this study can contribute to improving the overall quality of care and support provided to adolescent patients and their caregivers in Malaysia and beyond.
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Affiliation(s)
- Choy Qing Cham
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Clarisse Roswini Kalaman
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Meng Chuan Ho
- Centre for Pre-U Studies, UCSI University (Springhill Campus), Port Dickson, Malaysia
| | - Uma Visvalingam
- Department of Psychiatry and Mental Health, Hospital Sungai Buloh, Sungai Buloh, Malaysia
| | | | - Fairuz Nazri Abd Rahman
- Psychiatry Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Radzi Tarmizi A Halim
- Faculty of Business, Economics and Social Development, Universiti Malaysia Terengganu, Kuala Nerus, Malaysia
| | | | - Fatin Liyana Azhar
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Amira Najiha Yahya
- Department of Educational Psychology and Counselling, Faculty of Education, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Samsilah Roslan
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Plant BRC, Van Leeuwen ML, Peters P, Van der Heijden BIJM. Train to sustain: a randomised controlled trial evaluation of a vitality training employing behaviour-change techniques. Front Psychol 2024; 14:1320826. [PMID: 38292519 PMCID: PMC10826839 DOI: 10.3389/fpsyg.2023.1320826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction This paper reports on the effects of a 9-week vitality training that employed behaviour-change techniques and was evaluated using a randomised controlled trial (RCT) in three large companies based in the Netherlands. Methods A total of 84 adult employees from three participating organisations in the Netherlands were enrolled in the study. A parallel group RCT design was employed and participants were assigned using individual random assignment to either an intervention (n = 38) or a waitlist control group (n = 46). The intervention consisted of a 9-week vitality training employing the behaviour-change techniques of self-persuasion, implementation intentions, and self-efficacy, which was delivered in-house over five fortnightly 2-hour sessions. Primary outcomes (i.e., reported energy and stress) and secondary outcomes (i.e., reported daily life satisfaction and work capacity) were assessed prior to, immediately after, and 3 months following the intervention. Results A mixed MANOVA revealed a significant interaction effect between treatment group and time period for the combination of reported energy, stress, daily life satisfaction, and work capacity. Subsequent univariate ANOVAs revealed significant interactions between treatment group and time period for reported energy, stress, and daily life satisfaction; however, not for reported work capacity. Improvements in outcomes were observed for both groups following their completion of the vitality training; however, not all improvements reached statistical significance. Reported self-efficacy regarding managing work-life balance was found to mediate the relationship between the effects of the intervention and reported energy; however, such an effect was not found for stress. Discussion An intervention drawing upon evidence-based behaviour-change techniques shows promise for improving indicators associated with burnout; although, it is recommended that in future research a larger-scale evaluation be conducted over a longer time period with an active control group to establish effectiveness.Clinical trial registration: https://www.anzctr.org.au/, ACTRN12622001268730.
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Affiliation(s)
- Bernice R. C. Plant
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Clayton, VIC, Australia
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | | | - Pascale Peters
- Nyenrode Business Universiteit, Breukelen, Netherlands
- Department of Organisation, Leadership and Management, Inland School of Business and Social Sciences, Lillehammer, Norway
| | - Beatrice I. J. M. Van der Heijden
- Institute for Management Research, Radboud University, Nijmegen, Netherlands
- Faculty of Management, Open Universiteit, Heerlen, Netherlands
- Department of Marketing, Innovation and Organisation, Ghent University, Ghent, Belgium
- Business School, Hubei University, Wuhan, China
- Kingston Business School, Kingston University, Kingston upon Thames, United Kingdom
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17
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Llosa JA, Agulló-Tomás E, Menéndez-Espina S, Rivero-Díaz ML. Perceived precarious life: a SEM model for re-dimensioning of precarious work and its impact on mental health. Front Public Health 2024; 11:1254843. [PMID: 38249412 PMCID: PMC10796509 DOI: 10.3389/fpubh.2023.1254843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Precarious work is one of the most studied concepts related to work, and its effects have been analyzed in relation to variables such as mental health and wellbeing. However, there is a tendency to atomise the analysis of precarious work, without understanding that people's working life is intertwined with other areas of their life. Objective Faced with this situation, this paper presents the concept of perceived precarious life, which is aligned with contemporary models of social inclusion and exclusion. Thus, perceived precarious life comprises variables of labor precariousness, social support and hopelessness in the family economic situation. Methods To test this idea, a structural equation model (SEM) is presented, which tests the structure of the construct of perceived precarious life by relating it to mental health and coping strategies. Results After testing the fit of the model in both men and women, a SEM path analysis is designed between the variables, observing that perceived precarious life has an effect on mental health (β = 0.635, p < 0.01). This relationship is mediated by unproductive coping strategies (β = 0.142, p < 0.01). Conclusion This model exposes a broad and integrated conceptualization of precariousness, combining aspects of work, relationships and hopelessness, which allows for an understanding of the integral experience of precariousness.
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Affiliation(s)
- José Antonio Llosa
- Department of Social Education, Faculty Padre Ossó, University of Oviedo, Oviedo, Spain
| | - Esteban Agulló-Tomás
- Department of Psychology, Faculty of Psychology, University of Oviedo, Oviedo, Spain
| | - Sara Menéndez-Espina
- Department of Social Education, Faculty Padre Ossó, University of Oviedo, Oviedo, Spain
| | - María Luz Rivero-Díaz
- Department of Psychology, Faculty of Psychology, University of Oviedo, Oviedo, Spain
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Lum M, Grady A, Wolfenden L, Lecathelinais C, Lin Yoong S. Implementation of healthy eating and physical activity practices in Australian early childhood education and care services: A cross-sectional study. Prev Med Rep 2023; 36:102455. [PMID: 37840588 PMCID: PMC10571023 DOI: 10.1016/j.pmedr.2023.102455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/29/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023] Open
Abstract
Background The monitoring of healthy eating and physical activity environments is recommended to support population health. Early childhood education and care (ECEC) services are a key setting to deliver obesity prevention strategies as they reach the majority of children aged under five years and have existing supporting infrastructure. Objectives The aim of this study was to i) describe the prevalence of implementation of evidence-based healthy eating and physical activity practices in an Australian sample of ECEC services, and ii) examine associations between implementation of practices and service characteristics. Methods A random sample of 2,100 centre-based ECEC services across Australia were invited to participate in a cross-sectional survey online or via telephone (August 2021-April 2022). Service characteristics and implementation of 18 evidence-based healthy eating and physical activity practices were assessed. Descriptive statistics and linear mixed regression analyses were performed. Results A total of 1,028 (51.8%) eligible services participated. The healthy eating and physical activity practices with the lowest prevalence of implementation were related to encouraging children to consume age-appropriate beverages (17.9%) and providing families with child physical activity education via workshops or meetings (14.6%), respectively. There was a statistically significant difference in the implementation of healthy eating practices by service characteristics, with long day care services implementing significantly more practices than preschools (p < 0.01). Conclusion There is room to improve the implementation of evidence-based healthy eating and physical activity practices ECEC services. Implementation efforts should be directed towards preschools.
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Affiliation(s)
- Melanie Lum
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, School of Health and Social Development, Faculty of Health, Geelong VIC 3220 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend NSW 2287 Australia
- National Centre of Implementation Science, University of Newcastle, Locked Bag 10, Wallsend NSW 2287 Australia
| | - Alice Grady
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend NSW 2287 Australia
- National Centre of Implementation Science, University of Newcastle, Locked Bag 10, Wallsend NSW 2287 Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend NSW 2287 Australia
- National Centre of Implementation Science, University of Newcastle, Locked Bag 10, Wallsend NSW 2287 Australia
| | - Christophe Lecathelinais
- Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend NSW 2287 Australia
| | - Sze Lin Yoong
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, School of Health and Social Development, Faculty of Health, Geelong VIC 3220 Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308 Australia
- Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend NSW 2287 Australia
- National Centre of Implementation Science, University of Newcastle, Locked Bag 10, Wallsend NSW 2287 Australia
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Ahluwalia M, Shillington KJ, Irwin JD. The relationship between resilience and mental health of undergraduate students: A scoping review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-14. [PMID: 37856363 DOI: 10.1080/07448481.2023.2252925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/20/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE The aim of this scoping review was to examine what is known about the relationship between the resilience and mental health of undergraduate students enrolled in university or college programs, globally. METHODS Five electronic databases were searched, yielding a total of 1,498 articles that were screened independently by two researchers. Thirteen articles were eligible for inclusion. RESULTS The mental health of undergraduate students in the studies reviewed ranged from low to moderate. Undergraduate students also reported high, moderate, and low levels of resilience. Further, resilience was positively correlated with mental well-being. CONCLUSION Findings revealed that the mental health of undergraduate students was poor. Given the established relationship between students' mental health and resilience, evidence-based approaches aimed at strengthening students' resilience, such as providing opportunities for social support, are warranted in order to improve students' mental health. Additional research to rigorously assess this relationship in representative student populations is needed.
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Affiliation(s)
- Manvir Ahluwalia
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Katie J Shillington
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Jennifer D Irwin
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
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Piaggio D, Zarro M, Pagliara S, Andellini M, Almuhini A, Maccaro A, Pecchia L. The use of smart environments and robots for infection prevention control: A systematic literature review. Am J Infect Control 2023; 51:1175-1181. [PMID: 36924997 DOI: 10.1016/j.ajic.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND Infection prevention and control (IPC) is essential to prevent nosocomial infections. This manuscript aims at investigating the current use and role of robots and smart environments on IPC systems in nosocomial settings METHODS: The systematic literature review was performed following the PRISMA statement. Literature was searched for articles published in the period January 2016 to October 2022. Two authors determined the eligibility of the papers, with conflicting decisions being mitigated by a third. Relevant data was then extracted using an ad-hoc extraction table to facilitate the analysis and narrative synthesis. RESULTS The search strategy returned 1520 citations and 17 papers were included. This review identified 3 main areas of interest: hand hygiene and personal protective equipment compliance, automatic infection cluster detection and environments cleaning (ie, air quality control, sterilization). This review demonstrates that IPC practices within hospitals mostly do not rely on automation and robotic technology, and few advancements have been made in this field. CONCLUSIONS Increasing the awareness of healthcare workers on these technologies, through training and involving them in the design process, is essential to accomplish the Health 4.0 transformation. Research priorities should also be considering how to implement similar or more contextualized alternatives for low-income countries.
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Affiliation(s)
- Davide Piaggio
- School of Engineering, University of Warwick, Coventry, UK.
| | - Marianna Zarro
- School of Engineering, University of Warwick, Coventry, UK; Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | | | | | - Abdulaziz Almuhini
- School of Engineering, University of Warwick, Coventry, UK; Department of Biomedical Technology, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | - Leandro Pecchia
- School of Engineering, University of Warwick, Coventry, UK; Università Campus Bio-Medico, Roma, Italy; R&D Blueprint and COVID-19, World Health Organization, Genève, Switzerland
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McGhan G, McCaughey D, Flemons K. Examining the Needs of Family Caregivers of People Living with Dementia in the Community during the COVID-19 Pandemic. Can J Aging 2023; 42:485-494. [PMID: 37272524 DOI: 10.1017/s0714980823000119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
The COVID-19 pandemic has had a disproportionate effect on older adults and their family caregivers (FCGs). For FCGs, the pandemic has impacted almost every dimension of their lives and caregiving routines, from their own risk of becoming ill to their access to resources that support caregiving. The purpose of this mixed-methods study was to examine the impact of COVID-19 on FCGs' ability to provide care for their family member with dementia. A total of 115 FCGs who identified as having their family member living with dementia residing in the community completed the survey. Ten family caregivers participated in the follow-up focus groups. Recommendations to address the needs of FCGs now and in the future include: (1) making resources for care provision consistently available and tailored, (2) providing support for navigating the health care system, and (3) supplying concise information on how to provide care during public health emergencies.
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Affiliation(s)
- Gwen McGhan
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Deirdre McCaughey
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kristin Flemons
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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Leung AYL, Zhang J, Chan CY, Chen X, Mao J, Jia Z, Li X, Shen J. Validation of evidence-based questionnaire for TCM syndrome differentiation of heart failure and evaluation of expert consensus. Chin Med 2023; 18:70. [PMID: 37296429 DOI: 10.1186/s13020-023-00757-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/23/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Traditional Chinese Medicine (TCM) is widely used to treat heart failure (HF). Syndrome differentiation is a unique and crucial component in TCM practice for guiding disease diagnosis and treatment strategies as well as clinical research. The major bottlenecks in TCM syndrome differentiation are the diversity of the syndrome differentiation criteria and the broad spectrum of syndrome patterns, hindering evidence-based studies for clinical research. In the present study, we aim to develop an evidence-based questionnaire for the diagnosis of HF and establish a definitive set of criteria for syndrome differentiation. METHODS We designed a TCM syndrome differentiation questionnaire for heart failure (SDQHF) based on the "TCM expert consensus for diagnosis and treatment of heart failure" (expert consensus), literature review, and various clinical guidelines. To test the reliability and efficiency of the questionnaire, we performed a large-scale multiple-center clinical trial with the recruitment of 661 HF patients. Cronbach's alpha was used to assess the internal consistency of the SDQHF. Content validity was conducted through expert review. Principal component analysis (PCA) was applied to evaluate the construct validity. We constructed a proposed model for syndrome differentiation for HF based on the PCA results. Tongue analysis was performed to verify the accuracy of syndromes derived from the proposed model and the expert consensus. An evidence-based practical questionnaire for TCM syndrome differentiation patients was developed and validated with the data from 661 HF patients. RESULTS The syndrome differentiation criteria were constructed with five syndrome elements (qi-deficiency, yang-deficiency, yin-deficiency, blood stasis, and phlegm retention). The results revealed good convergent and discriminant validity, satisfactory internal consistency, and feasibility. The significant discoveries include: (1) A total of 91% of the derived TCM syndromes from the proposed model matched with the characterized tongue images of the syndrome patterns; (2) Qi Deficiency Syndrome is the dominant syndrome pattern for HF patients, followed by Yang-Qi Deficiency Syndrome and Qi-yin deficiency Syndrome, and finally, Yin-Yang Dual Deficiency Syndrome; (3) The majority of the HF patients had the combination of Blood Stasis and Phlegm Retention Syndromes; (4) The "Yin-Yang Dual Deficiency" Syndrome was a valid syndrome for HF, suggesting that this syndrome pattern should be included in the criteria for syndrome differentiation; and (5) Through the validation of the expert consensus, several recommendations were proposed to improve the accuracy of syndrome differentiation of HF. CONCLUSIONS The proposed SDQHF and the criteria could be a reliable and valid tool for syndrome differentiation of heart failure with high accuracy. It is recommended to use the proposed model for evidence-based study on Chinese Medicine to diagnose and treat HF. TRIAL REGISTRATION NUMBER The trial was registered at the Chinese Clinical Trial Registry, http://www.chictr.org.cn . (Registration No.: ChiCTR1900021929); Date: 2019-03-16.
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Affiliation(s)
- Alice Yeuk Lan Leung
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China
| | - Jialing Zhang
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China
| | - Chun Yin Chan
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China
| | - Xiaotong Chen
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China
| | - Jingyuan Mao
- Department of Cardiovascular Diseases, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
| | - Zhenhua Jia
- National Key Laboratory of Collateral Disease Research and Innovative Chinese Medicine, Shijiazhuang, China
- Hebei Yiling Hospital, Key Disciplines of State Administration of TCM for Collateral Disease, Shijiazhuang, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Jiangang Shen
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China.
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Llosa JA, Agulló-Tomás E, Menéndez-Espina S, Heleno CT, de Olivera Borges L. Cross-cultural adaptation of the Job Insecurity Scale (JIS) in Brazil and cross-national analysis of Job Insecurity effects in Brazil and Spain. BMC Psychol 2023; 11:117. [PMID: 37060104 PMCID: PMC10103497 DOI: 10.1186/s40359-023-01156-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/02/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Job flexibilisation has increased interest in job insecurity and its consequences. Job insecurity, understood as a fear of losing employment, is linked to a deterioration of mental health, social relations or job satisfaction. Its study has been developed primarily in Europe, in the absence of validated psychometric scales in the Latin American context. To bridge this knowledge gap, the aim of this study is to cross-culturally adapt the Job Insecurity Scale (JIS) in Brazil, and secondly, to establish a cross-national analysis between people employed in Brazil and Spain. METHODS As criteria for the sample, people with formally established employment in Brazil and Spain were selected. For the scale adaptation process, a sequence of EFA, CFA and validity tests are carried out, as well as a multigroup invariance according to the gender variable. The cross-national comparison compares the effect sizes of affective and cognitive job insecurity on the mental health variable measured with the GHQ-28 scale in both countries. RESULTS 1165 employed people participate in the study, of whom 573 reside in Brazil and 592 in Spain. The results of the scale adaptation show that the JIS is suitable for use in the Brazilian employment context. The scale offers a factorialisation in two dimensions (affective and cognitive) (CFI = 0.993; TLI = 0.987; RMSEA = 0.04; SRMR = 0.049; GFI = 0.999; NFI = 0.980) with good reliability (ω > 0.84). The cross-national comparison shows that job insecurity has a greater weight in explaining the mental health of the employed population in Brazil than in Spain, which is related to higher indicators of job insecurity in the Brazilian context. CONCLUSIONS With this validation we now have a validated scale of job insecurity validated for the Brazilian context. The comparison between countries shows the need to establish these analyses, since the behaviour of the phenomenon is different in the contexts studied.
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Affiliation(s)
| | - Esteban Agulló-Tomás
- Faculty of Psychology, University of Oviedo, Plaza de Feijoo, 33003, Oviedo, Asturias, Spain.
| | | | - Camila Teixeira Heleno
- Universidad Federal de los Valles de Jequitinhonha y Mucuri (UFVJM), Teófilo Otoni, Brazil
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Giménez-Espert MDC, Maldonado S, Prado-Gascó V. Influence of Emotional Skills on Attitudes towards Communication: Nursing Students vs. Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4798. [PMID: 36981707 PMCID: PMC10048995 DOI: 10.3390/ijerph20064798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
Communication in nursing is essential to the quality of care and patients' satisfaction, and personal variables such as empathy and emotional intelligence (EI) can improve it; however, no studies have to date analyzed these competencies and their relations among nursing students compared with nurses. The aims of this study are, therefore, to analyze the differences between nursing students and nurses in the means for empathy, EI and attitudes towards communication in order to assess the impact of empathy and EI on nurses' and nursing students' attitudes towards communication, and their influence on the behavioral dimension of attitude. A cross-sectional descriptive study was performed on a convenience sample of 961 nursing students and 460 nurses from the Valencian Community, Spain. T-test and hierarchical regression models (HRM) were used. The data was collected in the selected universities in the 2018/2019 academic year. The results showed high levels in all the variables analyzed (i.e., empathy, EI, and attitudes towards communication) in both samples. The HRM results suggested that empathy was a better predictor than EI of the attitudes towards patient communication among both the nursing students and nurses. In the behavioral dimension of the attitude, the cognitive and affective dimensions had greater weight than the emotional component (i.e., empathy and EI). Developing empathy and the cognitive dimension of the attitude in nursing students and nurses could, therefore, help improve EI and attitudes towards communication. These findings are important for developing intervention programs adjusted to real needs.
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Affiliation(s)
- María del Carmen Giménez-Espert
- Nursing Department, Faculty of Nursing and Chiropody, University of Valencia, Avd/ Menéndez Pelayo, s/n, 46010 Valencia, Spain
| | - Sandra Maldonado
- Nursing Department of the School of Health Sciences, Human Services and Nursing, Lehman College, CUNY, 250 Bedford Park West, New York, NY 10468, USA
| | - Vicente Prado-Gascó
- Social Psychology Department, Faculty of Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010 Valencia, Spain
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Farewell CV, Bergling E, Maiurro E, Puma J. Application of an Implementation Framework Using Mixed Methods in Preschool Settings. Health Promot Pract 2023; 24:272-281. [PMID: 34743643 DOI: 10.1177/15248399211053583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research Findings. Application of mixed methods in a dissemination and implementation framework can give researchers a better understanding of the reach and delivery of early childhood obesity prevention programs in preschool settings, as well as potential facilitators and barriers related to implementation and sustainability. This study utilized a simultaneous, exploratory, mixed-methods design to investigate individual-, organizational-, and intervention-level factors that were related to the implementation and sustainability of policy, system, and environment (PSE) changes as part of a larger obesity prevention program in a randomly selected sample of preschool centers (n = 20). Individual-level factors, and specifically the attitudes and skills of preschool providers, were identified in both the qualitative and quantitative data as important factors related to the sustainability of PSE changes (r = .56, p < .01). Staff and leadership engagement and adaptability of the program were also identified as important factors related to the implementation and sustainability of PSE changes. Practice or Policy. These findings highlight the complexity of implementation success and suggest PSE obesity prevention interventions in preschool centers require the consideration of numerous, multilevel factors to ensure programming is impactful and sustained over time.
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Affiliation(s)
| | | | | | - Jini Puma
- University of Colorado Denver, Aurora, CO, USA
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Miteniece E, Pavlova M, Rechel B, Kabakchieva M, Zuza I, Radu I, Groot W. Barriers to access adequate maternal care in Romania, Bulgaria, and Moldova: A cross-country comparison. Birth 2023; 50:205-214. [PMID: 36408741 DOI: 10.1111/birt.12693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 09/15/2020] [Accepted: 10/22/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Eastern European health system indicators (e.g., number of health workers and care coverage) suggest well-resourced maternity care systems, but maternal health outcomes compare poorly with those in Western Europe. Often, poor maternal health outcomes are linked to inequities in accessing adequate maternal care. This study investigates access-related barriers (availability, appropriateness, affordability, approachability, and acceptability) to maternity care in Romania, Bulgaria, and Moldova. METHODS This cross-country study (n = 7345) is based on an online survey where women who received maternity care and gave birth in 2015-2018 in Bulgaria (n = 4951), Romania (n = 2018), and Moldova (n = 376) provided information on their experiences with the care received. We used regression analysis to identify factors associated with accessing maternity care across the three countries. RESULTS Results show high rates of cesarean births (CB) and a low number of antenatal and postnatal care visits. Informal payments and use of personal connections are common practices. Formal and informal out-of-pocket payments create a financial burden for women with health complications. Women who had health complications, those who gave birth by cesarean, and women who gave birth in a public facility and had fewer antenatal check-ups, were more likely to describe facing access-related barriers. CONCLUSIONS This study identifies several barriers to high-quality maternity care in Romania, Bulgaria and Moldova. More attention should be paid to the appropriateness of care provided to women with complicated pregnancies, to those who have CBs, to women who give birth in public facilities, and to those who receive fewer antenatal care visits.
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Affiliation(s)
- Elina Miteniece
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bernd Rechel
- European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Irina Zuza
- World Health Organization Country Office for Moldova, Chisinau, Moldova
| | - Ilinca Radu
- Global Health Section, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Pharmacy practice in hospital settings in GCC countries: Dispensing and administration. Saudi Pharm J 2023; 31:453-461. [PMID: 37026051 PMCID: PMC10071320 DOI: 10.1016/j.jsps.2023.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose To outline dispensing and administration practices in hospital pharmacy across the Gulf Cooperation Councils (GCC) countries' hospitals. Paucity of data in appraising hospital pharmacy practice in GCC regions motivated us to conduct this study. Methods A modified survey questionnaire was prepared from the American Society of Health-System Pharmacist (ASHP) survey questions. Three major domains of questions for general characteristics of the medication use process for dispensing and administration were identified. These were, (1) medication distribution system, and medication distribution technology, (2) technology used to compound sterile preparations, compounding I.V. medication and method of compounding nutrition support preparations, (3) medication administration practices, medication orders, medication administration records (MARs), and technician activities. A list of hospitals was obtained from the Ministry of Health of the targeted GCC countries. A secure invitation link containing a survey questionnaire was sent to the participants directly. Results Sixty-four hospitals responded to this survey. The overall response rate was 52%. Most surveyed hospitals have centralized inpatient medications distribution system (75.0%). About 37.5% of hospitals used automated dispensing cabinets (ADCs) in their patient care areas. Compounding sterile preparations in the pharmacy, barcode verification technology, workflow management technology, and robotic technology were used by 17.2%, 15.6%, and 4.7% of hospitals, respectively. In using safety technology for medication administration, almost all hospitals have partially or completely implemented an electronic health record (EHR). About 40.6% of hospitals used electronic medication administration records (e-MARs), 20.3% used bar-code-assisted medication administration (BCMA), and 35.9% used smart infusion pumps. Conclusion The results of this survey revealed an opportunity to improve the medication use management process on dispensing and administration practices in hospitals in GCC countries.
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Vennu V, Bindawas SM. Deaths, causes, and their frequency among Saudi citizens: A descriptive analysis of data from the 2017 Population Characteristics Survey. Work 2023; 76:783-791. [PMID: 37066959 DOI: 10.3233/wor-220548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The number of deaths, causes, and frequency measures are crucial in determining the health of a country's population. OBJECTIVE The current study aimed to estimate deaths, causes of death, and their frequency for Saudi nationals in 2017. METHODS In this descriptive study, we used data from the 2017 Population Characteristics Survey (n = 14,215,901) and performed secondary data analysis between November 2021 and February 2022. We used a total number of survey samples to compute the deaths. The cause of death was determined by dividing the total number of fatalities according to sex. We calculated the overall population-, administrative region-, and gender-wise percentages, rates per 1,000 people per year, the ratios for mortality, and their reasons. RESULTS There were 58,915 (0.4%) total deaths, including 0.3% and 0.2% deaths among females and males, respectively. The illness was the most frequent cause of mortality (46.5% or 465 per 1,000 population/year), notably in women (52.5% or 525 per 1,000 population/year). The fatality rate was higher due to traffic accidents (a total of five in every female and four males in every female). CONCLUSION In 2017, illness-especially in women-was the cause of death. Road car accidents had a high mortality rate, especially among males. Saudi Arabia has lower death rates than other Arab nations and high-, moderate-, and low-income nations.
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Affiliation(s)
- Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Saad M Bindawas
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Uleanya C, Yu K. Data Collection in Times of Pandemic: A Self-Study and Revisit of Research Practices During a Crisis. SAGE OPEN 2023; 13:21582440231160698. [PMID: 37008258 PMCID: PMC10050996 DOI: 10.1177/21582440231160698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
COVID-19 as a global pandemic has greatly disrupted research, not only in terms of the practicality of research activities such as data collection, but also in data quality. Using self-study in form of duoethnography method for reflecting on research practice, this article reviews and reflects on the practices of remote data collection during the pandemic and further revisits additional issues brought about by these practices and concerns. One key observation from this self-study is the prevalence of practical challenges, particularly those related to participant access, that overshadows the potential advantages of remote data collection as well as other challenges. This challenge results in researchers' reduced control of the research process and also a requirement for more flexibility, greater sensitivity toward the participants and research skills for the researchers. We also observe greater conflation of quantitative and qualitative data collection and the emergence of triangulation as the main strategy to offset potential threats to data quality. This article concludes by calling for more discussions on several areas that feature scarce discussion in literature, including potential rhetoric importance assigned to data collection, adequacy of triangulation to safeguard data quality, and the potential difference between COVID-19's impact on quantitative and qualitative research.
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Affiliation(s)
- Chinaza Uleanya
- University of Johannesburg Faculty of Education, South Africa
| | - Ke Yu
- University of Johannesburg Faculty of Education, South Africa
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30
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Maier C, Thatcher JB, Grover V, Dwivedi YK. Cross-sectional research: A critical perspective, use cases, and recommendations for IS research. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2023. [DOI: 10.1016/j.ijinfomgt.2023.102625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Zhou T, Lin Y, Xu F, Ma X, Wang N, Ding Y. Factors influencing physical inactivity status among chinese pregnant women: a cross-sectional study. BMC Public Health 2022; 22:2310. [PMID: 36494799 PMCID: PMC9733201 DOI: 10.1186/s12889-022-14757-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Regular prenatal physical activity provides numerous health benefits to both mother and fetus. However, little is known about the physical activity status of pregnant women in China and whether they meet the current guidelines for prenatal physical activity. The aims of the study were to assess physical inactivity status and associated factors among pregnant women in Shanghai, China. METHODS A cross-sectional study of 1636 pregnant women were recruited at a tertiary obstetrics and gynecology hospital in Shanghai. Maternal sociodemographic characteristics and health information were obtained using structured questionnaires or from the electronic medical records. Physical inactivity status was assessed using the International Physical Activity Questionnaire-Short Form. Factors pertinent to physical inactivity were identified by binary logistic regression and were reported with adjusted odds ratios (ORs) and 95% confidence intervals (CIs). All statistical analyses were performed using the SPSS software package. RESULTS In total, the prevalence of physical inactivity was 47.5%. Walking was the main form of physical activity and only 2.8% of the pregnant women achieved the goal of at least 150 min of moderate-intensity physical activity weekly. Multivariate logistic regression identified a significant negative association of physical inactivity with personal monthly income (adjusted OR 0.648, 95% CI 0.505-0.831), engagement in regular exercise before pregnancy (adjusted OR 0.575, 95% CI 0.464-0.711) and in the second (adjusted OR 0.534, 95% CI 0.411-0.693) or third (adjusted OR 0.615, 95% CI 0.470-0.806) trimester of pregnancy. Women with nausea or vomiting during pregnancy were more likely to be physically inactive during pregnancy (adjusted OR 1.307, 95% CI 1.002-1.705). CONCLUSION Physical inactivity is highly prevalent among pregnant women in China. Further efforts should be taken to overcome the barriers to prenatal physical activity and to promote moderate- to vigorous-intensity activities among Chinese pregnant women.
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Affiliation(s)
- Tianchun Zhou
- grid.8547.e0000 0001 0125 2443Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090 China ,grid.8547.e0000 0001 0125 2443School of Nursing, Fudan University, Shanghai, China
| | - Yuping Lin
- grid.8547.e0000 0001 0125 2443Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090 China ,grid.8547.e0000 0001 0125 2443School of Nursing, Fudan University, Shanghai, China
| | - Feng Xu
- grid.8547.e0000 0001 0125 2443Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090 China ,grid.8547.e0000 0001 0125 2443School of Nursing, Fudan University, Shanghai, China
| | - Xiaoxia Ma
- grid.8547.e0000 0001 0125 2443Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090 China ,grid.8547.e0000 0001 0125 2443School of Nursing, Fudan University, Shanghai, China
| | - Na Wang
- grid.8547.e0000 0001 0125 2443Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090 China
| | - Yan Ding
- grid.8547.e0000 0001 0125 2443Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090 China
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Hlela M, du Toit C, Davies B. The Role of Alcohol and Drug Intoxication in Fire-Related Incidents in Africa: A Systematic Review. ANNALS OF BURNS AND FIRE DISASTERS 2022; 35:278-299. [PMID: 38680625 PMCID: PMC11041902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/03/2021] [Indexed: 05/01/2024]
Abstract
Fire-related burns contribute significantly to the global burden of burn injury and mortality. Alcohol and/or drug intoxication poses a risk to burn and fire-related injury, whether intentional or unintentional, but such evidence is scarce in the African context. This review aimed to fill the knowledge gap on health determinants of fire-related morbidity and mortality regionally by investigating the role of alcohol and drug intoxication in such events. Using key concepts, an extensive search was performed on 25 databases for relevant publications. Eligible articles were critically appraised using the appraisal tool for cross-sectional studies (AXIS tool), adapted to the review's objectives and outcomes. A total of 42 articles were included, of which less than half were solely investigating burn/fire-related events. Others indirectly mentioned burn injuries as part of larger health burdens such as injury, trauma, violence and other diseases. The measurement of alcohol and/or drug intoxication was inconsistent between studies with varying results. Alcohol and drug impairment in burn incidents in Africa requires evidence-based epidemiological research, and this review illustrated the limited scope of this topic in current literature. Routine toxicological results from post-mortem examinations were identified as important data sources and several research recommendations were provided.
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Affiliation(s)
- M.B.K.M. Hlela
- Forensic Toxicology Unit, University of Cape Town, Cape Town, South Africa
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Yanto TA, Lugito NPH, Hwei LRY, Virliani C, Octavius GS. Prevalence and Determinants of COVID-19 Vaccine Acceptance in South East Asia: A Systematic Review and Meta-Analysis of 1,166,275 Respondents. Trop Med Infect Dis 2022; 7:361. [PMID: 36355903 PMCID: PMC9696885 DOI: 10.3390/tropicalmed7110361] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 09/15/2023] Open
Abstract
Despite its importance in guiding public health decisions, studies on COVID-19 vaccination acceptance and its determinants in South East Asia (SEA) are lacking. Therefore, this study aims to determine the prevalence of COVID-19 vaccine acceptance and the variables influencing the vaccine's acceptance. This review is registered under PROSPERO CRD42022352198. We included studies that reported vaccination acceptance from all SEA countries, utilising five academic databases (Pubmed, MEDLINE, Cochrane Library, Science Direct, and Google Scholar), three Indonesian databases (the Indonesian Scientific Journal Database, Neliti, and Indonesia One Search), two pre-print databases (MedRxiv and BioRxiv), and two Thailand databases (ThaiJo and Thai-Journal Citation Index). The analysis was conducted using STATA 17.0 with metaprop commands. The prevalence for COVID-19 vaccination acceptance in SEA was 71% (95%CI 69-74; I2 99.87%, PI: 68.6-73.5). Myanmar achieved the highest COVID-19 vaccination acceptance prevalence, with 86% (95%CI 84-89), followed by Vietnam with 82% (95% CI 79-85; I2 99.04%) and Malaysia with 78% (95%CI 72-84; I2 99.88%). None of the ten determinants studied (age, sex, education, previous COVID-19 infections, smoking and marriage status, health insurance, living together, chronic diseases, and healthcare workers) were significantly associated with acceptance. This result will be useful in guiding vaccination uptake in SEA.
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Affiliation(s)
- Theo Audi Yanto
- Department of Internal Medicine, Universitas Pelita Harapan, Tangerang 15811, Indonesia
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Kosendiak AA, Adamczak B, Bania J, Kontek S. Stress Levels, Attitude toward Vaccination and Personal Protective Equipment of Students at Wroclaw Medical University during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13860. [PMID: 36360739 PMCID: PMC9655318 DOI: 10.3390/ijerph192113860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
The study was conducted in March of 2021 on the students at Wroclaw Medical University from different years and faculties. Students who had mandatory physical education classes in the current year and met other eligibility criteria were enrolled. The aim of the study was to examine the impact of the pandemic on the lives of medical students. Ultimately, 660 responses to the study were included. To determine the level of stress, KPS questionnaires were used, which distinguish five types of stress. Moreover, the attitudes towards and status of vaccination were examined using PPE and declarative fettle. The findings pointed to a significantly higher level of stress in males compared to females (overall stress, 5.35 and 4.66, p = 0.0002), and increased external stress in some faculties (5.71 in dentistry, compared to overall 4.83, p = 0.009). Furthermore, medical students in their 2nd year were more stressed compared to those in their 1st year (overall stress 4.95 and 4.15, p < 0.0001). By knowing where the stress is highest, we can fight it more effectively and efficiently, by directing resources right where they are needed the most. A study about stress levels during the pandemic compared to physical activity should be developed.
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Affiliation(s)
- Aureliusz Andrzej Kosendiak
- Department of Physical Education and Sport, Wroclaw Medical University, Wojciecha z Brudzewa 12a, 51-601 Wroclaw, Poland
| | - Bartosz Adamczak
- Student Scientific Association at Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Julia Bania
- Student Scientific Association at Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Sylwiusz Kontek
- Student Scientific Association at Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
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Liu S, Ding W. Chinese universities' special programs supporting talents to seek a United Nations career: a center-periphery-model analysis. HIGHER EDUCATION 2022; 86:1-20. [PMID: 36268463 PMCID: PMC9568918 DOI: 10.1007/s10734-022-00938-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
In recent years, China's higher education sector has started to establish special programs to train and support talents to seek career opportunities in the United Nations (UN). To explore these special programs and understand their relationship with China's internationalization strategies and its higher education, we used the center-periphery model as the theoretical framework. We analyzed 53 institutional documents and conducted semi-structured interviews among 5 university staff members and 21 students/recent graduates who were involved in these special programs. The analysis on the special programs implied Chinese higher education's peripheral position in supporting talents to work in the UN. This was reflected by the conforming practice, including accepting current UN recruitment regulations and English's dominance in the UN recruitment practice. However, we also identified alternative dynamics that China and its higher education do not simply obey the center-periphery model and accept their peripheral status. Instead, special programs were established to achieve China's global strategy of moving to the center of international arena via multilateralism and international organizations such as the UN. This study sheds light on further explorations of the state-university relationship in China in the globalization era, especially from the perspective of cultural diplomacy and soft power.
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Affiliation(s)
- Suyu Liu
- Zhongnan University of Economics and Law, Wuhan, China
| | - Wenjun Ding
- School of Education, University of Bristol, Bristol, UK
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36
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Zikargae MH, Woldearegay AG, Skjerdal T. Assessing the roles of stakeholders in community projects on environmental security and livelihood of impoverished rural society: A nongovernmental organization implementation strategy in focus. Heliyon 2022; 8:e10987. [PMID: 36276717 PMCID: PMC9582698 DOI: 10.1016/j.heliyon.2022.e10987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 03/28/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
The current study investigates how stakeholders' participation was used to improve environmental security and the livelihoods of the poor in rural community of Ethiopia. In particular, the study attempts to identify models of stakeholder participation and the factors that influence participation using qualitative methods. In-depth interviews, focus group discussions, organizational documents and observation used to collect the data. Thematic analysis of the data highlights consultation, collaboration, and partnership as key organizing constructs. The study offers a distinctive viewpoint on the literature and on rural community practice through the participation of stakeholders. We suggest nongovernmental organizations thoroughly utilize grassroots approach to gain acceptance, trust and sustainability of community projects.
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Affiliation(s)
| | | | - Terje Skjerdal
- NLA University College, Department of Journalism, Media and Communication, Kristiansand, Norway
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Parinyarux P, Sunkonkit K, Yotsombut K. Parental COVID-19 vaccination hesitancy among parents of children aged 5-18 years in Thailand: a cross-sectional survey study. J Pharm Policy Pract 2022; 15:59. [PMID: 36203192 PMCID: PMC9535229 DOI: 10.1186/s40545-022-00455-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To promote an acceptance rate of COVID-19 immunization among Thai children, concerns about parental vaccination hesitancy should be urgently studied. This study aimed to examine the parental COVID-19 vaccination hesitancy (PVh) level and influencing factors among Thai parents of children 5-18 years of age. METHODS This cross-sectional survey was conducted in Thailand during May and June of 2022. The Google forms for data collection were distributed to parents (a father, a mother, or one who nurtures and raises a child) via various online social media. Data regarding PVh level, relevant attitudes, experiences of COVID-19 and COVID-19 vaccination (EC&V), and family contexts (FC) were collected and analyzed using descriptive statistics. Mann-Whitney U test was used to compare the differences among groups of parents based on EC&V and FC. The factors influencing PVh were assessed by multiple regression analysis. RESULTS Four hundred and eighty-eight parents completed the online questionnaire. Their median (IQR) age was 41 (35-47) years. They lived in different provinces from all regions across Thailand. Ninety percent of them were authorized persons to make decision about children vaccination. Fifty-eight percent of the respondents had vaccine hesitancy, defined as PVh level at moderate or above. Parents who had ever refused COVID-19 vaccination for themselves or refused to vaccinate their children against any other diseases had statistically significant higher levels of PVh (p value < 0.001). Conversely, the parents who had finished the initial COVID-19 vaccine had lower PVh levels with statistical significance (p value = 0.001). Attitude towards COVID-19 (AC), attitude towards COVID-19 vaccine (AV), and perceived behavioral control (PC) of the parents negatively influenced PVh with statistical significance, according to the results of the multiple regression analysis (Betas = - 0.307, - 0.123, and - 0.232, respectively). CONCLUSIONS COVID-19 vaccination hesitancy was commonly found among Thai parents. The factors of the hesitancy were multifaceted. Different experiences regarding COVID-19 vaccination for themselves and any vaccinations for their children were associated with different PVhs. The attitudes especially AC, AV, and PC statistically influenced PVh. These findings should be exploited for national and local policy planning as well as public campaigns.
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Affiliation(s)
- Pantira Parinyarux
- Department of Social Pharmacy, Faculty of Pharmacy, Payap University, Chiang Mai, Thailand
| | - Kanokkarn Sunkonkit
- Division of Pulmonary and Critical Care, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kitiyot Yotsombut
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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Veldwijk-Rouwenhorst AE, Zuidema SU, Smalbrugge M, Persoon A, Koopmans RTCM, Gerritsen DL. Losing hope or keep searching for a golden solution: an in-depth exploration of experiences with extreme challenging behavior in nursing home residents with dementia. BMC Geriatr 2022; 22:758. [PMID: 36114482 PMCID: PMC9479311 DOI: 10.1186/s12877-022-03438-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 08/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Situations of extreme challenging behavior such as very frequent and/or severe agitation or physical aggression in nursing home residents with dementia can be experienced as an impasse by nursing home staff and relatives. In this distinct part of our WAALBED (WAAL-Behavior-in-Dementia)-III study, we aimed to explore these situations by obtaining the experiences and perspectives of nursing home staff and relatives involved. This can provide a direction in providing tools for handling extreme challenging behavior of nursing home residents with dementia and may improve their quality of life. Methods Qualitative multiple case study with individual interviews and focus group discussions. Interviewees were elderly care physicians, psychologists, care staff members, unit managers and relatives (n = 42). They were involved with nursing home residents with dementia and extreme challenging behavior living on dementia special care units in the Netherlands. For these residents, external consultation by the Centre for Consultation and Expertise was requested. Audio-recordings of the interviews were transcribed verbatim and analyzed with thematic analysis, including conventional content analysis. Results Seven cases were included. Forty-one individual interviews and seven focus group discussions were held. For six stakeholder groups (resident, relative, care staff, treatment staff, nursing home staff, and the organization), three main factors could be identified that contributed to experiencing a situation of extreme challenging behavior as an impasse: 1) characteristics and attitudes of a stakeholder group, 2) interaction issues within a stakeholder group and 3) interaction issues among (groups of) stakeholders. The experienced difficulties with the resident’s characteristics, as well as suboptimal interdisciplinary collaboration and communication among the nursing home staff are remarkable. Nursing home staff kept searching for a golden solution or lost hope. Conclusions This study offers important insights into situations of extreme challenging behavior in nursing home residents with dementia and offers caregivers targets for improving care, treatment and interdisciplinary collaboration, such as working uniformly and methodically. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03438-0.
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What Does Information Science Offer for Data Science Research?: A Review of Data and Information Ethics Literature. JOURNAL OF DATA AND INFORMATION SCIENCE 2022. [DOI: 10.2478/jdis-2022-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
This paper reviews literature pertaining to the development of data science as a discipline, current issues with data bias and ethics, and the role that the discipline of information science may play in addressing these concerns. Information science research and researchers have much to offer for data science, owing to their background as transdisciplinary scholars who apply human-centered and social-behavioral perspectives to issues within natural science disciplines. Information science researchers have already contributed to a humanistic approach to data ethics within the literature and an emphasis on data science within information schools all but ensures that this literature will continue to grow in coming decades. This review article serves as a reference for the history, current progress, and potential future directions of data ethics research within the corpus of information science literature.
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Al-Ghunaim T, Johnson J, Biyani CS, O'Connor DB. How UK surgeons experience burnout and the link between burnout and patient care: A qualitative investigation. Scott Med J 2022; 67:197-206. [PMID: 36069048 PMCID: PMC9643814 DOI: 10.1177/00369330221122348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background and Aims Poor well-being affects the performance of all kinds of workers, including
surgeons. This study aimed to answer two questions: (1) how does burnout
affect surgeons personally, and what is their burnout experience like? (2)
How does burnout affect the care that surgeons provide in the United Kingdom
(UK)? Method This study conducted thematic analysis of semi-structured interviews with 14
surgeons recruited from the UK National Health Service (NHS). Result The study found three themes in surgeons’ experiences of burnout: first,
burnout is common but frequently not recognised nor understood; second,
burnout is a personal crisis; and third, burnout creates vulnerability at
work. The study also revealed four themes related to burnout's effect on
patient care: first, burnout reduces the quality of surgeon-patient
relationships; second, burnout affects patient safety; third, burnout
impairs staff relationships; and fourth, burnout makes surgeons less
motivated to improve. Conclusion Burnout is common but not well recognised in surgeons. Improving
understanding and treatment of burnout could have benefits for both surgeons
themselves and the care they provide to patients.
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Affiliation(s)
| | - Judith Johnson
- School of Psychology, 4468University of Leeds, Leeds, UK.,Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Peters U, Krauss A, Braganza O. Generalization Bias in Science. Cogn Sci 2022; 46:e13188. [PMID: 36044007 DOI: 10.1111/cogs.13188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/27/2022]
Abstract
Many scientists routinely generalize from study samples to larger populations. It is commonly assumed that this cognitive process of scientific induction is a voluntary inference in which researchers assess the generalizability of their data and then draw conclusions accordingly. We challenge this view and argue for a novel account. The account describes scientific induction as involving by default a generalization bias that operates automatically and frequently leads researchers to unintentionally generalize their findings without sufficient evidence. The result is unwarranted, overgeneralized conclusions. We support this account of scientific induction by integrating a range of disparate findings from across the cognitive sciences that have until now not been connected to research on the nature of scientific induction. The view that scientific induction involves by default a generalization bias calls for a revision of the current thinking about scientific induction and highlights an overlooked cause of the replication crisis in the sciences. Commonly proposed interventions to tackle scientific overgeneralizations that may feed into this crisis need to be supplemented with cognitive debiasing strategies against generalization bias to most effectively improve science.
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Affiliation(s)
- Uwe Peters
- Leverhulme Centre for the Future of Intelligence, University of Cambridge.,Center for Science and Thought, University of Bonn
| | - Alexander Krauss
- CPNSS, London School of Economics.,Spanish National Research Council
| | - Oliver Braganza
- Institute for Experimental Epileptology and Cognition Research, University of Bonn.,Center for Science and Thought, University of Bonn
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Perception of Professionals from Different Healthcare Units Regarding the Use of Spray Technology for the Instantaneous Decontamination of Personal Protective Equipment during the Coronavirus Disease Pandemic: A Short Analysis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Within the context of the coronavirus disease (COVID-19) pandemic, different disinfection technologies have been developed to efficiently exercise microbial control, especially to minimize the potential risks that are associated with transmission and infection among healthcare professionals. Thus, the aim of this work was to evaluate the perception of professionals regarding the use of a new technology (chamber) for the instantaneous decontamination of personal protective equipment before the doffing stage. This was a cross-sectional descriptive study where the study data were obtained by using a questionnaire with qualitative questions. In total, 245 professionals participated in the study in three hospitals. Healthcare professionals represented 72.24% (n = 177) of the investigated sample. Approximately 69% of the professionals considered the disinfection chamber as a safe technology, and 75.10% considered it as an important and effective protective barrier for healthcare professionals in view of its application before the doffing process. The results found in this study demonstrate that the use of spray technology in the stage prior to the doffing process is acceptable to professionals, and that it can be an important tool for ensuring the additional protection of the professionals who work directly with patients who are diagnosed with COVID-19.
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Lazure P, Tomlinson JW, Kowdley KV, Magni P, Santos RD, Jacobs G, Murray S. Clinical practice gaps and challenges in non-alcoholic steatohepatitis care: An international physician needs assessment. Liver Int 2022; 42:1772-1782. [PMID: 35635757 PMCID: PMC9544805 DOI: 10.1111/liv.15324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS Even as several pharmacological treatments for non-alcoholic steatohepatitis (NASH) are in development, the incidence of NASH is increasing on an international scale. We aim to assess clinical practice gaps and challenges of hepatologists and endocrinologists when managing patients with NASH in four countries (Germany/Italy/United Kingdom/United States) to inform educational interventions. METHODS A sequential mixed-method design was used: qualitative semi-structured interviews followed by quantitative online surveys. Participants were hepatologists and endocrinologists practising in one of the targeted countries. Interview data underwent thematic analysis and survey data were analysed with chi-square and Kruskal-Wallis tests. RESULTS Most interviewees (n = 24) and surveyed participants (89% of n = 224) agreed that primary care must be involved in screening for NASH, yet many faced challenges involving and collaborating with them. Endocrinologists reported low knowledge of which blood markers to use when suspecting NASH (56%), when to order an MRI (65%) or ultrasound/FibroScan® (46%), and reported sub-optimal skills interpreting alanine aminotransferase (ALT, 37%) and aspartate aminotransferase (AST, 38%) blood marker test results, causing difficulty during diagnosis. Participants believed that more evidence is needed for upcoming therapeutic agents; yet, they reported sub-optimal knowledge of eligibility criteria for clinical trials. Knowledge and skill gaps when managing comorbidities, as well as skill gaps facilitating patient lifestyle changes were reported. CONCLUSIONS Educational interventions are needed to address the knowledge and skill gaps identified and to develop strategies to optimize patient care, which include implementing relevant care pathways, encouraging referrals and testing, and multidisciplinary collaboration, as suggested by the recent Global Consensus statement on NAFLD.
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Affiliation(s)
| | - Jeremy W. Tomlinson
- Oxford Centre for DiabetesEndocrinology and Metabolism (OCDEM) and NIHR Oxford Biomedical Research Centre, University of Oxford, Churchill HospitalHeadingtonUK
| | - Kris V. Kowdley
- Liver Institute Northwest and Washington State UniversitySeattleWAUSA
| | - Paolo Magni
- Università degli Studi di MilanoMilanoItaly,IRCCS MultiMedicaMilanItaly,International Atherosclerosis SocietyMilanItaly
| | - Raul D. Santos
- International Atherosclerosis SocietyMilanItaly,Heart Institute (InCor) University of São Paulo Medical School HospitalSão PauloBrazil,Hospital Israelita Albert EinsteinSão PauloBrazil
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Martin E, Di Meglio A, Menvielle G, Arvis J, Bourmaud A, Michiels S, Pistilli B, Vaz-Luis I, Dumas A. Informing the development of multidisciplinary interventions to help breast cancer patients return to work: a qualitative study. Support Care Cancer 2022; 30:8287-8299. [PMID: 35819520 DOI: 10.1007/s00520-022-07262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Return to work (RTW) after breast cancer (BC) can be a major challenge for patients. Multidisciplinary interventions seem to be effective but the role of digital solutions is under-developed and therefore not evaluated. We explored the preferences, needs, and barriers regarding RTW interventions, including opinions about the use of digital approaches to deliver such interventions. METHODS We conducted a qualitative study based on interviews with 30 patients with BC and 18 healthcare providers in four French regions. Emergent themes were identified using thematic content analysis. RESULTS Most providers declared that they did not proactively address RTW with patients, mainly due to having other priorities and a lack of knowledge. The following themes emerged: several development and deployment barriers regarding RTW interventions exist, multidisciplinary interventions are preferred, and there is a need to maintain contact between the patient and workplace during sick leave, including pathways and interlocutors that can facilitate RTW. Participants had mostly positive representations of using digital tools to facilitate RTW; however, fear of loss of human contact and the exacerbation of inequalities were identified as possible risks associated with the development of digital-only interventions. CONCLUSIONS Interventions blending the needs and preferences of patients with BC and the healthcare system are warranted. A personalized multimodal approach with mixed digital and in-person features has surfaced as a possible solution to address the weaknesses of existing interventions. IMPLICATIONS FOR CANCER SURVIVORS Since most women work at the time of diagnosis, it is of particular relevance to build interventions promoting RTW.
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Affiliation(s)
- Elise Martin
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.
| | - Antonio Di Meglio
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Sante Publique, Paris, France
| | | | | | - Stefan Michiels
- Office of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre Le Cancer, Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Ines Vaz-Luis
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Agnès Dumas
- Université Paris Cité, ECEVE, UMR 1123, INSERM, Paris, France
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Rahman MM, Rahaman MS. Psychological status of mass people in the capital city of Bangladesh during COVID-19: Do home quarantine challenges matter? JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2090-2103. [PMID: 34866196 PMCID: PMC9015609 DOI: 10.1002/jcop.22756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/26/2021] [Accepted: 11/14/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to identify the impact of home quarantine challenges on the psychological status of mass people during Coronavirus Disease (COVID-19) in the capital city (Dhaka) of Bangladesh. A highly organized questionnaire was created in "Google Form" and given to respondents at random via multiple social media sites, including WhatsApp, LinkedIn, and Messenger. However, a sample size of 208 people was taken and analysis was carried out using Statistical Package for the Social Sciences and Analysis of a Moment Structures software. Analysis showed that home quarantine challenges are positively related to the psychological status and home quarantine challenges have a significant impact on psychological status during COVID-19. In Bangladesh, the major challenges to home quarantine are lack of consciousness, lack of medical support, and the possibility of losing their current jobs. This study provides insight into the challenges of home quarantine and the psychological status of Bangladeshi people. The findings may be helpful for policymakers in identifying necessary measures to overcome these challenges. Only Dhaka division was taken out of seven divisions in Bangladesh to conduct this study, which might be difficult to generalize the findings of this study. Thus, in the future, it is suggested that more respondents from other divisions need to be covered.
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Affiliation(s)
| | - Md. Saidur Rahaman
- Department of Business AdministrationMetropolitan UniversitySylhetBangladesh
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A methodology for preprocessing structured big data in the behavioral sciences. Behav Res Methods 2022:10.3758/s13428-022-01895-4. [PMID: 35768746 DOI: 10.3758/s13428-022-01895-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/08/2022]
Abstract
The characteristics of big data, including high volume, increased variety, and velocity, pose special challenges for data analysis. As these characteristics generally preclude manual data inspection and processing, researchers must often use computational methodologies to deal with this type of data; techniques that may be unfamiliar to nonspecialists, including behavioral scientists. However, previous data analytics methodologies within the field of computer science, developed to handle the generic tasks of data collection, preprocessing, and analysis, can be appropriated for use in other disciplines. These methodologies involve a sequential pipeline of quality checks to prepare data sets for analysis and application. Building upon these methodologies, this paper describes the Big Data Quality & Statistical Assurance (BDQSA) model, applicable for researchers in the behavioral sciences. It involves a series of data preprocessing tasks, to achieve data understanding, as well as data screening, cleaning, and transformation. These are followed by a statistical quality phase, which includes extraction of the relevant data subset, type conversions, ensuring sample representativeness when appropriate, and assessing statistical assumptions. The resulting model thereby provides methodological guidance for the preprocessing of behavioral science big data, aimed at ensuring acceptable data quality before analysis is undertaken. Sample R code snippets demonstrating the application of this model are provided throughout the paper.
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Lifestyle, Physical Activity and Dietary Habits of Medical Students of Wroclaw Medical University during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127507. [PMID: 35742755 PMCID: PMC9223718 DOI: 10.3390/ijerph19127507] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
The new disease COVID-19, induced by SARS-CoV-2, causes acute respiratory infection. Many countries, including Poland, began to set a variety of different restrictions to reduce the spread of the virus. Most students had problems with online lessons. The study was conducted among second year medicine students of the Medical University of Wroclaw, and after the entire process of verification 200 respondents were accepted. The research consisted of completing the same anonymous online questionnaires twice in March and October 2020. This finally allowed for a critical assessment of the impact of the pandemic and its restrictions on the students’ daily lives. During the online classes, low levels of physical activity persisted (p = 0.718), whereas time spent sitting increased (p < 0.001). Despite positive changes in declared snacking (p = 0.061), we observed significant drops in the index of healthy diet (p = 0.001) and nutritional knowledge (p < 0.001) as well as an increase in the consumption of fast-food (p < 0.001) and energy drinks (p = 0.019). Reduced nutritional knowledge can cause a decrease in attention to healthy food preparation and much more frequent consumption of fast-food.
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Dähnhardt D, Dähnhardt-Pfeiffer S, Schulte-Walter J, Hanisch E, Neubourg T, Fölster-Holst R. Comparison of lipid foam cream and basic cream on epidermal reconstruction in mild atopic eczema. Skin Pharmacol Physiol 2022; 35:282-290. [PMID: 35705066 DOI: 10.1159/000525283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/11/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Basic therapy is of central importance in the treatment of atopic eczema. Using electron microscopic images, the morphology of epidermal skin barrier and its lipids was investigated after application of a lipid foam cream and basic cream. METHODS Patients with two contralateral comparable atopic eczema (local SCORAD 1-10) on the forearms were tested. Eczema was treated with a lipid foam cream or basic cream twice daily for 28 days. At the beginning, after 14 days and at the end of application, the local SCORAD, transepidermal water loss (TEWL), skin hydration, intercellular lipid length (ICLL) in the intercellular space (ICS) of the stratum corneum (SC) and skin lipids were determined. RESULTS After application of the foam cream, the epidermal skin barrier could be completely restored and corresponded to skin-healthy skin, while the epiderrmal skin barrier could not reach this state after care with the basic cream. The content of lipids in the SC increases significantly by 31% after basic cream treatment, whereas they are significantly increased by 85% after application of the lipid foam cream. The local SCORAD improved for both treatments to about the same extent, no significant results could be shown for TEWL and skin hydration. CONCLUSION In subjects with mild atopic eczema, the lipid foam cream leads to a measurable recovery of the skin barrier which is much more pronounced in comparison to the basic cream.
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Affiliation(s)
| | | | | | | | | | - Regina Fölster-Holst
- Klinik für Dermatologie, Allergologie und Venerologie, UKSH, Campus Kiel, Universitäts-Hautklinik Kiel, Kiel, Germany
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Methodological Aspects in Randomized Clinical Trials of Nutritional Interventions. Nutrients 2022; 14:nu14122365. [PMID: 35745096 PMCID: PMC9227614 DOI: 10.3390/nu14122365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/04/2022] [Accepted: 06/05/2022] [Indexed: 11/22/2022] Open
Abstract
Nutrition is an essential component when promoting human health. Without a doubt, improving the quality of one’s diet can improve one’s quality of life as a whole and help postpone the onset or control of many chronic diseases. The volume of publications in this field has increased in recent years, in line with increased awareness of the importance of nutrition in health; however, the quality of the evidence on which most nutritional guidelines are based remains low, due to errors in conducting nutritional interventions or because the information is primarily derived from observational studies. To enhance the evidence supporting clinical guidelines in nutrition, the quality of randomized clinical trials (RCT) based on nutritional interventions must be improved; nevertheless, due to their heterogeneous nature and a lack of specific guidelines for designing, performing, documenting, and reporting on this type of intervention, conducting a nutritional intervention is a real challenge. Following a review of the literature on the methodological and ethical standards, as well as four extensions of the CONSORT (Consolidated Standards of Reporting Trials) guidelines that should be considered when implementing a nutritional intervention, seven essential aspects were identified. The current narrative review includes definitions, examples, diagrams, and algorithms regarding aspects of the appropriate study design, the intervention of the control group, the randomization and blinding processes, the study population selection, as well as a description of the type of intervention and the personnel involved in carrying out the study in order to make the implementation of a nutritional intervention easier.
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Al-Ghunaim T, Johnson J, Biyani CS, O'Connor DB. Burnout in surgeons: A qualitative investigation into contributors and potential solutions. Int J Surg 2022; 101:106613. [PMID: 35421612 DOI: 10.1016/j.ijsu.2022.106613] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/04/2022] [Accepted: 04/07/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Poor wellbeing affects the performance of all types of workers. Surgeons are particularly at risk of suffering from burnout, but minimal qualitative research has examined the causes of burnout and potential solutions in this group. Understanding this could inform the development of future burnout interventions. PURPOSE This study aimed to explore the main factors that lead to surgeon burnout and to examine how surgeons cope with burnout at work. SETTING Surgical departments in the United Kingdom's National Health Service (NHS). MATERIALS Telephone interview and face-to-face interview. METHODS This qualitative study was conducted using semi-structured interviews with 14 surgeons from diverse specialisations. The interview consisted of two sections. The first addressed the main reasons for burnout. The second explored how surgeons manage burnout. RESULTS A thematic analysis identified several factors that can lead to surgeon burnout, captured in the themes of: rising to the challenge of surgical work; interpersonal conflict at work; greater demands than resources; the challenge of work-life balance; and the devastating impact of errors and poor patient outcomes. The study also revealed various strategies that surgeons employed to cope with burnout, namely: cognitive restructuring; seeking social support; stepping aside or down from the job; and prioritising personal health. Additionally, the study found some surgeons used maladaptive coping. CONCLUSION Healthcare organisations, surgeons, and psychological experts should work together to provide more and improved interventions to help surgeons, which might lead to a reduction in the number of surgeons who leave the profession and help improve patient outcomes.
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Affiliation(s)
- Tmam Al-Ghunaim
- School of Psychology University of Leeds, Leeds, LS2 9JT, UK.
| | - Judith Johnson
- School of Psychology University of Leeds, Leeds, LS2 9JT, UK; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD96RJ, UK; School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Chandra Shekhar Biyani
- Department of Urology, St James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK
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