Designing, Conducting, and Reporting Survey Studies: A Primer for Researchers

Development of a fibromyalgia-specific quality of life instrument: the Fibromyalgia Quality of Life Scale (FM-QoLS)

The study aimed to develop a quality of life (QoL) scale specific to patients with fibromyalgia. The scale development involved four steps: (1) Issue collection, (2) Face validity and selection of the most relevant items, (3) Formation of the preliminary scale and pilot testing, and (4) Psychometric evaluation. For psychometric evaluation, the scale was administered to a sample of fibromyalgia patients. Suitability for exploratory factor analysis (EFA) was assessed using the Kaiser-Meyer-Olkin (KMO) test and Bartlett's Test of Sphericity. Reliability was assessed with Cronbach's alpha, Guttman split-half test, and test-retest correlations. Construct validity was determined via EFA using Principal Axis Factoring. The correlation of the developed scale with established measures of QoL, fibromyalgia impact, fatigue, sleep, and mood was tested to assess convergent validity. Floor and ceiling effects were also examined. The initial item list included 25 issues related to QoL in fibromyalgia. Following the assessments and rating of the initial issue list through cognitive interviews, 10 issues were removed. The remaining questions were administered to 60 patients with fibromyalgia. The final version of the Fibromyalgia Quality of Life Scale (FM-QoLS) contained 14 items and two domains: symptomatology-functionality and psychosocial. Moderate-strong correlations between most items indicated that the scale has a homogeneous structure and measures the same construct. The FM-QoLS showed moderate-strong correlations with pain, anxiety, depression, sleep, fatigue, and established measures of QoL. Regarding the test-retest reliability of FM-QoLS items, the gamma values ranged from 0.923 to 0.995. The FM-QoLS is a 14-item QOL scale specific to patients with fibromyalgia. The scale has high validity and reliability, with no floor and ceiling effects. The FM-QoLS could help physicians address the multifaceted QoL challenges in fibromyalgia patients. Future research could refine the scale by exploring its use in different populations.

Demographic and clinical characteristics of spondyloarthritis patients in Jordan: A cross-sectional study

BACKGROUND/AIM

Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases with various subtypes. Given the limited research on SpA demographics and characteristics in the region, this study aims to provide insight into SpA in Jordan.

METHODS

A cross-sectional study of patients diagnosed with SpA according to the Assessment of SpondyloArthritis International Society (ASAS) criteria who attended rheumatology clinics at two tertiary care centers between January and September 2023. Data on clinical, laboratory, and imaging findings were collected, and the prevalence of fibromyalgia was assessed using the FiRST tool.

RESULTS

Among 155 patients, 51% were male, with a mean age of 43.8 ± 12.7 years and a disease duration of 8.12 ± 8.7 years. The diagnostic delay averaged 4.49 ± 5.6 years. Ankylosing spondylitis was diagnosed in 43.2%, non-radiographic axial SpA in 7.7%, and psoriatic arthritis in 58%. Six patients (3.9%) had undergone hip replacement. Fibromyalgia was present in 25.3%, significantly linked to enthesitis (P < 0.001). Biological DMARDs (B-DMARDs) were used by 68.4% of patients, and conventional synthetic DMARDs (Cs-DMARDs) by 46.5%. Males were more likely to have elevated CRP levels (P = 0.041), while females had a higher prevalence of enthesitis (P = 0.013) and were more likely to use CS-DMARDs (P = 0.001).

CONCLUSION

SpA was associated with gender differences, with males having higher CRP levels and females experiencing more enthesitis and greater Cs-DMARD use. Diagnostic delay remains an issue and may have contributed to disease progression, leading to hip replacement in some patients. Further research is necessary to elucidate these distinctions more precisely.

Assessment and management of midfoot osteoarthritis by podiatrists in Australia: a cross-sectional survey of current practice

Midfoot osteoarthritis (OA) is a common and disabling condition, yet lacks clinical guidelines for its assessment and management. This study aimed to investigate strategies used by Australian podiatrists to assess and manage midfoot OA. An exploratory cross-sectional survey of podiatrists working in Australia was conducted. Respondents were invited through professional organisations to complete an online questionnaire on their usual assessment and management practices for midfoot OA, based on a vignette. Between November 2022 and July 2023, 103 participants (52% women, mean age 40 years) with an average of 15 years of clinical experience responded. Physical assessments (including history taking and musculoskeletal assessments) (96%) and medical imaging (90%) were commonly used diagnostic methods, with palpation (96%), passive movement testing (95%) and x-ray imaging (62%) frequently reported. Associated impairments were assessed with range of motion testing of the midfoot (96%), gait analysis (95%), functional tests (83%), muscle strength (72%), and observation of static alignment (71%), including foot posture (69%). Most participants assessed comorbidities (93%), body composition (66%) and cognitive/psychosocial impairments (62%). Treatment approaches included footwear advice (97%), orthotic therapy (85%), strapping/taping (81%), education (79%), and exercise therapy (75%). One-third (34%) expected a 'satisfactory' treatment response within two months, and 36% would refer to another healthcare practitioner for co-management between two and three months if treatment was ineffective. A wide range of approaches are used to assess and manage midfoot OA. These findings have potential to inform the design of future studies in developing valid assessment approaches and effective interventions for this condition.

Implementation of a novel patient reported experience measure (PREM) in rheumatology: a cross-sectional online survey of Australian rheumatology outpatients

To determine rheumatology patient care experience using the novel Commissioning for Quality in Rheumatoid Arthritis-PREM-Australian version (CQRA-PREM-AU). Patients attending Central Adelaide Local Health Network rheumatology outpatient clinics were invited to complete a cross-sectional web-based survey, comprising CQRA-PREM-AU (22 items, 8 domains, scored 1-5), demographics, Patient Global Assessment (PGA) and Patient Reported Disease Activity (PRDA) Visual Analogue Scales (VAS) (scored 0-100), Single Item Literacy Screener (SILS). Analysed were multivariable linear regression analysis of CQRA-PREM-AU overall score with patient-related covariates (diagnosis, age, sex, SILS, PGA, PRDA), and univariate regression analysis with clinic-related covariates (site, nurse contact, type/number of consultations). Response rate was 1408/4591(31%). 214 incomplete records were excluded; 1194 records were analysed. Respondent characteristics: 68% female, median age 64 years (IQR 54, 73), 29% rural, 7% non-English language at home. PGA median score 50 (IQR 27, 63) and PRDA median score 50 (IQR 26, 69). CQRA-PREM-AU Domain 1 (regarding patient Needs and Preferences) had the best overall mean score (4.1, SD 0.86). Scored poorly were Domain 3 (Information about care, 3.5, SD 0.89), Domain 4 (Daily living, 3.5, SD 1.06) and Domain 5 (Emotional care, 3.6, SD 1.04). Worse PGA, and diagnoses of systemic lupus erythematosus, "other", or "unknown" were all associated with significantly lower CQRA-PREM-AU score (p < 0.01). Older age, and rheumatology nurse contact were associated with better experience score (p < 0.01). Use of CQRA-PREM-AU highlights the association between contact with a rheumatology nurse and better care experience, and identifies other targets for improving healthcare delivery.

The broad range of self-management strategies that people with rheumatic and musculoskeletal conditions apply: an online survey using a citizen science approach

Rheumatic and musculoskeletal diseases (RMDs) cause several restrictions in daily living. Self-management is an important aspect of managing RMDs. However, little is known about the self-management strategies that are currently applied in daily life. This study aimed to identify the current self-management strategies that people with RMDs apply through a citizen science approach. An online survey was iteratively developed together with people with RMDs. The survey was distributed among people with all types of RMDs. Survey responses were collected within Qualtrics, and once anonymized, analysed using Atlas.ti. General self-management strategies and motivations to start performing a strategy were deductively coded by two reviewers, after consultations with patient partners. 250 complete surveys were collected. 91.2% of the respondents were female. 1305 self-management strategies were mentioned, and 669 elaborations were given. Most participants applied self-management strategies within the 'physical activity' category in their daily lives (e.g., walking, biking). Motivations to start performing a certain self-management strategy mostly originated from the bodily functioning dimension (e.g., reducing pain). 1275 facilitators to start a self-management strategy were mentioned, which were mostly related to the 'support' category. Barriers (N = 480) were most frequent in the 'condition-related' category. Self-management is an important aspect of managing a person's condition in daily life. People choose one or several strategies based on the challenge they are facing, depending on their feasibility and preferences in line with their personal context. The comprehensive overview of strategies informs both patients and healthcare professionals to support a personalized self-management journey.

Referral patterns, influencing factors, and satisfaction related to referrals of patients with rheumatic diseases to other healthcare professionals: an online survey of rheumatologists

Managing rheumatic diseases requires teamwork, but referral patterns and challenges remain poorly understood. This study explored rheumatologists' perspectives on referral patterns in the Gulf countries. We conducted a web-based, 21-question cross-sectional survey between November and December 2024, collecting data on rheumatologists' demographics, referral patterns, influencing factors, and satisfaction. Participants were recruited through email invitations, WhatsApp groups and snowball sampling. Statistical analyses included descriptive and inferential methods, such as subgroup comparisons and logistic regression, to identify predictors of referral frequency and satisfaction. A total of 149 rheumatologists participated, with 58.4% being consultants. Approximately 55% had up to 10 years of post-training experience. The primary referral method was electronic health records (EHR) (84.8%). In the three months preceding the survey, 36.3% made 0-10 referrals, while 35.6% made over 20. Dermatology (85.5%) and physiotherapy (79.5%) were the most referred specialties, aligning with psoriatic arthritis and systemic lupus erythematosus as the most referred diseases. Most rheumatologists (78%) often or always followed up on referrals, and 37.4% reported moderate changes in their referral decision-making over time. Key influences on referral decisions included patient-, practice-, and diagnostic-related factors. Patient gender preference had no impact. Multidisciplinary meetings (78.2%), access to updated clinical guidelines (76.5%), attending multidisciplinary continuing medical education or training programs (67.2%), and improved EHR referral systems (64.7%) were the top resources for improving referrals. Satisfaction post-referral was affected by various factors such as patients' experiences post-referral (61.5%), and healthcare professionals' responsiveness to their questions (54.2%). Logistic regression analysis showed that age, employment status, practice setting, and geographical location were associated with referral decisions. This study is the first to provide valuable insights into referral practices among Gulf rheumatologists, identifying key influencing factors and areas for improvement. Findings suggest that enhancing EHR systems, multidisciplinary meetings, and clinical guidelines can optimize referrals and interdisciplinary care.

Comparison of musculoskeletal pain in neck, trunk, and upper limbs among Korean and Chinese smartphone users by posture: A cross-sectional survey

BackgroundPosture during smartphone use is an important factor that affects musculoskeletal pain.ObjectiveTo investigate the prevalence and characteristics of musculoskeletal pain in the neck, trunk, and upper extremities during smartphone use.MethodsA total of 326 Chinese and Korean smartphone users participated in an online survey on smartphone posture, addiction, and musculoskeletal pain.ResultsThe neck, shoulder, and lower back were most frequently affected, whereas the elbow, lower back, and forearm showed the highest level of discomfort. Stiffness was the predominant type of discomfort in most body parts. Numbness surpassed stiffness in the elbow and hand, whereas throbbing surpassed stiffness in the wrist. Body posture influenced upper arm and lower back discomfort, with a right-sided lying posture resulting in the highest level of lower back pain (p < 0.05). Using a smartphone with a more flexed neck posture increased neck discomfort (p < 0.05). Holding a smartphone with one hand, while controlling the screen with the opposite finger, increased hand pain (p < 0.05).ConclusionThe inferences obtained from this study indicate that smartphone usage posture significantly affects musculoskeletal discomfort. The suggested posture for minimizing musculoskeletal discomfort is to use the smartphone in a left-side-lying position, hold it vertically with both hands, and utilize both thumbs for texting and scrolling.

RhePort 1.3 enhances early identification of inflammatory rheumatic diseases: a prospective study in German rheumatology settings

More efficient means of identifying patients with inflammatory rheumatic diseases (IRDs) could allow earlier diagnosis and treatment. The objective of this study was to evaluate the characteristics of a revised version of an online patient questionnaire-based self-referral tool, RhePort 1.3. This prospective study included adult patients with musculoskeletal complaints presenting for a first rheumatology visit at German RheumaDatenRhePort (RHADAR) rheumatology network centers. All patients completed the RhePort 1.3 questionnaire on patient characteristics and symptoms. Data from RhePort 1.3 were compared with historical data from previous versions. Of 614 patients, 225 (36.6%) were diagnosed with an IRD by a rheumatologist and 164/225 IRD patients (72.9%) had a RhePort 1.3 score > 1, the cut-off point used to determine the need for rheumatologic evaluation. A score > 1 was associated with an approximately two-fold higher IRD risk (odds ratio [95% confidence interval] of 1.98 [1.39, 2.83] vs ≤ 1) and had good sensitivity (73%) and moderate specificity (42%). Among patients referred through a standard referral pathway (n = 283), RhePort 1.3 scores > 1 in addition to physician referral were associated with increases in rheumatology-diagnosed IRD rates from 33.2% (physician referral only) to 45.7%. RhePort 1.3 had higher accuracy than earlier versions (54% vs 35%). We conclude that modest changes to the RhePort questionnaire resulted in increased accuracy. A score > 1 was associated with a doubled risk for an IRD and higher IRD rates in physician-referred patients. These data suggest that RhePort has the potential to streamline the rheumatologist's workload and improve resource use. Further modifications are required to improve specificity.

Low vaccination rates and awareness status in patients with rheumatoid arthritis: a nationwide cross-sectional survey study

To examine the pneumococcal, haemophilus influenza, hepatitis A virus (HAV), and hepatitis B virus (HBV) vaccine rates and and predictors of vaccination among a Türkiye population of rheumatoid arthritis (RA) patients. In this multicenter, cross-sectional study, vaccination levels and related factors were questioned by face-to-face survey method during routine clinical examination of patients with RA followed in different regions of Türkiye. All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) software package, version 26. A total of 715 patients (mean age 53.1 ± 13 years), of whom 552 (77.2%) were women, were included in this study. The rate of vaccine awareness education in the whole patient group was 40.1%. The vaccination rates for influenza, pneumococcal, HAV, and HBV were 34.3%, 21.8%, 12.3%, and 28.5%, respectively. It was noteworthy that the level of vaccine awareness education was a positive predictive factor affecting vaccination in all vaccine types (p < 0.001, for all vaccine types). The rates of low income were higher in the vaccinated group for pneumococcal (p < 0.001) and haemophilus influenza (p = 0.011) vaccine than in the unvaccinated group. The participants with living in a rural area were significantly higher in the unvaccinated group for HAV and HBV vaccine than in the vaccinated group (p < 0.001). The frequency of less than two medical visits per year was significantly higher in the unvaccinated group for pneumococcal (p < 0.014) and haemophilus influenza (p < 0.001 ) and HBV vaccine (p = 0.009) than in the vaccinated group. multivariate analysis found that rural area (for Haemophilus influenza and HAV vaccines) and financial income (Pneumococcal vaccine) in specifically were associated with increased vaccination rates (p < 0.001). Additionally, the rate of vaccination education was significantly higher in the vaccinated group for all vaccine types, which is noteworthy as a result of the positive effect of education on vaccination (p < 0.001). Vaccination awareness education and rates are low in primary prevention for RA patients. Vaccination awareness training is important in increasing the level of vaccine rates.

The journey of patients with musculoskeletal complaints in Europe: a cross-sectional European survey

Rheumatic and musculoskeletal diseases (RMDs) are highly prevalent and place a significant socioeconomic burden on healthcare systems. However, their diagnosis and management remain suboptimal. This study aimed to analyze healthcare-seeking behaviors, key touchpoints, access barriers, and diagnostic pathways for individuals experiencing initial or progressive symptoms of RMDs across European countries. Understanding these differences is crucial for improving early access to specialized care. A cross-sectional online survey was conducted with 141 participants from seven European countries, including 67 rheumatologists and 39 general practitioners (GPs). The survey assessed initial healthcare-seeking behaviors, delays in diagnosis, and perceived barriers to specialized rheumatology care. Descriptive and inferential statistical methods were used for data analysis. The survey indicated that individuals experiencing RMD symptoms primarily seek information through internet research and GP consultations. Despite their role as primary gatekeepers, GPs' knowledge of RMDs was generally perceived as moderate to low. Significant disparities in access to rheumatological diagnostics, time to diagnosis, and treatment, coupled with organizational barriers between primary and specialist care, were reported across most countries. Spanish participants reported the longest diagnostic delays, while Swedish respondents experienced the shortest. Additionally, access to sacroiliac MRI was limited in Hungary and Spain, whereas glucocorticoids were widely available across all countries according to the participants. The study also revealed that early arthritis clinics were most accessible in the UK from the participants' perspectives. Significant variations in healthcare access for patients with RMDs persist across Europe. Strategies to enhance early detection, including GP education and improved specialist accessibility, are essential to optimizing patient outcomes.

Patients with vasculitis present a poor oral health: results of the online cross-sectional survey from Canada (VASC-TOOTH Survey)

To describe oral health complications and related quality of life in patients with vasculitis. Survey to assess clinical variables, pertinent to oral and dental health in patients with vasculitis and using the Oral Health Impact Profile 14 (OHIP14) questionnaire. 226 patients answered the survey. Globally, 179 (79.2%) patients reported good oral and dental health before the vasculitis diagnosis, while 92 (40.7%) patients reported a worsening since the diagnosis of vasculitis. Patients with a worsened oral health had a longer disease duration (10.0 (1.0) vs. 7.4 (0.7) years; p < 0.05), and had more relapses in the previous 2 years (34.8% vs. 16.4%; p < 0.005). The median OHIP14 score was 4 (IQR: 0-10); 97 (48.7%) patients scored > 4 points. Patients with Takayasu arteritis and Behçet disease showed worse OHIP14 scores, had a longer disease course but were younger than those with better scores or other vasculitis diagnoses. A high proportion of patients with vasculitis, especially those with Takayasu arteritis or Behçet disease, reported oral or dental complications, with subsequent impaired oral health-related quality of life.

Discounting seems the most toxic dimension of invalidation in fibromyalgia: a cross-sectional analysis

Invalidation, both discounting (overt negative social responses) and lack of understanding (absence of positive social responses), is a common problem in fibromyalgia. The 'Fibromyalgia Imbalance of Threat and Soothing Systems' (FITSS) model indicates that different neuropsychological processes may underlie these two components of invalidation. Guided by this model, the aim of the current study was to clarify the differentiation between these two components of invalidation by examining their association with fibromyalgia severity, anxiety, and depression. This cross-sectional study included the Illness Invalidation Inventory (3*I), the Fibromyalgia Impact Questionnaire (FIQ), and the Hospital and Depression Scale (HADS). Demographics of the 280 respondents with fibromyalgia were: mean age 42.6 ± 11.8 yrs., 95% female, mean FIQ score 59.1 ± 15,5, possible or probable cases of anxiety and depression, 49% and 42%, respectively. Regression analyses revealed that discounting was associated with severity of fibromyalgia (t = 4.10, β = 0.34, p <.001), anxiety (t = 3.50, β = 0.29, p <.001) and depression (t = 3.64, β = 0.30, p <.001) symptoms. Neither lack of understanding (-1.62 ≤ t ≤.10, -0.13 ≤ β ≤ 0.01, p ≥ 0.11) nor the interaction of discounting and lack of understanding (-0.19 ≤ t ≤ 1.10, -0.01 ≤ β ≤ 0.07, p ≥ 0.27) was related to any of the outcome variables. The total model accounted for 8.8%, 5.3%, and 8.3% (adjusted R2) of variance in fibromyalgia severity, anxiety, and depression, respectively. In relation to both mental and physical health, discounting seems the most toxic dimension of invalidation in fibromyalgia. This suggests that overt negative responses should get attention in its management, especially in more severe fibromyalgia. Both people with fibromyalgia and people in their environment have a role in reducing invalidation.

Characteristics of musculoskeletal pain in university music students: A cross-sectional survey

BackgroundThe prevalence of playing-related musculoskeletal disorders ranges from 46% to 90% in adult musicians. This pain sometimes forces the interruption of instrumental practice.ObjectiveTo describe the prevalence and characteristics of playing-related musculoskeletal disorders in music students, relating it to gender, and the relationship between the number of hours of weekly instrumental practice and the number of pain locations.MethodsAn online questionnaire was conducted with university music students, which assesses the presence of pain, location, intensity and interference of pain comparing gender, and the number of weekly practice hours.Results435 valid responses were obtained. 93.3% of women vs. 88.3% of men (p < 0.001) report having suffered from some type of playing-related musculoskeletal disorders. Pain intensity is 2.99 points for women and 1.74 for men, and pain interference is 3.42 and 2.16 respectively (p < 0.001). The number of hours dedicated to instrumental does not influence the number of pain locations (p > 0.05).ConclusionMost music students report playing-related musculoskeletal disorders, presenting on average more than 3 body pain locations. This pain is considered mild, with low interference on mood, quality of life and instrumental practice. Women report pain more often and more intensely, however, men report pain in more anatomical regions.

Towards Global Health Equity: A Prototype for Standardizing Patient Satisfaction Measurement in Alignment with the United Nations' Sustainable Development Goals

Background/Objectives: Global patient satisfaction is vital for healthcare quality, yet no survey enables effective cross-country comparisons. Existing tools are limited in scope, focusing on aspects like Patient-Reported Experience Measures, Patient-Reported Outcome Measures, or systemic factors within individual settings. This study introduces the Morico International Healthcare Satisfaction Survey prototype to facilitate global comparisons, aligning with the United Nations' Sustainable Development Goals. Methods: We developed the prototype by reviewing existing surveys to identify relevant question formats, thematic focuses, and distribution methods. Surveys were chosen for their relevance and established use in healthcare settings. Our analysis highlighted common elements and gaps, guiding the design of a comprehensive tool that integrates Patient-Reported Experience Measures, Patient-Reported Outcome Measures, and systemic factors for global comparisons. Results: Existing surveys varied significantly in length and focus, revealing a lack of standardization. Best practices emphasized concise, clear surveys with standardized responses and online distribution. Our prototype includes 25 questions across eight sections, adapted for global use and broader healthcare systems. It provides a comprehensive framework for international comparisons. Conclusions: No standardized survey exists for cross-country healthcare comparisons. The Morico International Healthcare Satisfaction Survey prototype addresses this gap, paving the way for future refinement and implementation to enhance global healthcare quality and policy development.

Assessment of the quality and reliability of YouTube videos related to teleradiology in musculoskeletal and rheumatic diseases: a cross-sectional study

Teleradiology, the remote evaluation of medical images using digital communication technologies, has altered healthcare delivery, particularly in musculoskeletal and rheumatic disorders. This article aims to assess YouTube videos regarding teleradiology in these disorders. The video inspection was conducted on January 15, 2025, using the search terms "teleradiology musculoskeletal system," "teleradiology rheumatic diseases," "teleradiology rheumatology," and "teleradiology arthritis".A total of 200 videos were evaluated. Total views, likes and comments, video duration, time since upload, and daily engagement metrics were recorded. The videos were categorized based on their origin. The evaluation tools utilized to analyze each video were the Global Quality Scale (GQS), Modified DISCERN Questionnaire, JAMA Benchmark Criteria, and Patient Education Materials Assessment Tool for Audio/Visual Materials (PEMAT-A/V). Of the 44 videos, 20.4% (n = 9) were of low quality, 27.3% (n = 12) were of intermediate quality, and 52.3% (n = 23) were of high quality. Physicians (81.8%) and nonprofit organizations (66.7%) were the predominant producers of high-quality videos. In contrast, health-related websites (29.4%) and nonacademic healthcare institutions (28.6%) constituted the primary sources of poor content. The quality groups showed significant differences in daily views and likes (p < 0.05), with high-quality videos receiving the highest engagement. Significant correlations were detected between video duration and content assessment tools (p < 0.01). The current results emphasize the need to select high-quality videos from reliable sources such as physicians and nonprofit organizations. Considering YouTube's extensive use as a source of medical information, it is essential to advocate for expert-driven, high-quality content to augment its educational efficacy.

Perceived Health Impacts of Surface Mining: Local Perspectives from the Mining Communities in Libjo, Dinagat Islands, Philippines

This study examines the perceived health impacts of a mining company on residents of Libjo, Dinagat Islands, Philippines, addressing a critical research gap in understanding the perceived health impacts of mining activities in underrepresented regions. The perceived health impacts of mining operations were examined using a qualitative research approach, employing semi-structured interviews. The interview instrument was developed to investigate how mining company activities impact key health determinants, such as water quality, sanitation, income, employment, infrastructure, education, and women's empowerment. The study was conducted across multiple sites at different distances from the mining area to further investigate the possible distance-based variations. The findings indicate that the mining company has positively impacted several areas, particularly income, employment, infrastructure, education, and women's empowerment. However, there were mixed perceptions regarding water quality and sanitation. The majority of respondents, particularly those who are near the mining sites, perceived a significant positive impact on health service delivery, attributing it to the company's support initiatives. Despite these positive impacts, the community expressed concerns about potential negative environmental consequences, such as air and water pollution, deforestation, land degradation, and noise pollution. This study reveals the complex relationship between mining operations and community health, emphasizing the importance of balancing economic benefits and environmental safety. The study further contributes to a deeper understanding of how mining operations affect the community's health and well-being and their potential distance-based variations.

Exploring the influence of social support, disease activity, and fibromyalgia on the emotional well-being of women with systemic lupus erythematosus

BACKGROUND

Systemic Lupus erythematosus (SLE) is an autoimmune disorder in which females are affected more commonly than males. In addition to the physical burden of the disease, patients with SLE are at higher risk of psychological disorders. In Jordan, there is a paucity of studies assessing the emotional well-being and psychosocial burden of SLE. This study aims to explore fibromyalgia, mental health-related problems and their association with SLE disease activity and its various manifestations.

METHODS

This cross-sectional study enrolled all sequential female patients diagnosed with SLE who attended a single-provider rheumatology clinic at the Jordan University Hospital (JUH), in Amman, Jordan. Data was collected between September 2023 and March 2024. A structured questionnaire was utilized to collect demographic data as well as SLE disease features. Comorbid psychiatric disorders were assessed using PHQ-9 and GAD-7 for depression and anxiety, respectively, fibromyalgia by FiRST, disease activity by SLEDAI score, quality of life by SF-12 and perceived social support were evaluated using MSPSS.

RESULTS

We analyzed the data of 63 female patients diagnosed with SLE. The mean age was 40.3 ± 15.3 years with a mean age of 28.3 ± 12.1 years at diagnosis. The most common manifestations were mucocutaneous and hematological manifestations each affecting 84.1% of patients. Regarding treatments, 79.4% of patients were using hydroxychloroquine and 73.0% of patients were using glucocorticoids. According to PHQ-9, 34.9% of patients had depression and 7.9% of patients had severe depression. positive FiRST screening suggestive of fibromyalgia was found in 31.7%. The mean PCS-12 scores were 41.9 ± 9.8 and the mean MCS-12 was 51.9 ± 3.4 indicating a moderate level of physical and mental health, respectively. Using multivariate logistic regression, vascular involvement (OR = 14.9, 95% CI: 1.1-202.4) were associated with depression while patients with high PCS-12 scores (OR = 0.889, 95% CI: 0.79-0.96) had lower odds of positive FiRST screening.

CONCLUSION

Our study showed that patients with SLE are at an increased risk of comorbid psychiatric disorders, which adds to the complexity of the disease. The management of SLE should adopt a multidisciplinary approach to address both the physical and psychosocial burdens.

Use of complementary and alternative medicine (CAM) among people living with Sjögren's: a cross-sectional survey using a modified international CAM questionnaire (I-CAM-Q)

Sjögren's is a chronic autoimmune disease with diverse symptomatology, and varying patient satisfaction with management. Patients with chronic conditions are known to be higher users of complementary and alternative (CAM) practices, yet little information regarding extent of such use exists. This paper describes usage of CAM practices among people living with Sjögren's, encompassing visits to healthcare providers, CAM practitioners, self-administered CAM and self-help practices. We explored both purposes and perceived helpfulness of the various modalities utilised. 296 respondents completed an online survey administered through Sjögren's Research Ireland in 2023. An adapted form of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) was utilised as the survey instrument. 88.5% of respondents had a formal diagnosis of Sjögren's. The majority (93.6%) were female, across all age groups. Over half (52%) of non-retired respondents were at least partially unable to work due to their diagnosis. Over half of all respondents (58.8%) listed at least one concomitant health problem. Most respondents (248, 83.8%) had used some form of CAM within the preceding 12 months. One-in-four had attended a CAM practitioner, most commonly chiropractors (8.4%) or acupuncturists (7.8%). Conventional healthcare and CAM providers were both consulted more commonly for management of chronic conditions or for well-being than for acute symptom management, although this was particularly stark for CAM consultations. 196 respondents (66.2%) reported use of self-administered CAM, predominantly vitamins/minerals or dietary supplements. 69.9% used various self-care practices, with the most reported being meditation, relaxation techniques and prayer. People living with Sjögren's attend both conventional healthcare providers and CAM practitioners to a high degree and use a diverse range of complementary therapies and practices. Health care professionals need to consider and discuss potential CAM use by this patient cohort and offer evidence-based patient education about therapies and practices encountered.

Psoriatic arthritis in Jordan: a cross-sectional study of disease characteristics, patient-reported outcomes, and disease activity

BACKGROUND

Psoriatic arthritis (PsA) is a chronic, inflammatory rheumatic disease. We aim to describe the characteristics of PsA patients and examine factors affecting their psychological and physical well-being.

METHODS

This multicenter, cross-sectional study enrolled consecutive PsA patients from rheumatology clinics over six months. Data was collected through questionnaires and chart reviews. Disease activity was assessed using Disease Activity in Psoriatic Arthritis (DAPSA) and Psoriatic Arthritis Impact of Disease-12 (PsAID-12), with fibromyalgia and psychological well-being screened via Fibromyalgia Rapid Screening Tool (FiRST) and Patient Health Questionnaire-4 (PHQ-4), respectively.

RESULTS

The study enrolled 105 patients with a mean age of 45.6 ± 12.9, and 46.7% (N = 49) were males. The predominant disease type was polyarthritis (80%, N = 84), with 90.5% (N = 95) having psoriasis (PSO). Arthritis and PSO were diagnosed simultaneously in 18 patients (17.1%), arthritis preceded PSO in 11 patients (10.5%) by 3.5 ± 3.8 years, and PSO preceded arthritis in 76 patients (72.4%) by 10.65 ± 11.27 years. The diagnostic delay of PsA was 3.1 ± 4.9 years. Methotrexate was used by 50.5% (N = 53) and 20% (N = 21) used anti-TNF. Severe disease activity, according to DAPSA scores, was present in 38.1%, positive screening for fibromyalgia in 29.5% (N = 31), and 35.2% (N = 37) had severe depression and anxiety-related symptoms. Using multivariate regression analysis, Obesity (OR = 3.267, 95% CI: 1.015-10.513) and the presence of CVD (OR = 4.769, 95% CI: 1.121-20.293) were predictors of bone erosions. PsAID-12 scores and ESR were associated with severe depression and anxiety-related symptoms (95% OR: 1.443-4.459 and 1.001:1.078), respectively.

CONCLUSIONS

Patients with PsA often face diagnostic delays, with fibromyalgia, depression, and anxiety being common, resulting in poorer patient-reported outcomes.

Gender differences in illness acceptance and coping strategies among patients with rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis: a cross-sectional survey study

This study aimed to investigate potential gender differences in illness acceptance and coping strategies in patients with inflammatory arthritis (IA). Furthermore, the study aimed to identify factors associated with illness acceptance and coping strategies specific to men and women. A cross-sectional nationwide survey design was applied. Illness acceptance was measured by using the Acceptance of Illness Scale and coping was measured by using the Medical Coping Modes Questionnaire. Descriptive statistics were used to explore gender differences in illness acceptance and coping strategies in patients with IA, while logistic regression analyses investigated associated factors. The study included 664 participants (85.1% women) with a mean age of 50 and median disease duration of 10 years. Diagnoses included 53.3% rheumatoid arthritis, 27.1% psoriatic arthritis, and 19.6% axial spondyloarthritis. A statistically significant difference was found between men and women in use of avoidance (P = 0.015). Higher illness acceptance was associated with tertiary education in men (OR: 3.90) and older age in women (OR: 1.35 per 10 years). Women with higher disease activity used confrontation more (OR: 1.64) than women with less activity. Men relied more on avoidance when facing psychological distress (OR: 1.29) or severe fatigue (OR: 1.31), as did women with high disease activity (OR: 2.09). Acceptance-resignation was linked to higher disability and psychological distress in men (OR: 1.32 and 1.52) and higher disease activity in women (OR: 2.09). We identified factors associated with illness acceptance and coping strategies among IA patients. Gender-sensitive approaches are needed to address specific factors influencing illness acceptance and coping in men and women.

Knowledge of Vulvovaginal Candidiasis Characteristics, Signs, Symptoms, and Appropriate Treatment Among Portuguese Pharmacy Professionals

BACKGROUND/OBJECTIVES

Vulvovaginal candidiasis (VVC) is a common cause of vaginitis. Over-the-counter drugs are usually dispensed by pharmacy professionals to treat this condition without prior medical consultation. This study aimed at assessing the knowledge of Portuguese pharmacy professionals regarding VVC.

METHODS

An online questionnaire including questions about the symptoms and treatment of VVC was distributed between March and April of 2024.

RESULTS

A total of 376 professionals participated in this study. There was a significantly lower proportion of men (p = 0.007) and pharmacy technicians (p = 0.005) who correctly identified the main causative agent of VVC when compared to women and pharmacists. Only 30% of women correctly identified the number of VVC episodes in the same year they classified as complicated, but this was significantly higher (p = 0.038) than the proportion of men who identified complicated VVC (20%). Topical clotrimazole preparations were the more frequently identified medicines for the treatment of uncomplicated VVC, and fluconazole-containing medicines were the preferred choice for the treatment of complicated VVC.

CONCLUSIONS

This study highlights the need to improve education and training for pharmacy professionals. By addressing these knowledge gaps, pharmacists and pharmacy technicians can provide more accurate and effective advice to patients.

Healthcare Professionals' Knowledge, Views, and Perceptions of the Roles and Functions of Research Ethics Committees: A Web-Based Cross-Sectional Survey

BACKGROUND

This survey examined healthcare professionals' knowledge, views, and perceptions of the responsibilities and functions of Research Ethics Committees (RECs). The study aimed to analyze ethical principles and operational issues faced by RECs and guide researchers, journal editors, and publishers on publication ethics notes.

METHODS

A cross-sectional survey was conducted using the SurveyMonkey.com platform to assess healthcare professionals' knowledge, views, and practices concerning RECs' responsibilities, functions, and roles. The survey focused on REC definitions, functions, research types that require REC approval, and research protocols' evaluation time frames. It also reflected on ethics considerations and REC adaptations during the coronavirus disease 2019 (COVID-19) pandemic, REC member qualifications, evaluation periods, and additional challenges confronting RECs. Convenience sampling was adopted, and the survey was distributed via social media platforms.

RESULTS

The survey was based on an analysis of questionnaires filled by 182 responders (104 females [57.1%] and 76 males [41.8%]), with a median age of 36. The survey respondents were from 28 different countries. The top three countries with most responders were Kazakhstan (n = 83), Türkiye (n = 33) and Poland (n = 10). Most participants (n = 128, 70.3%) were familiar with the definition of RECs and recognized the importance of REC approval for clinical trials and interventional research. Research study protocols should be submitted for REC evaluation and approval during the planning phase, according to 145 responders (79.7%). Participants emphasized the significance of formal ethics training for REC members. The involvement in research approved by RECs was also viewed as an important precondition for membering RECs. Participants suggested online submissions (n = 127, 69.8%), virtual meetings (n = 99, 54.4%), and fast evaluation schedules for low-risk research protocols (n = 77, 42.3%) during the COVID-19 pandemic.

CONCLUSION

Healthcare professionals comprehend the basics of REC duties and responsibilities. However, improvements in the consistency and efficiency of ethics evaluations are still warranted. The COVID-19 pandemic stressed the importance of adaptive REC procedures; researchers, editors, and publishers learned a vitally important lesson. More efforts are warranted to increase REC member training, simplify administrative procedures, and define standard operating procedures in times of crisis. Continuous progress in these areas will allow RECs to maintain high ethical standards while supporting productive research. Editors and publishers will greatly benefit from related advances in research ethics considerations.

Translation and Cross-Cultural Adaptation: A Critical Step in Multi-National Survey Studies

Survey studies are valuable tools that can quickly and cost-effectively collect data from diverse populations across different cultures and locations. When conducted across multiple countries, careful translation and cross-cultural adaptation are necessary to maintain the validity and reliability of the findings. This point is particularly important for patient-facing questionnaires, especially in fields like psychology and sexual medicine. Translation to other languages also helps the researchers reach a more diverse and broader sample, which enables the generalizability of the findings/conclusions. An accurate translation would ensure higher response rates. Careful and rigorous selection of translators, following a translation guideline, ensuring sufficient time for the translation process, using a checklist, and quality assessment following translation can increase the accuracy of the translation. At each step, the specific field of the questionnaire should be taken in consideration. The objective of this article is to underscore the necessity of translation and cross-cultural adaptation in survey studies, as well as to discuss the methods to combat against challenges experienced in the translation process.

Healthcare professionals' knowledge and perceptions of post-stroke rehabilitation in the peripandemic period: an online cross-sectional survey

The COVID-19 pandemic has profoundly affected healthcare systems, particularly post-stroke rehabilitation centers. The elevated severity of strokes and delayed hospital admissions caused numerous hurdles to rehabilitation administration during the peri-pandemic period. This study surveyed healthcare professionals' knowledge and perceptions of post-stroke rehabilitation during this period. An online cross-sectional survey was administered from September 17, 2023 to February 23, 2024, utilizing the SurveyMonkey platform. The questionnaire included 30 questions addressing participant baseline characteristics, knowledge of definitions and experiences, post-stroke rehabilitation procedures, obstacles encountered during the peri-pandemic period, and the utilization of telerehabilitation. Only complete responses from health professionals were considered. This report utilized convenience sampling. Data were analyzed via descriptive statistics and chi-square tests, with a significance threshold of p < 0.05. A total of 79 health professionals, predominantly physiatrists, neurologists, and physiotherapists, from eight countries participated in the study. Over half of the participants (64.6%) indicated the existence of a dedicated department for post-stroke rehabilitation. Significant obstacles comprised an absence of advanced rehabilitative treatments (60.8%), inadequately skilled workers (50.6%), and restricted space for rehabilitation (46.8%). Telerehabilitation was regarded as a feasible option by 45.6% of participants; nonetheless, obstacles, including patients' telecommunication proficiency and the possibility of diagnostic inaccuracies, were acknowledged. Complementary therapies, such as music and dance therapy, received favorable evaluations from 67.1% to 63.3% of respondents, respectively. The pandemic reduced rehabilitation admissions due to infection concerns (75.9%) and increased multimorbidity cases among patients (48.1%). The study underscores the pandemic's negative effect on post-stroke rehabilitation, emphasizing the necessity for multidisciplinary, customized therapy and enhanced integration of telerehabilitation to overcome access barriers. Addressing obstacles regarding infrastructure, training, and access to advanced approaches, particularly in a post-pandemic context, is essential to improving rehabilitation outcomes.

Patients with systemic sclerosis frequently use phytopharmaceuticals: a cross-sectional survey

The use of complementary and alternative medicine (CAM) has increased. Phytotherapy, also known as herbal medicine, is one of the CAM therapies that involves using medicinal plants and plant-derived substances. This study aims to evaluate the use of phytopharmaceuticals and the factors associated with their use in patients with Systemic sclerosis (SSc). Our study is designed as a survey and consists of two parts with 32 questions. The first part gathers demographic data with 14 questions, and the second part assesses participants' knowledge about phytotherapy with 18 questions. The questionnaire was administered face-to-face to patients with SSc who consented to participate. One hundred participants completed the survey. Fifty-two (52%) participants had diffuse sclerosis. Raynaud's phenomenon affected 97 (97%) participants; 53 (53%) participants suffered from lung involvement, and 64 (64%) had musculoskeletal system involvement. A total of 55 (55%) participants had used phytopharmaceuticals after SSc diagnosis. Phytotherapy users and non-users had similar demographic and clinical characteristics in terms of age, gender, disease duration, type of SSc, organ involvement, and education level. Participants mostly used the following phytopharmaceuticals: 23 participants used Camellia sinensis (green tea), 16 used Hypericum perforatum, and 12 used Curcuma longa (curcumin). The most improved symptoms with phytopharmaceuticals were musculoskeletal system findings and skin thickness, as stated by participants. A significant portion of SSc patients used phytopharmaceuticals in their disease duration. Although patients stated that they benefited from phytopharmaceuticals, studies on the effectiveness of these treatments are insufficient.

Determinants associated with the prescription of a first biologic therapy in patients with axial spondyloarthritis and concomitant fibromyalgia in daily practice

OBJECTIVES

There is no consensus on the therapeutic strategy of rheumatologists for patients with spondyloarthritis (SpA) and concomitant fibromyalgia (FM). The main aim of this study was to identify, in a population of rheumatologists practicing in Normandy, France, the determinants associated with their decision to prescribe a first biologic DMARD (bDMARD) in patients with Spa/FM. Specific objectives were to evaluate professional prescribing practices to identify a set of criteria likely to contribute to the therapeutic decision of rheumatologists, and to validate the relevance of these criteria.

METHOD

This is a cross-sectional survey-based study using a mixed (qualitative and quantitative) method. The quantitative approach was web-based and conducted among rheumatologists in Normandy.

RESULTS

The qualitative study allowed us to identify a set of criteria likely to contribute to the therapeutic decision of rheumatologists. In the quantitative study, 54/113 rheumatologists filled the questionnaire. Four criteria were considered by all respondents to contribute to their decision to prescribe a first bDMARD: arthritis on physical examination, extra-articular manifestations, systemic inflammation and structural damage on imaging.

CONCLUSIONS

The determinants associated with the decision of rheumatologists to prescribe a first bDMARD in patients with SpA/FM were mostly objective, in line with the recommendations in the literature. Most criteria were more related to an approach aimed at ensuring the diagnosis of SpA than evaluating its activity or severity.

Artificial intelligence in rheumatology: perspectives and insights from a nationwide survey of U.S. rheumatology fellows

Artificial Intelligence (AI) is poised to revolutionize healthcare by enhancing clinical practice, diagnostics, and patient care. Although AI offers potential benefits through data-driven insights and personalized treatments, challenges related to implementation, barriers, and ethical considerations necessitate further investigation. We conducted a cross-sectional survey using Qualtrics from October to December 2023 to evaluate U.S. rheumatology fellows' perspectives on AI in healthcare. The survey was disseminated via email to program directors, who forwarded it to their fellows. It included multiple-choice, Likert scale, and open-ended questions covering demographics, AI awareness, usage, and perceptions. Statistical analyses were performed using Spearman correlation and Chi-Square tests. The study received IRB approval and adhered to STROBE guidelines. The survey aimed to reach 528 U.S. rheumatology fellows. 95 fellows accessed the survey with response rate to each question varying between 85 and 95 participants. 57.6% were females, 66.3% aged 30-35, and 60.2% in their first fellowship year. There was a positive correlation between AI familiarity and confidence (Spearman's rho = 0.216, p = 0.044). Furthermore, 67.9% supported incorporating AI education into fellowship programs, with a significant relationship (p < 0.005) between AI confidence and support for AI education. Fellows recognized AI's benefits in reducing chart time (86.05%) and automating tasks (73.26%), but expressed concerns about charting errors (67.86%) and over-reliance (61.90%). Most (84.52%) disagreed with the notion of AI replacing them. Rheumatology fellows exhibit enthusiasm for AI integration yet have reservations about its implementation and ethical implications. Addressing these challenges through collaborative efforts can ensure responsible AI integration, prioritizing patient safety and ethical standards in rheumatology and beyond.

Current practice, trends and attitudes of rheumatologists towards glucocorticoids use for rheumatoid arthritis (GURANTEE): a national cross-sectional survey across China

INTRODUCTION

To investigate current practices, changes, and perceptions of rheumatologists regarding GC use in RA patients.

METHODS

A cross-sectional survey was conducted using a structured questionnaire between April and August 2023. Rheumatologists from 31 province-level regions of Mainland China were invited to participate. Chi-squared tests were adopted to investigate the differences by sociodemographic characteristics.

RESULTS

1,717 rheumatologists from 598 hospitals completed the survey with a response rate of 92%. Up to 60% of participants expressed currently infrequent initiation of GC co-therapy with csDMARDs (hardly ever 7.0%; occasionally 24.6%; sometimes 29.1%), accompanied by a decline of frequency over time reported in 64.2%. Regarding attitudes towards bridging therapy with GC, 604 (35.2%) participants supported this approach, 468 (27.3%) opposed it, and 645 (37.6%) remained inconclusive. Time to GC discontinuation in context of csDMARDs was commonly reported within 6 months in current practice which has been narrowed over time. Reasons for chronic GC use were mostly reported due to suboptimal disease control, followed by the need of RA complications, and pre-existing comorbidities. After failure of GC cessation, majority of respondents (84.4%) would escalate RA therapy (commonly by addition of JAK inhibitors, TNF inhibitors), which usually or often facilitated the GC cessation. The most frequently reported advantages and weaknesses of GC were rapid and strong efficacy, adverse events, respectively. Regarding long-term low-dose GC use for RA, the percentage of respondents who supported, opposed, or depended on the situation were 15.9%, 17.2%, and 66.9%, respectively.

CONCLUSIONS

The current data demonstrate that GC initiation for RA treatment is not as frequent as before and the awareness of GC discontinuation is growing in current practice. Attitudes towards GC co-therapy with csDMARDs vary considerably and long-term low-dose GC use remain situation dependent.

Job Satisfaction Among First-Generation Migrant Physicians in Anesthesiology and Intensive Care Medicine in Germany

BACKGROUND/OBJECTIVES

This study examines job satisfaction, burnout, and well-being among first-generation migrant physicians in anesthesiology and intensive care medicine in Germany, comparing them to their native German counterparts.

METHODS

A cross-sectional survey design was utilized, collecting data from 513 physicians, 110 of whom identified as having a migration background. Job satisfaction was measured using the Warr-Cook-Wall (WCW) Job Satisfaction Scale, burnout was assessed with the Copenhagen Burnout Inventory (CBI), and well-being was evaluated using the WHO-5 Well-Being Index.

RESULTS

The job satisfaction ratings revealed no significant differences between migrant and German physicians in most dimensions, including physical workload, freedom to choose work methods, satisfaction with colleagues, responsibility, income, skill utilization, and variety in work tasks. However, migrant physicians reported significantly higher satisfaction with recognition received for their work and lower dissatisfaction with working hours. Burnout assessments showed that migrant physicians experienced higher psychological strain, perceiving every work hour as more exhausting and having significantly less energy for family and friends. Migrant physicians reported higher difficulty and frustration in working with patients. Well-being items indicated that migrant physicians felt less energetic and active but found their daily life more filled with interesting activities. Notably, the multivariate analyses of the total scale scores did not show significant associations between migration background and the overall outcome scales.

CONCLUSIONS

The findings indicate unique challenges faced by migrant physicians, particularly in terms of recognition and patient-related burnout. These results highlight the need for targeted interventions to support migrant physicians, including cultural competence training and flexible working hours to enhance their job satisfaction and overall well-being. Addressing these issues is crucial for maintaining the quality of patient care and the occupational health of migrant physicians in Germany.

Advancing Research, Writing, and Publishing in Nursing: Addressing Challenges and Improving Standards

Nurses constitute nearly 50% of the worldwide health workforce, and the World Health Organisation has advocated for an enlargement of their roles to guarantee fair health care and address the increasing need for services. The growing specialization in nursing practice has led to a rise in educational options for nurses, including the growth of PhD programs. These programs play a crucial role in preparing nurse researchers and educators. This growth underlines the importance of evidence-based practice and high-quality academic writing in nursing. The article highlights the importance of nurses' involvement in creating evidence-based practice guidelines. The active engagement of nurses in developing evidence-based practice recommendations is essential to ensure the practicality, relevance, and grounding of these guidelines in real-world clinical experiences. The advancement of nursing depends mainly on using rigorous research procedures to generate, analyze, and disseminate knowledge and data. The current article discusses essential research methodologies, including interviews, surveys, and bibliometric and altmetric analyses. It also aims to tackle concerns about inadequate writing skills, plagiarism, and insufficient comprehension of ethical norms in research and publishing. The recommended strategies to promote nursing research and publications encompass enhancing writing skills through specialized education, embracing open-access publishing, and utilizing social media for broader distribution following publication. Implementing these approaches would increase the quality and impact of nursing publications and reinforce nursing's role in defining health policy and enhancing the care of patients.

Patient experiences of muscle biopsy in idiopathic inflammatory myopathies: a cross-sectional survey

INTRODUCTION

Muscle biopsy plays an important role in the diagnostic evaluation of individuals with suspected idiopathic inflammatory myopathies (IIM). However, variability in biopsy practices may result in a heterogenous patient experience. The existing literature offers limited insights into the experiences and perspectives of patients undergoing muscle biopsy.

METHODS

This study employed a 27-item online survey to comprehensively characterise the experience of muscle biopsy among Australian patients, including their concerns, beliefs about procedure utility, information sources, physical sensations, perceived complications and recovery.

RESULTS

A total of 111 Australian individuals who reported a diagnosis of IIM completed the survey, with data collected from March to June 2023. Most participants had inclusion body myositis (76/111, 68.5%) and had undergone one biopsy procedure (87/111, 78.4%) as part of their IIM work-up. Nine of the 111 respondents did not undergo a muscle biopsy. The procedure was well-tolerated by many respondents, however, a notable number of respondents experienced post-procedural pain lasting > 72 h (27/102, 26.5%), increasing weakness post-biopsy (13.7%), numbness at the biopsy site (18/102, 17.6%) and a recovery time beyond 3 days (36/102, 35.3%). A substantial minority (30/111, 27%) felt they were inadequately informed about the risks and benefits of the procedure.

CONCLUSIONS

This survey highlights that although muscle biopsy is often well-tolerated, there are considerable patient concerns that are often inadequately addressed. Our findings underscore the need for improved patient-doctor communication and support throughout the biopsy process.

Living with axial spondyloarthritis: a cross-sectional survey of patient knowledge and perceptions

Diagnosis and effective treatment of axial spondyloarthritis (AxSpA) are often delayed due to inadequate awareness and poor patient-physician communication. Some AxSpA patients fail to maintain an active lifestyle by exercising regularly, further worsening their disease management. The evolving concept of patient-centred care necessitates better understanding of patient awareness and their needs. We aimed to survey AxSpA patients to reflect on healthcare planning and management perspectives. Our self-administered questionnaire focused on perceptions of AxSpA diagnosis and management, particularly exploring issues of physical activity and active lifestyle. Satisfaction with AxSpA medical care and its accessibility, diagnostic delays, patient-physician communication, and support for disease management were also explored. This offline survey was arranged at the Department of Rheumatology, Immunology, and Internal Medicine of Jagiellonian University Medical College and Krakow University Hospital. We surveyed patients with AxSpA attending outpatient clinics between December 1st, 2023 and April 22nd, 2024. The questionnaire included questions on types of physical activities, barriers to exercising, satisfaction with medical care, patient-physician interactions, diagnostic delays, and use of teleconsultations. A total of 117 patients with AxSpA were enrolled (mean age 41.62 years). The majority (n = 93, 79.5%) were employed. There was a male predominance (69, 59%). The average diagnostic delay was 5.5 years. Notably, 104 (88.9%) responders perceived physical activity as a factor influencing their disease course. However, only 32 (27.35%) managed to exercise regularly (≥ 30 min, 2-3 times a week). The majority (70, 59.83%) were irregularly engaged in some form of physical activity, with 15 (12.8%) not exercising at all, and nearly half (48%) reported at least one barrier to maintaining a physically active lifestyle. Pain (32, 27.35%), fatigue (27, 23.08%), lack of motivation (17, 14.53%), and lack of time (12, 10.26%) were noted as barriers to exercising. The respondents preferred to exercise at home. The survey identified critical areas where patient dissatisfaction or uncertainty were notably prevalent: 38 (32.5%) were uncertain and 35 (30%) were dissatisfied with rehabilitation access. For spa therapy, 63 (53.85%) reported uncertainty and 23 (19.7%) expressed dissatisfaction. Only 48 (41%) were treated by a rehabilitation specialist last year. Only 23% of AxSpA patients took part in teleconsultations last year, and 65% preferred in-person visits. While AxSpA patients recognize the importance of physical activity, significant barriers exist to engaging them regularly in exercising. Addressing these barriers through personalized, motivational, and educational strategies could improve patient outcomes. Improving patient satisfaction with healthcare services, particularly in areas of rehabilitation and physician-patient communication, is crucial for improving the overall care of AxSpA patients.

Knowledge, perceptions, and practices of axial spondyloarthritis diagnosis and management among healthcare professionals: an online cross-sectional survey

Spondyloarthritis (SpA) is a group of inflammatory disorders, including axial SpA (axSpA), characterized by inflammation in the spine and sacroiliac joints. Healthcare professionals have a crucial role in diagnosing and managing axSpA. Assessing their knowledge, perceptions, and practices is essential to enhance patient care. The objective of this study is to evaluate these factors by conducting an online survey. This online survey was performed using SurveyMonkey.com to assess healthcare professionals' knowledge, perceptions, and practices related to axSpA diagnosis, management, and monitoring. The questionnaire included questions about definitions, management strategies, monitoring approaches, treatment options, and barriers to care. Convenience sampling was used, and the data were analyzed descriptively by Microsoft Excel. One hundred sixty-four healthcare professionals participated; most respondents were rheumatologists from various geographic locations (27 countries). Most participants were familiar with axSpA definitions and diagnostic criteria, demonstrating high expertise. Variations were seen in follow-up intervals and diagnostic preferences, reflecting clinical heterogeneity. Seventy-two (43.9%) individuals had a multidisciplinary team, frequently including rheumatologists, physiotherapists, and radiologists. Of the participants, 73 (44.5%) had online/telephone follow-up sessions. The pharmacological and non-pharmacological treatment approaches varied, pointing to the importance of personalized care. Glucocorticoid use varied among countries. Recognizing inflammatory back pain, interpreting radiographs, and diagnosing early was essential to medical education. This study provides beneficial data on healthcare professionals' knowledge, perceptions, and practices regarding axSpA. While diagnostic familiarity and multidisciplinary approach are positives, there is a potential to standardize management, improve telemedicine services, remove barriers to physical activity, and optimize treatment options.

Relationships Among Pelvic Congestion Syndrome Pain, Daily Activities, and Quality of Life

OBJECTIVE

To examine women's experiences of pelvic congestion syndrome (PCS) pain.

DESIGN

Descriptive, cross-sectional.

SETTING

Online questionnaires in a Facebook PCS support group.

PARTICIPANTS

Convenience sample of 143 women who self-identified as being diagnosed with PCS.

METHODS

We recruited women through a social media support group and invited them to participate in a self-reported questionnaire. We collected demographic information and used the McGill Pain Questionnaire to elicit responses related to pain quality, pain intensity, quality of life, and satisfaction with health care. We analyzed data using descriptive statistics and correlation coefficients.

RESULTS

Respondents characterized their PCS pain as exhausting, stabbing, sharp, shooting, and tender. Respondents indicated that 19 of 24 daily activities increased PCS pain, whereas only 5 reduced PCS pain. Pain intensity was negatively related to the quality of life, health satisfaction, sleep, and sexual relationships.

CONCLUSION

Chronic pelvic pain from PCS severely affected quality of life among respondents. These findings suggest a difference in the presentation of PCS from historical pain depictions and further highlight the need to identify pain profiles to increase timely and precise diagnosis. Further research is needed to evaluate interventions to increase the quality of life for women with PCS.

Government Initiatives for Research Ethics During COVID-19 Pandemic in Korea

BACKGROUND

Despite the growing necessity for government-led policy changes on clinical research ethics during pandemic, the scope of previous literature is limited to Korean government's pandemic response strategies or reflections of research ethics at the level of institutions and academic societies. This paper examines the proactive policy changes and responses by the South Korean government in addressing the challenges and issues of research ethics against the backdrop of the urgency of rapid development and emergency supply of medical products during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

We conducted searches of various government documents, using predetermined keywords related to research ethics and integrity during the COVID-19 pandemic. Only documents issued by governments or public institutions were included. A total of 24 documents were selected for analysis. They were divided into two phases: the first phase for urgent response (January 2020-February 2021) and the second phase (March 2021-February 2023) for long-term preparedness.

RESULTS

The Korean government recommended several measures of research governance to accelerate the ethical review of COVID-related research to be shortened less than one week: the joint operation of Institutional Review Boards (IRBs), exempted or expedited review by a special review committee, guidelines for urgent reviews, and designation of the Korean Academy of Medical Sciences as the supervising agency for the Clinical Trial Safety Support Institution as well as the Central IRB. It allowed temporary non-face-to-face methods for informed consent process (telephone explanations and a photo of the original signed consent) and clinical trials (telephone counselling and prescription, proxy prescription, and drug delivery and supply to clinical trial participants, and online ethics training).

CONCLUSION

As a result of South Korea's commitment to ethical principles in their pandemic response, the medical system did not experience collapses due to the pandemic, and pandemic research was conducted with careful ethical considerations. The pandemic ethics immunization during the Middle East respiratory syndrome epidemic in 2015 laid the foundation for prompt government initiatives that ensured both pandemic research ethics and pandemic response ethics.

Drug persistence in patients with rheumatic and musculoskeletal diseases during a major economic crisis: results from a nationwide cross-sectional online survey

To evaluate the drug persistence in patients with rheumatic and musculoskeletal diseases (RMDs) during the current economic crisis in Lebanon and to estimate predictors of persistence. A nationwide multicentric cross-sectional study using an online questionnaire was conducted in Lebanon with patients with chronic inflammatory rheumatic diseases (CIRDs) and non-inflammatory RMDs controls between July and October 2022. Disease-modifying antirheumatic drugs (DMARDs) were categorized as conventional synthetic (cs), biological (b), subcutaneous (SC) or intravenous (IV), and targeted synthetic (ts). Persistence was defined as "number of tablets or injections taken during the past month versus prescribed". The percentage of patients who discontinued or changed treatment due to cost or non-availability was reported. Factors associated with persistence were identified using multivariable linear regression. The study included 317 patients with RMDs (286 CIRDs); mean age 49.5 years, 68% females, 58% reporting currently low economic level. Persistence at one month was low for tsDMARDs (36%) and bDMARDs (SC55%, IV63%), and acceptable for csDMARDs (88%). A persistence ≥80% was found in 23.3% of patients on tsDMARDs, 42.9% on SC bDMARDs, 45.0% on IV bDMARDs, and 74.7% on csDMARDs. During the past 6 months, 55.8% of CIRD patients discontinued or changed treatment due to non-availability (45.3%) or cost (21.2%). Persistence was positively associated with finding alternative sources such as buying abroad (36%), depending on friends or families abroad (20%), charities (10%), and negatively associated with unemployment and low financial status. Persistence was significantly compromised for essential antirheumatic drugs and was mostly driven by treatment unavailability and cost.

Self-Efficacy and Life Satisfaction Mediate the Relationship between Perceived Social Support and Career Exploration among College Students: A Cross-Sectional Study

Previous research on career exploration has mainly focused on cognitive-personal variables. Although the social cognitive career theory model posits that personality could influence career exploration through both personal agency and contextual factors, very few studies have examined the two possible paths simultaneously. We hypothesized that individuals who perceive higher social support experience more career exploration behavior, and this relationship is mediated by higher self-efficacy and life satisfaction. The participants of this study were 853 Chinese college students. The results showed that self-efficacy and life satisfaction independently and jointly mediated the relationship between perceived social support and career exploration. The multiple mediation model showed that the high perceived social support would increase students' sense of self-efficacy, which could improve their sense of life satisfaction, and further help them engage in more career exploration activities.