Electronic surveys: how to maximise success

A survey of the radiation safety practices of veterinary practitioners during portable equine radiography in Ireland

Veterinary practitioners and other personnel involved in the examination are exposed to ionizing radiation while performing portable radiographs on horses. An online survey was distributed to all Veterinary Council of Ireland-registered practices where the self-reported practice profile is at least 20% equine work. The survey contained questions relating to radiation safety training, protocols, personal dosimetry and lead protection usage, repeat exposures, sedation, and personnel roles during the examination. The aim of the survey was to document the current radiation safety practices of equine veterinary practitioners during portable radiography. The results showed that although adherence to guidance set out by the Environmental Protection Agency (EPA) is reasonably good, compliance rates can be improved. Personal dosemeter usage and repeat rate reduction could particularly benefit from further improvement. This is of the utmost importance in ensuring that occupational radiation exposure to veterinary practitioners is kept to an absolute minimum during their daily practice.

Strategies to improve the magnetic resonance imaging experience for autistic individuals: a cross-sectional study exploring parents and carers' experiences

BACKGROUND

Autistic individuals encounter numerous barriers in accessing healthcare, including communication difficulties, sensory sensitivities, and a lack of appropriate adjustments. These issues are particularly acute during MRI scans, which involve confined spaces, loud noises, and the necessity to remain still. There remains no unified approach to preparing autistic individuals for MRI procedures.

METHODS

A cross-sectional online survey was conducted with parents and carers of autistic individuals in the UK to explore their experiences, barriers, and recommendations concerning MRI scans. The survey collected demographic information and experiential accounts of previous MRI procedures. Quantitative data were analysed descriptively, while key themes were identified within the qualitative data through inductive thematic analysis.

RESULTS

Sixteen parents/carers participated. The majority reported difficulties with communication, inadequate pre-scan preparation, and insufficient adjustments during MRI scans for their autistic children. Key barriers included an overwhelming sensory environment, radiographers' limited understanding of autism, and anxiety stemming from uncertainties about the procedure. Recommended improvements encompassed accessible communication, pre-visit familiarisation, noise-reduction and sensory adaptations, staff training on autism, and greater flexibility to meet individual needs.

CONCLUSIONS

There is an urgent need to enhance MRI experiences for autistic individuals. This can be achieved through improved staff knowledge, effective communication strategies, thorough pre-scan preparation, and tailored reasonable adjustments. Co-producing clear MRI guidelines with the autism community could standardise sensitive practices. An individualised approach is crucial for reducing anxiety and facilitating participation. Empowering radiographers through autism-specific education and incorporating insights from autistic individuals and their families could transform MRI experiences and outcomes.

Enhancing Prostate Cancer Diagnosis with a Novel Artificial Intelligence-Based Web Application: Synergizing Deep Learning Models, Multimodal Data, and Insights from Usability Study with Pathologists

Prostate cancer remains a significant cause of male cancer mortality in the United States, with an estimated 288,300 new cases in 2023. Accurate grading of prostate cancer is crucial for ascertaining disease severity and shaping treatment strategies. Modern deep learning techniques show promise in grading biopsies, but there is a gap in integrating these advances into clinical practice. Our web platform tackles this challenge by integrating human expertise with AI-driven grading, incorporating diverse data sources. We gathered feedback from four pathologists and one medical practitioner to assess usability and real-world alignment through a survey and the NASA TLX Usability Test. Notably, 60% of users found it easy to navigate, rating it 5.5 out of 7 for ease of understanding. Users appreciated self-explanatory information in popup tabs. For ease of use, all users favored the detailed summary tab, rating it 6.5 out of 7. While 80% felt patient demographics beyond age were unnecessary, high-resolution biopsy images were deemed vital. Acceptability was high, with all users willing to adopt the app, and some believed it could reduce workload. The NASA TLX Usability Test indicated a low-moderate perceived workload, suggesting room for improved explanations and data visualization.

Critical Appraisal of Electronic Surveys: An Integrated Literature Review

Background and Purpose: Electronic surveys are an essential data collection method in survey research but there are pros and cons. The purpose of this literature review was to understand the advantages and disadvantages of electronic surveys in research. Methods: An integrated literature review was performed. Results: Twenty publications met the criteria and were analyzed. The advantages of electronic surveys include speed, cost, convenience, flexibility, ease of analyses, global reach, reduced errors, and question diversity. The disadvantages of electronic surveys are response outcomes (nonresponse, item-nonresponse/poor completion rates, and careless responding errors) and digital literacy requirements. Conclusions: The advantages of electronic surveys outweigh their disadvantages, but researchers must understand the problems associated with electronic surveys and avoid them.

Bridging the transition from homelessness: Developing an occupational therapy framework

BACKGROUND

Occupational therapists support individuals experiencing homelessness in traditional roles, and occupational therapy positions focussed specifically on homelessness appear to be growing.

OBJECTIVES

To develop and refine a framework to guide occupational therapy practice and research in homelessness.

METHOD

We developed a framework and refined it through a stakeholder consultation process conducted with 17 international occupational therapy experts using an online survey. In this survey, we presented an initial framework and requested qualitative feedback. We analyzed this qualitative data using content analysis.

RESULTS

Stakeholder feedback was categorized into eight recommendations: (1) Revision to the 'four processes'; (2) Emphasizing social justice and systems-level advocacy; (3) Reflecting intersectionality; (4) Emphasizing meaningful activity; (5) Emphasizing peer support; (6) Incorporating a focus on independent living skills; (7) Increasing a focus on an activity for addressing substance misuse; and (8) Acknowledging cognitive and physical health. Each of these recommendations was incorporated into a refined version of this framework. These recommendations and a refined version of the framework are presented in this paper.

CONCLUSIONS

We have developed and refined a framework aimed at guiding practice and research in occupational therapy in homelessness that will be evaluated in future research.

SIGNIFICANCE

Though a range of frameworks exists for guiding the practice of occupational therapists more generally, this framework represents the first that is focussed specifically on guiding occupational therapy practice and research with individuals who experience homelessness. Research and practice implications are discussed.

Attitudes and knowledge of nurses working at night and sleep promotion in nursing home residents: multicenter cross-sectional survey

BACKGROUND

Sleep disturbances are common in nursing home residents and challenging for their nurses. Knowledge about sleep and sleep promoting factors is essential to provide adequate sleep management, where nurses play a key role. Therefore, nurses' knowledge and attitudes towards sleep and sleep promoting interventions is important as enabling or inhibiting factor for successful sleep management.

METHODS

A multicenter cross-sectional study was conducted among nurses working wholly or partially at night in nursing homes in Germany. Data were collected between February and April 2021 via online or paper and pencil questionnaires, comprising 56 items. Nursing homes were recruited through existing cooperation with the study centers as well as via nursing home registers.

RESULTS

Finally, 138 nursing homes participated and 271 nurses completed the survey. Nurses agreed that sleep disturbances are an important topic with important impact on resident' health. Although, the assessment of sleep was seen as nurses' responsibility, only 40 nurses (14.7%) stated that residents' sleep was always documented. Only 21.7% reported the availability of policy documents providing guidance regarding the management of sleep disturbances. The vast majority (93.2%) reported never having received training about sleep and management of sleep disturbances after their basic nursing training.

CONCLUSIONS

Our results indicate that nurses working at night can play an important role in residents' sleep promotion. The findings indicate nurses' educational needs regarding sleep and sleep promotion. Nursing homes should implement institutional guidelines in order to promote residents' sleep based on adequate evidence-based non-pharmacological interventions.

Inter-rater reliability of descriptors for the classification of mucosal pressure injury: A prospective cross-sectional study

BACKGROUND

Mucosal pressure injuries (PIs) are usually caused by pressure from essential medical devices. There is no universally accepted criterion for assessment, monitoring, or reporting mucosal PI. Reliable descriptors are vital to benchmark the frequency and severity of this hospital-acquired complication.

OBJECTIVES

The objective of this study was to determine whether modified Reaper Oral Mucosa Pressure Injury Scale (ROMPIS) descriptors improved the reliability of mucosal PI assessment. Secondary aims were to explore nurses' knowledge of and attitudes toward mucosal PI.

METHODS

A prospective cross-sectional survey was distributed to nurses from two tertiary affiliated intensive care units via REDCap® to capture demographic data, knowledge, attitudes, and inter-rater reliability (IRR) measures. Nurses were randomised at a 1:1 ratio to original or modified ROMPIS descriptors and classified 12 images of mucosal PI. IRR was assessed using percentage agreement, Fleiss' kappa, and intraclass correlation coefficients.

RESULTS

The survey response rate was 20.9% (n = 98/468), with 73.5% (n = 72/98) completing IRR measures. Agreement was higher with modified (75%) than original ROMPIS descriptors (69.4%). IRR was fair for the original (κ = 0.30, 95% confidence interval [CI] [0.28, 0.33], z 26.5, p < 0.001) and modified ROMPIS (κ = 0.29, 95% CI [0.26, 0.31], z 25.0, p < 0.001). Intraclass correlation coefficient findings indicated ratings were inconsistent for the original (0.33, 95% CI [0.18, 0.59], F 18.8 (11 df), p < 0.001) and modified ROMPIS (0.31, 95% CI [0.17, 0.57], F 17.6 (11 df), p < 0.001). PI-specific education and risk factor recognition were common.

CONCLUSION

Modified descriptors had marginally better agreement. Participants understand management and prevention but need to strengthen their perceived capacity for mucosal PI risk assessment. This work provides a foundation for future benchmarking and a platform from which further research to refine and test descriptors specific to mucosal PI can be generated.

Career satisfaction amongst dental students and dentists in Saudi Arabia: A cross-sectional survey

INTRODUCTION

Dental students' satisfaction with their own career can significantly improve the quality of care provided to patients. The aim of the current study was to assess the level of career satisfaction amongst Saudi dental students and dentists.

MATERIALS AND METHODS

A cross-sectional survey was conducted from October 2019 to January 2020 all over Saudi Arabia. A sample of 750 Saudi dental students and dentists were invited to complete an online questionnaire. The questionnaire was composed of two sections of closed-ended questions. The first section included personal, professional background factors and level of career satisfaction assessed. The second section included different reasons for choosing dentistry as a career. Multivariable linear regression was used at significance <0.05.

RESULTS

Only 674 responded to the questionnaire. About half of the included respondents were males. Most of the participants were undergraduate students attended Saudi dental schools. 72.3% chose dentistry for helping other people. Graduated dentists had significantly lower satisfaction score than dental students (p = .007). Dentists, who chose dentistry because it is a secured job with good income (p < .001), had significantly lower satisfaction score than those who did not, whilst those who chose it for the social status had significantly higher satisfaction score than those who did not (p = .04).

CONCLUSION

Dental students and dentists were motivated to choose dentistry as it is an opportunity to help others and achieve good salary with appropriate social position in community. Dental students were more satisfied than dentists due to lack of financial responsibilities and absence of educational expenses.

Holacracy, a modern form of organizational governance predictors for person-organization-fit and job satisfaction

This study compares illegitimate tasks and appreciation in traditional work organisations and holacracy work organisations based in Switzerland and Germany. In addition, the study tests whether the fit between employees and holacracy organisations depends on personality characteristics. Ninety-five employees working in holacratic companies participated in an online survey with standardised questionnaires on illegitimate tasks, Big Five personality dimensions, perceived holacracy satisfaction and person-organisation fit. For the comparison of illegitimate tasks and appreciation, a propensity-matching comparison group of people working in traditional companies was used. The results revealed significantly lower illegitimate tasks t(53) = -2.04, p < 0.05, with a lower level (2.49) in holacracy than in traditional work (2.78). Concerning appreciation, the results showed significantly higher values for holacratic (5.33) than for traditional work [4.14, t(53) = 4.86, p < 0.001]. Multiple linear regression of holacracy satisfaction on personality dimensions showed neuroticism (b = -4.72, p = 0.006) as a significant predictor. Agreeableness showed marginally significant results (b = 2.39, p = 0.06). This indicates that people scoring low on neuroticism and high in agreeableness may thrive better in holacracy organisations. Based on the results, theoretical and practical implications as for example implications for corporates hiring strategy, are discussed. Finally, this study presents numerous directions for future research.

Patient Support Program and Healthcare Resource Utilization in Patients Using Clean Intermittent Catheterization for Bladder Management

The primary purpose of this study was to evaluate the impact of a patient-centered, chronic care self-management support program of clean intermittent catheterization (CIC) on emergency department (ED) visits and hospitalizations within the first 30 days of starting CIC. Secondary research objectives were to compare reuse of catheters, adherence to healthcare provider–instructed frequency of CIC, and reasons for nonadherence.

An exploration of New Zealand mental health nurses' personal physical activities

This study assessed the physical activities of Mental Health Nurses (MHN) in New Zealand against the 2018 World Health Organization recommended minimum levels of moderate-to-vigorous physical activity. The research design was exploratory and descriptive as there were no previous studies about physical activity levels of MHNs in New Zealand. Quantitative and qualitative data were collected using the International Physical Activity Questionnaire (IPAQ, Long Version) which included options for free-text responses. Data were analysed using descriptive and inferential statistics. A total of 266 participants returned the survey, a response rate of 4%, and a limitation of the study. More than 50% of MHNs reported <150 min of moderate-to-vigorous exercise per week for each of the four physical activity domains. When individual physical activity domains were combined, only 10% spent <150 min on moderate-to-vigorous physical activity. Work-related physical activities were higher for those working in the inpatient area than in community settings. Transport-related physical activities were higher for those working in community settings. Participants registered from 6 to 20 years had more time sitting than other groups. Nurses aged 55 years and above showed the highest total physical activity levels. Moreover, healthcare organizations and nurse leaders need to promote physical activity and provide wellness intervention for their staff. Nurses who are physically active may be more effective in supporting their patients to increase their physical activity.

Validation of an Instrument Assessing Certified Nurse Midwives' Attitudes toward Breastsleeping

To date, attitudes towards breastsleeping among certified nurse-midwives caring for post-partum women are not well known. This study describes the validation procedures of two instruments assessing the attitudes of certified nurse-midwives (CNMs) towards breastsleeping. These tools were validated using an 18-item survey administered to a convenience sample of certified nurse-midwives. Participating CNMs were recruited for anonymous participation in an online survey in September-November of 2019. Factor analysis and parallel analysis each revealed a two-factor solution, suggesting that there were two main concepts representing the attitudes of certified nurse-midwives towards breastsleeping; breastsleeping safety and breastfeeding experience. Statistically significant differences for mean breastsleeping safety scores were noted by age group, place of practice, and US geographical region. This article is protected by copyright. All rights reserved.

Initiation of paediatric advance care planning: Cross-sectional survey of health professionals reported behaviour

BACKGROUND

Globally, initiation of paediatric advance care planning discussions is advocated early in the illness trajectory; however, evidence suggests it occurs at crisis points or close to end of life. Few studies have been undertaken to ascertain the prevalence and determinants of behaviour related to initiation by the healthcare professional.

METHOD

Underpinned by the Capability, Opportunity, Motivation-Behaviour (COM-B) model for behaviour change, a cross-sectional online survey was conducted in United Kingdom and Ireland using a purposive sample of health professionals. Descriptive and inferential statistics were applied and nonparametric statistical analysis used. Open-ended questions were mapped and correlations between COM-B and demographic profiles identified.

RESULTS

Responses (n = 140): Paediatric advance care planning was viewed positively; however, initiation practices were found to be influenced by wide ranging diagnoses and disease trajectories. Whilst some tools and protocols exist, they were not used in a systematic manner, and initiation behaviour was often not guided by them. Initiation was unstandardized, individually led, guided by intuition and experience and based on a range of prerequisites. Such behaviour, combined with inconsistencies in professional development, resulted in varying practice when managing clinical deterioration. Professionals who felt adequately trained initiated more conversations (capability). Those working in palliative care specialties, hospice settings and doctors initiated more discussions (opportunity). There was no difference in Motivation between professions, clinical settings or specialisms, although 25% (n = 35) of responses indicated discomfort discussing death and 34% (n = 49) worried about families' emotional reaction.

CONCLUSION

Although advocated, paediatric advance care planning is a complex process, commonly triggered by the physical deterioration and rarely underpinned by support tools. The COM-B framework was useful in identifying fundamental differences in initiation behaviour; however, further research is required to explore the complexity of initiation behaviour and the system within which the care is being delivered to identify influences on initiation.

Assessment of patient safety culture in two emergency departments in Australia: a cross sectional study

Purpose

Patient safety culture is a vital element to create patient safety in healthcare organisations. Emergency department (ED) professionals operate in unstable conditions that may pose risk to patient safety on day-to-day basis. The aim of this study was to assess the status of patient safety culture and to quantify the dimensions of safety culture in the ED setting.

Design/methodology/approach

This was a descriptive cross sectional study that used a validated questionnaire distributed to the staff working in the nominated EDs . Perceptions on various dimensions of safety culture were reported and the frequency of positive responses for each dimension was calculated.

Findings

“Teamwork” is the only dimension that rated positive by over 70% of participants. Other dimensions rated below 50%, except for “Organisational learning–continuous improvement” which rated 51.2%. Areas that rated the lowest were “Handover and transitions”, “Staffing”, “Non-punitive response to error” and “Frequency of event reporting” with average positive response rate of 15.4%, 26%, 26.8% and 27.6%, respectively.

Originality/value

This study displayed a concerning perceptions held by participants about the deficiency of patient safety culture in their EDs. Moreover, it provided a baseline finding giving a clearer vision of the areas of patient safety culture that need improvement.

Knowledge, use and attitudes of healthcare professionals towards patient-reported outcome measures (PROMs) at a comprehensive cancer center

BACKGROUND

Despite evidence of the positive impact of routine assessment of patient-reported outcome measures (PROMs), their systematic collection is not widely implemented in cancer care.

AIM

To assess the knowledge, use and attitudes of healthcare professionals (HCPs) towards PROMs and electronically collected PROMs (ePROMs) in clinical practice and research and to explore respondent-related factors associated with the above dimensions.

METHOD

An ad hoc developed online survey was administered to all HCPs employed in clinical activity in an Italian comprehensive cancer center. The survey investigated which PROMs were known and used, as well as HCPs' opinions on the advantages and drawbacks of routine PROM assessment, including electronic assessment (ePROM). Linear and logistic regression models were used for association analyses.

RESULTS

Five Hundred Eleven of nine hundred ninety-two invited HCPs (52%) provided analyzable responses. 68% were women, 46% were nurses and 42% physicians, and 52.5% had > 20 years seniority. The average number of PROMs known was six among 17 proposed. All proved to be under-used (< 28%) except unidimensional and multidimensional pain scales (77 and 36%). Respondents expressed an overall positive attitude towards PROMs, with strengths outweighing weaknesses (mean overall scores 3.6 and 2.9, respectively, on a 1-5 scale). 67% of respondents preferred electronic collection over paper and pencil. Profession was associated with knowledge and use (physicians reported knowing more PROMs than other professionals) and with a preference for electronic collection (nurses were less likely to prefer the electronic format than physicians). Senior HCPs were slightly more critical about both PROMs and electronic administration.

CONCLUSIONS

This survey indicates an acceptable level of knowledge of common PROM tools but low usage in practice. Based on the generally positive attitude of HCPs, routine implementation of ePROMs can be promoted as long as adequate resources and training are provided.

TRIAL REGISTRATION

Not registered.

Anxiety and depression among vaccinated anesthesia and intensive care doctors during COVID-19 pandemic in United Arab Emirates: a cross-sectional study

Background

The coronavirus disease 2019 (COVID-19) pandemic had an impact on frontline healthcare workers’ (HCW) mental health as they experienced depression, anxiety, and sleep disturbances. There is a need to investigate the impact on anesthesia and intensive care doctors (ICU), especially after the rise of vaccination. Anesthesia and ICU doctors are among the frontline HCW dealing with suspected and confirmed COVID-19 patients. Their job puts them at risk of developing psychological disorders because of the daily stress. The aim of the current study was to assess factors affecting anxiety and depression among vaccinated anesthesia and ICU doctors working in United Arab Emirates (UAE). A cross-sectional study targeting vaccinated anesthesia and ICU doctors in UAE was conducted during March 2021. Data were collected using an online questionnaire uploaded to Google Forms including two sections; the first section included question assessing personal data, professional background data, previous COVID-19 diagnosis, and type of vaccine received. The second section of the questionnaire included the Hospital Anxiety and Depression Scale (HADS). Logistic regression analysis was used to assess the association of different factors with anxiety and depression. Adjusted odds ratio (AOR) and 95% confidence intervals (CI) were calculated.

Results

Significantly higher anxiety (46%) and depression (53.6%) were associated with the Pfizer–BioNTech vaccine. The lowest anxiety (23.9%) and depression (21.6%) scores were related to the Sinopharm vaccine. Anxiety was significantly higher for participants previously diagnosed with COVID-19 (AOR = 2.55), and depression was lower for those who deal with COVID-19-positive patients (AOR = 0.28). Anesthesiologists had significantly lower anxiety and depression than those specialized in both anesthesia and ICU (AOR = 0.32 and 0.51)

Conclusions

Previous diagnosis with COVID-19, female gender, and medical comorbidities were associated with high rates of symptoms of anxiety and depression among anesthesia and ICU doctors. Regular monitoring of the mental health impact of COVID-19, especially after the availability of different vaccines, is recommended.

Developing Reporting Guidelines for Studies of HIV Drug Resistance Prevalence: A Protocol for a Mixed-methods Study (Preprint)

Background

HIV drug resistance is a global health problem that limits the effectiveness of antiretroviral therapy. Adequate surveillance of HIV drug resistance is challenged by heterogenous and inadequate data reporting, which compromises the accuracy, interpretation, and usability of prevalence estimates. Previous research has found that the quality of reporting in studies of HIV drug resistance prevalence is low, and thus better guidance is needed to ensure complete and uniform reporting.

Objective

This paper contributes to the process of developing reporting guidelines for prevalence studies of HIV drug resistance by reporting the methodology used in creating a reporting item checklist and generating key insights on items that are important to report.

Methods

We will conduct a sequential explanatory mixed methods study among authors and users of studies of HIV drug resistance. The two-phase design will include a cross-sectional electronic survey (quantitative phase) followed by a focus group discussion (qualitative phase). Survey participants will rate the essentiality of various reporting items. This data will be analyzed using content validity ratios to determine the items that will be retained for focus group discussions. Participants in these discussions will revise the items and any additionally suggested items and settle on a complete reporting item checklist. We will also conduct a thematic analysis of the group discussions to identify emergent themes regarding the agreement process.

Results

As of November 2021, data collection for both phases of the study is complete. In July 2021, 51 participants had provided informed consent and completed the electronic survey. In October 2021, focus group discussions were held. Nine participants in total participated in two virtual focus group discussions. As of May 2022, data are being analyzed.

Conclusions

This study supports the development of a reporting checklist for studies of HIV drug resistance by achieving agreement among experts on what items should be reported in these studies. The results of this work will be refined and elaborated on by a writing committee of HIV drug resistance experts and external reviewers to develop finalized reporting guidelines.

International Registered Report Identifier (IRRID)

DERR1-10.2196/35969

Delivery of cancer care via an outpatient telephone support line: a cross-sectional study of oncology nursing perspectives on quality and challenges

RATIONALE

Patient support lines (PSLs) assist in triaging clinical problems, addressing patient queries, and navigating a complex multi-disciplinary oncology team. While providing support and training to the nursing staff who operate these lines is key, there is limited data on their experience and feedback.

METHODS

We conducted a cross-sectional study of oncology nurses' (ONs') perspectives on the provision of care via PSLs at a tertiary referral cancer center via an anonymous, descriptive survey. Measures collected included nursing and patient characteristics, nature of questions addressed, perceived patient and nursing satisfaction with the service, common challenges faced, and initiatives to improve the patient and nursing experience. The survey was delivered online, with electronic data collection, and analysis is reported descriptively.

RESULTS

Seventy-one percent (30/42) of eligible ONs responded to the survey. The most common disease site, stage, and symptom addressed by PSLs were breast cancer, metastatic disease, and pain, respectively. The most common reported issue was treatment-related toxicity (96.7%, 29/30). Sixty-seven percent (20/30) of respondents were satisfied with the care provided by the service; however, many areas for potential improvement were identified. Fifty-nine percent (17/29) of respondents recommended redefining PSLs' responsibilities for improved use, with 75% (6/8) ONs identifying high call volumes due to inappropriate questions as a barrier to care. Sixty percent (18/30) of ONs reported having hospital-specific management plans for common issues would improve the care provided by the PSL.

CONCLUSION

Despite high rates of satisfaction with the care provided by the PSL, our study identified several important areas for improvement which we feel warrant further investigation.

The current practices of Australian speech-language pathologists in providing communication services to children with autism spectrum disorder

PURPOSE

Evidence-Based Practice (EBP) is fundamental to speech-language pathology practice. Australian speech-language pathologists (SLPs) who treat communication disorders in children with autism spectrum disorder (ASD) face unique challenges in implementing EBP. Challenges may include selecting an intervention from a myriad of available interventions for use within a complex population. Identification of current practices of Australian SLPs in communication service provision to children with ASD will provide a baseline for use of EBP and may guide future efforts to engage in EBP.

METHOD

A total of 109 Australian SLPs who provide communication services to children with ASD completed an online survey. Descriptive and inferential statistics were used to analyse service delivery and participant experiences of EBP.

RESULT

The most common barrier to delivering EBP was inadequate resources. The most utilised strategy was discussing evidence with colleagues. Most participants reported using therapies which did not adhere to a standard protocol, such as eclectic approaches. The majority also reported use of outcome measures which they believe adequately represent functional communication changes for their client.

CONCLUSION

Resource limitations may result in over-reliance on interventions lacking empirical support and over-reliance on subjective outcome measurement tools. Reflective practice and self-evaluation of communication services to children with ASD may support improved provision of EBP.

HIV testing in secondary care: a multicentre longitudinal mixed methods electronic survey of non-HIV specialist hospital physicians in South-East Scotland and Northern England

BACKGROUND

Increasing the uptake of HIV testing in people who may have undiagnosed HIV is essential to reduce the morbidity associated with late HIV diagnosis.

METHODS

We conducted a multicentre, longitudinal, mixed-methods study, surveying the attitudes, knowledge and practice of non-HIV specialist hospital physicians in South-East Scotland and North-East England with respect to HIV testing.

RESULTS

We found that although awareness of indications for HIV testing had improved over time, only 13% of clinicians recognised all of the surveyed HIV indicator conditions. Physicians were better at recognising the indicator conditions relevant to their specialty. The perception of working with a low-risk patient population was the most frequently cited barrier to offering an HIV test. Only a third of study respondents had requested more than 10 HIV tests in the preceding year.

CONCLUSIONS

Our study supports a need for targeted and sustained educational initiatives to increase rates of HIV testing in secondary care.

Improving Electronic Survey Response Rates Among Cancer Center Patients During the COVID-19 Pandemic: Mixed Methods Pilot Study

BACKGROUND

Surveys play a vital role in cancer research. During the COVID-19 pandemic, the use of electronic surveys is crucial to improve understanding of the patient experience. However, response rates to electronic surveys are often lower compared with those of paper surveys.

OBJECTIVE

The aim of this study was to determine the best approach to improve response rates for an electronic survey administered to patients at a cancer center during the COVID-19 pandemic.

METHODS

We contacted 2750 patients seen at Moffitt Cancer Center in the prior 5 years via email to complete a survey regarding their experience during the COVID-19 pandemic, with patients randomly assigned to a series of variations of prenotifications (ie, postcard, letter) or incentives (ie, small gift, modest gift card). In total, eight combinations were evaluated. Qualitative interviews were conducted to understand the level of patient understanding and burden with the survey, and quantitative analysis was used to evaluate the response rates between conditions.

RESULTS

A total of 262 (9.5%) patients completed the survey and 9 participated in a qualitative interview. Interviews revealed minimal barriers in understanding or burden, which resulted in minor survey design changes. Compared to sending an email only, sending a postcard or letter prior to the email improved response rates from 3.7% to 9.8%. Similarly, inclusion of an incentive significantly increased the response rate from 5.4% to 16.7%, especially among racial (3.0% to 12.2%) and ethnic (6.4% to 21.0%) minorities, as well as among patients with low socioeconomic status (3.1% to 14.9%).

CONCLUSIONS

Strategies to promote effective response rates include prenotification postcards or letters as well as monetary incentives. This work can inform future survey development to increase response rates for electronic surveys, particularly among hard-to-reach populations.

Identifying factors increasing the risk of acquiring HIV among Egyptians to construct a consensus web-based tool for HIV risk assessment

BACKGROUND

Accurate information on HIV transmission risk is required to construct evidence-based risk reduction practices for individuals and to direct the provision of prevention strategies at the population level. HIV transmission risk assessment will help in identifying individuals at high risk of HIV infection and directing the provision of post exposure prophylaxis (PEP).

OBJECTIVE

To identify the common risk factors for HIV transmission in the Egyptian community in order to construct a web-based HIV risk assessment tool.

METHODS

Following a systematic review and meta-analysis of published literature on HIV transmission and risk factors, we retrieved the key determinants of HIV exposure risk. In parallel, we conducted a case control study to identify the common risk factors for HIV transmission in the Egyptian community. The identified risk factors were incorporated in weighted risk scoring models to allow the quantification of the risk of HIV acquisition.

RESULTS

There were 38 determinants associated with HIV seropositivity [people living with HIV (PLWH)] among Egyptians compared to 34 risk factors identified in our meta-analysis. All the derived scores showed high accuracy for predicting HIV infection status [sensitivity, specificity, PPV and NPV of greater than 90.0%, (AUC = 0.998-1.000; p < .001)].

CONCLUSION

Key drivers of HIV transmissions can be incorporated into a risk scoring model in order to quantify the risks of HIV acquisition. Such tools can facilitate the screening of PLWH and at-risk-individuals and direct interventions to halt HIV transmission.

Physical Activity Levels of Adult Virtual Football Players

Esports, including virtual football, are a worldwide phenomenon. Yet, little is known about the physical activity levels of individuals engaged in virtual football game play. Therefore, we aimed to perform a preliminary evaluation of the levels of physical activity, sedentarism, and habits of physical training of adults engaged with virtual football in Portugal. This was a cross-sectional investigation based on a structured online survey using the International Physical Activity Questionnaire (IPAQ) and a set of questions regarding habits of physical training. The participants (n = 433) reported spending a median of 5,625 MET-min⋅week⁻¹ being physically active. Still, the participants spent 320 min/day sitting, and 150 min/day practicing virtual football. According to the IPAQ scores, high physical activity levels were reported by 84.5% of the participants, and 87.1% were considered physically active considering the WHO guidelines on physical activity and sedentary behavior. Overall, 60.0% of the participants reported planning their own physical training. Maintaining or improving overall physical health was one of the main reasons for doing physical training (66.7%), with only 6.1% responding being active to improve virtual football performance. Overall, the results showed that virtual football players accomplished the standard recommendations for physical activity, with high levels of physical activity, and encompassing regular physical training focused mostly on health promotion, rather than improved virtual football performance.

Older adult care in nursing education: How have curricula been developed?

Given the rapidly growing older adult population, future nurses should increase their knowledge and skills in gerontological nursing to deliver high-quality care to older adults. The aim of this national survey (n = 40 nursing schools) was to analyse the status of gerontology education in Portuguese baccalaureate nursing programmes. Data were collected using a 51-item questionnaire about baccalaureate nursing education programmes and gerontology-related topics. Descriptive analysis was used. A total of 18 nursing schools returned the questionnaire (response rate = 45%). Results showed that 66.7% (n = 12) of nursing schools integrated gerontology content into several courses, 38.9% (n = 7) of them had stand-alone courses, and 11.1% (n = 2) of them had both options. The most significant factor inhibiting the development of the gerontological nursing curriculum was the negative image of gerontological nursing (44.4%). Gerontological-related competencies were identified in only two nursing programmes. Thirteen schools reported needing help to strengthen the gerontological content in the nursing curriculum. This study has demonstrated that gerontological content is covered in the nursing curriculum of all nursing schools. The increase of knowledge and skills in gerontological nursing and the development of a standard gerontological curriculum could contribute to enhancing gerontological nursing education and practice.

‘It’s like Going to the Regular Class but without Being there’: A Qualitative Analysis of Older people’s Experiences of Exercise in the Home during Covid-19 Lockdown in England

It is expected that the Covid-19 lockdown will have increased physical inactivity with negative impacts for older people, who are at greater risk of health complications from the virus. This paper draws on customer evaluation questionnaire of a Pilates class aimed at people aged over 50 years old, which transitioned from a studio setting to online classes via Zoom at the start of the lockdown in England. The paper aims to (i) evaluate the shift of exercise services to online and (ii) examine how engagement with online services has influenced people’s reaction to Covid-19 and unprecedented confinement to their homes. Our analysis shows that experiences of exercise in the home are dependent on prior exercise engagement, particularly a sense of progress and competency in exercise movements, trust in the instructor and socio-economic privileges that enable participants to love and appreciate their homes. This paper argues that online classes have had positive impact on participants’ ability to cope with lockdown: routine, structure and being seen by others all proved important well-being aspects.

Establishing a Standardized Facial Cosmetic Preinjection Safety Tool: The ACIST

In the past 20 years, the American population has seen an increased demand for nonsurgical minimally invasive facial rejuvenation solutions for the aging process. This widespread and increased demand for cosmetic injections brings a greater propensity for complications and adverse events. Choosing suitable patients for dermal filler is essential, as is concrete knowledge of the factors related to adverse events; however, there was no standardized tool to facilitate this process. The Joint Commission's Universal Safety checklist tools have been integrated into hospital surgical operating rooms and ambulatory outpatient settings across America and internationally and have successfully reduced errors in patient safety and outcomes. This article establishes the importance of integrating the Assessment Cosmetic Injection Safety Tool (ACIST), a standardized preinjection safety tool, into the cosmetic practice to decrease the incidence of adverse events associated with dermal filler and to achieve optimal patient satisfaction and outcomes. The ACIST was designed from the scientific literature, piloted at an urban cosmetic practice in the southern United States, finalized on the basis of feedback from participating staff members at the pilot study center, and disseminated to cosmetic nurse injectors.

Decision-making approaches used by UK and international health funding organisations for allocating research funds: A survey of current practice

Innovations in decision-making practice for allocation of funds in health research are emerging; however, it is not clear to what extent these are used. This study aims to better understand current decision-making practices for the allocation of research funding from the perspective of UK and international health funders. An online survey (active March-April 2019) was distributed by email to UK and international health and health-related funding organisations (e.g., biomedical and social), and was publicised on social media. The survey collected information about decision-making approaches for research funding allocation, and covered assessment criteria, current and past practices, and considerations for improvements or future practice. A mixed methods analysis provided descriptive statistics (frequencies and percentages of responses) and an inductive thematic framework of key experiences. Thirty-one responses were analysed, representing government-funded organisations and charities in the health sector from the UK, Europe and Australia. Four themes were extracted and provided a narrative framework. 1. The most reported decision-making approaches were external peer review, triage, and face-to-face committee meetings; 2. Key values underpinned decision-making processes. These included transparency and gaining perspectives from reviewers with different expertise (e.g., scientific, patient and public); 3. Cross-cutting challenges of the decision-making processes faced by funders included bias, burden and external limitations; 4. Evidence of variations and innovations from the most reported decision-making approaches, including proportionate peer review, number of decision-points, virtual committee meetings and sandpits (interactive workshop). Broadly similar decision-making processes were used by all funders in this survey. Findings indicated a preference for funders to adapt current decision-making processes rather than using more innovative approaches: however, there is a need for more flexibility in decision-making and support to applicants. Funders indicated the need for information and empirical evidence on innovations which would help to inform decision-making in research fund allocation.

Knowledge of dental academics about the COVID-19 pandemic: a multi-country online survey

BACKGROUND

COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries.

METHODS

We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants' background variables. Multilevel linear models were used to assess the association between dental academics' knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries.

RESULTS

Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007).

CONCLUSIONS

Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need.

PATIENT VOICES, a project for the integration of the systematic assessment of patient reported outcomes and experiences within a comprehensive cancer center: a protocol for a mixed method feasibility study

BACKGROUND

Listening to "patient voices" in terms of symptoms, emotional status and experiences with care, is crucial for patient empowerment in clinical practice. Despite convincing evidence that routine patient reported outcomes and experience measurements (PRMs) with rapid feed-back to oncologists can improve symptom control, patient well-being and cost effectiveness, PRMs are not commonly used in cancer care, due to barriers at various level. Part of these barriers may be overcome through electronic PRMs collection (ePRMs) integrated with the electronic medical record (EMR). The PATIENT VOICES initiative is aimed at achieving a stepwise integration of ePRMs assessment into routine cancer care. The feasibility project presented here is aimed at assessing the knowledge, use and attitudes toward PRMs in a comprehensive cancer centre; developing and assessing feasibility of a flexible system for ePRM assessment; identifying barriers to and developing strategies for implementation and integration of ePRMs clinical practice.

METHODS

The project has been organized into four phases: a) pre-development; b) software development and piloting; c) feasibility assessment; d) post-development. A convergent mixed method design, based on concurrent quantitative and qualitative data collection will be applied. A web-survey on health care providers (HCPs), qualitative studies on patients and HCPs (semi-structured interviews and focus groups) as well as longitudinal and cross-sectional quantitative studies will be carried out. The quantitative studies will enroll 600 patients: 200 attending out-patient clinics (physical symptom assessement), 200 attending inpatient wards (psychological distress assessment) and 200 patients followed by multidisciplinary teams (patient experience with care assessment). The Edmonton symptom assessment scale, the Distress Thermometer, and a tool adapted from existing patient reported experience with cancer care questionnaires, will be used in quantitative studies. A multi-disciplinary stakeholder team including researchers, clinicians, health informatics professionals, health system administrators and patients will be involved in the development of potentially effective implementation strategies in the post development phase.

DISCUSSION

The documentation of potential advantages and implementation barriers achieved within this feasibility project, will serve as a starting point for future and more focused interventions aimed at achieving effective ePRMs routine assessment in cancer care.

TRIAL REGISTRATION

ClinicalTrials.gov ( NCT03968718 ) May 30th, 2019.

Orthopedic Trainees' Perceptions of the Educational Value of Daily Trauma Meetings

OBJECTIVE

The daily orthopedic trauma meeting is considered to serve a dual purpose; a way of discussing management of trauma patients and as a forum for teaching trainees. This study is first to explore orthopedic trainees' perspectives on the educational value of trauma meetings and identify factors that influence educational benefit across England.

DESIGN

An online questionnaire was created including free text responses questions. After initial pilot testing, orthopedic registrar trainees with a national training number within England were emailed and the questionnaire completed online. Results were analyzed using thematic analysis and online survey software.

SETTING

A national study conducted across England in trauma and orthopedic departments in a secondary care setting.

RESULTS

One hundred and thirteen responses were recorded nationally with wide spread of seniority and geographical location. About 73.5 % of trainees found the trauma meeting to be educationally valuable. However, only 30.1% of trainees felt that they were "often" asked questions that aided their learning and 60.1% of trainees felt that decision making in patient management was only explained "sometimes" in the trauma meeting. Positive perceived educational themes included the volume of cases discussed, constructive questioning, and discussion as a form of learning. Negative themes involved time pressures, adverse consultant attitudes, and an aggressive trauma meeting atmosphere limiting learning. Suggested improvements include clearer explanation of decision making, detailed feedback, and a more supportive atmosphere with incorporation of postoperative radiographic review.

CONCLUSIONS

This is the first nationwide study providing an insight into factors influencing the educational value of the trauma meeting as perceived by trainees with improvements being directly sourced from trainees. Recommendations from this study are applicable internationally and guide the implementation of changes to maximize the educational benefit for trainees during trauma meetings.

Cross-cultural validation of the motivation to change lifestyle and health behaviours for dementia risk reduction scale in the Dutch general population

BACKGROUND

This study aimed to translate and validate the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) scale in the Dutch general population.

METHODS

A random sample of Dutch residents aged between 30 and 80 years old were invited to complete an online questionnaire including the translated MCLHB-DRR scale. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted to assess construct validity. Cronbach's alpha was calculated to assess internal consistency.

RESULTS

Six hundred eighteen participants completed the questionnaire. EFA and Cronbach's alpha showed that four items were candidate for deletion. CFA confirmed that deleting these items led to an excellent fit (RMSEA = 0.043, CFI = 0.960, TLI = 0.951, χ²/df = 2.130). Cronbach's alpha ranged from 0.69 to 0.93, indicating good internal consistency.

CONCLUSION

The current study demonstrated that the Dutch MCLHB-DRR scale is a valid scale for assessing health beliefs and attitudes towards dementia risk reduction among Dutch adults aged between 30 and 80 years old.

Identifying nurse managers' essential information needs in daily unit operation in perioperative settings

Aim

To identify nurse managers' essential information needs in daily unit operation in perioperative settings.

Design

Qualitative and quantitative descriptive design.

Methods

The study consisted of (I) generation of an item pool of potential information needs, (II) assessment of the item pool by an expert panel and (III) confirming the essential information needs of nurse managers in daily unit operation with a survey (N = 288). Content validity index values were calculated for the assessments by expert panel and in the survey. Internal consistency of the final item pool was explored with Cronbach's alpha. The data were collected from 2011-2015.

Results

During the study process, the number of essential information needs decreased from 92-41. The final item pool consisted of 12 subthemes, and they were categorized into four main themes: patient's care process, surgical procedure, human resources and tangible resources. The findings can be used to create a knowledge map for information system purposes.

Men's view on participation in decisions about prostate-specific antigen (PSA) screening: patient and public involvement in development of a survey

Background

Prostate-Specific Antigen (PSA) screening for early detection of prostate cancer (PCa) may prevent some cancer deaths, but also may miss some cancers or lead to unnecessary and potentially harmful treatment. Therefore, involving patients in decision-making about PSA screening is recommended. However, we know little about the attitude of men regarding participation in decisions about PSA screening and how to assess such attitudes. The purpose of this paper is to describe patient and public participation in the development of a national, web-based case vignette survey for studying men’s view on participation in decision-making about PSA screening.

Methods

The project group developed a first draft plan for the survey, its vignettes and choice of measurements. This included multiple vignette variants representing various levels of patient participation in decision-making about PSA screening with different outcomes. Additionally, it included questions on respondents’ satisfaction with imagined courses of health care, their propensity to initiate a malpractice complaint, their own health care experiences, socio-demography, personality, and preferences for control regarding health care decision-making. Following feedback from a workshop with academic peers on the draft plan, a group of 30 adult men was engaged to help develop case vignette versions and questionnaire items by providing feedback on structure, comprehension, response patterns, and time required to complete the survey. Furthermore, a panel of three patients with PCa experience was assembled to assist development through a separate review-and-feedback process.

Results

Based on reviews of survey drafts, the large group made further suggestions about construction of the survey (e.g. clarification and modification of case vignette versions, deletion of items and adjustment of wording, instructions to guide respondents, replacement of technical terms, and optimization of sequence of survey elements). The patient panel ensured fine-tuning of vignette versions and questionnaire items and helped review the internet version of the survey.

Conclusions

Patient and public involvement during various phases of the survey development helped modify and refine survey structure and content. The survey exemplifies a way to measure health care users’ satisfaction with imagined courses of health care and wish to complain, taking into account their characteristics.

A Feasibility Study Of Administering The Electronic Research And Development Culture Index To The Multidisciplinary Workforce In A UK Teaching Hospital

Purpose

The study aims were: (i) to convert the Research and Development Culture Index (a validated rating instrument for assessing the strength of organizational Research and Development culture) into electronic format (eR&DCI), and (ii) to test the format and assess the feasibility of administering it to the multidisciplinary (allied health professionals, doctors and nurses) workforce in a National Health Service Hospital (NHS) in the United Kingdom (UK) by trialing it with the workforce of the tertiary Children’s Hospital within the organization.

Population and methods

The eR&DCI was emailed to all professional staff (n=907) in the Children’s Hospital. Data were analyzed using IBM SPSS Statistics 22.

Results

The eR&DCI was completed by 155 respondents (doctors n=38 (24.52%), nurses n=79 (50.96%) and allied health professionals (AHPs) n=38 (24.52%)). The response rate varied by professional group: responses were received from 79 out of 700 nurses (11%); 38 out of 132 doctors (29%) and 38 out of 76 AHPs (50%). Index scores demonstrated a positive research culture within the multidisciplinary workforce. Survey responses demonstrated differences between the professions related to research training and engagement in formal research activities.

Conclusion

This is the first study to assess the feasibility of assessing the strength of an organization’s multidisciplinary workforce research and development (R&D) culture by surveying that workforce using the eR&DCI. We converted the index to “Online Surveys” and successfully administered it to the entire multidisciplinary workforce in the Children’s Hospital. We met our criteria for feasibility: ability to administer the survey and a response rate comparable with similar studies. Uptake could have been increased by also offering the option of the paper-based index for self-administration. Results of the survey are informing delivery of the research strategy in the Children’s Hospital. This methodology has potential application in other healthcare contexts.

Establishing a Standardized Facial Cosmetic Preinjection Safety Tool: The ACIST

In the past 20 years, the American population has seen an increased demand for nonsurgical minimally invasive facial rejuvenation solutions for the aging process. This widespread and increased demand for cosmetic injections brings a greater propensity for complications and adverse events. Choosing suitable patients for dermal filler is essential, as is concrete knowledge of the factors related to adverse events; however, there was no standardized tool to facilitate this process. The Joint Commission's Universal Safety checklist tools have been integrated into hospital surgical operating rooms and ambulatory outpatient settings across America and internationally and have successfully reduced errors in patient safety and outcomes. This article establishes the importance of integrating the Assessment Cosmetic Injection Safety Tool (ACIST), a standardized preinjection safety tool, into the cosmetic practice to decrease the incidence of adverse events associated with dermal filler and to achieve optimal patient satisfaction and outcomes. The ACIST was designed from the scientific literature, piloted at an urban cosmetic practice in the southern United States, finalized on the basis of feedback from participating staff members at the pilot study center, and disseminated to cosmetic nurse injectors.

National recruitment scheme for pre-registration pharmacist training in England and Wales: a mixed method evaluation of experiences of applicant pharmacy students

BACKGROUND

A national pre-registration pharmacist training recruitment scheme, which replaces local recruitment models, was introduced in England and Wales in 2017. The national recruitment system allows pharmacy students to apply for the 52 weeks training programmes (mandatory requirement for registration as a pharmacist), through a single application system prior to undertaking a nationally administered assessment. This study aimed to explore experiences of pharmacy students on the national recruitment scheme, particularly their views on the selection methodology, application process, and offer outcomes.

METHODS

This mixed method study involved a) an online survey of all (approximate n = 2800) year 4 (final year of MPharm degree) pharmacy students in England and Wales and b) a qualitative focus group with four students. The study population was eligible to participate in the 2017/18 national recruitment scheme. Survey respondents were invited to participate in a focus group. Quantitative data were analysed using descriptive and inferential analysis. Qualitative data were analysed using the framework technique. Participation was voluntary. Ethical approval from University of Birmingham was obtained.

RESULTS

A total of 307 completed surveys were returned (approximate response rate 11%). Respondents were generally satisfied with the application process and commended the fairness of the selection methodology and convenience in allowing them to apply to multiple training providers. Most survey respondents (n = 181, 72.9%) were either satisfied or highly satisfied with the training programme they were offered based on their assessment performances. Three themes and eight sub-themes obtained from the analysis of over 200 open comments data from the survey and transcript of a focus group with four participants. Results suggested the need to widen the timeframe available for applicants to shortlist their preferred employers, improve the method of programme listing in the application system, and consideration of prior achievements including academic performances and placement experiences to be included in the selection methodology.

CONCLUSIONS

Experiences of pharmacy students on the national recruitment scheme suggest that respondents considered the selection methodology to be fair. Student engagement and satisfaction with the recruitment system can be maximised through improved listing of employers and widening the timescales for students to shortlist their preferred employers during application process. Inclusion of University achievements in the selection methodology will require consideration of evidence based approaches. Low response rate limits generalisation of findings.

Understanding the Sustainable Usage Intention of Mobile Payment Technology in Korea: Cross-Countries Comparison of Chinese and Korean Users

Mobile payment (m-payment) enables consumers to perform their payment tasks via a mobile technology platform. In this study, we summarized, evaluated, and expanded upon the literature about m-payment usage intention by synthetically integrating the advantages of three information systems theories into an integrated model, which details the complementary relationship between the objective measures, subjective perception of m-payment services, and m-payment technology–task fit characteristics. Based on a sample of 908 individuals in two different Kakaopay user groups (467 Chinese Kakaopay users in Korea and 441 local Korean Kakaopay users) and the three-model integrated optimization, we integrated the unified theory of acceptance and use of technology model (UTAUT), the information systems success model (D&M ISS), and the task-technology fit model (TTF), considering moderating variables (Chinese and Korea experienced consumers) and multi-group analysis. We chose the factors influencing Chinese and Korean consumers' usage intention as the research objects, and ultimately achieved our purpose of more accurately predicting consumer behavior patterns to expand the scale of potential Chinese consumers. The empirical results theoretically contribute to academic and practical solutions for the Korean m-payment product and help technology suppliers to stimulate the sustainable growth of Korean mobile payment consumer groups in Korea.

Improving adrenaline autoinjector adherence: A psychologically informed training for healthcare professionals

BACKGROUND

Clinicians draw on instructional approaches when training patients with anaphylaxis to use adrenaline autoinjectors, but patient use is poor. Psychological barriers to these behaviours exist but are not considered routinely when training patients to use autoinjectors. Health Psychology principles suggest exploring these factors with patients could improve their autoinjector use.

OBJECTIVE

To evaluate the impact of a 90-minute workshop training clinicians in strategies and techniques for exploring and responding to psychological barriers to autoinjector use with patients. Attendees' knowledge, confidence and likelihood of using the strategies were expected to improve.

METHODS

Impact was evaluated using a longitudinal mixed-method design. Twenty-nine clinicians (general and specialist nurses, general practitioners, and pharmacists) supporting patients with anaphylaxis in UK hospitals and general practice attended. Self-rated knowledge, confidence, and likelihood of using the strategies taught were evaluated online 1 week before, 1 to 3, and 6 to 8 weeks after the workshop. Clinicians were invited for telephone interview after attending to explore qualitatively the workshop impact.

RESULTS

χ2 analyses were significant in most cases (P < .05), with sustained (6-8 weeks) improvements in knowledge, confidence, and likelihood of using the strategies taught. Thematic analysis of interview data showed the workshop enhanced attendees' knowledge of the care pathway, understanding of patient's experience of anaphylaxis as psychological not purely physical, and altered their communication with this and other patient groups. However, interviewees perceived lack of time and organisational factors as barriers to using the strategies and techniques taught in clinical contexts.

CONCLUSION

Training clinicians in psychologically informed strategies produce sustained improvements in their confidence and knowledge around patient autoinjector education, and their likelihood of using strategies in clinical practice.

CLINICAL RELEVANCE

Exploring psychological barriers should be part of training patients with anaphylaxis in autoinjector use.

Gender differences in information needs and preferences regarding depression among individuals with multiple sclerosis, inflammatory bowel disease and rheumatoid arthritis

OBJECTIVE

We assessed the information needs of persons with any of three immune-mediated inflammatory diseases (multiple sclerosis [MS], inflammatory bowel disease [IBD] and rheumatoid arthritis [RA]) regarding depression, as a first step toward developing patient-relevant information resources, ultimately to facilitate self-management and appropriate care. We also compared information needs across genders.

METHODS

We surveyed participants with MS, IBD and RA regarding depression-related information needs including types of treatments, effectiveness, risks, benefits, and perceived helpfulness of treatments. We compared responses between groups using multivariate regression.

RESULTS

328 participants provided complete responses (MS: 141, IBD: 114, RA: 73). Most of the topics queried were perceived as very important, and similarly important for all groups. Women placed higher importance than men on most topics. The most popular formats for receiving information were discussion with a counselor (very preferred: 67.4%) and written information (very preferred: 65.5%); this did not differ between groups.

CONCLUSIONS

Persons affected by MS, IBD and RA are interested in receiving information about multiple topics related to depression treatment, from multiple sources. Women desire more information than men.

PRACTICE IMPLICATIONS

These findings can be used to design information resources to meet information needs regarding depression in MS, IBD and RA.

Surveying Allied Health Professionals Within a Public Health Service: What Works Best, Paper or Online?

Poor response rate, self-selection bias, and item noncompletion negatively impact the generalization of results from surveys. This study examined differences in these factors between a paper and online survey among allied health clinicians. Clinicians within a large local health district were initially invited to complete the Research Capacity in Context Tool online via an e-mail link. Following a lower-than-expected response rate, potential selection bias, and item noncompletion, the survey was readministered in paper form to the same cohort of clinicians 6-12 months later. The response rate to the paper survey was higher than to the online survey (27.6% vs. 16.5%). Selection biases were evident, characterized by seniority and discipline: Junior clinicians responded at rates significantly less than expected to the online survey but as expected to the paper survey. Occupational therapists, speech pathologists, and podiatrists responded more highly to the online survey, while other disciplines responded more highly to the paper survey. The rate of item noncompletion was higher for online than paper survey (6.72% vs. 3.8% questions not completed, respectively), with patterns of noncompletion also differing. These data suggest paper surveys are likely to produce less biased and more generalizable data from allied health clinicians.

A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Practice

BACKGROUND

Implementation and sustainability of a culture of evidence-based practice (EBP) require a systematic approach. A baseline assessment of the organizational context can inform implementation efforts.

AIMS

To examine organizational hospital context and provider characteristics associated with EBP readiness and to describe EBP context across hospitals.

METHODS

A nonexperimental descriptive correlational design was used to conduct a web-based survey of direct-care registered nurses (N = 701) and nurse managers (N = 94) across a large Midwestern multisite healthcare system using the Alberta Context Tool (ACT).

RESULTS

Many significant relationships existed among nurse characteristics and ACT domains, including age (lower age had higher Leadership, Evaluation, and Formal Interactions), education (graduate education had lower Social Capital than a bachelor's or associate degree), role (direct-care nurses had lower Culture than managers and lower Social Capital), and work status (full-time employees had lower Evaluation and Social Capital). EBP context across type of hospitals is similar, with marginal differences in Social Capital and Organizational Slack (higher in critical access hospitals).

LINKING EVIDENCE TO ACTION

Assessing organizational context to support EBP is the first step in developing and enhancing a sustainable culture of inquiry. The ACT has been tested across countries, settings, and healthcare disciplines to measure perception of readiness of the practice environment toward EBP. Optimal organizational context is essential to support EBP and sustain the use of evidence in professional nursing practice. Nursing leaders can use baseline assessment information to identify strengths and opportunities to enhance EBP implementation. Enhancing organizational context across nurse characteristics (e.g., age, role, and work status) to acknowledge nurses' contributions, balance nurses' personal and work life, enhance connectedness, and support work culture is beneficial. Fostering development of Social Capital in nurses is needed to influence EBP readiness. A systematic and standardized approach to foster EBP across health systems is key to successful implementation.

Nursing workload: influence of indirect care interventions

OBJECTIVE

To evaluate nurses' perception of the degree of interference of indirect care interventions on the team's workload and to verify the association between these interventions and the professional and institutional variables.

METHOD

A research survey through e-mail conducted with clinical nurses, unit managers and service managers from eight Brazilian states. A questionnaire containing 28 indirect care interventions and their definitions proposed by the Nursing Interventions Classification was applied.

RESULTS

A total of 151 clinical nurses participated, and a response rate of 14.8% was obtained. The indirect care interventions reported as those which most increase the workload were: Preceptor: employee (M = 3.2), Employee Development (M = 3.1), Physician Support (M = 3.0) and Conflict mediation (M = 3.0). Statistically significant associations between the investigated interventions and the institutional variables (legal nature and size) were evidenced.

CONCLUSION

Nurses in different practice scenarios perceive that indirect care interventions influence the workload in a differentiated way, with emphasis on the demands related to the monitoring and qualification of employees.

Using Facebook in Recruiting Kidney Transplant Recipients for a REDCap Study

This web-based study recruited kidney transplant recipients from Facebook using three recruiting methods over a 5-week period. Participants completed 125 survey items via REDCap (Research Electronic Data Capture) survey. Facebook recruitment generated 153 eligible participants who completed surveys. The average survey response time was 15.07 min (SD = 6.12; range: 4-43), with a low missing item rate (<5%). Facebook's standard ads were most effective for recruiting subjects (n = 78, 51%), followed by three targeted Facebook kidney transplant support groups (n = 52, 34%) and a pay-to-promote study page (n = 12, 7.8%). The average cost paid for each valid survey was US$2.19 through standard Facebook ads and US$2.92 from the study page. The cost for online survey completion is economically feasible even for those with limited funds. Issues related to online surveys including extreme survey response times and participant misrepresentation were reported in this study.

Knowledge and Practices of Family and Emergency Physicians in Managing Nontraumatic Dental Conditions: A Case-based Survey

INTRODUCTION

Physicians are often patients' first point of contact for management of nontraumatic dental conditions (NTDCs). This study's aim was to evaluate the knowledge and practices of Ontario physicians in managing NTDCs, with a specific focus on antibiotic usage.

METHODS

A Web-based survey featured 4 NTDC clinical scenarios: irreversible pulpitis, localized acute apical abscess with or without systemic involvement, and chronic apical abscess. The survey link was distributed to active Ontario family and emergency physicians. The sample group was asked questions about their management of and experience with NTDCs, and demographic and practice characteristics were collected. Descriptive and multivariate logistic regression analyses were undertaken (P ≤ .05).

RESULTS

Sampled Ontario physicians tend to manage NTDCs in a manner that is not consistent with evidence-based care. For irreversible pulpitis and for localized acute apical abscess with or without systemic involvement, most physicians would prescribe an antibiotic (57.4%, 84.8%, and 96.3%, respectively), and 23.5% would prescribe an antibiotic for chronic apical abscess. Approximately half the sample (52.9%) felt discomfort in managing NTDCs, and 85.3% felt they were inadequately trained to manage NTDCs.

CONCLUSION

Areas that present opportunities for improvement in the physician management of NTDCs were identified, including the incorporation of further NTDC training in medical curricula and continuing medical education courses, and development and dissemination of guidelines for physicians in managing NTDCs.

The type and pain provoking nature of exercise prescribed for low back pain: A survey of Australian health professionals

OBJECTIVES

To explore the type of exercise prescribed by Australian health professionals for LBP, and whether the exercises prescribed are pain-free or into pain.

METHODS

A survey of physiotherapists and exercise physiologists was conducted from all states/territories in Australia. The survey contained two chronic LBP vignettes with different pain mechanisms (dominant nociceptive or central sensitisation pain) and one acute LBP vignette. Respondents were asked if they would prescribe advice to stay active and exercise. If exercise was prescribed, respondents were asked to specify the type and pain provoking nature (exercise with no pain, exercise to the start of pain, exercise with pain at a tolerable level or exercise irrespective of pain).

RESULTS

The response rate was 17%(218/1276). Most respondents prescribed advice to stay active(≥95%) and exercise(≥90%) for all vignettes. Irrespective of the vignette, several exercises were prescribed [aerobic (57-85% of clinicians), motor control (62-84% of clinicians), range of motion (72-75% of clinicians)]. Strengthening exercise was prescribed more for chronic(>60%) than acute LBP(23%). Irrespective of the exercise, between 20 and 25% of respondents prescribed pain-free exercise, between 71 and 79% of respondents prescribed exercise into pain, and ≤4% prescribed exercise irrespective of pain for acute and chronic LBP.

CONCLUSIONS

Several exercises are prescribed for LBP, irrespective of pain mechanism or duration, with more clinicians prescribing strengthening exercise for chronic than acute LBP. Most clinicians prescribed exercise into pain for acute and chronic LBP, irrespective of the exercise. Further research should determine which exercises are beneficial based on pain mechanism and duration, and whether exercise into pain should be prescribed for LBP.

Development and Psychometric Testing of the Provider Co-Management Index: Measuring Nurse Practitioner-Physician Co-Management

BACKGROUND AND PURPOSE

Provider co-management has emerged in practice to alleviate demands of larger, more complex patient panels, yet no tools exist to measure nurse practitioner (NP)-physician co-management. The purpose of this study is to develop a tool that measures NP-physician co-management.

METHODS

Items were generated based on three theoretical dimensions of co-management. Face and content validity were established with six experts. Pilot testing was conducted with a convenience sample of 40 NPs and physicians. We computed mean, standard deviation, skewness, interitem and corrected item-total correlations, and Cronbach's alpha.

RESULTS

Psychometric analysis yielded high subscale reliability: effective communication (α = .811); mutual respect and trust (α = .746); and shared philosophy of care (α = .779).

CONCLUSIONS

PCMI demonstrates strong internal reliability consistency. Future research to examine construct validity is recommended.