1
|
Ziv G, Levin O, Netz Y. Selecting an appropriate control group for studying the effects of exercise on cognitive performance. Psychol Sport Exerc 2024; 72:102602. [PMID: 38280537 DOI: 10.1016/j.psychsport.2024.102602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/12/2023] [Accepted: 01/24/2024] [Indexed: 01/29/2024]
Abstract
Differences in expectations between experimental and control groups can influence the outcomes of exercise interventions, emphasizing the need to match expectations across study groups. This online study examined whether the expectations to improve the performance of different cognitive tasks differ between various activities commonly used in research on the effects of exercise and cognitive function. Two hundred and five middle-aged adults performed two reaction-time tasks and one memory task. They were then asked to rate, on a 1-5 Likert scale, their expectations to improve performance in those tasks should they engage in six types of activities for three months: brisk walking, resistance exercise, stretching and balance exercises, watching videos with lectures on art, history, and science, a program of relaxation techniques, and yoga/tai chi/meditation. Results revealed that the highest expectations for improvement were associated with relaxation techniques and yoga/tai chi/meditation. Some activities, such as brisk walking and stretch and balance exercises, shared similar expectations. Previous knowledge of the possible beneficial effects of exercise on cognitive performance also led to higher expectations. To establish causal relationships, researchers should strive to use activities that share similar expectations to improve performance for the experimental and control groups. The findings of this study provide such activity pairs. Finally, researchers should also try to match participants with and without prior knowledge of the benefits of exercise to cognitive function between experimental and control groups.
Collapse
Affiliation(s)
- Gal Ziv
- Levinsky-Wingate Academic College - Wingate Campus, Netanya, Israel.
| | - Oron Levin
- Movement Control & Neuroplasticity Research Group, KU Leuven, Leuven, Belgium; Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
| | - Yael Netz
- Levinsky-Wingate Academic College - Wingate Campus, Netanya, Israel; Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
| |
Collapse
|
2
|
Qian X, Yuan S. AI-powered mental health communication: Examining the effects of affection expectations on health behavioral intentions. Patient Educ Couns 2024; 122:108142. [PMID: 38237529 DOI: 10.1016/j.pec.2024.108142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/17/2023] [Accepted: 01/08/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES This study proposed and examined users' expectations of chatbots in mental health communication and compared them with human doctors. Focusing on the affective expectation, we aimed to unveil the impacts of changes in affection on individuals' expectations and behavioral intentions. METHODS A 2 (chatbot vs. human doctor) x 2 (affective vs. neutral) online experiment (N = 364) was conducted. Participants were asked about their expectations towards communicating health with chatbots and human doctors, watched pre-recorded conversations, and answered questions about expectancy violation toward affection and willingness to further health actions. RESULTS Individuals have higher expectations from human doctors in almost all aspects. Individuals' expectation of online chat with doctors is more likely to be violated compared with chatbots. Significant results are found on individuals' behavioral intentions, with a greater likelihood of switching to online chatbots when chatbots use an affective approach or doctors use a neutral tone. Individual's past experiences with chatbots play a key role in expectancy violations. CONCLUSION Individuals have higher expectations of human doctors, but using an affective approach may better meet individuals' expectations toward chatbots and switch their behavioral intentions. PRACTICE IMPLICATIONS Chatbots that meet expectations can be designed and applied to address mental health concerns.
Collapse
Affiliation(s)
- Xuan Qian
- Department of Communication, Northern Illinois University, Dekalb, IL 60115, USA
| | - Shupei Yuan
- Department of Communication, Northern Illinois University, Dekalb, IL 60115, USA.
| |
Collapse
|
3
|
Chun J, Curtiss SL, Richard C, Zhou K, Rios YC, Park S, Kim J, Koc M. Where Does Hope Lie? The Dialectical Tensions Between Hopes and Expectations of Vocational Transition Planning from the Perspectives of Autistic Young Adults, Parents, and Practitioners. J Autism Dev Disord 2024:10.1007/s10803-024-06348-9. [PMID: 38635131 DOI: 10.1007/s10803-024-06348-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2024] [Indexed: 04/19/2024]
Abstract
The post-secondary transition for autistic youth is a complex process, with hopes and expectations serving as malleable mediators often overlooked in research and practice. Career awareness, exploration, and counseling services play a critical role in facilitating vocational transition, but the vocational hopes and expectations of autistic youth and their parents are often disregarded. This study aims to explore these aspirations and their impact on the vocational transition process, seeking to harmonize elements to better align with the needs of autistic youth and their families. This study used a focus group design involving group interviews with three participant groups: autistic transition-aged youth, parents, and practitioners. The findings reveal five key themes: 1) Accepting Disability or Constrained by Ableism: Resisting Marginalization, 2) Finding the Sweet Spot: Are Parents and Youth's Expectations Too High or Too Low, 3) Market Forces at Work-Finding a Meaningful Vocational Path in a Capitalist Society, 4) Despite Meticulous Planning, there is a Disconnect Between Needs and Resources, and 5) The Hills and Valleys of Finding Resilience. Navigating the multifaceted landscape of vocational transition planning for autistic youth necessitates a collaborative and flexible approach. Identified tensions serve as opportunities for growth and transformation. Recognizing and addressing system shortcomings is crucial for informed decision-making. Challenges extend beyond individual circumstances, reflecting broader systemic issues, and identifying these gaps allows for a comprehensive understanding of available resources, cultivating a basis of hope as uncertainties are addressed.
Collapse
Affiliation(s)
- Jina Chun
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 1000 Bascom Mall, Room 415, Madison, WI, 53706, U.S.A..
| | - Sarah L Curtiss
- College of Education and Human Development, University of Delaware, Newark, DE, U.S.A
| | - Constance Richard
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 1000 Bascom Mall, Room 415, Madison, WI, 53706, U.S.A
| | - Kaiqi Zhou
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, U.S.A
| | - Yazmin Castruita Rios
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, U.S.A
| | - Sara Park
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 1000 Bascom Mall, Room 415, Madison, WI, 53706, U.S.A
| | - Jaeyong Kim
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, U.S.A
| | - Muharrem Koc
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 1000 Bascom Mall, Room 415, Madison, WI, 53706, U.S.A
| |
Collapse
|
4
|
Worsfold ME, Jouanny C, Hamer E, Mohrsen SA, Jadzinski P, Harper M. "This is how I'm going to do it, but this is not how you're going to do it": the expectation gap between student paramedics and mentors in East and Central Scotland. BMC Med Educ 2024; 24:368. [PMID: 38570785 PMCID: PMC10993586 DOI: 10.1186/s12909-024-05319-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 03/14/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND The role of paramedics has expanded significantly over the past two decades, requiring advanced skills and education to meet the demands of diverse healthcare settings. In 2021, the academic requirements for paramedics were raised to a bachelor's degree to align with other registered professions. The limited evidence on effective paramedic practice education necessitates a novel or new examination of unique learning methods, emphasising the need to establish effective learning relationships between mentors and learners to enhance professional respect and support achieving learning outcomes. This study aimed to investigate expectations between student paramedics and their mentors, focusing on the learning dynamics within paramedic education. METHODS This qualitative study used purposive sampling to recruit participants from two distinct cohorts: student paramedics from the University of Stirling and Practice Educator Mentors from the Scottish Ambulance Service. Focus groups were conducted to illuminate comprehensive insights into participants' expectations regarding practice education and their respective roles in the learning process. Codebook thematic analysis was used to assess the alignment of these expectations. RESULTS Findings illustrate important challenges within practice placement across learning paradigms and highlight the attitudes surrounding the integration of higher education and expectations of practice placements. These challenges encompass systemic barriers, including the support provided to mentors as they assume increased responsibilities and barriers that deter qualified staff from initially undertaking this role. CONCLUSION The study aimed to assess expectations between practice educators and students within the paramedic profession in Scotland. The methodology effectively identified key themes from comprehensive data, marking the first primary research in this field. There are disparities in learning styles, expectation measurement, and attitudes toward higher education during practice placements, which could significantly impact the teaching and assessment processes. The findings suggest increased support for practice educators, educational programs addressing challenges of mentorship, and stronger links between higher education institutes and the Scottish Ambulance Service. Further research is needed to understand the extent of the expectation gap, how expectations evolve, and to develop strategies to address disparities.
Collapse
Affiliation(s)
| | | | - Ela Hamer
- University of Stirling, Stirling, Scotland
| | | | | | - Mick Harper
- University of Portsmouth, Portsmouth, England
| |
Collapse
|
5
|
Zamanzadeh A, Cavoli T, Ghasemi M, Rokni L. The effect of actual and expected income shocks on mental wellbeing: Evidence from three East Asian countries during COVID-19. Econ Hum Biol 2024; 53:101378. [PMID: 38593608 DOI: 10.1016/j.ehb.2024.101378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/11/2024]
Abstract
This paper evaluates the effects of economic shocks to current and expected income reduction on mental wellbeing. We use individual-level data from three East Asian countries; China, Japan, and South Korea, during the early phases of the pandemic when the COVID-induced economic shocks were severe. The findings reveal significant causal effects from current and expected income reduction on different aspects of mental health deterioration, including anxiety, trouble sleeping, boredom, and loneliness. Interestingly, we found that expectations of future income loss have a significantly larger effect on people's mental wellbeing compared to current falls in income. This has significant implications for the design of policies to support income during pandemics.
Collapse
Affiliation(s)
- Akbar Zamanzadeh
- Business School, University of South Australia, Adelaide, South Australia, Australia; Centre for Markets, Values and Inclusion (CMVI), University of South Australia, Adelaide, South Australia, Australia
| | - Tony Cavoli
- Business School, University of South Australia, Adelaide, South Australia, Australia; Centre for Markets, Values and Inclusion (CMVI), University of South Australia, Adelaide, South Australia, Australia.
| | - Matina Ghasemi
- Faculty of Business and Economics, Girne American University, Kyrenia, Cyprus
| | - Ladan Rokni
- Asia Contents Institute, Konkuk University, Seoul 05029, South Korea
| |
Collapse
|
6
|
Borgmann A, Petrie KJ, Seewald A, Shedden-Mora M. Can side effect expectations be assessed implicitly? A comparison of explicit and implicit expectations of vaccination side effects. J Psychosom Res 2024; 179:111616. [PMID: 38401222 DOI: 10.1016/j.jpsychores.2024.111616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/23/2024] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Treatment expectations alter the probability of experiencing unpleasant side effects from an intervention, including vaccinations. To date, expectations have mostly been assessed explicitly bearing the risk of bias. This study aims to compare implicit expectations of side effects from COVID-19 and flu vaccinations and to examine their relationships with vaccine attitudes and intentions. METHODS N = 248 participants took part in a cross-sectional online survey assessing explicit and implicit expectations, as well as vaccine-related attitudes and personal characteristics. A Single Category Implicit Association Test (SC-IAT) was developed to assess implicit side effect expectations. Explicit side effect expectations were measured with the Treatment Expectation Questionnaire (TEX-Q). RESULTS Whereas explicit and implicit expectations regarding COVID-19 vaccine were significantly correlated (r = -0.325, p < .001), those correlations could not be found regarding flu vaccine (r = -0.072, p = .32). Explicit measures (COVID-19: β = -0.576, p < .001; flu: β = -0.301, p < .001) predicted the intention to receive further vaccinations more than implicit measures (COVID-19: β = -0.005, p = .93; flu: β = 0.004, p = .96). Explicit measures (COVID-19: OR = 0.360, p < .001; flu: OR = 0.819, p = .03) predicted vaccination status, while implicit measures did not (COVID- 19: OR = 2.643, p = .35; flu: OR = 0.829, p = .61). CONCLUSION Expectations to experience side effects from vaccinations can be measured implicitly, in addition to explicit measures. Further investigation needs to determine the relative contribution and additive value of using implicit measures to assess treatment expectations.
Collapse
Affiliation(s)
- Anna Borgmann
- Department of Psychology, Medical School Hamburg, Hamburg, Germany.
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Anna Seewald
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Meike Shedden-Mora
- Department of Psychology, Medical School Hamburg, Hamburg, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
7
|
Nadarevic L, Bell R. Remembering the truth or falsity of advertising claims: A preregistered model-based test of three competing theoretical accounts. Psychon Bull Rev 2024:10.3758/s13423-024-02482-8. [PMID: 38528303 DOI: 10.3758/s13423-024-02482-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 03/27/2024]
Abstract
Given the large amount of information that people process daily, it is important to understand memory for the truth and falsity of information. The most prominent theoretical models in this regard are the Cartesian model and the Spinozan model. The former assumes that both "true" and "false" tags may be added to the memory representation of encoded information; the latter assumes that only falsity is tagged. In the present work, we contrasted these two models with an expectation-violation model hypothesizing that truth or falsity tags are assigned when expectations about truth or falsity must be revised in light of new information. An interesting implication of the expectation-violation model is that a context with predominantly false information leads to the tagging of truth whereas a context with predominantly true information leads to the tagging of falsity. To test the three theoretical models against each other, veracity expectations were manipulated between participants by varying the base rates of allegedly true and false advertising claims. Memory for the veracity of these claims was assessed using a model-based analysis. To increase methodological rigor and transparency in the specification of the measurement model, we preregistered, a priori, the details of the model-based analysis test. Despite a large sample size (N = 208), memory for truth and falsity did not differ, regardless of the base rates of true and false claims. The results thus support the Cartesian model and provide evidence against the Spinozan model and the expectation-violation model.
Collapse
Affiliation(s)
- Lena Nadarevic
- Department of Psychology, School of Social Sciences, University of Mannheim, D-68131, Mannheim, Germany.
- University of Applied Sciences Fresenius Heidelberg, Heidelberg, Germany.
| | - Raoul Bell
- Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
8
|
Ivanova D, Newell D, Field J, Bishop FL. The development of working alliance in early stages of care from the perspective of patients attending a chiropractic teaching clinic. Chiropr Man Therap 2024; 32:10. [PMID: 38515190 PMCID: PMC10958961 DOI: 10.1186/s12998-023-00527-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/21/2023] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The clinician-patient relationship has consistently been found to predict treatment success in both physical and mental health settings. This relationship has been operationalised in the literature as "Working Alliance," which consists of three key components: patient-clinician agreement on the goals of care, agreement on the tasks required to achieve those goals, and the establishment of a strong bond. While research has demonstrated the impact of working alliance in physical health settings, it often measures working alliance early in patients' care journeys. However, no primary research has investigated how early working alliance develops between patients and chiropractors. Evidence suggests that musculoskeletal practitioners may require further training to feel confident in establishing working alliance. Therefore, this study aims to explore the development of working alliance in the early stages of chiropractic care from the patients' perspective to inform evidence-based practice. METHODS Participants for this qualitative study were recruited from a teaching clinic at a specialised healthcare professions training university in the United Kingdom between September 2022 and April 2023. A total of 25 adult patients completed semi-structured interviews during the early stages of their care. The interview transcripts were analysed using Reflexive Thematic Analysis, from a critical realist stance. RESULTS The findings highlight that an early working alliance entails the gradual development of patients' confidence in their decision to seek help from trainee chiropractors to alleviate their symptoms. The four themes describe the impact of the clinical context on patients' expectations, the trainee chiropractors' qualities that participants considered important for early working alliance, the role of explanations, and the interplay between pain and early working alliance. CONCLUSIONS Establishing an early trainee chiropractor-patient working alliance involves a process of building patients' confidence in the trainee chiropractors' expertise, identifying the correct goals of care, and recognising the value of the proposed treatment plan. Factors shaping this process include the context of the care journey, patients' perceptions of trainee chiropractors' qualities, their bodily sensations, their expectations, their past experiences, and their satisfaction with trainee chiropractors' explanations.
Collapse
Affiliation(s)
- Dima Ivanova
- School of Psychology, University of Southampton, University Road, Southampton, Hampshire, SO17 1BJ, UK.
| | - Dave Newell
- AECC University College, Parkwood Campus, Parkwood Road, Bournemouth, Dorset, BH5 2DF, UK
| | | | - Felicity L Bishop
- School of Psychology, University of Southampton, University Road, Southampton, Hampshire, SO17 1BJ, UK
| |
Collapse
|
9
|
Faktor L, Small K, Bradfield Z, Baird K, Fenwick J, Gray JE, Robinson M, Warton C, Cusack S, Homer CS. What do women in Australia want from their maternity care: A scoping review. Women Birth 2024; 37:278-287. [PMID: 38142159 DOI: 10.1016/j.wombi.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Just over 300,000 women give birth in Australia each year. It is important for health care providers, managers, and policy makers know what women want from their care so services can be provided appropriately. This review is a part of the Midwifery Futures Project, which aims to prepare the midwifery workforce to best address the needs of women. The aim of this review was to describe and analyse current literature on the maternity care needs of women in Australia. METHODS A scoping review methodology was used, guided by the Joanna Briggs Institute framework. A systematic search of the literature identified 9023 studies, and 59 met inclusion criteria: being peer-reviewed research focusing on maternity care needs, conducted in Australian populations, from 2012 to 2023. The studies were analysed using inductive content analysis. RESULTS Four themes were developed: Continuity of care, being seen and heard, being safe, and being enabled. Continuity of care, especially a desire for midwifery continuity of care, was the central theme, as it was a tool supporting women to be seen and heard, safe, and enabled. CONCLUSION This review highlights that women in Australia consistently want access to midwifery continuity of care as an enabler for addressing their maternity care needs. Transforming Australian maternity care policy and service provision towards continuity would better meet women's needs.
Collapse
Affiliation(s)
- Lachlan Faktor
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia; School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Kirsten Small
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia; School of Nursing and Midwifery, Griffith University, Logan, QLD, Australia
| | - Zoe Bradfield
- Faculty of Health Sciences, Curtin University, WA, Australia
| | - Kathleen Baird
- Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Jennifer Fenwick
- Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Joanne E Gray
- Faculty of Health, University of Technology Sydney, NSW, Australia
| | | | - Chanelle Warton
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia
| | | | - Caroline Se Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia; Faculty of Health, University of Technology Sydney, NSW, Australia.
| |
Collapse
|
10
|
Omale UI, Uduma VU, Adeke AS, Ikegwuonu CO, Nkwo GE, Nwali UI, Nnachi OO, Ukpabi OO, Okeke IM, Ewah RL, Iyare O, Oka OU, Amuzie CI. COVID-19 and COVID-19 vaccination experiences and perceptions and their predictors among community members during the COVID-19 pandemic in Ebonyi state, Nigeria: an analytical cross-sectional study. BMC Public Health 2024; 24:567. [PMID: 38388448 PMCID: PMC10885597 DOI: 10.1186/s12889-024-18028-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND COVID-19 is still a disease of global public health importance which requires long term application of control measures as millions of new infections or re-infections and thousands of related deaths still occur worldwide and the risk of an upsurge from new strains of the virus continues to be a threat. The decrease in the use of and non-use of preventive public health measures are among the factors fuelling the disease. The (previous) experiences and perceptions of people regarding the COVID-19 pandemic, COVID-19 vaccination, and the vaccination process are factors that will influence subsequent use of preventive/control measures. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the community members in Ebonyi state, Nigeria. METHODS We conducted an analytical cross-sectional study between March 12 and May 9, 2022 among all consenting/assenting community members aged 15 years and above in 28 randomly selected geographical clusters. A structured interviewer-administered electronic questionnaire in KoBoCollect installed in android devices was used to collect data which was analysed using descriptive statistics and bivariate and multivariate generalized estimating equations. RESULTS Of the 10,825 community members surveyed: only 31.6% had strong COVID-19 experience and perception, 72.2% had good COVID-19 vaccination expectation and perception, and only 54.2% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent/level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of attitude towards COVID-19 and COVID-19 vaccination and level of knowledge about COVID-19. Other important predictors were marital status, educational level, and main occupation. CONCLUSIONS This study's evidence, including the identified predictors, will inform subsequent policy actions regarding COVID-19 in the strategies to improve the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of community members (and their use of preventive/control measures) in Ebonyi state and Nigeria, and other similar contexts. It will also inform future policy actions/strategies regarding similar diseases.
Collapse
Affiliation(s)
- Ugwu I Omale
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria.
| | - Victor U Uduma
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Azuka S Adeke
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Cordis O Ikegwuonu
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Glory E Nkwo
- Department of Community Medicine, Federal Medical Centre Umuahia, Umuahia, Abia State, Nigeria
| | - Ugochi Ia Nwali
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Olaedo O Nnachi
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Okechukwu O Ukpabi
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Ifeyinwa M Okeke
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Richard L Ewah
- Department of Anaesthesia, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
- Anaesthesia Unit, Department of Surgery, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - Osarhiemen Iyare
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Onyinyechukwu U Oka
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Ebonyi State, Nigeria
| | - Chidinma I Amuzie
- Department of Community Medicine, Federal Medical Centre Umuahia, Umuahia, Abia State, Nigeria
| |
Collapse
|
11
|
Lledó García E, González García FJ, Jara Rascón J, García Muñoz J, Lledó Graell E, Sánchez Ochoa MA, Hernández Fernández C. Satisfaction assessment study in patients (and their partners) with/without Peyronie's disease and penile prosthesis implantation. Actas Urol Esp 2024:S2173-5786(24)00010-6. [PMID: 38367908 DOI: 10.1016/j.acuroe.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 02/19/2024]
Abstract
INTRODUCTION AND OBJECTIVE Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. However, patients with coexistent Peyronie's disease (PD) and refractory erectile dysfunction and/or severe deformities may show different results. The aim of our study was to assess and to compare the level of satisfaction, with an inflatable penile prosthesis (IPP), in men with/without coexistent PD. MATERIAL AND METHODS A survey study based on a five-item satisfaction questionnaire was submitted to all those live patients implanted in the period 1992-2022 at our center (n = 570) and their partners. Ninety-two percent of implants were inflatable devices. Surgeries were mainly performed by two surgeons. The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after IPP. RESULTS Of the 570 eligible patients, 479 (84%) completed the survey (393 Non-PD: GROUP 1; 70 non-complex PD-Group 2; 16 complex PD). Eighty-six per cent of patients in Group 1 reported satisfactory sexual intercourse (very or moderately satisfied). Non-complex PD implanted patients (Group 2) reported a global 81% satisfactory sexual intercourse (very or moderately satisfied) (p > 0.05). However, when we evaluated the PD subgroup of patients with severe PD who require incision/excision/grafting at the time of implant (Group 3: n = 20), only 61% reported satisfactory sexual intercourse (p < 0.01) with predominance of moderately satisfied patients over very satisfied: 78% vs. 22%). Additionally, 84% (Group 1), 80% (Group 2) and 54% (Group 3) of partners reported satisfactory intercourses, respectively (p < 0.01). Overall, 84% of Group 1 implants and 79% of Group 2 reported that they would undergo the procedure again if the IPP failed (p > 0.05; ns). Only 50% of Group 3 patients would do it again. With regard to cosmetic aspects, 48% of the Group 3 implant reported penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of total PP patients expressed difficulty in manipulating the device. CONCLUSION The presence of PD alone may not impact PP patient and partner satisfaction, but patients with more severe baseline deformity who require incision/grafting may be less satisfied with outcomes including penile length and glans sensation.
Collapse
Affiliation(s)
- E Lledó García
- Sección de Urología Funcional, Reconstructiva y Andrología-Servicio de Urología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, Universidad Complutense, Madrid, Spain.
| | - F J González García
- Sección de Urología Funcional, Reconstructiva y Andrología-Servicio de Urología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - J Jara Rascón
- Sección de Urología Funcional, Reconstructiva y Andrología-Servicio de Urología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - J García Muñoz
- Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - E Lledó Graell
- Facultad de Medicina, Universidad Europea, Madrid, Spain
| | - M A Sánchez Ochoa
- Sección de Urología Funcional, Reconstructiva y Andrología-Servicio de Urología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - C Hernández Fernández
- Sección de Urología Funcional, Reconstructiva y Andrología-Servicio de Urología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, Universidad Complutense, Madrid, Spain
| |
Collapse
|
12
|
Zhao Y, Sazlina SG, Rokhani FZ, Chinna K, Su J, Chew BH. The expectations and acceptability of a smart nursing home model among Chinese older adults: a mixed methods study. BMC Nurs 2024; 23:40. [PMID: 38218894 PMCID: PMC10788001 DOI: 10.1186/s12912-023-01676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Smart nursing homes (SNHs) integrate advanced technologies, including IoT, digital health, big data, AI, and cloud computing to optimise remote clinical services, monitor abnormal events, enhance decision-making, and support daily activities for older residents, ensuring overall well-being in a safe and cost-effective environment. This study developed and validated a 24-item Expectation and Acceptability of Smart Nursing Homes Questionnaire (EASNH-Q), and examined the levels of expectations and acceptability of SNHs and associated factors among older adults in China. METHODS This was an exploratory sequential mixed methods study, where the qualitative case study was conducted in Hainan and Dalian, while the survey was conducted in Xi'an, Nanjing, Shenyang, and Xiamen. The validation of EASNH-Q also included exploratory and confirmatory factor analyses. Multinomial logistic regression analysis was used to estimate the determinants of expectations and acceptability of SNHs. RESULTS The newly developed EASNH-Q uses a Likert Scale ranging from 1 (strongly disagree) to 5 (strongly agree), and underwent validation and refinement from 49 items to the final 24 items. The content validity indices for relevance, comprehensibility, and comprehensiveness were all above 0.95. The expectations and acceptability of SNHs exhibited a strong correlation (r = 0.85, p < 0.01), and good test-retest reliability for expectation (0.90) and acceptability (0.81). The highest tertile of expectations (X2=28.89, p < 0.001) and acceptability (X2=25.64, p < 0.001) towards SNHs were significantly associated with the willingness to relocate to such facilities. Older adults with self-efficacy in applying smart technologies (OR: 28.0) and those expressing a willingness to move to a nursing home (OR: 3.0) were more likely to have the highest tertile of expectations compared to those in the lowest tertile. Similarly, older adults with self-efficacy in applying smart technologies were more likely to be in the highest tertile of acceptability of SNHs (OR: 13.8). CONCLUSIONS EASNH-Q demonstrated commendable validity, reliability, and stability. The majority of Chinese older adults have high expectations for and accept SNHs. Self-efficacy in applying smart technologies and willingness to relocate to a nursing home associated with high expectations and acceptability of SNHs.
Collapse
Affiliation(s)
- Yuanyuan Zhao
- The School of Smart Health and Wellness (Health Medical College), Zhejiang Dongfang Polytechnic, Wenzhou, Zhejiang Province, China
| | - Shariff-Ghazali Sazlina
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing TM ), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Fakhrul Zaman Rokhani
- Faculty of Engineering, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing TM ), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Kulala Lumpur, Selangor, Malaysia
| | - Jing Su
- International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan Province, China
| | - Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia.
- Clinical Research Unit, Hospital Sultan Abdul Aziz Shah (HSAAS Teaching Hospital), Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
| |
Collapse
|
13
|
Tindyebwa T, Ssempala R, Ssennyonjo A, Mayora C, Muhoozi M, Tusabe J, Mukama P, Freddie S. Expectations of clients, insurers, and providers: a qualitative responsiveness assessment among private health insurance sector in Kampala-Uganda. BMC Health Serv Res 2023; 23:1358. [PMID: 38053178 DOI: 10.1186/s12913-023-10386-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND There is less attention to assessing how health services meet the expectations of private health insurance (PHI) actors, clients, insurers, and providers in developing countries. Interdependently, the expectations of each actor are stipulated during contract negotiations (duties, obligations, and privileges) in a PHI arrangement. Complementary service roles performed by each actor significantly contribute to achieving their expectations. This study assessed the role of PHI in meeting the expectations of clients, insurers, and providers in Kampala. Lessons from this study may inform possible reviews and improvements in Uganda's proposed National Health Insurance Scheme (NHIS) to ensure NHIS service responsiveness. METHODS This study employed a qualitative case-study design. Eight (8) focus group discussions (FGDs) with insured clients and nine (9) key informant interviews (KIIs) with insurer and provider liaison officers between October 2020 and February 2021 were conducted. Participants were purposively selected from eligible institutions. Thematic analysis was employed, and findings were presented using themes with corresponding anonymized narratives and quotes. RESULTS Client-Provider, Client-Insurer, and Provider-Insurer expectations were generally not met. Client-provider expectations: Although most facilities were clean with a conducive care environment, clients experienced low service care responsiveness characterized by long waiting times. Both clients and providers received inadequate feedback about services they received and delivered respectively, in addition to prompt care being received by a few clients. For client-insurer expectations, under unclear service packages, clients received low-quality medicines. Lastly, for provider-insurer expectations, delayed payments, selective periodic assessments, and inadequate orientation of clients on insurance plans were most reported. Weak coordination between the client-provider and insurer did not support delivery processes for responsive service. CONCLUSION Health care service responsiveness was generally low. There is a need to commit resources to support the setting up of clearer service package orientation programs, and efficient monitoring and feedback platforms. Uganda's proposed National Health Insurance Act may use these findings to: Inform its design initiatives focusing on operating under realistic expectations, investment in quality improvement systems and coordination, and efficient and accountable client care relationships.
Collapse
Affiliation(s)
- Tonny Tindyebwa
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda.
| | - Richard Ssempala
- Department of Economic Theory and Analysis, School of Economics, Makerere University, Kampala, Uganda
| | - Aloysius Ssennyonjo
- Department of Health Policy Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Chrispus Mayora
- Department of Health Policy Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Micheal Muhoozi
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Joan Tusabe
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Paul Mukama
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Ssengooba Freddie
- Department of Health Policy Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| |
Collapse
|
14
|
Manoharan D, Thompson KG, Gage D, Scott JF. An organizational framework for patient-reported outcome instruments in dermatologic surgery: a systematic review and qualitative analysis. Arch Dermatol Res 2023; 316:15. [PMID: 38047921 DOI: 10.1007/s00403-023-02738-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 04/30/2023] [Accepted: 09/16/2023] [Indexed: 12/05/2023]
Abstract
Patient-reported outcomes (PROs) describe measures of a patient's experience throughout medical care as reported by the patient (Mercieca-Bebber et al. in Patient Relat Outcome Meas, 2018). Various PRO instruments exist. It is challenging to select appropriate instruments given the absence of an organizational framework which describes all measurable PROs in dermatologic surgery and represents which instruments measure which outcomes. Our objective was to systematically review all validated PRO instruments in dermatologic surgery and use qualitative analysis to develop an organizational framework representing PRO measures and instruments. PubMed/MEDLINE, Embase, CINAHL, PsycINFO, and Cochrane databases were searched to retrieve validated PRO instruments in the dermatologic surgery population. The constant comparative method of qualitative analysis was used to develop an organizational framework representing all PROs in dermatologic surgery. All instruments were sorted into this framework. The search identified 3195 articles; 35 validated instruments were extracted and qualitatively analyzed. The organizational framework sorted all instruments into 36 PRO measures aligned with the National Institutes of Health Patient-Reported Outcomes Measurement Information System (Gershon RC, Rothrock N, Hanrahan R, et al (2010) The use of PROMIS and assessment center to deliver patient-reported outcome measures in clinical research). Measures were grouped into four categories (expectations, satisfaction, quality of life, needs) describing how patients experience these outcomes and lenses through which researchers can evaluate them. In conclusion, we have proposed an organizational framework for use in choosing validated instruments to develop and answer PRO research questions.
Collapse
Affiliation(s)
- Divya Manoharan
- Department of Dermatology, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD, 21287, USA.
| | - Katherine G Thompson
- Department of Dermatology, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD, 21287, USA
| | - Davies Gage
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jeffrey F Scott
- Department of Dermatology, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD, 21287, USA
- Clinical Skin Center of Northern Virginia, Fairfax, VA, USA
| |
Collapse
|
15
|
Kusaibati AM, Sultan K, Hajeer MY, Burhan AS, Alam MK. Adult patient expectations and satisfaction: Can they be influenced by viewing the three-dimensional predicted outcome before fixed orthodontic treatment of dental crowding? J World Fed Orthod 2023; 12:269-279. [PMID: 37777351 DOI: 10.1016/j.ejwf.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/06/2023] [Accepted: 08/31/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Investigating the possible changes in patients' expectations of and satisfaction with the orthodontic treatment outcomes when they were given the three-dimensional digital prediction of their teeth alignment before the beginning of treatment. METHODS A prospective non-controlled single-group clinical trial was conducted on 28 (18 females, 10 males, mean age: 20.68 ± 1.91 years) patients with Class I malocclusion and moderate dental crowding who required a nonextraction orthodontic treatment. Patients were given the expectations questionnaire on their first visit (T0). Then, patients were shown a three-dimensional digital setup-created by Orthoanalyzer software (3Shape, Copenhagen, Denmark)-of the proposed treatment results before orthodontic treatment (T1) and received two questionnaires, the second expectations questionnaire and the satisfaction with the proposed changes questionnaire. Treatment was then initiated using the fixed appliances and completed. After debonding, a question about patients' satisfaction with the achieved changes was completed (T2). RESULTS Patients' expectations level significantly increased after watching the predicted alignment of teeth compared with the initial levels in terms of chewing (x¯ = 5.54 and x¯= 6.71), speech (x‾ =5.93 and x¯= 6.93), and oral hygiene improvement (x‾= 7.93 and x¯=8.61 ± 1.06; at T0 and T1, respectively). The remaining items showed no significant differences between the two assessment times. Patients had a higher level of satisfaction at the end of treatment than after watching the proposed outcome. There were significant statistical differences in the items related to teeth appearance (x¯= 9.12 and x¯= 9.60 at T1 and T2, respectively), and teeth engagement (x¯= 8.92 and x¯= 9.40 at T1 and T2, respectively) CONCLUSIONS: Watching the predicted alignment outcome increased patients' expectations of chewing, speech, and oral hygiene improvement compared with the initially recorded levels. Patients were more satisfied with the final result than what was recorded after viewing the predicted plan. However, these results were not clinically significant.
Collapse
Affiliation(s)
| | - Kinda Sultan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Mohammad Y Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria.
| | - Ahmad S Burhan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| |
Collapse
|
16
|
Myers H, Keefe FJ, George SZ, Kennedy J, Lake AD, Martinez C, Cook CE. Effect of a Patient Engagement, Education, and Restructuring of Cognitions (PEERC) approach on conservative care in rotator cuff related shoulder pain treatment: a randomized control trial. BMC Musculoskelet Disord 2023; 24:930. [PMID: 38041042 PMCID: PMC10691016 DOI: 10.1186/s12891-023-07044-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/16/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Despite similar outcomes for surgery and physical therapy (PT), the number of surgeries to treat rotator cuff related shoulder pain (RCRSP) is increasing. Interventions designed to enhance treatment expectations for PT have been shown to improve patient expectations, but no studies have explored whether such interventions influence patient reports of having had surgery, or being scheduled for surgery. The purpose of this randomized clinical trial was to examine the effect of a cognitive behavioral intervention aimed at changing expectations for PT on patient-report of having had or being scheduled for surgery and on the outcomes of PT. METHODS The Patient Engagement, Education, and Restructuring of Cognitions (PEERC) intervention, was designed to change expectations regarding PT. PEERC was evaluated in a randomized, pragmatic "add-on" trial in by randomizing patients with RCRSP to receive either PT intervention alone (PT) or PT + PEERC. Fifty-four (54) individuals, recruited from an outpatient hospital-based orthopedic clinic, were enrolled in the trial (25 randomized to PT, 29 randomized to PT + PEERC). Outcomes assessed at enrollment, 6 weeks, discharge, and six months after discharge included the patient report of having had surgery, or being scheduled for surgery (primary) and satisfaction with PT outcome, pain, and function (secondary outcomes). RESULTS The average age of the 54 participants was 51.81; SD = 12.54, and 63% were female. Chronicity of shoulder pain averaged 174.61 days; SD = 179.58. Study results showed that at the time of six months follow up, three (12%) of the participants in the PT alone group and one (3.4%) in the PT + PEERC group reported have had surgery or being scheduled for surgery (p = .32). There were no significant differences between groups on measures of satisfaction with the outcome of PT (p = .08), pain (p = .58) or function (p = .82). CONCLUSIONS In patients with RCRSP, PT plus the cognitive behavioral intervention aimed at changing expectations for PT provided no additional benefit compared to PT alone with regard to patient report of having had surgery, or being scheduled to have surgery, patient reported treatment satisfaction with the outcome of PT, or improvements in pain, or function. TRIAL REGISTRATION The trial is registered on ClinicalTrials.gov: NCT03353272 (27/11/2017).
Collapse
Affiliation(s)
- Heather Myers
- Urbaniak Sports Science Institute, Department of Rehabilitation Services, Duke University Health System, 3475 Erwin Rd, Durham, NC, 27705, USA.
| | - Francis J Keefe
- Department of Psychiatry and Behavioral Sciences; Psychology and Neuroscience, Medicine, and Anesthesiology, Duke University School of Medicine, 2200 W Main St, Suite 340, Durham, NC, 27705, USA
| | - Steven Z George
- Department of Orthopaedic Surgery, Duke University School of Medicine, 200 Morris Street, Durham, NC, 27701, USA
| | - June Kennedy
- Urbaniak Sports Science Institute, Department of Rehabilitation Services, Duke University Health System, 3475 Erwin Rd, Durham, NC, 27705, USA
| | - Ashley Davis Lake
- Urbaniak Sports Science Institute, Department of Rehabilitation Services, Duke University Health System, 3475 Erwin Rd, Durham, NC, 27705, USA
| | - Corina Martinez
- Urbaniak Sports Science Institute, Department of Rehabilitation Services, Duke University Health System, 3475 Erwin Rd, Durham, NC, 27705, USA
| | - Chad E Cook
- Department of Orthopaedics, Duke University School of Medicine, 311 Trent Drive, Durham, NC, 27705, USA
| |
Collapse
|
17
|
Sillero Sillero A, Gil Poisa M, Marques-Sule E, Ayuso Margañon R. Motivations and expectations of generation Z nursing students: A post-pandemic career choice qualitative analysis. J Prof Nurs 2023; 49:178-185. [PMID: 38042554 DOI: 10.1016/j.profnurs.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND The global nursing shortage is a growing concern so recruiting and retaining Generation Z (Gen Z) students is vital to the sustainability of the profession. PURPOSE To explore the perceptions and expectations of first-year nursing students regarding the nursing profession, its working conditions, and how these factors influenced their career choices. METHOD Descriptive qualitative research design, employing an interpretive research approach and content analysis conducted following Graneheim & Lundman's method. Our study involved 105 Generation Z nursing degree students enrolled in first year at the Mar Nursing School in Barcelona, Spain in 2021. Data collection included voluntary written narratives about their career choice and questionnaires of demographic information and their healthcare experiences. RESULTS It became evident that Generation Z students' perceptions and expectations of nursing don't align with the actual professional experience. This mismatch could lead to disillusionment and attrition among these students. CONCLUSIONS Several factors (economic, aspirational, perception of nursing during the COVID-19, or gender) influence new students' career choice. These factors shape their expectations and often do not match actual working conditions in nursing. Educational institutions must prepare students by transferring cross-cutting competencies to effectively meet these challenges and avoid potential dropout from the profession.
Collapse
Affiliation(s)
- Amalia Sillero Sillero
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra affiliated, Barcelona, Spain; SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - María Gil Poisa
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra affiliated, Barcelona, Spain; SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTin MOTION), Department of Physiotherapy, University of Valencia, Carrer de Gascó Oliag, 5, 46010, Valencia, Spain.
| | - Raquel Ayuso Margañon
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra affiliated, Barcelona, Spain; SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| |
Collapse
|
18
|
Naserirad M, Tavakol M, Abbasi M, Jannat B, Sadeghi N, Bahemmat Z. Predictors of international Muslim medical tourists' expectations on halal-friendly healthcare services: A hospital-based study. Health Serv Manage Res 2023; 36:230-239. [PMID: 35713661 PMCID: PMC10552339 DOI: 10.1177/09514848221109831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Halal-friendly healthcare services have emerged as an important sector of the overall healthcare service delivery system. This study aimed to examine levels and determinants of expectations on halal-friendly healthcare services from the Muslim medical tourists' perspective. METHODS A cross-sectional survey was conducted in four cities, seventeen hospitals, across Iran, with a sample of 365 international Muslim medical tourists. RESULTS Mean expectation score of the respondents was 3.95 ± 1.43. Being in the 25-34 age group (aOR = 2.65; CI 95%: 2.14-3.16), being married (aOR = 2.09; CI 95%: 1.46-2.72), having completed secondary education (aOR = 2.14; CI 95%: 1.26-3.02), belonging to a high-income socioeconomic background (aOR = 1.69; CI 95%: 1.06-2.33), coming from Iraq (aOR = 3.08; CI 95%: 2.12-4.04), being Shia (aOR = 2.83; CI 95%: 2.00-3.67), receiving information by recommendation as a source for travel decision (aOR = 3.02; CI 95%: 1.82-4.22), traveling with family or relatives (aOR=2.16; CI 95%: 1.42-2.90), receiving medical service of cosmetic surgery (aOR = 1.57; CI 95%: 1.22-1.92) and cardiovascular therapy (aOR = 2.33; CI 95%: 1.23-3.43), and traveling one or two times in the past (aOR = 2.33; CI 95%: 1.00-3.66) significantly increased the expectations on halal-friendly healthcare services. CONCLUSION This study will represent an important contribution to the literature concerned with the levels and drivers of expectations on halal-friendly healthcare services.
Collapse
Affiliation(s)
- Mohsen Naserirad
- Department of Sociology, Faculty of Social Sciences, University of Tehran, Tehran, Iran
- Halal Research Center, Food and Drug Administration, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohamad Tavakol
- Department of Sociology, Faculty of Social Sciences, University of Tehran, Tehran, Iran
| | - Mahmoud Abbasi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behrooz Jannat
- Halal Research Center, Food and Drug Administration, Ministry of Health and Medical Education, Tehran, Iran
| | - Naficeh Sadeghi
- Department of Drug and Food Control, Tehran University of Medical Sciences School of Pharmacy, Tehran, Iran
| | - Zahra Bahemmat
- Department of Social Sciences, Faculty of Humanities and Social Sciences, University of Mazandaran, Babolsar, Iran
| |
Collapse
|
19
|
Cui B, Li H, Cheng Y, Wang J, Sun Q, Jia Y. Expectations for safety of nursing home residents and their family members during the COVID-19 pandemic: a qualitative study. BMC Nurs 2023; 22:365. [PMID: 37803387 PMCID: PMC10559523 DOI: 10.1186/s12912-023-01535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND COVID-19 has spread worldwide. Older adults are at the greatest risk of contracting and dying from the virus. Nursing homes are densely populated places for older adults who are generally vulnerable and at high-risk. Although Chinese nursing homes have been trying to protect their residents, the needs and expectations of the residents and their families have been ignored. This study aimed to promote the safety of NH residents, including their physical and psychological safety, and to meet their expectations during the COVID-19 pandemic in China. METHODS Data were collected through face-to-face semi-structured interviews with nursing home residents and focus group online interviews with family members between June 2021 and February 2022. Data analysis was performed using inductive content analysis. RESULTS 16 residents and 24 family members were interviewed. Four themes with 10 sub-themes were identified from the participants' descriptions. Their expectations were mainly focused on prevention and control measures for COVID-19, medical capacity of nursing homes, health literacy and expectations for some aged care policies. CONCLUSIONS In the face of concerns about the impact of COVID-19 on nursing homes, we sought to bring firsthand perspectives to the forefront by interviewing residents and their family members about their expectations for safety to address this issue. Our findings provide important areas on which should be focused and may improve the sense of gain, happiness, and security of nursing home residents during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Baojuan Cui
- Department of Rehabilitation Medicine, The Second Hospital of Shandong University, Jinan, China
- Jinan Shande Nursing Home, Jinan, China
| | - Hui Li
- Department of Rehabilitation Medicine, The Second Hospital of Shandong University, Jinan, China
- Jinan Shande Nursing Home, Jinan, China
| | - Yan Cheng
- Department of Rehabilitation Medicine, The Second Hospital of Shandong University, Jinan, China
- Jinan Shande Nursing Home, Jinan, China
| | - Jinmei Wang
- Department of Rehabilitation Medicine, The Second Hospital of Shandong University, Jinan, China
- Jinan Shande Nursing Home, Jinan, China
| | - Qiangsan Sun
- Department of Rehabilitation Medicine, The Second Hospital of Shandong University, Jinan, China
| | - Yuxiu Jia
- Standardized training Department for residents, The Second Hospital of Shandong University, Jinan, 250033 China
| |
Collapse
|
20
|
Larki KN, Mohammadi T, Zakerimoghadam M, Sayadi L. Effects of Interventions Based on Patient Expectations on Coronary Surgery Outcomes: A Randomized Clinical Trial. J Tehran Heart Cent 2023; 18:269-277. [PMID: 38680642 PMCID: PMC11053240 DOI: 10.18502/jthc.v18i4.14826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/13/2023] [Indexed: 05/01/2024] Open
Abstract
Background Coronary surgery can have various outcomes, such as fear of death, cardiac anxiety, and pain disability. This study aimed to evaluate the effects of interventions based on patient expectations on different outcomes of coronary surgery, including expectations, cardiac anxiety, and pain-induced disability. Methods This randomized clinical trial evaluated 60 coronary surgery candidates. Patients meeting the inclusion criteria were randomly assigned to control and intervention groups. The patients were contacted 1 to 2 weeks before coronary surgery to complete the Cardiac Surgery Patient Expectations Questionnaire (C-SPEQ). Based on the analysis of expectations, the intervention group underwent interventions to optimize expectations, whereas the control group received only routine care. The Cardiac Anxiety Questionnaire (CAQ) and the Pain Disability Index (PDI) were completed on the day of hospitalization. Three months later, the participants recompleted all 3 questionnaires. The data were analyzed with descriptive and analytical statistics in SPSS 16.0. Results There were no significant differences between the control and intervention groups in baseline variables, pain-induced disability (P=0.353), and cardiac anxiety (P=0.479). After the intervention, no significant differences were observed between the groups concerning expectations (P=0.554) and pain-induced disability (P=0.557) when the confounding variables were adjusted. Nevertheless, cardiac anxiety decreased significantly (P=0.027). Conclusion Our interventions improved expectations and mitigated anxiety among coronary surgery patients. Actualization and optimization of patient expectations should be considered in the care of coronary surgery candidates.
Collapse
Affiliation(s)
- Kobra Noruzi Larki
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayeb Mohammadi
- Departments of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Leila Sayadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
21
|
Dorfman N, Snellman L, Kerley Y, Kostick-Quenet K, Lazaro-Munoz G, Storch EA, Blumenthal-Barby J. Hope and Optimism in Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives. NEUROETHICS-NETH 2023; 16:17. [PMID: 37905206 PMCID: PMC10615366 DOI: 10.1007/s12152-023-09524-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/29/2023] [Indexed: 11/02/2023]
Abstract
Introduction Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions. Objective This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies. Materials and Methods Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, transcribed, and coded. Results Using thematic content analysis, four major themes from clinician interviews and five major themes from caregiver interviews related to hopes and expectations were identified. Clinicians expressed concerns about caregiver false hopes (86%, 25/29) and desperation (68.9%, 20/29) in light of DBS being a last resort. As a result, 68.9% of clinicians (20/29) expressed that they intentionally tried to lower caregiver expectations about DBS outcomes. Clinicians also expressed concern that, on the flip side, unrealistic pessimism drives away some patients who might otherwise benefit from DBS (34.5%, 10/29). Caregivers viewed DBS as the last option that they had to try (61.3%, 27/44), and 73% of caregivers (32/44) viewed themselves as having high hopes but reasonable expectations. Fewer than half (43%, 19/44) expressed that they struggled setting outcome expectations due to the uncertainty of DBS, and 50% of post-DBS caregivers (14/28) expressed some negative feelings post treatment due to unmet expectations. 43% of caregivers (19/44) had experiences with clinicians who tried to set low expectations about the potential benefits of DBS. Conclusion Thoughtful clinician-stakeholder discussion is needed to ensure realistic outcome expectations.
Collapse
Affiliation(s)
- Natalie Dorfman
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | | | | | - Kristin Kostick-Quenet
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | | | - Eric A Storch
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | | |
Collapse
|
22
|
Panchal S, Hendrick P. The lived experiences of musculoskeletal physiotherapists managing patient expectations for diagnostic imaging: A qualitative study using a phenomenological analysis. Musculoskelet Sci Pract 2023; 67:102833. [PMID: 37672861 DOI: 10.1016/j.msksp.2023.102833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/29/2023] [Accepted: 07/21/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES Unnecessary diagnostic imaging for musculoskeletal presentations is a pervasive phenomenon, placing a substantial weight on healthcare resources. Their overuse can lead to iatrogenic consequences associated with overdiagnosis and overtreatment. Factors which contribute to inappropriate imaging are multifactorial. Clinician-patient beliefs, behaviours, and expectations have been identified as central drivers. Physiotherapists play an important role in the utilisation of diagnostic imaging for musculoskeletal presentations throughout healthcare settings. This study aims to explore the lived experiences of physiotherapists managing patient expectations for diagnostic imaging. DESIGN A qualitative study using an interpretative phenomenological analysis. Five participants were purposefully recruited and took part in semi-structured individual interviews. RESULTS The central themes identified were expectations for diagnostic imaging, managing expectations, communicating imaging findings, imaging as a therapeutic tool, and risk and uncertainty. CONCLUSION The findings from this study gives new insights into how musculoskeletal physiotherapists manage expectations for diagnostic imaging, the associated complexities, and the challenges encountered.
Collapse
|
23
|
Ortiz-Tudela J, Nicholls VI, Clarke A. Parameters of prediction: Multidimensional characterization of top-down influence in visual perception. Neurosci Biobehav Rev 2023; 153:105369. [PMID: 37619646 PMCID: PMC7615211 DOI: 10.1016/j.neubiorev.2023.105369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/12/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Despite the recent popularity of predictive processing models of brain function, the term prediction is often instantiated very differently across studies. These differences in definition can substantially change the type of cognitive or neural operation hypothesised and thus have critical implications for the corresponding behavioural and neural correlates during visual perception. Here, we propose a five-dimensional scheme to characterise different parameters of prediction. Namely, flow of information, mnemonic origin, specificity, complexity, and temporal precision. We describe these dimensions and provide examples of their application to previous work. Such a characterisation not only facilitates the integration of findings across studies, but also helps stimulate new research questions.
Collapse
Affiliation(s)
- Javier Ortiz-Tudela
- Department of Psychology, Goethe University Frankfurt, Germany; Mind, Brain, and Behavior Research Center, Department of Experimental Psychology, University of Granada, Spain
| | | | - Alex Clarke
- Department of Psychology, University of Cambridge, UK.
| |
Collapse
|
24
|
Cazzulino A, Bach K, Cordero R, Swarup I. Patient Expectations and Satisfaction in Pediatric Orthopedics. Curr Rev Musculoskelet Med 2023:10.1007/s12178-023-09869-5. [PMID: 37728727 DOI: 10.1007/s12178-023-09869-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE OF REVIEW The purpose of the current review is to analyze the current literature regarding the tools available to evaluate patient expectations and satisfaction. There have been an increasing number of tools that have been developed and validated for various orthopedic procedures. Despite the growing number of tools, there are a limited number of tools available for pediatric patients. RECENT FINDINGS Several tools have been developed in orthopedics to evaluate patient expectations. However, there are no tools that have been validated in the pediatric population. In addition, pediatric patient expectations should be collected in conjunction with parent/caregiver expectations. Although not specifically validated for pediatric patients, there are several tools available that may pertain to pediatric patients including the HSS ACL Expectations Survey, HSS Shoulder Expectations Survey, HSS Knee Surgery Expectations Survey, HSS Foot and Ankle Surgery Expectation Survey, Sunnybrook Surgery Expectations Survey, Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) Instruments, Quick DASH, and DASH. In terms of patient satisfaction, there are even fewer tools available. Several tools have been developed to evaluate patient satisfaction and five additional tools within orthopedics. Of these tools, there are two that have been validated for pediatric patients: The Swedish Parents Satisfaction Questionnaire and the Scoliosis Research Society-22. There are a growing number of tools to evaluate patient's expectations and satisfaction in the orthopedic literature. Given most of these tools pertain to adult patients, there is a need for further development of tools specifically validated for pediatric patients and their parents/caregivers. Through the measurement of expectations and satisfaction, medical professionals can hope to improve satisfaction and outcomes.
Collapse
Affiliation(s)
- Alejandro Cazzulino
- Department of Orthopedic Surgery, University of California San Francisco, 500 Parnassus Ave. Millberry Union MU 320 W, San Francisco, CA, USA.
| | - Katherine Bach
- Department of Orthopedic Surgery, University of California San Francisco, 500 Parnassus Ave. Millberry Union MU 320 W, San Francisco, CA, USA
| | | | - Ishaan Swarup
- Department of Orthopedic Surgery, University of California San Francisco Benioff Children's Hospital Oakland, Oakland, CA, USA
| |
Collapse
|
25
|
Ike OO, Ugwu LE, Enwereuzor IK, Eze IC, Omeje O, Okonkwo E. Expanded-multidimensional turnover intentions: scale development and validation. BMC Psychol 2023; 11:271. [PMID: 37697427 PMCID: PMC10496226 DOI: 10.1186/s40359-023-01303-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 08/24/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND This study aims to provide researchers and practitioners with a more elaborate instrument to measure turnover intentions based on the planned behaviour theory model. The questionnaire assesses 5 distinct aspects of turnover intentions (i.e., subjective social status, organisational culture, personal orientation, expectations, and career growth). METHODS In this cross-sectional study (comprise of 2 studies in one) a wave survey design was applied to a large diversity of workers drawn from the staff of universities, banks, hospitals, factories, and telecommunication companies. Exploratory factor analysis (EFA) was applied the identify the sub-dimensions and Cronbach's alpha to assess the reliability of the first study. In the second study, for the Confirmatory factor analysis to establishing structural model of the dimensions. RESULTS We demonstrate the reliability, factor structure, and validity evidence based on internal structure and relationship with other variables of the new measure among two samples (N1 = 622; N2 = 433). Twenty-five items with 5 factors were extracted to represent a broader perspective of turnover intention scale. CONCLUSIONS In total, the study indicates that the assessment can be used to reliably assess several major indicators of turnover intentions. Therefore, improved employees' evaluations and reduced loss of valuable staff as a result of avoidable measures in considering the interests of workers.
Collapse
Affiliation(s)
| | - Lawrence Ejike Ugwu
- Psychology Department, Psychology Department, Renaissance University Ugbawka Enugu, Enugu, Nigeria.
| | | | | | - Obiageli Omeje
- Psychology Department, Enugu State University of Science and Technology, Enugu, Nigeria
| | - Ejike Okonkwo
- Psychology Department, Enugu State University of Science and Technology, Enugu, Nigeria
| |
Collapse
|
26
|
Oberfichtner K, Oppelt P, Fritz D, Hrauda K, Fritz C, Schildberger B, Lastinger J, Stelzl P, Enengl S. Breastfeeding in primiparous women - expectations and reality: a prospective questionnaire survey. BMC Pregnancy Childbirth 2023; 23:654. [PMID: 37689660 PMCID: PMC10493027 DOI: 10.1186/s12884-023-05971-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Breastfeeding provides the optimal nutrition for infants and offers numerous benefits for both mother and child. The World Health Organisation recommends exclusive breastfeeding during the first 6 months of life and the introduction of complementary feeding between the fifth and seventh months of life. There is a discrepancy between breastfeeding recommendations and the actual duration of breastfeeding. The aim of this study was to analyse breastfeeding behaviour in primiparous women in order to be able to provide support for mothers. METHODS In this prospective, questionnaire-based study conducted between 2020 and 2022, primiparous women were asked to complete three questionnaires at three defined survey time points (routine prepartum presentation, postpartum hospitalization, completed sixth month of life). RESULTS A total of 140 women were included and returned all three questionnaires. Fifty-eight percent performed breastfeeding exclusively at least until their baby had reached the age of 6 months, whereas 20% already stopped within the first 6 months. The main reasons given for early cessation were insufficient milk supply and inadequate infant weight gain. A comprehensive level of prepartum knowledge had a significant positive effect on participants' sense of confidence with breastfeeding. Sociodemographic factors such as age and educational level were also associated with breastfeeding behaviour, but significant corresponding differences in the duration of breastfeeding were not observed. Women with postpartum midwifery care breastfed significantly longer (p < 0.05). CONCLUSIONS Breastfeeding behaviour and duration are influenced by multiple factors. Although certain sociodemographic factors are unalterable, comprehensive prepartum knowledge transfer and postpartum midwifery care have a positive impact on breastfeeding behaviour. TRIAL REGISTRATION The study was retrospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) on 6 December 2022 (DRKS00030763).
Collapse
Affiliation(s)
- Katrin Oberfichtner
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria.
| | - Peter Oppelt
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Daniela Fritz
- University of Applied Sciences for the Health Professions, Linz, Austria
| | - Katharina Hrauda
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Christian Fritz
- Institute for Statistical Analysis Jaksch & Partner GmbH, Linz, Austria
| | | | - Julia Lastinger
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Patrick Stelzl
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Sabine Enengl
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| |
Collapse
|
27
|
Kang L, Victoria C, Desai K, Nguyen J, Lee SK, Mancuso CA. Factors Influencing Surgical Decision Making in Trapeziometacarpal Osteoarthritis. J Hand Surg Glob Online 2023; 5:655-660. [PMID: 37790830 PMCID: PMC10543771 DOI: 10.1016/j.jhsg.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/06/2023] [Indexed: 10/05/2023] Open
Abstract
Purpose With trapeziometacarpal osteoarthritis (TMC OA), the relationship between disease severity and pretreatment dysfunction, patient expectations, and preferred patient treatment and management remains unclear. This study aimed to assess the association between functional status, pretreatment expectations, and demographic and clinical characteristics of TMC OA patients who decide to undergo operative management. Methods Patients diagnosed with TMC OA (n = 96) were administered the Thumb Arthritis Expectations Survey and the Brief Michigan Hand Questionnaire (bMHQ) during their initial office visit. Demographic data (sex, age, race, education level, marital status, comorbidities, and hand dominance) and clinical characteristics (prior injury, and therapeutic interventions including splinting, steroid injections, therapy, and anti-inflammatory medication) were collected. Multiple logistic regression was used to assess the association between surgical treatment and expectation scores. Results Our logistic regression model found that lower bMHQ scores, high thumb arthritis expectation survey scores, and prior treatments for TMC OA were associated significantly with the surgical treatment of TMC OA. After controlling for all possible covariates, the odds of having surgery was 3.9 times higher among patients with high expectations (above median) compared to patients with low expectations (adjusted odds ratio [AOR], 3.9; 95% confidence interval [CI], 1.3-11.2). Patients with average function, as measured by bMHQ scores, were 74.5% less likely to elect for surgery than those with the lowest bMHQ (AOR, 0.3; 95% CI, 0.1-0.9). Patients treated previously with steroids were 13 times more likely to elect for surgery than those who were never treated for TMC arthritis (AOR,13.1; 95% CI, 2.2-77.0). Conclusions Patients with TMC OA who elect to proceed with surgical management have lower bMHQ (greater perceived dysfunction) and higher expectations, and have had prior treatment. Age was not a significant predictor of surgical management of TMC OA. Type of study/level of evidence Prognostic IV.
Collapse
Affiliation(s)
- Lana Kang
- Hand and Upper Extremity Service, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA
| | - Christian Victoria
- Hand and Upper Extremity Service, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA
| | - Khusboo Desai
- Hand and Upper Extremity Service, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA
| | - Joseph Nguyen
- Biostatistics Core, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA
| | - Steve K. Lee
- Hand and Upper Extremity Service, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA
| | - Carol A. Mancuso
- Department of Rheumatology, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA
| |
Collapse
|
28
|
Rauf T. Differential sensitivity to adversity by income: Evidence from a study of Bereavement. Soc Sci Res 2023; 115:102920. [PMID: 37858363 DOI: 10.1016/j.ssresearch.2023.102920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/21/2023]
Abstract
Adverse life events are often understood as having negative consequences for mental health via objective hardships, which are worse for persons with less income. But adversity can also affect mental health via more subjective mechanisms, and here, it is possible that persons with higher income will exhibit greater psychological sensitivity to negative events, for various reasons. Drawing on multiple sociological literatures, this article theorizes potential mechanisms of increasing sensitivity with income. The proposition of differential sensitivity is tested using the strategic case of spousal and parental bereavement among older US adults. The analyses find consistent evidence of increasing sensitivity of depressive symptoms with income. A series of robustness checks indicate that findings are not due to endogenous or antecedent selection. Further, exploratory analyses of mechanisms suggest that higher sensitivity among the affluent was driven by greater expectations and better relationship quality with the deceased. These findings problematize the conceptualization and assessment of human suffering in economically stratified societies.
Collapse
Affiliation(s)
- Tamkinat Rauf
- Department of Sociology, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI, 53706, USA.
| |
Collapse
|
29
|
Tyner TE, Freysteinson WM, Evans SC, Woo J. "My body, my choice": A qualitative study of women's mastectomy with flat closure experiences. Body Image 2023; 46:419-433. [PMID: 37573764 DOI: 10.1016/j.bodyim.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023]
Abstract
This qualitative study aimed to describe and explore the pre and post-mastectomy experiences of women choosing flat closure after a breast cancer diagnosis. Aesthetic flat closure creates a flat contoured chest wall after a mastectomy. There is limited research on women's flat closure experiences. To fill this gap, we interviewed 19 women (Mage = 53, range 31-72) with breast cancer who underwent a bilateral mastectomy with flat closure, examining decision-making, mirror-viewing, and flat closure experiences. Using a hermeneutic phenomenological design, we generated seven themes. Broadly, women choosing flat closure experienced pressure from their clinicians to undergo breast reconstruction. We found flat closure information to be consistently lacking. Mirror-viewing experiences of women obtaining suboptimal flat closure outcomes led to shattered expectations, mirror avoidance, psychological distress, and body image disturbances. Women negotiated their new reality by discovering ways to feel comfortable with their flat bodies. Regardless of surgical outcome, decision satisfaction was high. These findings illustrate the importance of bodily autonomy and supportive healthcare environments for women making flat closure decisions. Providing comprehensive information on all surgical options and addressing post-operative expectations can improve women's decision-making and mirror-viewing experiences and assist women in adapting to their new body image.
Collapse
Affiliation(s)
- Tracy E Tyner
- College of Nursing, Texas Woman's University, P.O. Box 425498, ASB 216, Denton, TX 76204-5498, USA.
| | - Wyona M Freysteinson
- Nelda C. Stark College of Nursing, Texas Woman's University, 6700 Fannin Street, Houston, TX 77030-2897, USA
| | - Stephanie C Evans
- Houston J. and Florence A. Doswell College of Nursing, Texas Woman's University, 5500 Southwestern Medical Avenue, Dallas, TX 75235-7299, USA
| | - Jennifer Woo
- Houston J. and Florence A. Doswell College of Nursing, Texas Woman's University, 5500 Southwestern Medical Avenue, Dallas, TX 75235-7299, USA
| |
Collapse
|
30
|
Meng CK, Piaralal SK, Islam MA, Yusof MFB, Chowdhury RS. International medical Tourists' expectations and behavioral intention towards health resorts in Malaysia. Heliyon 2023; 9:e19721. [PMID: 37809654 PMCID: PMC10559008 DOI: 10.1016/j.heliyon.2023.e19721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 10/10/2023] Open
Abstract
Medical tourism, a thriving industry encompassing both healthcare and tourism sectors, has experienced exponential growth over the past decades. The intensifying competition within the global market necessitates a closer examination of the pivotal role played by the perceptions of medical tourists in their decision-making process regarding health destination visits. Thus, this study aims to explore the interplay between international medical tourists' perceptions of health resort attractions and their expectations, while also investigating the mediating effect (expectations) of these perceptions on their behavioral intentions to seek medical and healthcare treatments in a Malaysian health resort. Drawing on the Expectation Confirmation Theory (ECT) and the Theory of Planned Behavior (TPB), this research employed a quantitative research method, surveying 386 international medical tourists. The distribution of the survey questionnaire utilized the online internet email method. The study employed the partial least square structural equation modeling (PLS-SEM) method to examine the hypothesized relationships. The results conclusively support the positive influence of health resort attractions on international medical tourists' expectations and behavioral intentions. Consequently, this study provides valuable implications for the future growth and development of the health resort and medical tourism industry in Malaysia.
Collapse
Affiliation(s)
| | | | - Md Aminul Islam
- Faculty of Business & Communication, Universiti Malaysia Perlis, Malaysia
- Faculty of Business & Entrepreneurship, Daffodil International University, Bangladesh
| | | | - Rubaiyat Shaimom Chowdhury
- Faculty of Business & Communication, Universiti Malaysia Perlis, Malaysia
- Faculty of Business Administration and Economics, Bangladesh University, Bangladesh
| |
Collapse
|
31
|
Lützner C, Beyer F, David L, Lützner J. Fulfilment of patients' mandatory expectations are crucial for satisfaction: a study amongst 352 patients after total knee arthroplasty (TKA). Knee Surg Sports Traumatol Arthrosc 2023; 31:3755-3764. [PMID: 36740633 PMCID: PMC10435619 DOI: 10.1007/s00167-022-07301-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/18/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Patient satisfaction with the results of their total knee arthroplasty (TKA) is one of the primary goals of this elective procedure. Furthermore, the association between the fulfilment of patients' expectations and their satisfaction is well known. The aim of this study was to identify the key expectations of patients awaiting a TKA, evaluate their fulfilment, and compare the outcomes between very and not fully satisfied patients. METHODS A prospective cohort study of patients with knee OA scheduled for primary TKA was performed. Pre- and one-year postoperatively patient-reported outcome measures (PROMs) were assessed. Expectations and their fulfilment were evaluated via a questionnaire encompassing 31 expectations. Preoperatively, expectations were indicated as mandatory, desirable and not important. Postoperatively, fulfilment was rated as exceeded, fulfilled, partially or not fulfilled, and not applicable. Satisfaction with the results of TKA was measured with a numeric rating scale (NRS) of 0-10. Discrimination between not fully satisfied and very satisfied patients was set at ≥ 8, as has been proposed recently. To identify independent predictors of this discrimination, a multivariate logistic regression analysis was performed. RESULTS Complete data sets of 352 patients were analysed. A set of 17 key expectations was identified. Relief of knee pain was fulfilled the most, and improvement of physical function was fulfilled the least. When asked about overall fulfilled expectations, 40% of patients rated them as exceeded, 34% as fulfilled and 26% as less fulfilled than expected. Not fully satisfied patients showed significantly lower PROMs pre- and postoperatively and less fulfilled key expectations. Higher numbers of exceeded and fulfilled mandatory expectations, higher overall fulfilment and better range of motion (ROM) were significant predictors for satisfaction ≥ 8. CONCLUSION Patients' expectations of TKA outcomes were high with equal emphasis on knee-related and general health-related aspects. Their fulfilment was positively associated with satisfaction. Surgeons should ask patients about mandatory expectations for successful TKA and counsel them about the likelihood of their fulfilment to avoid unrealistic expectations. LEVEL OF EVIDENCE II.
Collapse
Affiliation(s)
- Cornelia Lützner
- Department for Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Franziska Beyer
- Department for Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Ludwig David
- Department for Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Jörg Lützner
- Department for Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| |
Collapse
|
32
|
Washington-Nortey M, Anum A, Serpell Z, Xu Y. Expectations for Children with Autism Spectrum Disorders or Intellectual Disabilities in Ghana: A Comparison Between Service Providers and Parents. J Autism Dev Disord 2023:10.1007/s10803-023-06073-9. [PMID: 37530915 DOI: 10.1007/s10803-023-06073-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 08/03/2023]
Abstract
Little is known about care providers' expectations for children with autism spectrum disorders (ASD) and intellectual disabilities (ID) in Ghana. This study used group concept mapping (n = 9) and a quantitative survey (n = 128) to explore and compare service providers' and parents' expectations for children with ASD or ID. Data were analyzed using hierarchical clustering procedures and Multivariate Analysis of Variance (MANOVA). Concept mapping results revealed several expectation clusters, including independence, love and acceptance, equal social rights and opportunities, and professional and caregiver training. MANOVA results revealed significant differences between parents, teachers, and healthcare providers in their perceptions of the importance and likelihood of a child achieving these expectations. Results are discussed in reference to the cultural context, and implications are outlined.
Collapse
Affiliation(s)
| | - Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Zewelanji Serpell
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
| | - Yaoying Xu
- Department of Counseling and Special Education, Virginia Commonwealth University, Richmond, USA
| |
Collapse
|
33
|
Coe NB, Goda GS, Van Houtven CH. Family spillovers and long-term care insurance. J Health Econ 2023; 90:102781. [PMID: 37315472 PMCID: PMC10533212 DOI: 10.1016/j.jhealeco.2023.102781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/16/2023]
Abstract
We examine how long-term care insurance (LTCI) affects informal care use and expectations among the insured individuals and co-residence and labor market outcomes of their adult children. We address the endogeneity of LTCI coverage by instrumenting for LTCI with changes in state tax treatment of LTCI insurance policies. We do not find evidence of reductions in informal care use over a horizon of approximately eight years. However, we find that LTCI coverage reduces parents' perceptions of the willingness of their children to care for them in the future and that the behavior of adult children changes, with LTCI resulting in lower likelihoods of adult children co-residing and stronger labor market attachment. These findings provide empirical support for the presence of spillovers of LTCI on the economic behaviors of family members.
Collapse
Affiliation(s)
- Norma B Coe
- University of Pennsylvania, Medical Ethics and Health Policy, Perelman School of Medicine, 423 Guardian Drive, Philadelphia, PA 19104, USA; NBER, 1050 Massachusetts Ave., Cambridge, MA 02138, USA
| | - Gopi Shah Goda
- NBER, 1050 Massachusetts Ave., Cambridge, MA 02138, USA; Stanford University, Stanford Institute for Economic Policy Research (SIEPR), 366 Galvez Street, Stanford, CA 94305-6015, USA
| | - Courtney Harold Van Houtven
- Durham VA Medical Center, Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), 508 Fulton Street, Durham, NC 27705, USA; University School of Medicine, Department of Population Health Sciences and Duke-Margolis Center for Health Policy, 215 Morris St. 2nd Floor, The Imperial Building, Campus Box: 104023, Durham, NC 27701, USA.
| |
Collapse
|
34
|
Gustavsson L, Mohaddes M, Samsson K, Beischer S. No major difference in perceived quality of care in patients with hip or knee osteoarthritis assessed in a physical therapy-led triage compared with standard care: a randomized controlled trial. BMC Musculoskelet Disord 2023; 24:530. [PMID: 37386368 DOI: 10.1186/s12891-023-06659-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/22/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Physical therapy-led orthopedic triage is a care model used to optimize pathways for patients with hip or knee osteoarthritis. However, scientific evidence of the effectiveness of this model of care is still limited and only a few studies report patients' perception of it. The aim of this study was to compare patients' perceived quality of care after physical therapy-led triage with standard practice in a secondary care setting for patients with primary hip or knee osteoarthritis. METHODS In this randomized study, patients with hip or knee osteoarthritis referred for an orthopedic consultation received either physical therapy-led triage (n = 344) or a standard care assessment by an orthopedic surgeon (n = 294). To evaluate the patients' perceived quality of care, a short version of the Quality from the Patient's Perspective (QPP) questionnaire was sent to the patients within a week after their assessment. The primary outcome was the statement "I received the best examination and treatment" on QPP. RESULTS A total of 348 patients (70%, physical therapy-led triage: n = 249, standard care: n = 199) answered the questionnaire. No significant difference was found in the primary outcome between the groups (p = 0.6). Participants in the triage group perceived themselves to have received significantly better information about how to take care of their osteoarthritis (p = 0.017) compared with the standard care group. The standard care group reported that they participated in the decision-making process to a greater extent (p = 0.005), that their expectations were met to a greater degree (p = 0.013), and that their care depended more on their need for care rather than the caregivers' routines (0.007). CONCLUSION Both groups report high perceived quality of care. Significant differences were found in four of 14 questions, one in favor of the physical therapist and three in favor of the standard care group. The findings of this study are in line with previous research and support the use of this care model for patients with hip or knee OA in secondary care. However, due to the dropout size, the results should be interpreted with caution. TRIAL REGISTRATION Clinical Trials NCT04665908, registered 14/12/2020.
Collapse
Affiliation(s)
- Linnea Gustavsson
- Institute of Clinical Sciences, Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Sportrehab, Gothenburg, Sweden.
| | - Maziar Mohaddes
- Institute of Clinical Sciences, Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karin Samsson
- Institute of Neuroscience and Rehabilitation, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Capio Ortho Center Göteborg, Gothenburg, Sweden
| | - Susanne Beischer
- Sportrehab, Gothenburg, Sweden
- Institute of Neuroscience and Rehabilitation, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
35
|
AlMuhaissen SA, Elayeh E, Sharaydih R, Abdullah TM, AlShalalfeh A, AlKhatib HS. Doctor of pharmacy as a career option: a cross-sectional study exploring PharmD students and practitioners expectations in Jordan. Hum Resour Health 2023; 21:49. [PMID: 37344909 DOI: 10.1186/s12960-023-00836-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/15/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE This study aimed to (1) investigate the expectations and preferences of PharmD students and practitioners regarding their role in the health care system, and (2) to contrast those expectations and preferences of PharmD practitioners with real-life practice in Jordan. METHODS Two cross-sectional descriptive questionnaires were used to collect data from PharmD students and PharmD practitioners in Jordan. A total number of 330 students and 280 practitioners were interviewed. The responses to all questions were encoded, entered, and summarized as frequencies and percentages or as means and standard deviations. Comparisons between groups were performed using Chi-square test. A p-value of < 0.05 was considered significant. RESULTS Both PharmD students and practitioners chose working as a clinical pharmacist in a hospital as their first-choice job. However, their second and third jobs choices were significantly different as practitioners opted for income as a main criterion for job selection. Interestingly, salary expectations by PharmD students were significantly higher than the reality as reported by PharmD practitioners. Both students and practitioners placed the work environment as the highest priority criterion for making a work choice on the work environment. In general, both students and practitioners agree on the ideal roles of PharmD graduate with the issues of prescribing and compounding responsibilities being the ones with the highest disparity between practitioners and students. Significant differences were found between the student's and practitioner's perceptions of the ideal role of a PharmD in and the current professional practice in Jordan. CONCLUSION Job preferences and salary expectations differ significantly between students and practitioners. Professional orientation of PharmD. students should be implemented to minimize misconceptions of their job nature, availability, and compensations. The fact that students do not prefer to work in a community pharmacy should be addressed by educational institutions and professional organizations. The prescribing and compounding responsibilities of pharmacists should be also emphasized in the curricula of pharmacy schools and worked in by professional organization to achieve optimal implementation in real-life practice.
Collapse
Affiliation(s)
- Suha A AlMuhaissen
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, 11942, Jordan.
| | - Eman Elayeh
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, 11942, Jordan
| | - Rawia Sharaydih
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, 11942, Jordan
| | - Taibah M Abdullah
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, 11942, Jordan
| | - Aseel AlShalalfeh
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, 11942, Jordan
| | - Hatim S AlKhatib
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, 11942, Jordan
| |
Collapse
|
36
|
Lee KMK, Page A, Kim S, Al-Diery T, Koeper I, Singh I, Hawthorne D, Johnson J. Perceptions and expectations of health professionals regarding hospital pharmacy services and the roles of hospital pharmacists: A qualitative systematic review and meta-synthesis. Explor Res Clin Soc Pharm 2023; 10:100264. [PMID: 37193372 PMCID: PMC10182321 DOI: 10.1016/j.rcsop.2023.100264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/18/2023] Open
Abstract
Background Pharmacists have become increasingly integrated within the interprofessional hospital team as their scope of practice expanded in recent decades. However, limited research has explored how the roles of hospital pharmacists are perceived by other health professionals. Aim/Objectives To identify what is known about the perceptions of hospital pharmacists' roles and hospital pharmacy services held by non-pharmacist health professionals. Methods A systematic literature search was conducted in August 2022 in MEDLINE, Embase, and CINAHL to identify peer-reviewed articles published between 2011 and 2022. Title/abstract and full-text screening, by two independent reviewers, identified eligible articles. Inclusion criteria included qualitative studies in hospital settings that reported perceptions regarding the roles of hospital pharmacists held by non-pharmacist health professionals. Data were extracted using a standardised extraction tool. Collated qualitative data underwent inductive thematic analysis by two independent investigators to identify codes, which were reconciled and merged into over-arching themes through a consensus process. Findings were assessed to measure confidence using the GRADE-CERQual criteria. Results The search resulted in 14,718 hits. After removing duplicates, 10,551 studies underwent title/abstract screening. Of these, 515 underwent full-text review, and 36 were included for analysis. Most studies included perceptions held by medical or nursing staff. Hospital pharmacists were perceived as valuable, competent and supportive. At an organisational level, the roles of hospital pharmacists were perceived to benefit hospital workflow and improve patient safety. Roles contributing to all four domains of the World Health Organization's Strategic Framework of the Global Patient Safety Challenge were recognised. Highly-valued roles include medication reviews, provision of drug information, and education for health professionals. Conclusion This review describes the roles hospital pharmacists performed within the interprofessional team, as reported by non-pharmacist health professionals internationally. Multidisciplinary perceptions and expectations of these roles may guide the prioritisation and optimisation of hospital pharmacy services.
Collapse
Affiliation(s)
- Kyung Min Kirsten Lee
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- Corresponding author.
| | - Amy Page
- WA Centre for Health & Ageing, School of Allied Health, University of Western Australia, Perth, Australia
| | - Sangseo Kim
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | | | - Ivanka Koeper
- SA Pharmacy, Central Adelaide Local Health Network, SA Health, Adelaide, Australia
| | - Isabella Singh
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Deborah Hawthorne
- WA Centre for Health & Ageing, School of Allied Health, University of Western Australia, Perth, Australia
| | - Jacinta Johnson
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| |
Collapse
|
37
|
van Zaanen Y, Kievit AJ, van Geenen RCI, Pahlplatz TMJ, Hoozemans MJM, Blankevoort L, Schafroth MU, Haverkamp D, Vervest TMJS, Das DHPW, Scholtes VA, van der Beek AJ, Kuijer PPFM. Does Consulting an Occupational Medicine Specialist Decrease Time to Return to Work Among Total Knee Arthroplasty Patients? A 12-Month Prospective Multicenter Cohort Study. J Occup Rehabil 2023; 33:267-276. [PMID: 36083360 PMCID: PMC10172284 DOI: 10.1007/s10926-022-10068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE The aim of this study is to investigate whether total knee arthroplasty (TKA) patients who consulted an occupational medicine specialist (OMS) within 3 months after surgery, return to work (RTW) earlier than patients who did not consult an OMS. METHODS A multi-center prospective cohort study was performed among working TKA patients, aged 18 to 65 years and intending to RTW. Time to RTW was analyzed using Kaplan Meier and Mann Whitney U (MWU), and multiple linear regression analysis was used to adjust for effect modification and confounding. RESULTS One hundred and eighty-two (182) patients were included with a median age of 59 years [IQR 54-62], including 95 women (52%). Patients who consulted an OMS were less often self-employed but did not differ on other patient and work-related characteristics. TKA patients who consulted an OMS returned to work later than those who did not (median 78 versus 62 days, MWU p < 0.01). The effect of consulting an OMS on time to RTW was modified by patients' expectations in linear regression analysis (p = 0.05). A median decrease in time of 24 days was found in TKA patients with preoperative high expectations not consulting an OMS (p = 0.03), not in patients with low expectations. CONCLUSIONS Consulting an OMS within 3 months after surgery did not result in a decrease in time to RTW in TKA patients. TKA patients with high expectations did RTW earlier without consulting an OMS. Intervention studies on how OMSs can positively influence a timely RTW, incorporating patients' preoperative expectations, are needed.
Collapse
Affiliation(s)
- Y van Zaanen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - A J Kievit
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - R C I van Geenen
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, Netherlands
| | - T M J Pahlplatz
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - M J M Hoozemans
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - L Blankevoort
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - M U Schafroth
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - T M J S Vervest
- Department of Orthopaedic Surgery, Tergooi Hospital, Hilversum, Netherlands
| | - D H P W Das
- Department and Research Center of Orthopaedic Surgery, St. Anna Hospital, Geldrop, Netherlands
| | - V A Scholtes
- Joint Research Orthopedic Surgery, OLVG+, Amsterdam, Netherlands
| | - A J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - P P F M Kuijer
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| |
Collapse
|
38
|
Jin H, Huang Y, Xi X, Chen L. Exploring the training of pharmacists oriented to the demands for clinical pharmacy services: from the perspective of physicians. BMC Med Educ 2023; 23:357. [PMID: 37217963 DOI: 10.1186/s12909-023-04353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 05/12/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND To evaluate physicians' perceptions, experiences and expectations of clinical pharmacists in China from the perspective of physicians' demands, to improve the training of pharmacists. METHODS A cross-sectional survey involving physicians (except for primary physicians) was conducted from July to August 2019 in China. Using a field questionnaire, this study gathered data on descriptive information about the respondents and their perceptions, experiences and expectations of clinical pharmacists. Data were analysed descriptively using frequencies, percentages and mean. Several subgroup analyses using Chi-square tests were conducted to identify physicians' demands for clinical pharmacists in China. RESULTS A total of 1376 physicians from secondary and tertiary hospitals in China (response rate = 92%) participated. The majority of the respondents were comfortable with clinical pharmacists providing education to patients (59.09%) and detecting and preventing prescription errors (60.17%), but they appeared uncomfortable when asked about clinical pharmacists suggesting the use of prescription medications to patients (15.71%). Most respondents agreed that clinical pharmacists are a reliable source of general drug information (81.84%) instead of clinical drug information (79.58%). The majority of the respondents expected clinical pharmacists to be knowledgeable drug therapy experts (95.56%) and to educate their patients about the safe and appropriate use of medications (95.56%). CONCLUSION Physicians' perceptions and experiences were positively associated with the frequency of their interaction with clinical pharmacists. They had high expectations of clinical pharmacists as knowledgeable drug therapy experts. Corresponding policies and measures are needed to improve the education and training system of clinical pharmacists in China.
Collapse
Affiliation(s)
- Hang Jin
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, China
| | - Yuankai Huang
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, China
| | - Xiaoyu Xi
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, China.
| | - Lei Chen
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, No.639 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, China.
| |
Collapse
|
39
|
Munangatire T, Tomas N, Asino HMM. Nursing students' experiences and expectations of clinical learning: A qualitative study. Nurse Educ Today 2023; 124:105758. [PMID: 36821947 DOI: 10.1016/j.nedt.2023.105758] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/25/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Clinical learning is an important component of nursing education that can support the development of competence. Nursing students have expectations before clinical learning, however if these expectations are not matched with their experiences, then development can be hampered. OBJECTIVE To explore nursing students' expectations and experiences of their clinical learning experiences. DESIGN Qualitative descriptive design. SETTINGS The study was conducted at a large teaching hospital in Namibia. PARTICIPANTS Fifteen first to fourth year undergraduate nursing students who were allocated to a teaching hospital in Namibia. METHODS The participants were purposively sampled among the teaching hospital's undergraduate nursing students. Data were collected between June to November 2021 through in-depth, semi-structured interviews that lasted between 35 and 45 min each. Data were analyzed using thematic analysis. RESULTS The data analysis identified four themes: clinical outlook and role, supporting/role modelling, clinical teaching and learning, and linking theory and practice. CONCLUSION The expectations and experiences of nursing students regarding the clinical environment were mixed. The findings demonstrated the need to moderate students' expectations, as well as to reorganize the clinical learning environment to enhance students' learning. Further studies should look at the standardization of student expectations based on the context of their clinical learning environment, and how this can improve learning experiences.
Collapse
Affiliation(s)
| | - Nestor Tomas
- University of Namibia, P.O. Box 88, Rundu, Namibia.
| | | |
Collapse
|
40
|
Horváth Á, Szabo A, Gál V, Suhaj C, Aranyosy B, Köteles F. Are there placebo or nocebo effects in balancing performance? Cogn Res Princ Implic 2023; 8:25. [PMID: 37093367 PMCID: PMC10126169 DOI: 10.1186/s41235-023-00476-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 04/05/2023] [Indexed: 04/25/2023] Open
Abstract
Placebo and nocebo effects could influence the perceived, actual, or both postural stabilities. Therefore, this experiment examined whether postural stability is susceptible to placebo and nocebo effects. Driven by expectations, these cognitions could influence the motor stability of people in physical rehabilitation and those with motion instability. We randomly assigned 78 participants to a placebo, nocebo, or control group. Then, we applied a sham sports cream with positive, negative, or neutral instructions about its impact on balance. Next, we tested postural stability with a modified version of the Modified Clinical Test of Sensory Interaction in Balance, including standard, proprioceptive, visual, and vestibular tests before and after the intervention. Further, we measured expected and perceived performance with visual analog scales and assessed trait anxiety, change in state anxiety, optimism, holistic thinking, persistence, and cooperation with questionnaires. The intervention did not affect actual test performances; similarly, trait and state variables and expectations did not have an impact. Furthermore, the experimental manipulation and trait and state variables did not significantly affect perceived performance. However, the association between expectation and perceived performance was strong (ϱ = 0.627, p < 0.001). These findings suggest that postural stability is not susceptible to placebo and nocebo influences. Still, there is a dissociation between objective and subjective performance, showing that expectations impact perceived but not actual performance, which could fuel motivation in rehabilitation settings.
Collapse
Affiliation(s)
- Áron Horváth
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary
- Institute of Psychology and Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, 1117, Budapest, Hungary
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Attila Szabo
- Institute of Psychology and Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, 1117, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Vera Gál
- Institute of Psychology and Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, 1117, Budapest, Hungary
| | - Csilla Suhaj
- Institute of Psychology and Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, 1117, Budapest, Hungary
| | - Blanka Aranyosy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary
- Institute of Psychology and Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, 1117, Budapest, Hungary
| |
Collapse
|
41
|
De Togni G, Erikainen S, Chan S, Cunningham-Burley S. Beyond the hype: 'acceptable futures' for AI and robotic technologies in healthcare. AI Soc 2023:1-10. [PMID: 37358940 PMCID: PMC10122446 DOI: 10.1007/s00146-023-01659-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/30/2023] [Indexed: 06/28/2023]
Abstract
AI and robotic technologies attract much hype, including utopian and dystopian future visions of technologically driven provision in the health and care sectors. Based on 30 interviews with scientists, clinicians and other stakeholders in the UK, Europe, USA, Australia, and New Zealand, this paper interrogates how those engaged in developing and using AI and robotic applications in health and care characterize their future promise, potential and challenges. We explore the ways in which these professionals articulate and navigate a range of high and low expectations, and promissory and cautionary future visions, around AI and robotic technologies. We argue that, through these articulations and navigations, they construct their own perceptions of socially and ethically 'acceptable futures' framed by an 'ethics of expectations.' This imbues the envisioned futures with a normative character, articulated in relation to the present context. We build on existing work in the sociology of expectations, aiming to contribute towards better understanding of how technoscientific expectations are navigated and managed by professionals. This is particularly timely since the COVID-19 pandemic gave further momentum to these technologies.
Collapse
Affiliation(s)
- Giulia De Togni
- The University of Edinburgh; College of Medicine and Veterinary Medicine; Molecular, Genetic and Population Health Sciences; Usher Institute; Centre for Biomedicine, Self and Society, 23 Buccleuch Place, Edinburgh, EH8 9LN United Kingdom
| | - S. Erikainen
- University of Aberdeen, School of Social Science; Department of Sociology, Aberdeen, AB24 3FX United Kingdom
| | - S. Chan
- The University of Edinburgh; College of Medicine and Veterinary Medicine; Molecular, Genetic and Population Health Sciences; Usher Institute; Centre for Biomedicine, Self and Society, 23 Buccleuch Place, Edinburgh, EH8 9LN United Kingdom
| | - S. Cunningham-Burley
- The University of Edinburgh; College of Medicine and Veterinary Medicine; Molecular, Genetic and Population Health Sciences; Usher Institute; Centre for Biomedicine, Self and Society, 23 Buccleuch Place, Edinburgh, EH8 9LN United Kingdom
| |
Collapse
|
42
|
van Sasse van IJsselt MEA, van der Biessen DAJ, van Puffelen AJ, Robbrecht DGJ, Oldenmenger WH. "If only I had", patients' experiences during early oncology trials. Support Care Cancer 2023; 31:290. [PMID: 37084141 PMCID: PMC10121491 DOI: 10.1007/s00520-023-07738-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE Until today, it is not clear why patients decide to continue with early clinical trial (ECT) participation. Therefore, the aim of this study is to explore to which extent the self-determination theory of Ryan and Deci, according to the ECT enrollment phase, corresponds to the motivations of participants during ECT's. METHODS This study has a qualitative design. Data were collected using semistructured interviews and were deductively analyzed in Nvivo12 using the thematic analysis approach of Braun and Clarke. RESULTS As a result of the deductive analysis performed, six themes and twenty subthemes emerged which matched the three personal needs: competence, relatedness, and autonomy (n = 11). "Competence" included the following themes: mixed future expectations, treatment expectations, and control of the outcome. "Relatedness" included the theme altruistic motivation. "Autonomy" included the themes; to live and act in harmony as well as mental and physical burden. CONCLUSION Participants felt they tried everything and that they were treated to the limit. This not only gives the motivation to continue participating but also a sense of altruism. Despite different burdens, side-effects, and the feeling of being a test subject, the participants will not easily choose to stop participation in order to prevent saying afterwards: "If only I had".
Collapse
Affiliation(s)
| | - Diane A J van der Biessen
- Erasmus MC Cancer Institute, Department of Medical Oncology, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Andrea J van Puffelen
- Erasmus MC Cancer Institute, Department of Medical Oncology, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Debbie G J Robbrecht
- Erasmus MC Cancer Institute, Department of Medical Oncology, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Wendy H Oldenmenger
- Erasmus MC Cancer Institute, Department of Medical Oncology, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| |
Collapse
|
43
|
Panagiotis M, Hanna T, Sonja P, Shahar A, Simon K, Dan A. On the interplay between pain observation, guilt and shame proneness and honesty. Acta Psychol (Amst) 2023; 236:103920. [PMID: 37086665 DOI: 10.1016/j.actpsy.2023.103920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/27/2023] [Accepted: 04/17/2023] [Indexed: 04/24/2023] Open
Abstract
Seeing others in pain can stimulate powerful socio-emotional responses. Does it also make us more moral? In two laboratory experiments, we examined the interplay between pain observation, self-reported guilt and shame, subjective perceptions of pain intensity, and subsequent honest behavior. Watching a confederate perform a moderately painful (vs. non-painful) task did not affect honest behavior in a subsequent die-roll task. Independent of pain observation, there was a positive relationship between self-reported guilt proneness and shame proneness and honesty. More specifically, individuals who are more prone to feeling guilt -and to a lesser extent shame- behaved more honestly. Furthermore, we found weak support for the hypothesis that greater perceived pain (rather than objective pain) is associated with less cheating. We call for further research in the interconnections between perceived pain, guilt, shame, and moral behavior.
Collapse
Affiliation(s)
- Mitkidis Panagiotis
- Department of Management, Aarhus University, Fuglesangs Alle 4, 8210 Aarhus V, Denmark; Social Science Research Institute, Duke University, 334 Blackwell Street, Durham 27701, NC, USA.
| | - Thaler Hanna
- Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804 Munich, Germany
| | - Perkovic Sonja
- Department of Management, Aarhus University, Fuglesangs Alle 4, 8210 Aarhus V, Denmark
| | - Ayal Shahar
- Baruch Ivcher School of Psychology, Reichman University, 8 Ha'universuta St., P.O. Box 167, Herzliya 46150, Israel
| | - Karg Simon
- Department of Political Science, Aarhus University, Bartholins Allé 7, 8000 Aarhus C, Denmark
| | - Ariely Dan
- Social Science Research Institute, Duke University, 334 Blackwell Street, Durham 27701, NC, USA
| |
Collapse
|
44
|
Kaplan A, Comisar L, Ufere NN, Jannat-Khah D, Rosenblatt R, Fortune B, Prigerson HG, Brown R. Understanding Prognosis: Discrepancy in Prognosis Estimates Between Patients With Cirrhosis and their Hepatologists. Clin Gastroenterol Hepatol 2023; 21:1005-1012.e4. [PMID: 35643416 PMCID: PMC9699897 DOI: 10.1016/j.cgh.2022.04.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/28/2022] [Accepted: 04/26/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Patients require a clear understanding of their prognosis to make informed decisions about their care. The aim of this study was to compare the perceptions of prognosis and transplant candidacy between patients with cirrhosis and their hepatologists. METHODS Patients with cirrhosis and their hepatologists were prospectively recruited at an urban liver transplant center. Patients and hepatologists were asked about transplant candidacy and about how many years patients would live with and without a liver transplant. Agreement between patients and hepatologists was assessed with the weighted kappa statistic. Associations between patient/hepatologists' prognostic estimates and those predicted by patients' Model for End-Stage Liver Disease-Sodium (MELD-Na) score were estimated using the Pearson correlation coefficient. RESULTS Seventy patients and 6 hepatologists were enrolled in the study. Patients were predominantly male (61.4%) and white (68.6%), with a mean MELD-Na score of 19 ± 9. There was no-slight agreement between patients and hepatologists regarding survival without and with a liver transplant (κ = 0.1 and 0.2, respectively), with patients more optimistic than their hepatologists. There was greater agreement between patients and hepatologists about transplant candidacy (κ = 0.6). There was a negligible association between MELD-Na and patient estimates (r = -0.24, P = .05) but a moderate association between MELD-Na and hepatologist estimates (r = -0.51, P < .001), with higher MELD-Na scores associated with lower predicted survival. CONCLUSIONS Patients with cirrhosis are more optimistic and less accurate in their predictions of survival compared with hepatologists, although they are more realistic about their transplant candidacy. Aligning patient and provider expectations may increase the likelihood that patients receive value-concordant care.
Collapse
Affiliation(s)
- Alyson Kaplan
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell School of Medicine, New York Presbyterian, New York, New York
| | - Lauren Comisar
- Weill Cornell Medical College, Weill Cornell Medicine, New York, New York
| | - Nneka N Ufere
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Deanna Jannat-Khah
- Weill Cornell Medical College, Weill Cornell Medicine, New York, New York
| | - Russell Rosenblatt
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell School of Medicine, New York Presbyterian, New York, New York
| | - Brett Fortune
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell School of Medicine, New York Presbyterian, New York, New York
| | - Holly G Prigerson
- Weill Cornell Medical College, Weill Cornell Medicine, New York, New York
| | - Robert Brown
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell School of Medicine, New York Presbyterian, New York, New York.
| |
Collapse
|
45
|
Ihrig A, Richter J, Bugaj TJ, Friederich HC, Maatouk I. Between hope and reality: How oncology physicians and information providers of a cancer information service manage patients' expectations for and experiences with immunotherapies. Patient Educ Couns 2023; 109:107622. [PMID: 36641334 DOI: 10.1016/j.pec.2023.107622] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/31/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Immune checkpoint inhibitors have established themselves as a further therapeutic pillar in the treatment of various types of cancer. This can create challenges and possible misunderstandings for patients. The aim of this study was to assess the experiences of physicians and information providers in their interactions with patients about immunotherapy. METHODS The study design was exploratory with qualitative research methodology. We performed focus groups with 8 oncology physicians and 9 information providers of a cancer information service. RESULTS In the coding process, five focal points could be identified: (1) image of immunotherapy, (2) presentation of immunotherapy in the media, (3) hope, (4) creation of an information base, and (5) lessons learned and future directions. Physicians and information providers report that immunotherapy has a very positive image among patients. This seems to be due to the presentation of immunotherapy in the media and the positive associations of people with terms such as the immune system and the body's own defense. CONCLUSIONS In contrast to chemotherapy, patients are at risk of underestimating the early symptoms of serious side effects of immunotherapy. From the point of view of physicians, the exaggerated expectations of patients regarding the possibilities of immunotherapy are often not met. The challenge for practitioners is to consider patients' expectations to provide balanced information and recommendations. PRACTICAL IMPLICATIONS Communication skills training and up-to-date information tools should improve physician-patient communication.
Collapse
Affiliation(s)
- Andreas Ihrig
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
| | - Jenniffer Richter
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany; Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, University Hospital Wuerzburg, Wuerzburg, Germany
| |
Collapse
|
46
|
Siang S. Insights on Coaching, Mentorship, and Leadership from Business to Health Care. Clin Sports Med 2023; 42:281-9. [PMID: 36907626 DOI: 10.1016/j.csm.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
The still-evolving global pandemic has accelerated changes in how we work, how we lead, and how we interact. The power dynamic that once drove institutions has shifted to an infrastructure and operating framework encouraging new employee expectations, including the humanization of leadership from those in power. Trends in the corporate world show organizations have shifted to operational frameworks with humanized leadership models: leader-as-coach and leader-as-mentor.
Collapse
|
47
|
Briscese G, Lacetera N, Macis M, Tonin M. Expectations, reference points, and compliance with COVID-19 social distancing measures. J Behav Exp Econ 2023; 103:101983. [PMID: 36714370 PMCID: PMC9870805 DOI: 10.1016/j.socec.2023.101983] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/23/2022] [Accepted: 01/17/2023] [Indexed: 05/28/2023]
Abstract
We study the behavioral impact of announcements about the duration of a policy and their relationship with people's expectations in the context of the COVID-19 lockdowns. We surveyed representative samples of Italian residents at three moments of the first wave of the pandemic to test how intentions to comply with social-isolation measures depend on the duration of their possible extension. Individuals were more likely to reduce, and less likely to increase, their compliance effort if the hypothetical extension was longer than they expected, whereas positive surprises had a lesser impact. The behavioral response to the (mis)match between expected versus hypothesized extensions is consistent with expectations acting as reference points and can help explain the increase in observed physical proximity in Italy following lockdown extension announcements. Our findings suggest that public authorities should consider citizens' expectations when announcing policy changes.
Collapse
Affiliation(s)
| | | | - Mario Macis
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Mirco Tonin
- Free University of Bozen-Bolzano, Bolzano, Italy
| |
Collapse
|
48
|
Wilson AT, Bishop MD, Beneciuk JM, Tilley HE, Riley JL, Cruz-Almeida Y, Bialosky JE. Expectations affect pain sensitivity changes during massage. J Man Manip Ther 2023; 31:84-92. [PMID: 36069038 PMCID: PMC10013429 DOI: 10.1080/10669817.2022.2118449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND Pain-inducing massage produces comparable changes in pain sensitivity as a cold pressor task, suggesting shared neurophysiological mechanisms of conditioned pain modulation. Manual therapy and conditioned pain modulation are influenced by positive and negative expectations. Therefore, the purpose of this study was to examine the effects of positive and negative expectations on pain-free and pain-inducing massage. METHODS 56 healthy participants were randomly assigned to receive a positive or negative expectation instructional set followed by a pain-inducing or a pain-free massage. Pressure pain threshold (PPT) was measured followed by each interval of massage. A repeated measures ANCOVA controlling for post-randomization differences in sex tested for massage x expectation set x PPT interaction effects, as well as two-way interaction effects. RESULTS A significant three-way interaction effect (p = 0.04) and time x expectation interaction effect was observed for individuals receiving pain inducing massage (p = 0.02). Individuals who received the positive expectation instructional set demonstrated significantly higher PPT at minutes 3 and 4 of massage compared to individuals who received the negative expectation instructional set. CONCLUSIONS Expectations impact pain sensitivity changes produced during massage. Clinicians planning to provide pain-inducing massage should consider the role of expectations in modulating pain sensitivity changes.
Collapse
Affiliation(s)
- Abigail T Wilson
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
- Musculoskeletal Research Laboratory, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida
| | - Mark D. Bishop
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Jason M. Beneciuk
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
- Clinical Research Center, Brooks Rehabilitation, Jacksonville, FL
| | - Hannah E. Tilley
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Joseph L. Riley
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Joel E. Bialosky
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
- Clinical Research Center, Brooks Rehabilitation, Jacksonville, FL
| |
Collapse
|
49
|
Peñalver JMG, López-García D, González-García C, Aguado-López B, Górriz JM, Ruz M. Top-down specific preparatory activations for selective attention and perceptual expectations. Neuroimage 2023; 271:119960. [PMID: 36854351 DOI: 10.1016/j.neuroimage.2023.119960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/01/2023] Open
Abstract
Proactive cognition brain models are mainstream nowadays. Within these, preparation is understood as an endogenous, top-down function that takes place prior to the actual perception of a stimulus and improves subsequent behavior. Neuroimaging has shown the existence of such preparatory activity separately in different cognitive domains, however no research to date has sought to uncover their potential similarities and differences. Two of these, often confounded in the literature, are Selective Attention (information relevance) and Perceptual Expectation (information probability). We used EEG to characterize the mechanisms that pre-activate specific contents in Attention and Expectation. In different blocks, participants were cued to the relevance or to the probability of target categories, faces vs. names, in a gender discrimination task. Multivariate Pattern (MVPA) and Representational Similarity Analyses (RSA) during the preparation window showed that both manipulations led to a significant, ramping-up prediction of the relevant or expected target category. However, classifiers trained with data from one condition did not generalize to the other, indicating the existence of unique anticipatory neural patterns. In addition, a Canonical Template Tracking procedure showed that there was stronger anticipatory perceptual reinstatement for relevance than for expectation blocks. Overall, the results indicate that preparation during attention and expectation acts through distinguishable neural mechanisms. These findings have important implications for current models of brain functioning, as they are a first step towards characterizing and dissociating the neural mechanisms involved in top-down anticipatory processing.
Collapse
|
50
|
Jacobs H, Seeber GH, Lazovic D, Maus U, Hoffmann F. Disease burden of and expectations from surgery in patients prior to total knee arthroplasty: Results of the prospective FInGK study. Knee 2023; 41:257-265. [PMID: 36773371 DOI: 10.1016/j.knee.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/30/2022] [Accepted: 01/26/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND Disease burden in patients prior to total knee arthroplasty (TKA) varies widely between studies and countries. We aimed to characterize individuals undergoing TKA and examine their expectations from the surgery, focusing on variations in disease burden. METHODS Consecutive patients undergoing primary TKA in a German university hospital were recruited. A questionnaire including information on disease burden, preoperative expectations from surgery, health care utilization, demography, and socioeconomics was collected one day prior to surgery and linked to data from medical records. Patients were categorized into disease burden quartiles using the Western Ontario and McMaster Universities Osteoarthritis Index' (WOMAC) total score. Subsequently, study population's characteristics and expectations from surgery were analyzed stratified by disease burden. RESULTS A total of 196 patients were included (41 % male; mean age: 68.2 years). The median WOMAC was 52.0 (IQR: 41.0-58.0). Patients in Q1 were more often males (Q1: 63 % vs Q4: 29 %) and had a shorter duration of complaints with the impaired knee. They were also less restricted in social participation, reported less often signs of depression, and were less often treated with physiotherapy (Q1: 27 % vs Q4: 54 %). Furthermore, expectations from surgery were highest in patients with a low disease burden. CONCLUSION We found large variations in disease burden with a considerable number of patients undergoing TKA whose functional capacity is still maintained and for which guideline-recommended conservative treatment options are not fully exhausted. Further research on this subgroup as well as establishing an international consensus on specific thresholds for TKA indication are needed.
Collapse
Affiliation(s)
- Hannes Jacobs
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
| | - Gesine H Seeber
- University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany; Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Djordje Lazovic
- University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany
| | - Uwe Maus
- Department of Orthopaedics & Trauma Surgery, University Hospital Düsseldorf, Germany
| | - Falk Hoffmann
- Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| |
Collapse
|