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Impacts of mental health in the sleep pattern of healthcare professionals during the COVID-19 pandemic in Brazil. J Affect Disord 2023; 323:472-481. [PMID: 36455718 PMCID: PMC9705011 DOI: 10.1016/j.jad.2022.11.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND After >2 years of the Coronavirus Disease-19 (COVID-19) pandemic, it is well established how sleep symptoms are rising, especially among healthcare workers (HCW). The aim of this study is to evaluate what features are associated with sleep disturbances in the HCW population. METHODS Cross-sectional and longitudinal analysis of social and clinical variables associated with sleep problems and insomnia incidence in HCW in a large, national-level cohort. The measurement of sleep problems was assessed by self-report using Jenkins Sleep Scale (JSS). A multivariate analysis was used in the cross-sectional design and generalized linear models were used in the longitudinal design. RESULTS 10,467 HCW were analyzed in the cross-sectional analysis, 3313 participants were analyzed in the three timepoints of the study. Sex, previously diagnosed mental illness and frontline work with COVID-19 were associated with higher scores in JSS in the univariate analysis. In the multivariate analysis, only previous diagnosis of mental illness was related with sleep difficulties, especially previously diagnosed insomnia. The longitudinal analysis concluded that previous diagnosis of mental illnesses was associated with higher levels of insomnia development (OR = 11.62). The self-reported disorders found to be major risk factors were addiction (OR = 7.69), generalized anxiety disorder (OR = 3.67), social anxiety (OR = 2.21) and bipolar disorder (OR = 2.21). LIMITATIONS Attrition bias. CONCLUSIONS Previous diagnosis of mental illness was strongly related to insomnia development in HCW during the COVID-19 pandemic. Strategies that focus on this population are advised.
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Allin L, Haighton C, Dalkin S, Das J, Allen G. Understanding the challenges and impact of training on referral of postnatal women to a community physical activity programme by health professionals: A qualitative study using the COM-B model. Midwifery 2023; 116:103516. [PMID: 36283295 DOI: 10.1016/j.midw.2022.103516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/26/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To understand the value of training for health professionals for improving their ability to effectively refer postnatal women to a targeted community physical activity programme. The study also sought to understand challenges to effective referral of postnatal women from deprived areas. DESIGN, SETTING AND PARTICIPANTS Semi-structured interviews were conducted in January-February 2020 with early years practitioners (n = 4), health visitors (n = 1) and community midwives (n = 2) who had participated in a training workshop implemented as part of a targeted community physical activity referral programme for postnatal women from deprived areas in the North East of England. Two follow up interviews were also conducted with one midwife and one early years practitioner during the Covid-19 pandemic. Data were analysed thematically and the Capability, Opportunity, Motivation, Behaviour (COM-B) model was employed to facilitate identification of the impact of training and the challenges in referral from the health professionals' perspective. FINDINGS The training increased capability to refer by improving knowledge and confidence of health professionals in being able to give appropriate guidance to postnatal women about physical activity without having to refer to other professionals. Health professionals reported adequate opportunities to engage with postnatal women, were motivated to refer and perceived this to be part of their role. The timing and method of message delivery were key contexts for perceived successful referral, particularly for midwives who wanted to ensure the messaging began in the antenatal period. Low staffing levels, limited interprofessional collaboration and finding strategies to engage women from deprived areas were key challenges to effective delivery of physical activity messages. These challenges were exacerbated during Covid-19, with increased mental health issues amongst postnatal women. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Training health professionals for physical activity messaging can be a useful way to increase capability, opportunity, and motivation to refer to physical activity interventions for postnatal women in deprived areas to potentially increase physical wellbeing and reduce postnatal depression. The COM-B is a relevant framework to underpin training. A clearly identified referral pathway and staffing issues need to be addressed to improve referrals by health professionals.
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Valavani A, Garavela E, Papathanasiou IV, Tsaras K, Fradelos EC, Papagiannis D, Kirgou P, Raptis DG, Gourgoulianis KI, Malli F. Investigation of the Level of Burnout in Health Care Professionals in COVID-19 Pandemic Conditions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:319-324. [PMID: 37581805 DOI: 10.1007/978-3-031-31986-0_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to high levels of stress and anxiety for health care professionals. The purpose of this study was to investigate the burnout of health care professionals in COVID-19 pandemic conditions. Quantitative research was performed, and the Copenhagen Burnout Inventory was used to study burnout. The research sample consisted of 360 health care professionals. Health professionals have been found to have fairly high levels of personal burnout, work burnout, and burnout associated with patient interactions. It has also been found that women and health professionals working in department for patients with COVID-19 have significantly greater burnout. However, it was found that age, marital status, years of service, specialty, non-basic degree, and whether they or a first-degree relative had COVID-19 were not correlated to burnout. Given the very high level of burnout among health professionals, it is necessary to develop appropriate strategies to reduce burnout.
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Wang P, Giovannucci EL. Are exposure-disease relationships assessed in cohorts of health professionals generalizable?: a comparative analysis based on WCRF/AICR systematic literature reviews. Cancer Causes Control 2023; 34:39-45. [PMID: 36197566 DOI: 10.1007/s10552-022-01633-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/15/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Although cohorts of health professionals are not representative of the general US population, the generalizability of exposure-disease relationships identified in these cohorts has not been extensively evaluated. Our objective was to compare the associations of risk factors with cancer risk obtained in the Nurses' Health Study (NHS), Nurses' Health Study II (NHSII), and the Health Professionals Follow-Up Study (HPFS) with those from meta-analyses of cohort studies. METHODS Data were extracted from the most recent systematic literature reviews conducted by the World Cancer Fund/American Institute of Cancer Research (WCRF/AICR). We examined risk factors with "convincing," "probable," or "limited-suggestive" evidence for 17 cancer types. Cohort-specific results for NHS, NHSII, and HPFS and corresponding sex-specific pooled meta-analysis results were obtained when available. We compared associations for continuous variables and inspected potential non-linearity in the dose-response meta-analyses. RESULTS Data for 88 comparisons across 11 cancer types were available. For most risk factors, we observed a close resemblance between the cohort-specific and corresponding sex-specific pooled associations. The 45 comparisons for factors considered as "convincing" or "probable" invariably exhibited similar associations in direction and magnitude. In 44 of the 45, the 95% CI from the NHS, NHSII, or HPFS captured the pooled estimate. In the one exception, the difference was 0.01. CONCLUSION The NHS, NHSII, and HPFS studies are not representative of the general US population concerning sociodemographic and behavioral factors. However, the generalizability of the exposure-disease relationship assessed in these cohorts is not impaired by these factors.
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Abstract
COVID-19 has increased the interest in the wellbeing of health professionals (HPs) as they have experienced stress, loss, and fatigue-related symptoms. Research evidence from previous epidemics points to an increase in the prevalence of affective, anxiety, and addictive disorders among them. HPs are trained to care for others and to recover from severe stressors. However, they tend to neglect self-care and have difficulties in seeking appropriate help when need it. This new scenario becomes an opportunity to promote a new culture of professionalism whereby caring for the caregivers becomes a priority both at a personal and institutional level.
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Theodorou P, Matzoula C, Maria-Elissavet P, Charalampos P, Thalia B. Investigating Mobbing Syndrome's Incidence in the Working Environment of a Public and a Private Greek Hospital. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:217-227. [PMID: 37581796 DOI: 10.1007/978-3-031-31986-0_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
To investigate the phenomenon of moral harassment (mobbing) as well as the effect of demographic and occupational characteristics of healthcare professionals working in a public provincial general hospital and a private hospital in Athens a cross-sectional survey was designed. The study was conducted from November to December 2021 through the application of the Leymann Inventory of Psychological Terror (LIPT) a widely recognized research tool for the quantitative investigation of ethical harassment in the workplace. 264 fully completed questionnaires were collected out of the 300 that were distributed in both hospitals (response rates: 92% for the public hospital and 83.3% for the private). It was observed that private hospital's employees were morally harassed to a greater extent and for a longer time than the employees of a public hospital. The levels of moral harassment were quite high, indicating the necessity of thorough audit by the management in both hospitals.
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Riaz BK, Islam MZ, Ahmed HU, Akhtar K, Haque A, Amin KB, Mahmood F, Refat MNH, Islam F. Post-traumatic stress disorders and coping strategies of health professionals during COVID-19 pandemic in Bangladesh: Findings of a countrywide cross-sectional study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 11:100131. [PMID: 36575773 PMCID: PMC9780642 DOI: 10.1016/j.lansea.2022.100131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/30/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
Background COVID-19 pandemic imposed a devastating effect on the psychological health of health professionals as they worked nonstop to withstand the hardship of the pandemic. The present study intended to determine the post-traumatic stress disorders (PTSD) and coping strategies among health professionals during the COVID-19 pandemic in Bangladesh. Methods This country-wide cross-sectional study was conducted from July to December 2021 among 1394 health professionals (596 physicians, 713 nurses, 85 medical technologists) who served COVID-19 patients at the secondary, tertiary, and specialized government healthcare facilities in Bangladesh and completed at least one month after exposure to COVID-19 patient-care. Data were collected through face-to-face interviews using a semi-structured questionnaire and analyzed by SPSS software. All the ethical issues were maintained strictly. Findings Most of the participants, 877(62∙9%) [95% CI: 60∙3-65∙5], were female, and 327(23∙5%) [95% CI: 21∙3-25∙8] developed PTSD. Females (AOR:1∙42 [95% CI: 1∙083-1∙868] p=0∙011), having an elderly family member (AOR:1∙515 [95% CI: 1∙173-1∙956] p=0∙0014), working in specialized hospitals (AOR:2∙685 [95% CI: 1∙928-3∙739] p<0∙001), and working ≥8 hours/day (AOR:1∙897 [95% CI: 1∙350-2∙666] p=0∙0002) had higher odds of developing PTSD. Most of the participants adopted spiritual approaches 96(29∙4%) [24∙5-34∙6] and distraction by watching TV/YouTube 59(18∙0%) [14∙0-22∙6] as coping strategies. Interpretation The study findings would be helpful for health policymakers and managers to develop comprehensive measures for restoring the mental well-being of health professionals by alleviating PTSD induced by a pandemic like COVID-19. Funding The study got funding from the Directorate General of Medical Education under the Ministry of Health and Family Welfare, Bangladesh.
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Håkansson C, Lexén A. Work conditions as predictors of Swedish occupational therapists' occupational balance. Scand J Occup Ther 2022; 30:520-526. [PMID: 36548520 DOI: 10.1080/11038128.2022.2158928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is little knowledge of how organizational and social work environmental conditions impact workers' perceptions of occupational balance. The aim of the present study was to investigate organizational and social work environmental conditions as predictors of Swedish occupational therapists' perceptions of occupational balance. MATERIALS/METHODS This prospective study collected data twice, with a one-year interval, and used a web survey. The present study included 1835 participants. Logistic regression analysis was used to analyze the work predictors of occupational balance. RESULTS A reasonable workload, high control, and high reward predicted high occupational balance. Having no children living at home, a satisfactory financial situation, and being physically active also predicted high occupational balance. CONCLUSION A reasonable workload, high control and high reward predicted occupational balance among the occupational therapists. All these factors may be of importance for a sustainable working life for occupational therapists. SIGNIFICANCE This knowledge can support occupational therapists in the development of interventions at the work place, with focus on the workload and the resources (control and reward), to promote employees' occupational balance.
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Henderson C, Ouali U, Bakolis I, Berbeche N, Bhattarai K, Brohan E, Cherian A, Girma E, Gronholm PC, Gurung D, Hanlon C, Kallakuri S, Kaur A, Ketema B, Lempp H, Li J, Loganathan S, Maulik PK, Mendon G, Mulatu T, Ma N, Romeo R, Venkatesh RK, Zgueb Y, Zhang W, Thornicroft G. Training for mental health professionals in responding to experienced and anticipated mental health-related discrimination (READ-MH): protocol for an international multisite feasibility study. Pilot Feasibility Stud 2022; 8:257. [PMID: 36514144 PMCID: PMC9745687 DOI: 10.1186/s40814-022-01208-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Mental health and other health professionals working in mental health care may contribute to the experiences of stigma and discrimination among mental health service users but can also help reduce the impact of stigma on service users. However, few studies of interventions to equip such professionals to be anti-stigma agents took place in high-income countries. This study assesses the feasibility, potential effectiveness and costs of Responding to Experienced and Anticipated Discrimination training for health professionals working in mental health care (READ-MH) across low- and middle-income countries (LMICs). METHODS This is an uncontrolled pre-post mixed methods feasibility study of READ-MH training at seven sites across five LMICs (China, Ethiopia, India, Nepal and Tunisia). OUTCOME MEASURES knowledge based on course content, attitudes to working to address the impact of stigma on service users and skills in responding constructively to service users' reports of discrimination. The training draws upon the evidence bases for stigma reduction, health advocacy and medical education and is tailored to sites through situational analyses. Its content, delivery methods and intensity were agreed upon through a consensus exercise with site research teams. READ-MH will be delivered to health professionals working in mental health care immediately after baseline data collection; outcome measures will be collected post-training and 3 months post-baseline, followed by qualitative data collection analysed using a combined deductive and inductive approach. Fidelity will be rated during the delivery of READ-MH, and data on training costs will be collected. Quantitative data will be assessed using generalised linear mixed models. Qualitative data will be evaluated by thematic analysis to identify feedback about the training methods and content, including the implementability of the knowledge and skills learned. Pooled and site-specific training costs per trainee and per session will be reported. CONCLUSIONS The training development used a participatory and contextualised approach. Evaluation design strengths include the diversity of settings, the use of mixed methods, the use of a skills-based measure and the knowledge and attitude measures aligned to the target population and training. Limitations are the uncertain generalisability of skills performance to routine care and the impact of COVID-19 restrictions at several sites limiting qualitative data collection for situational analyses.
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Byungura JC, Nyiringango G, Fors U, Forsberg E, Tumusiime DK. Online learning for continuous professional development of healthcare workers: an exploratory study on perceptions of healthcare managers in Rwanda. BMC MEDICAL EDUCATION 2022; 22:851. [PMID: 36482342 PMCID: PMC9733237 DOI: 10.1186/s12909-022-03938-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Due to outbreaks of new diseases, development of new treatment regimens and requirement of evidence-based practice, health professionals continuously need to acquire updated knowledge and skills. This type of learning is known as continuous professional development (CPD). The scarcity of skilled health care professionals in developing countries further increases the need of CPD. Traditionally, face-to-face approach has been preferred as the best mode of CPD. Currently, health professionals have started using online learning for continued professional growth in different parts of the world. Consequently, research studies from different settings are needed to investigate the significance of online learning for CPD. Therefore, the aim of this study was to investigate the importance and challenges attributed to online learning by the managers of health facilities in Rwanda. Moreover, the study aimed to identify the status of infrastructures that could support online CPD, and assess the perceived enhancement and barriers for implementing online CPD. METHODS The study used a convergence mixed-method design to explore quantitative and qualitative data from 42 health care managers. A descriptive analysis was conducted on quantitative data while qualitative data were thematically analyzed to inform the study findings. RESULTS It was revealed that 90.5% of managers, who participated in this study, consider positively the use of online learning for CPD. All managers acknowledged that online learning could improve the knowledge and practice skills of health care professionals. Nevertheless, 52.4% of health institutions who participated in this study currently do not use online for CPD. Participants demonstrated challenges such as the lack of access to digital devices, poor or lack of internet access, poor online learning design, low digital skills of healthcare professionals, lack of time dedicated to online learning, and heavy workload of staff. CONCLUSION These findings indicate then that the managers of health institutions value the importance of online learning for CPD of health professionals. However, online learning should be designed to fit for the purpose and with a high consideration on needs and preferences of healthcare professionals and thereby improve information communication technology infrastructure that support online learning for CPD. Traditional in-person CPD courses are still recommended in health institutions with shortage in resources and technology. Also, the barriers of online CPD delivery such as low internet connectivity and lack of access to digital devices by healthcare professionals need to be co-creatively addressed through the pyramidal structure of the Rwandan health system.
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McAuliffe MJ, Gledhill SE. Enablers and barriers for mandatory training including Basic Life Support in an interprofessional environment: An integrative literature review. NURSE EDUCATION TODAY 2022; 119:105539. [PMID: 36327789 DOI: 10.1016/j.nedt.2022.105539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 08/12/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES It is vital health services have systems in place for staff mandatory training to meet safe quality health outcomes. The aim of this review is to identify enablers supporting staff attendance at mandatory training (including BLS) and barriers that pose challenges for staff participation in mandatory training that will be used to inform the development of a structured mandatory staff training program in an IPE environment. DESIGN An integrative literature review was sought to answer the question: What are the enablers and barriers that influence health professional attendance and successful completion of mandatory training (including BLS) in an IPE environment? DATA SOURCES An international literature search was undertaken using advance search of the databases: Medline, CINAHL, Google Scholar and Web of Science (WoS). English language, peer reviewed articles published from 2010 to 2022 were retrieved and screened for relevance. REVIEW METHODS An integrative review of papers included systematic reviews, a case study, quantitative and qualitative studies, RCT, mixed method studies and expert opinion papers. RESULTS Only 34 articles were eligible for inclusion in the review based on their relevance to staff attendance at mandatory training (including BLS). Analysis of literature identified four key themes: 'mandatory training' and 'certification'; 'knowledge and skills'; 'enablers' and 'barriers' for 'mandatory training (including BLS) attendance' and 'IPE'. The literature highlighted that IPE is an appropriate means of delivering a redesign education/training process that may increase attendance at mandatory training with recommendations for increased inclusivity and interactivity as well as providing useful logistic information. CONCLUSION The outcome of the review can inform development of an IPE Implementation Strategy in a health service aiming to improve staff attending and engaging in mandatory training. The findings are valuable to other health services seeking to improve and achieve mandatory and accreditation targets.
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Perez-Araluce R, Martinez-Gonzalez M, Fernández-Lázaro C, Bes-Rastrollo M, Gea A, Carlos S. Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort. Clin Nutr 2022; 41:3061-3068. [PMID: 33934925 PMCID: PMC8047333 DOI: 10.1016/j.clnu.2021.04.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS A potential protection against COVID-19 by a high-quality dietary pattern is to be expected given the biological plausibility supporting the beneficial effects of an adequate dietary intake on the immune system. However, knowledge on the relationship between long-term maintained healthy dietary patterns, such as the Mediterranean diet, and the risk of SARS-CoV-2 infection is still sparse. We longitudinally assessed this association in a well-known Mediterranean cohort. METHODS We assessed 9,677 participants from the SUN Project, a prospective cohort of middle-aged university graduates in Spain. We inquired about a positive result in a COVID-19 diagnostic test during the months of February to December 2020. After excluding health professionals (HP), 5,194 participants were included in the statistical analyses (mean age: 52.6, SD: 12.4; 55.2% women). Food habits were assessed at baseline using a previously validated semiquantitative 136-item food frequency questionnaire. Adherence to the Mediterranean diet (cumulative average of 2 repeated measurements 10 years apart) was assessed using the 0-to-9 Mediterranean Diet Score (MDS). We used multivariable logistic regression models to estimate odds ratios and 95% confidence intervals for incident COVID-19 according to the MDS. RESULTS Among 5,194 non-HP participants, 122 reported to have received a positive COVID-19 diagnostic test. Participants with intermediate adherence to the Mediterranean diet (3 < MDS ≤ 6) had a significantly lower odds of developing COVID-19 (multivariable-adjusted OR = 0.50, 95% CI: 0.34-0.73), and those with the highest adherence (MDS > 6) exhibited the lowest risk (multivariable-adjusted OR = 0.36, 95% CI: 0.16-0.84, p for trend < 0.001) as compared with participants with MDS ≤ 3. This inverse association remained robust within subgroups and in sensitivity analyses. Notwithstanding, no significant associations were observed for health professionals (p for interaction = 0.06). CONCLUSION In conclusion, better adherence to the Mediterranean diet may be associated with a lower risk of COVID-19. Our results are applicable only to persons who are not health professionals.
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McCormack JC, Chu JTW, Marsh S, Bullen C. Knowledge, attitudes, and practices of fetal alcohol spectrum disorder in health, justice, and education professionals: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104354. [PMID: 36375286 DOI: 10.1016/j.ridd.2022.104354] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 07/12/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIMS Fetal alcohol spectrum disorder (FASD) is one of the most common forms of developmental disability, and yet, anecdotally, is poorly understood by both the public and professionals across health, justice, education, and social services. This review aims to understand the knowledge, attitudes, and practices of professionals who work across a range of sectors - specifically health, education and justice - where they may encounter people with FASD, their families and caregivers. METHOD We conducted a systematic search for research using surveys or questionnaires to address knowledge, and attitudes of professionals in health, education, and justice with regards to FASD between 1990 and 2021. Our search consisted of electronic databases (APA PsychInfo, CINAHL, EMBASE, Medline, PubMed, and PAIS Index) and grey literature sources. RESULTS Our search yielded 971 results, of which 58 were relevant. The studies surveyed professionals from health (n = 35), education (n = 10), justice (n = 8), social services (n = 1), and multiple settings (n = 4). Most studies were conducted in North America. The areas surveyed included knowledge of FASD, attitudes towards people with FASD, experience with FASD, practices towards people with FASD, and education and training needs. CONCLUSIONS Knowledge, attitudes, and practices towards FASD have been surveyed extensively in healthcare professionals over the last 30 years, but less so with those working in justice and education sectors. Findings from surveys suggest that although most professionals had some knowledge of the effects of FASD, their knowledge of the specific criteria of Fetal Alcohol Syndrome (FAS) and FASD is poor across most professional groups, including most health professionals. Our review highlights the need to provide training and information across sectors ongoing surveillance to determine where gaps in knowledge are and what resources are needed. WHAT THIS PAPER ADDS This study is the first to systematically synthesize knowledge, attitudes, and practices toward FASD across different sectors. Poor knowledge and insufficient training were common. Knowledge, attitudes, and practices about FASD have been surveyed extensively in the healthcare setting, but surveys are more limited outside of this setting. Continuous surveillance is needed to identify and respond to knowledge gaps and changes in practice.
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An evaluation of the impact for healthcare professionals after a leadership innovation fellowship program. J Med Imaging Radiat Sci 2022; 53:S137-S144. [PMID: 36202725 DOI: 10.1016/j.jmir.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Leadership among healthcare professionals is required to address important healthcare challenges. The TAHSNp Health Professions Innovation Fellowship program ("Program") supports health professionals' leadership development by offering them an opportunity to lead a quality improvement project and participate in a curriculum focused on leading change. OBJECTIVE As part of an outcome evaluation of the program, our objective was to determine the program's impact on leadership activities and roles undertaken by alumni. METHODS A questionnaire was administered to participants who completed the program in 2019 and 2020 at 6 and 18 months post-program to assess their leadership activities, leadership roles and the program's impact. Prospectively, we conducted internal and LinkedIn searches to identify current roles and obtained personal statements from program alumni of medical imaging health professions as complementary data sources for our program evaluation. RESULTS At 6 and 18 months post-program, 47% - 59% of alumni respondents reported participation in hospital/organization committees, mentoring fellows or students, and presenting scholarly work inside or outside their organizations (6 months: N = 25, response rate = 39.1%; 18 months: N = 17, response rate = 26.6%). Additionally, at 18 months post program, 35% - 41% of alumni reported leading a new quality improvement initiative, pursuing formal education, and having a new leadership role. Most alumni reported their leadership activities were influenced by the program, with the largest impact occurring after 18 months post-program for leading a new quality improvement initiative (100%), career plans for the next five years (94%), mentoring fellowship staff (91%), presenting at their healthcare organization (91%) and a new leadership role (90%). Alumni reported the program helped build their confidence, create networking opportunities, leadership skill-building and interest in pursuing other roles beyond their clinical role. More specifically, alumni reported that leadership skills gained from the program were used in subsequent roles and responsibilities. CONCLUSION/IMPLICATIONS The program evaluation demonstrates engaged alumni who undertake informal and formal leadership activities and roles. Our results are illustrative of the value-add as a result of healthcare organizations' investment in developing leadership among healthcare professionals. As continued engagement and career development are known to be important for staff retention and succession planning strategies, our findings are highly relevant given the current staffing challenges in healthcare.
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Dubé E, Labbé F, Malo B, Manca T, Aylsworth L, Driedger SM, Graham J, Greyson D, MacDonald N, Meyer SB, Parsons Leigh J, Sadarangani M, Wilson S, MacDonald SE. " I don't think there's a point for me to discuss it with my patients": exploring health care providers' views and behaviours regarding COVID-19 vaccination. Hum Vaccin Immunother 2022; 18:2088970. [PMID: 35767434 PMCID: PMC9621068 DOI: 10.1080/21645515.2022.2088970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Health care providers' knowledge and attitudes about vaccines are important determinants of their own vaccine uptake, their intention to recommend vaccines, and their patients' vaccine uptake. This qualitative study' objective was to better understand health care providers' vaccination decisions, their views on barriers to COVID-19 vaccine acceptance and proposed solutions, their opinions on vaccine policies, and their perceived role in discussing COVID-19 vaccination with patients. METHODS Semi-structured interviews on perceptions of COVID-19 vaccines were conducted with Canadian health care providers (N = 14) in spring 2021. A qualitative thematic analysis using NVivo was conducted. RESULTS Participants had positive attitudes toward vaccination and were vaccinated against COVID-19 or intended to do so once eligible (two delayed their first dose). Only two were actively promoting COVID-19 vaccination to their patients; others either avoided discussing the topic or only provided answers when asked questions. Participants' proposed solutions to enhance COVID-19 vaccine uptake in the public were in relation to access to vaccination services, information in multiple languages, and community outreach. Most participants were in favor of mandatory vaccination policies and had mixed views on the potential impact of the Canadian vaccine-injury support program. CONCLUSIONS While health care providers are recognized as a key source of information regarding vaccines, participants in our study did not consider it their role to provide advice on COVID-19 vaccination. This is a missed opportunity that could be avoided by ensuring health care providers have the tools and training to feel confident in engaging in vaccine discussions with their patients.
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Agbetou M, Camara IF, Diallo LL, Soumah AS, Constant A, Djibo FH, Lamino I, Maiga Y, Koné Z, Diagana M, Hamadi H, Ibrahim E, John J, Ndiaye M, Diarra E, Foksouma S, Dakissia K, Millogo A, Moussavou C, Daniel GM, Razafimahefa J, Dorée A, Mbelesso P, Mwendaweli N, Kissani N. Epilepsy and stigma in Africa: Viewpoint of healthcare professionals and combat strategies. Seizure 2022; 107:172-176. [PMID: 36935262 DOI: 10.1016/j.seizure.2022.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
Epilepsy is a major public health problem in developing countries where eighty percent (80%) of people with epilepsy (PWE) live. Stigma has psychological consequences as well as serious repercussions on patients' quality of life. This study assesses the perception of health professionals in Africa regarding the stigmatization of PWE. METHODOLOGY This is a multicenter descriptive, cross-sectional study, from 1st August 2020 to 1st September 2021. Medical practitioners from African countries involved in the management of epilepsy and who agreed to fill out forms were included in the study. Sampling was nonrandom and based on respondent choice. The data were analyzed using the EPI INFO 7 software. RESULTS A total of two hundred and twenty-nine (229) health workers from twenty-six (26) African countries participated in this survey. 24.89% of the respondents were specialists and 46.72% were neurologists. Ninety-one percent (91%) of practitioners felt that PWE were stigmatised. The main forms of stigma were isolation (68.56%), celibacy (60.70%), unemployment (53.28%), divorce (44.54%) and exclusion (37.99%)%). Community, school and family were recognized as the main places of stigmatization. The fight against this stigma was carried out mainly in hospitals and in isolation in 58.4% and 55.8% of cases, respectively. Only 0.4% of practitioners opted for mass awareness. CONCLUSION PWE are victims of various forms of stigmatization, particularly in community settings. Measures aimed at raising awareness of the public are essential to reduce this stigma and improve patients' quality of life.
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Awosoga OA, Odunaiya NA, Oyewole OO, Ogunlana MO, Mbada CE, Onyeso OK, Adegoke OM, Ayodeji AF, Odole AC. Pattern and perception of wellbeing, quality of work life and quality of care of health professionals in Southwest Nigeria. BMC Health Serv Res 2022; 22:1387. [PMID: 36419074 PMCID: PMC9682769 DOI: 10.1186/s12913-022-08808-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Personal wellbeing (PW) including quality of life and work life is a very complex concept that influences health professionals' commitment and productivity. Improving PW may result in positive outcomes and good quality of care. Therefore, this study aimed to assess the pattern and perception of wellbeing, quality of work life (QoWL) and quality of care (QoC) of health professionals (HPs) in southwest Nigeria. METHODS: The study was a convergent parallel mixed method design comprising a cross-sectional survey (1580 conveniently selected participants) and a focus group interview (40 purposively selected participants). Participants' PW, quality of life (QoL), QoWL, and QoC were assessed using the PW Index Scale, 5-item World Health Organization Well-Being Index, QoWL questionnaire, and Clinician QoC scale, respectively. The pattern of wellbeing, QoWL and quality of care of HPs were evaluated using t-test and ANOVA tests. Binary regression analysis was used to assess factors that could classify participants as having good or poor wellbeing, QoWL, and quality of care of HPs. The qualitative findings were thematically analyzed following two independent transcriptions. An inductive approach to naming themes was used. Codes were assigned to the data and common codes were grouped into categories, leading to themes and subthemes. RESULTS Of 1600 administered questionnaires, 1580 were returned, giving a 98.75% response rate. Only 45.3%, 43.9%, 39.8% and 38.4% of HP reported good PW, QoL, QoC and QoWL, respectively; while 54.7%, 56.1%, 60.2% and 61.6% were poor. There were significant gender differences in PW and QoC in favor of females. With an increase in age and years of practice, there was a significant increase in PW, QoWL and QoC. As the work volume increased, there was significant decrease in QoWL. Participants with master's or Ph.D. degrees reported improved QoWL while those with diploma reported better QoC. PWI and QoC were significantly different along the type of appointment, with those who held part-time appointments having the least values. The regression models showed that participant's characteristics such as age, gender, designation, and work volume significantly classified health professionals who had good or poor QoC, QoWL, PW and QoL. The focus group interview revealed four themes and 16 sub-themes. The four themes were the definitions of QoC, QoWL, and PW, and dimensions of QoC. CONCLUSION More than half of health professionals reported poor quality of work life, quality of life and personal wellbeing which were influenced by personal and work-related factors. All these may have influenced the poor quality of care reported, despite the finding of a good knowledge of what quality of care entails.
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Patja K, Huis in ‘t Veld T, Arva D, Bonello M, Orhan Pees R, Soethout M, van der Esch M. Health promotion and disease prevention in the education of health professionals: a mapping of European educational programmes from 2019. BMC MEDICAL EDUCATION 2022; 22:778. [PMID: 36369021 PMCID: PMC9652036 DOI: 10.1186/s12909-022-03826-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Health professionals face barriers in carrying out effective health promotion and disease prevention. To indicate what are the needs for curriculum development in educational programmes, this study aims to provide an overview of how various health professionals are currently trained in health promotion and disease prevention at different educational levels. METHODS In 2019, a descriptive mapping exercise was performed focusing on European programmes for different health and healthcare professionals at the three levels of education (undergraduate, postgraduate, and continuous professional development [CPD]). Data were collected by a self-developed online survey that was distributed using a modified snowball method. RESULTS A total of 186 educational programmes of 17 different health professionals were analysed, implemented in 31 countries (60% were undergraduate, 30% postgraduate and 10% CPD programmes). Nearly all programmes indicated that expected outcomes were defined on knowledge (99%), skills (94%) and behaviours/attitudes (89%) regarding health promotion and disease prevention. A multidisciplinary approach was reported to be applied by 81% of the programmes. Traditional teaching methods such as lectures (97%) and assignments (81%) were dominant, while e-learning was less frequently used (46%). Digitalization in health promotion and digital health coaching were the least addressed topics in most programmes. CONCLUSIONS Health promotion and disease prevention are reported at all surveyed levels of education for a broad spectrum of health professionals. Educational programmes cover contents on knowledge, skills, and behaviours. There is a need for capacity building and joint development in health promotion education. Specifically, there is a need to include digitalisation and novel teaching in the educational programmes of health promotion and disease prevention.
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Peñaranda A, García E, Pérez-Herrera LC, Trojan A, Peñaranda D, Molina J, Moreno-López S. Effect of the COVID-19 pandemic on the mental health, daily and occupational activities among health professionals in Colombia: a national study. BMC Psychiatry 2022; 22:682. [PMID: 36333782 PMCID: PMC9635125 DOI: 10.1186/s12888-022-04337-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has placed an unprecedented physical and mental burden on healthcare workers who are frequently at high risk of infection, particularly in low-income countries. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress, as well as changes in daily and occupational activities among healthcare professionals due to the COVID-19 pandemic in Colombia. METHODS An observational, cross-sectional study was conducted between February and June 2021. The survey incorporated validated mental health tools such as the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10. Multivariable ordinal logistic regression analysis was performed to determine the factors associated with severe mental health outcomes. RESULTS Among 1345 healthcare workers the prevalence of anxiety, depression, and stress were 75.61, 59.18, and 53.09%, respectively. Anxiety (OR:1.44; 95%CI:1.16-1.8), depression (OR:1.74; 95%CI:1.27-2.37), and stress (OR:1.51; 95%CI:1.18-1.94) were more frequent in women, and individuals who expressed fear of a negative outcome (death, sequelae) (OR:2.25; 95%CI:1.60-3.25), (OR:1.49; 95%CI:1.03-2.16) and (OR:2.36; 95%CI:1.69-3.29) respectively. Age was negatively associated with anxiety (OR:0.98; 95%CI:0.98-0.99), stress (OR:0.98; 95%CI:0.97-0.99), and depression (OR:0.97; 95% CI:0.96-0.98). Reduction in consultations and surgeries (OR:1.01; 95%CI:1.0-1.01) was positively associated with anxiety. Due to the pandemic, most specialists expected to incorporate drastic long-term (> 1 year) changes in their clinical setting and daily activities. CONCLUSIONS The prevalence of anxiety, depression, and stress is higher among Colombian healthcare workers compared to previous reports. Further research regarding these psychological outcomes is needed to achieve early mental health intervention strategies. TRIAL REGISTRATION Hospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-12992-2021.
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Golz C, Oulevey Bachmann A, Defilippis TS, Kobleder A, Peter KA, Schaffert R, Schwarzenbach X, Kampel T, Hahn S. Preparing students to deal with the consequences of the workforce shortage among health professionals: a qualitative approach. BMC MEDICAL EDUCATION 2022; 22:756. [PMID: 36333793 PMCID: PMC9636659 DOI: 10.1186/s12909-022-03819-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/26/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Healthcare is facing a shortage of qualified healthcare professionals. The pandemic has brought to light the fragile balance that affects all healthcare systems. Governments have realized that these systems and the professionals working in them need support at different levels to strengthen the retention of the workforce. Health professionals' education can play an important role in ensuring that new generations of workers have sound personal and professional competencies to successfully face the challenges of professional practice. These challenges are described in the literature, but the extent to which they are considered in health professionals' education is less clear. METHODS This qualitative study compares the professional challenges and educational needs described in the literature with the current curricula for health professionals offered in Switzerland. Data were collected nationally through focus group interviews with 65% of Switzerland's directors of bachelor's and master's programs of health professions (nursing, physiotherapy, occupational therapy, midwifery, nutrition and dietetics, osteopathy, radiologic medical imaging technology, health promotion and prevention, and health sciences). The data attained were analyzed using knowledge mapping. RESULTS The results reveal a gap among education programs with regard to occupational health promotion and cultural diversity. Both topics are taught with a sole focus on patients, and students are expected to adopt similar strategies for their health promotion and stress management. Physicians are insufficiently involved in interprofessional education. The programs fail to enhance health professionals' political, economic and digital competencies. CONCLUSION The results of this study offer clear guidance about what topics need to be integrated into curricula to improve health professionals' well-being at work and their preparedness to face daily professional challenges.
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Turner S, Benstead K, Millar BA, Morris L, Seel M, Leech M, Eriksen JG, Giuliani M. A new wave of leaders: Early evaluation of the interdisciplinary Foundations of Leadership in Radiation Oncology (FLiRO) program. Tech Innov Patient Support Radiat Oncol 2022; 24:94-100. [PMID: 36338012 PMCID: PMC9633739 DOI: 10.1016/j.tipsro.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/04/2022] [Accepted: 09/15/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Effective leadership across all areas of radiation oncology (RO) is vital to fully realise the benefits of radiation therapy in cancer care. We report outcomes of a novel interdisciplinary leadership program designed for RO professionals under a global joint society initiative. METHODS The Foundations of Leadership in RO (FLiRO) program was designed for aspiring RO leaders. Initially delivered in a blended learning format, it was adapted to fully virtual in 2021. It comprised a webinar tutorial, on-line modules and homework followed by 'live' in-person/virtual workshops over an approximately 6-week period. Topics included personal awareness, effective teamwork, quality improvement skills, leading change and conflict management. An immediate post-program online survey was performed using Likert scales to measure self-reported educational value, interaction with others and the likely application of learning to practice. Open comments were invited. RESULTS 170 participants from 36 countries and 6 continents took part from 2018 to 2021 (99 doctors, 36 physicists, 32 radiation therapists/RTTs and 3 others). 141 (83%) participants responded to the post-program survey. Average weightings for responders' views on whether pre-determined learning objectives were met ranged from 4.30 to 4.61 on a 5-point scale (1 = 'not met at all' and 5 = completely met). For the question addressing potential value of learning for application to their workplace, 124 of 130 (95%) of responders indicated that FLIRO would be 'very useful' or 'extremely useful'. CONCLUSION Initial evaluation of the FLiRO program supports its continuation and expansion with ongoing evolution based on emerging evidence around leadership education and participant feedback.
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Vrotsou K, Orive-Calzada M, González N, Vergara I, Pascual-Fernández N, Guerra-López C, García-Montes R, Ortiz-Ribes J, Onaindia-Ecenarro MJ, Regalado-de Los Cobos J, Millet-Sampedro M. [Factors associated with the hospital at home workload: A Delphi consensus study]. J Healthc Qual Res 2022:S2603-6479(22)00075-6. [PMID: 36272932 DOI: 10.1016/j.jhqr.2022.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/20/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To identify and prioritize a list of factors that contribute to the workload of the hospital at home (HaH) professionals. MATERIAL AND METHODS A qualitative methodology study performed between January and December 2019 in the 10 HAH units of the Basque Country. The data were obtained in 4phases: 1. Systematic literature search and review; 2. Expert group meeting; 3. Consensus method: Delphi technique (2 survey rounds) and nominal group meeting; 4. Meeting of the research team. RESULTS In the systematic literature search and review 85 factors were initially identified. These were reduced to 38 after the 8-person expert group meeting, in which 10 new factors were added. After the 2 Delphi rounds (106 and 57 professionals, respectively), 17 factors were maintained and 12 remained in doubt. The latter were evaluated at the nominal group meeting, consisting of 13 professionals who decided to eliminate 5 factors, include 3, and keep 3 as doubt. After the 8-person research team meeting, 14 potential factors were finally selected. They are related to the place of residence, the health state and social situation of the patients, as well as the health care provided at home. CONCLUSIONS The identified factors could serve for improving the organization and optimize the daily word of the HaH professionals.
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Kumar N, Gupta R, Gupta S. Research and academic output evaluation for career initiation or progression: Critical issues for Health Professionals. MEDICAL TEACHER 2022; 44:1179-1181. [PMID: 35868010 DOI: 10.1080/0142159x.2022.2102471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In current times, much stress is being laid on the evaluation of research productivity of researchers or faculty in addition to the academic qualifications and experience for the purposes of recruitment, promotion, and research grant funding. Over the years, several quantitative indices have been devised for this purpose. Some of these indices such as h-index, impact factor and e-index are being extensively used by research organizations, universities, accreditation bodies and funding agencies for basic scientists as well as health professionals. In the absence of any formal training, these parameters or their advantages and shortcomings may not be well understood by the health professionals, especially in the early stages of their careers and sometimes, even by the evaluators. A big unanswered question is the validity of the same criteria for health professionals as are applicable for the basic science researchers. Since health professional undertaking research assignments are neither adequately trained in basic research nor can they comprehend these indices well, the same yardstick to evaluate these two widely different groups of researchers often places the health professionals at a disadvantage.This paper aims to highlight certain vital issues related to the application of research productivity indicators for recruitment and career progression of health care professionals.
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McLindon E, Diemer K, Kuruppu J, Spiteri-Staines A, Hegarty K. "You can't swim well if there is a weight dragging you down": cross-sectional study of intimate partner violence, sexual assault and child abuse prevalence against Australian nurses, midwives and carers. BMC Public Health 2022; 22:1731. [PMID: 36096766 PMCID: PMC9469630 DOI: 10.1186/s12889-022-14045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background Domestic and family violence (DFV), including intimate partner violence (IPV), sexual assault and child abuse are prevalent health and social issues, often precipitating contact with health services. Nurses, midwives and carers are frontline responders to women and children who have experienced violence, with some research suggesting that health professionals themselves may report a higher incidence of IPV in their personal lives compared to the community. This paper reports the largest study of DFV against health professionals to date. Method An online descriptive, cross-sectional survey of 10,674 women and 772 men members of the Australian Nursing and Midwifery Federation (ANMF) (Victorian Branch). The primary outcome measures were 12-month and adult lifetime IPV prevalence (Composite Abuse Scale); secondary outcomes included sexual assault and child abuse (Australian Bureau of Statistics Personal Safety Survey) and prevalence of IPV perpetration (bespoke). Results Response rate was 15.2% of women/11.2% of men who were sent an invitation email, and 38.4% of women/28.3% of men who opened the email. In the last 12-months, 22.1% of women and 24.0% of men had experienced IPV, while across the adult lifetime, 45.1% of women and 35.0% of men had experienced IPV. These figures are higher than an Australian community sample. Non-partner sexual assault had been experienced by 18.6% of women and 7.1% of men, which was similar to national community sample. IPV survivors were 2-3 times more likely to have experienced physical, sexual or emotional abuse in childhood compared to those without a history of IPV (women OR 2.7, 95% CI 2.4 to 2.9; men OR 2.8, 95% CI 2.0 to 4.1). Since the age of sixteen, 11.7% of men and 1.7% of women had behaved in a way that had made a partner or ex-partner feel afraid of them. Conclusions The high prevalence of intimate partner violence and child abuse in this group of nurses, midwives and carers suggests the need for workplace support programs. The findings support the theory that childhood adversity may be related to entering the nursing profession and has implications for the training and support of this group.
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Neill S, Bray L, Carter B, Roland D, Carrol ED, Bayes N, Riches L, Hughes J, Pandey P, O'Donnell J, Palmer-Hill S. Navigating uncertain illness trajectories for young children with serious infectious illness: a modified grounded theory study. BMC Health Serv Res 2022; 22:1103. [PMID: 36042434 PMCID: PMC9427158 DOI: 10.1186/s12913-022-08420-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background Infectious illness is the biggest cause of death in children due to a physical illness, particularly in children under five years. If mortality is to be reduced for this group of children, it is important to understand factors affecting their pathways to hospital. The aim of this study was to retrospectively identify organisational and environmental factors, and individual child, family, and professional factors affecting timing of admission to hospital for children under five years of age with a serious infectious illness (SII). Methods An explanatory modified grounded theory design was used in collaboration with parents. Two stages of data collection were conducted: Stage 1, interviews with 22 parents whose child had recently been hospitalised with a SII and 14 health professionals (HPs) involved in their pre-admission trajectories; Stage 2, focus groups with 18 parents and 16 HPs with past experience of SII in young children. Constant comparative analysis generated the explanatory theory. Results The core category was ‘navigating uncertain illness trajectories for young children with serious infectious illness’. Uncertainty was prevalent throughout the parents’ and HPs’ stories about their experiences of navigating social rules and overburdened health services for these children. The complexity of and lack of continuity within services, family lives, social expectations and hierarchies provided the context and conditions for children’s, often complex, illness trajectories. Parents reported powerlessness and perceived criticism leading to delayed help-seeking. Importantly, parents and professionals missed symptoms of serious illness. Risk averse services were found to refer more children to emergency departments. Conclusions Parents and professionals have difficulties recognising signs of SII in young children and can feel socially constrained from seeking help. The increased burden on services has made it more difficult for professionals to spot the seriously ill child. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08420-5.
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