Navigating uncertain illness trajectories for young children with serious infectious illness: a modified grounded theory study

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.

Mental health and the effects on methylation of stress-related genes in front-line versus other health care professionals during the second wave of COVID-19 pandemic: an Italian pilot study

Healthcare workers experienced high degree of stress during COVID-19. Purpose of the present article is to compare mental health (depressive and Post-Traumatic-Stress-Disorders-PTSD-symptoms) and epigenetics aspects (degree of methylation of stress-related genes) in front-line healthcare professionals versus healthcare working in non-COVID-19 wards. Sixty-eight healthcare workers were included in the study: 39 were working in COVID-19 wards (cases) and 29 in non-COVID wards (controls). From all participants, demographic and clinical information were collected by an ad-hoc questionnaire. Depressive and PTSD symptoms were evaluated by the Patient Health Questionnaire-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R), respectively. Methylation analyses of 9 promoter/regulatory regions of genes known to be implicated in depression/PTSD (ADCYAP1, BDNF, CRHR1, DRD2, IGF2, LSD1/KDM1A, NR3C1, OXTR, SLC6A4) were performed on DNA from blood samples by the MassARRAY EpiTYPER platform, with MassCleave settings. Controls showed more frequent lifetime history of anxiety/depression with respect to cases (χ² = 5.72, p = 0.03). On the contrary, cases versus controls presented higher PHQ-9 (t = 2.13, p = 0.04), PHQ-9 sleep item (t = 2.26, p = 0.03), IES-R total (t = 2.17, p = 0.03), IES-R intrusion (t = 2.46, p = 0.02), IES-R avoidance (t = 1.99, p = 0.05) mean total scores. Methylation levels at CRHR1, DRD2 and LSD1 genes was significantly higher in cases with respect to controls (p < 0.01, p = 0.03 and p = 0.03, respectively). Frontline health professionals experienced more negative effects on mental health during COVID-19 pandemic than non-frontline healthcare workers. Methylation levels were increased in genes regulating HPA axis (CRHR1) and dopamine neurotransmission (DRD2 and LSD1), thus supporting the involvement of these biological processes in depression/PTSD and indicating that methylation of these genes can be modulated by stress conditions, such as working as healthcare front-line during COVID-19 pandemic.

Initiatives to enhance medical subspecialist training in Zambia: A cross-sectional analysis

Introduction

There is a significant shortage of medical subspecialists in Zambia. The government of Zambia, through programmes at the Ministry of Health, spends considerable resources to send patients outside the country for subspecialist medical treatment. The objective of this analysis was to evaluate the current situation pertaining to medical subspecialty training at the University of Zambia School of Medicine (UNZASOM) and to illustrate the new programmes that are to be introduced.

Methods

We collected data from formal desk reviews on the state of medical specialisation in Zambia, the UNZASOM graduation archives and patient referral records at the Ministry of Health (MoH). In addition, information on planned subspecialist programmes is presented.

Results

From the first graduates in 1986up to 2019,UNZASOM produced 351medical specialists, 63 (18%) in Internal Medicine, 77 (22%) in Obstetrics &Gynaecology, 82 (23%) in Paediatrics&Child Health, 68 (19%) in General Surgery, 17 (5%) in Anaesthesia & Critical Care, 20 (6%) in Orthopaedics &Trauma and 8 (2%) in Urology. The remaining graduates were in Ophthalmology, Psychiatry, Infectious Diseases, Paediatric Surgery and Pathology contributing 1% each. To enhance medical subspecialist training at UNZASOM, new curricula for Breast Surgery, Urology, Glaucoma, Vitreo-retinalSurgery, Adult Gastroenterology, Forensic Pathology, Dermatology & Venereology, Ophthalmology, Gynaecological Oncology and Paediatric anaesthesia, Infectious Diseases, and Gastroenterology were developed. Since 2013, only 44% of patients requiring subspecialist treatment out of Zambia got assisted with the remainder still on the waiting list or having had bad outcomes.

Conclusions

These programmes will provide an opportunity for accessible and affordable medical subspecialization training for Zambia and its neighbouring countries. With enhanced infrastructural support, the subspecialists will contribute toward enhanced healthcare provision and improvement in patient outcomes. They will also form a cohort of trainers to expand the space for quality training and skills building of specialists and subspecialists in the region and beyond.

Health professionals' licensing: the practice and its predictors among health professional hiring bodies in Ethiopia

BACKGROUND

Evidence suggests that not all human resource departments have hired their facility staff based on federal licensing standards, with some hiring without an active license. This is common in some, if not all, parts of the country. The paucity of healthcare experts, high turnover rates, employee burnout, and challenges in training and development issues were all key recruiting challenges globally.

OBJECTIVE

To assess the practice of health professionals' licensing and its predictors among hiring bodies in Ethiopia, March 24/2021-May 23/2021.

METHODS

A cross-sectional study was conducted in privately and publicly funded health facilities throughout Ethiopia. For each region, a stratified sampling strategy was utilized, followed by a simple random sampling method. Documents from the recruiting bodies for health professionals were reviewed. A pretested structured questionnaire and document review tool were used to extract data confidentially. A descriptive analysis of the basic hiring body characteristics was conducted. Hiring body characteristics were analyzed in bivariate and multivariate logistic regression to identify factors associated with best health professionals licensing practice. Data management and analysis were conducted with Epi-Data version 4.4.3.1 and SPSS version 23, respectively.

RESULTS

The analysis included 365 hiring bodies and 4991 files of health professionals (1581 from private and 3410 from public health organizations). Out of 365 hiring bodies studied, 66.3% practiced health professional licensing. A total of 1645 (33%) of the 4991 professionals whose files were reviewed were found to be working without any professional license at all. Furthermore, about 2733 (55%) have an active professional license, and about 603 (12%) were found to work with an expired license. Being a private facility (adjustedOR = 21.6; 95% CI = 8.85-52.55), obtaining supervision from a higher organ (adjustedOR = 19.7; 95%CI: 2.3-169.1), and conducting an internal audit (adjustedOR = 2.7; 95% CI: 1.15-6.34) were predictors of good licensing practice.

CONCLUSIONS

The licensing of health practitioners was poorly practiced in Ethiopia as compared to the expected proclamation of the country. A system for detecting fake licenses and controlling revoked licenses does not exist in all regions of the country.

The development and education of a workforce in childhood cancer services in low- and middle-income countries: a scoping review protocol

BACKGROUND

An estimated 400,000 children develop cancer worldwide. Of those, 90% occur in low- and middle-income countries, where survival rates can be as low as 30%. To reduce the childhood cancer survival gap between high- and low- and middle-income countries (LMIC), the World Health Organization launched the Global Initiative for Childhood Cancer in 2018, to support governments in building sustainable childhood cancer programs, with the aim to increase access and quality of care for children with cancer. Developing a high-quality and trained workforce is key to the success of childhood cancer services, but more information is needed on the interventions used to develop and train a workforce. The objective of this review is to understand the key factors described in the literature in relation to the development and training of a workforce in childhood cancer (defined here as ages 0-19) in LMIC, including challenges, interventions and their outcomes.

METHODS

We will include sources of evidence that describe the development or training of a childhood cancer workforce in health services that diagnose, refer or treat children and adolescents with cancer, in low- and middle-income countries as defined by the World Bank. The following databases will be searched: OVID Medline, Embase and Pubmed from 2001 to present with no restriction of language. Grey literature searches will also be performed in Proquest Dissertation and Theses, as well as relevant organizations' websites, and conference proceedings will be searched in conference websites. In addition, references lists will be reviewed manually. Two people will screen abstracts and full-texts and extract data. Data will be presented in a table or chart, with an accompanying narrative summary responding to the review questions. A framework synthesis will be conducted: data will be charted against a framework adapted from the 2016 WHO Global Strategy for Human Resources for Heath: Workforce 2030.

DISCUSSION

This scoping review will allow to map the existing literature on workforce development in LMIC, identify potential interventions and highlight data and knowledge gaps. This constitutes a first step towards adopting successful strategies more broadly, formulating research priorities and developing effective policies and interventions.

SYSTEMATIC REVIEW REGISTRATION

Open Science Framework osf.io/3mp7n.

What do Italian healthcare professionals think about orthorexia nervosa? Results from a multicenter survey

PURPOSE

Orthorexia nervosa (ON) is an obsession for healthy and proper nutrition. Diagnostic criteria for ON are lacking and the psychopathology of ON is still a matter of debate in the clinical and scientific community. Our aim was to better understand the Italian clinical and scientific community's opinion about ON.

METHODS

Anonymous online survey for Italian healthcare professionals, implemented with the REDCap platform and spread through a multicenter collaboration. Information was gathered about socio-demographic, educational and occupational features, as well as about experience in the diagnosis and treatment of EDs. The main part of the survey focused on ON and its features, classification and sociocultural correlates.

RESULTS

The survey was completed by 343 participants. Most responders (68.2%) considered ON as a variant of Eating Disorders (EDs), and 58.6% a possible prodromal phase or evolution of Anorexia Nervosa (AN). Most participants (68.5%) thought the next DSM should include a specific diagnostic category for ON, preferably in the EDs macro-category (82.1%). Moreover, 77.3% of responders thought that ON deserves more attention on behalf of researchers and clinicians, and that its treatment should be similar to that for EDs (60.9%). Participants thinking that ON should have its own diagnostic category in the next DSM edition had greater odds of being younger (p = 0.004) and of considering ON a prodromic phase of another ED, such as AN (p = 0.039).

DISCUSSION

Our survey suggests that the scientific community still seems split between those who consider ON as a separate disorder and those who do not. More research is still needed to better understand the construct of ON and its relationship with EDs; disadvantages and advantages of giving ON its own diagnosis should be balanced.

LEVEL OF EVIDENCE

V (descriptive cohort study).

Experiences and needs of women in vulnerable situations receiving additional interventions in maternity care: a qualitative study

BACKGROUND

Tailoring an intervention to the needs and wishes of pregnant women in vulnerable situations (e.g., socioeconomic disadvantages) can reduce the risk of adverse outcomes and empower these women. A relatively high percentage of pregnant women in the North of the Netherlands are considered vulnerable to adverse pregnancy outcomes because of their low socioeconomic status and the intergenerational transmission of poverty. In order to improve perinatal and maternal health, next to standard prenatal care, various interventions for pregnant women in vulnerable situations have been developed. We do not know to what extent these additional interventions suit the needs of (pregnant) women. Therefore, the aim of this study is to gain insight into the experiences and needs of women in vulnerable situations who receive additional maternity care interventions in the Northern Netherlands.

METHODS

Qualitative research was performed. We used a phenomenological framework, which is geared towards understanding people's experiences in the context of their everyday lives. In-depth semi-structured interviews were conducted with 17 pregnant women in vulnerable situations living in the Northern Netherlands. A thematic analysis was carried out.

RESULTS

We found three themes that reflect the experiences and needs of pregnant women in vulnerable situations in relation to the intervention they receive. These themes relate to the care provided by health professionals, to the impact of being offered an intervention, and to practical issues related to receiving an additional intervention. We found that the needs of pregnant women in vulnerable situations who received an additional maternity care intervention varied. This variation in needs was mainly related to practical issues. Women also expressed common needs, namely the desire to have control over their situation, the wish to receive tailor-made information about the intervention, and the wish for the intervention to be specifically tailored to their circumstances.

CONCLUSIONS

Living in vulnerable situations and being offered additional care evoked diverse reactions and emotions from pregnant women. We recommend that health professionals ensure open and clear communication with women, that they ensure continuity of care and relationship-centered care, and that they become aware of the process of stigmatization of women in vulnerable situations.

Practice of code of ethics and associated factors among health professionals in Central Gondar Zone public hospitals, Northwest Ethiopia, 2021: a mixed-method study design

BACKGROUND

Ethics is the science of moral and ethical rules recognised in human life and attempts to verify what is morally right and wrong. Healthcare ethics is seen as an integrated part of the daily activities of health facilities. Healthcare professionals' standardisation and uniformity in healthcare ethics are urgent and basic requirements. Therefore, this study aimed to assess the practice of the code of ethics and associated factors among health professionals in Central Gondar Zone public hospitals, Northwest Ethiopia, 2021.

METHODS

A facility-based cross-sectional study design with a mixed method was conducted on 631 health professionals from Central Gondar Zone public hospitals. For the quantitative part, pre-tested self-administered questionnaires were used, and for the qualitative part, key informant interviews with a semi-structured questionnaire were used. Variables with a p value of < 0.2 in binary logistic regression entered into a multivariable logistic regression, then p value < 0.05 and AOR were used to declare statistically significant variables in quantitative data. A thematic content analysis was used for qualitative data analysis.

RESULTS

This study revealed that only 286 (46.7%) health professionals had good practice of the code of ethics. Good ethical knowledge (AOR = 1.95, 95% CI 1.37, 2.77), favourable attitude (AOR = 1.55, 95% CI 1.11, 2.16), and satisfaction of health professionals with their jobs (AOR = 1.45, 95% CI (1.04, 2.04) were significantly associated with the practice of health care ethics.

CONCLUSIONS

Health professionals' overall level of practice of health care ethics in the Central Gondar Zone public hospitals was poor. This necessitates practical training, ongoing follow-up, availing of necessary medical equipment, a smooth working environment, and modification of the recognition system for health professionals.

The experience of coronaphobia among health professionals and their family members during COVID-19 pandemic: A qualitative study

Background

Coronaphobia is an excessive fear of becoming infected by the COVID-19 virus. Situations of coronaphobia against health professionals have been identified. Therefore, there is a need to develop studies to understand family impact and experience of COVID-19 pandemic and coronaphobia.

Aim

To describe the coronaphobia experience of health professionals and of one of their family members during the first wave of the COVID-19 pandemic.

Methods

Exploratory qualitative study using narrative inquiry was used. This study was guided by the concept of coronaphobia and Family Systems Nursing as conceptual frameworks. Face-to-face and telephone interviews were conducted from September to November 2020 with 14 health professionals, including nurses and physicians and one of their family members (n = 14).

Findings

Three descriptive themes were identified which highlight professional-family dyads’ experience of coronaphobia as a reciprocal and relational process. Coronaphobia was demonstrated by unknown or close people, in a disguised or explicit way, and generated suffering in the dyads and in the family unit. Consequently, individual and/or family strategies were developed to allow for the protection of the family system and the maintenance of its functioning.

Discussion

This study describes how the dyads of health professionals and their family members identify the experiences of coronaphobia. In addition, it was possible to analyze the repercussions of coronaphobia on the dyad and the strategies they used to deal with it.

Conclusions

This study extends understanding about the relationships between the experience of coronaphobia among health professionals and one of their family members and the experience of physical, cognitive and emotional suffering during the COVID-19 pandemic.

Health professionals' view on the role of hope and communication challenges with patients in palliative care: A systematic narrative review

OBJECTIVE

To identify health professionals' (HPs) perspectives on the role of hope and the main challenges faced when communicating with patients in palliative care (PC).

METHODS

Search on PubMed, Scopus, SocIndex, Cochrane, and Web of Science using: palliat*, palliative care, palliative medicine, hospice care, terminal care, long term care, supportive care, end of life (EOL) care and hope*, followed by a thematic narrative analysis.

RESULTS

Thirty-five studies were included. HPs' views were grouped in: Bringing out hope and Taking down hope. HPs believe that hope is elicited through a personal patient-provider bond and exhibited through medical treatment delivery. HPs face difficulties when delivering prognosis, referring to hospice, and providing palliation.

CONCLUSION

Hope is conveyed through verbal and non-verbal communication. HPs struggle to account for hope's shifting character, challenging the engagement in EOL discussions.

PRACTICAL IMPLICATIONS

Findings show a patient-provider clash of perspectives, suggesting a gap in acknowledging the shifting nature of hope. An important question emerges: Are the existing theories of hope that are solely explained from a patient experience relevant for HPs' own interpretation? Investigating the HPs' attitudes gathered in collective experiences in PC, might contribute to answering the question in the context of building more constructive communication approaches.

Shared meditation involving cancer patients, health professionals and third persons is relevant and improves well-being: IMPLIC pilot study

BACKGROUND

Alleviating suffering and improving quality of life are universally shared goals. In this context, we implemented a pilot study to assess the feasibility and acceptability of a mindfulness intervention in the form of meditation involving together cancer patients, health professionals, and third persons.

METHODS

Two groups of 15 participants equally composed of patients, health professionals and third persons were constituted. A dedicated programme on mindfulness and compassion was constructed, including 12 weekly sessions of 1.5 h and a half-day retreat. Adherence and satisfaction with the programme were evaluated. All participants completed questionnaires on perceived stress, quality of life, mindfulness, empathy, and self-efficacy. Burnout was assessed in health professionals.

RESULTS

Shared meditation was feasible as 70% of participants attended ≥ 80% of the 13 meditation sessions. Satisfaction with the programme was high (median satisfaction score: 9.1 out of 10) and all participants expressed positive attitudes towards shared meditation and a benefit on their global quality of life. Participants reported significant improvement in stress (p < 0.001), global quality of life (p = 0.004), self-efficacy (p < 0.001), and mindfulness skills (p < 0.001) from baseline to post-programme.

CONCLUSIONS

This study demonstrated the feasibility of a shared dedicated meditation programme in terms of participation and acceptability of participants. The measured benefits observed among participants furthermore justify the interest of a subsequent randomized study aiming to demonstrate the potential added value of shared meditation by promoting bridge-building between cancer patients, health professionals and others.

TRIAL REGISTRATION

ClinicalTrials.gov. NCT04410185 . Registered on June 1, 2020.

Perspectives from healthcare professionals on the nutritional adequacy of plant-based dairy alternatives: results of a mixed methods inquiry

BACKGROUND

Healthcare professionals are important sources of nutrition and health information for Americans. As plant-based (PB) dairy alternative products increase in popularity, concerns have been raised about their nutritional adequacy, and whether consumers understand nutritional differences to dairy. Healthcare professionals directly advise consumers on dietary choices, therefore we sought to examine their understanding and opinions of PB dairy alternatives.

METHODS

We analyzed comments submitted to the U.S. Food and Drug Administration (FDA) by health professionals (n = 191) in 2018-2019 in response to a request for public comment on the nutrition of PB dairy alternatives and the use of dairy terms like "milk", "cheese", and "yogurt" on their labels. Survey data from healthcare professionals (n = 417) was collected in 2020-2021. Comments and survey responses to open-ended questions were coded using template analysis and thematically analyzed. Logistic regression models examined perceptions across health professional characteristics for close-ended survey responses.

RESULTS

Three-fourths of health professionals believe consumers are confused about the nutritional differences between dairy and PB dairy alternatives. Over half (53%) do not believe either product is nutritionally superior to the other. Many believe dairy products have higher nutrient value, but also believe PB dairy alternatives can be part of a healthful diet. Compared to other types of health professionals, dietetics professionals demonstrated a more accurate understanding of the nutritional value of both products and were more likely to believe nutrients like protein (OR 2.02; 95% CI 1.22-3.34, p = 0.006) and vitamin D (OR 2.46; 95% CI 1.48-4.09, p = 0.001) may be nutrients of concern for PB dairy alternative consumers. They were also more likely to believe consumers are confused about these products (OR 3.44; 95% CI 1.65-7.21; p = 0.001). Health professionals who submitted comments to the FDA showed stronger opinions in favor of PB dairy alternatives.

CONCLUSIONS

Although PB dairy alternatives have nutritional value in certain diets, responses from health professionals suggest that changing their labeling to be different than dairy may reduce confusion. Improved nutrition education among health professionals may also be necessary.

Cervical cancer screening among HIV-positive women in urban Uganda: a cross sectional study

Background

Women living with Human Immunodeficiency Virus (HIV) are at a high risk for early development of cervical cancer. Adherence to cervical cancer prevention strategies in this population is vital for the early detection and treatment of cervical cancer. This study aimed to determine the prevalence and factors associated with cervical cancer screening among HIV-positive women attending an urban HIV care center in Uganda.

Methods

This cross-sectional study included 205 HIV-positive women receiving care at an urban HIV care center. An interviewer-administered questionnaire was used to capture sociodemographic information, history of screening for cervical cancer, and reproductive health characteristics. Logistic regression analysis was used to determine the factors associated with cervical cancer screening.

Results

Of the 205 HIV-positive women with a mean age of 37.5 ± 8.87 that participated in the study, majority (n = 201, 98%) were aware of cervical cancer screening. Ninety participants (44%) had ever been screened for cervical cancer and only 33 (16.1%) had been screened in the past year. Obtaining information about cancer of the cervix and cervical cancer screening from health care professionals was significantly associated with higher levels of cervical cancer screening (adjusted odds ratio = 5.61, 95% confidence interval: 2.50–12.61, p value < 0.001).

Conclusion

This study highlights the low prevalence of cervical cancer screening among HIV-positive women and underscores the role of health professionals as an effective source of information on cervical cancer and cervical cancer screening. Patient education programs in HIV prevention and care facilities should emphasize cervical cancer screening messages to enhance the uptake of screening services.

What do we know about written assessment of health professionals' communication skills? A scoping review

OBJECTIVE

The aim of this scoping review was to investigate the published literature on written assessment of communication skills in health professionals' education.

METHODS

Pubmed, Embase, Cinahl and Psychnfo were screened for the period 1/1995-7/2020. Selection was conducted by four pairs of reviewers. Four reviewers extracted and analyzed the data regarding study, instrument, item, and psychometric characteristics.

RESULTS

From 20,456 assessed abstracts, 74 articles were included which described 70 different instruments. Two thirds of the studies used written assessment to measure training effects, the others focused on the development/validation of the instrument. Instruments were usually developed by the authors, often with little mention of the test development criteria. The type of knowledge assessed was rarely specified. Most instruments included clinical vignettes. Instrument properties and psychometric characteristics were seldom reported.

CONCLUSION

There are a number of written assessments available in the literature. However, the reporting of the development and psychometric properties of these instruments is often incomplete. Practice implications written assessment of communication skills is widely used in health professions education. Improvement in the reporting of instrument development, items and psychometrics may help communication skills teachers better identify when, how and for whom written assessment of communication should be used.

"An uncomfortable topic": Health professionals' perspectives on child protection capacities, training offers and the potential need for action in Germany

Background

Child maltreatment, due to its high prevalence and often long-lasting (health and/or psycho-social) consequences, is one of the main reasons for global health inequalities. The medical field offers many opportunities to support affected children. This gives physicians and other health professionals the opportunity to provide protective measures and therapies to affected children at an early stage. However, the level of training concerning child protection is often too low among health professionals. This can affect the quality of care as well as providing the appropriate treatment and thus, the long-term (health) burden. The present work aims to survey the state of knowledge and capacities of health professionals regarding child protection in medicine and elicit health professionals' perspectives who absolved a child protection online course on a potential need for action in Germany.

Methods

From June 2016 until February 2021, 3,360 health professionals were interviewed. Using quantitative and qualitative items, the questionnaire assessed demographic and professional background information as well as assessments regarding the awareness of child protection, abilities in child protection among health professionals and training offers in medicine.

Results

The analysis indicates that the topic of child protection in medicine is not as present as the high prevalence of child maltreatment would imply. The majority (94.0%; n = 3.159) of the health professionals stated that they need more knowledge and capacities regarding child protection in medicine. More than half of the health professionals assessed the importance of the issue of child protection as low among health professionals. The reasons cited included child protection as an uncomfortable topic, an unwillingness among managers, and a lack of training on the topic.

Conclusions

There is too little awareness and importance regarding child protection in the medical field in Germany. Hence, it is difficult to ensure adequate care for those affected. Child protection topics should be mandatory in the training curricula of all health professionals, and quality standards for prevention and intervention should be implemented in medical institutions. Furthermore, networking in child protection has to be improved, and medical campaigns should address the topic to sensitize health professionals and society to the issue and to destigmatize the topic.

Understanding the impact of expert by experience roles in mental health education

BACKGROUND

People with lived experience of mental distress and mental health service use (known as Experts by Experience) in mental health education have demonstrated positive outcomes and attitudinal change in students. Despite these findings, academic positions for Experts by Experience remain limited in number and scope, and the implementation of positions has primarily been driven by supportive mental health academics (known as allies). Less is known about the impact on Experts by Experience themselves, their colleagues and the broader organisation.

OBJECTIVES

The aim of this research is to better understand the impact of EBE on the universities they work in, from the perspectives of allies who have supported the implementation and sustainability of their positions.

DESIGN

Qualitative exploratory.

SETTINGS

Academic institutions providing education programs for health professionals, and had implemented academic positions for Experts by Experience, in Australia, Ireland and New Zealand.

PARTICIPANTS

Allies involved in supporting the implementation of Experts by Experience roles in mental health education (n = 16).

METHODS

Ethics approval was obtained prior to study commencement. Individual in-depth interviews were conducted with 16 participants, based on a broad interview guide. Data were analysed to identify main themes. Analysis was conducted independently by two researchers and reviewed by the team.

RESULTS

Participants described the impact of Experts by Experience in mental health education as positively influencing the participants themselves, the Experts by Experience, their colleagues, and the broader organisational culture.

CONCLUSIONS

Support for the implementation of Experts by Experience roles must move beyond the efforts of allies alone. Demonstrating the benefits beyond student outcomes is crucial to achieving this goal. The positive impact for a broader range of stakeholders provides further evidence of the value of Experts by Experience and supports the need to develop a more strategic approach to implementation of these roles.

General biosafety measures for laboratory environments, outpatient clinics, medical centers, and veterinary hospitals during the SARS-CoV-2 pandemic

This study aimed to guide professionals working in veterinary laboratories, outpatient clinics, medical centers, and hospitals regarding the biosafety measures that should be adopted during the novel coronavirus (SARS-CoV-2) pandemic. While the population is not yet fully immunized by vaccines, the adoption of biosafety measures is essential to control the spread of circulating strains of the new coronavirus. Thus, the importance of professionals and collaborators following biosafety guidelines in different veterinary work environments is highlighted. The main protocols on biosafety to be adopted include frequent handwashing with water and soap or using 70% alcohol-based hand sanitizers, using personal protective equipment (PPE) (including gloves, lab coat, face mask), avoiding the contact of the hands with mucous membranes (eyes, nose and mouth), not sharing personal objects, keeping environments clean and well ventilated, social distancing of 1.5 m between individuals, and maintaining objects and surfaces regularly clean throughout the work environment. The transformation of work processes, such as various biosafety practices, is necessary within the context of the COVID-19 pandemic and improves the safety of professionals in their work environment and other people and animals, decreasing contamination risks in order to reduce the spread of this viral agent.

Workplace exercise program in a hospital environment: an effective strategy for the promotion of employees physical and mental health. A randomized controlled study

PURPOSE

The demanding and exhausting working hours, as well as the bad and unsuitable working conditions that prevail in several hospitals, affect employees' physical and mental health. The purpose of this study was to examine the effectiveness of a daily 6-week supervised workplace exercise program on health indices, functional capacity, overall fitness, subjective vitality, and life satisfaction in health professionals.

METHODS

A randomized controlled study was used. 50 health professionals (40-55 years), working in a hospital environment, were divided into two groups: exercise (EG) and control group (CG). EG performed a 6-week supervised concurrent chair-based exercise program (stretching, strength, balance exercises, aerobic dance; 5 days/week, 30-40 min/day, 2 workouts/day lasted 15-20 min) in the hospital. Health indices (body composition, blood pressure, respiratory function), functional capacity (flexibility, balance), physical fitness (strength, cardiorespiratory fitness), subjective vitality, and life satisfaction were measured before and after the completion of the program. Additionally, after the completion of the program, EG participants' enjoyment was assessed.

RESULTS

EG significantly increased (p < 0.001) lean body mass and respiratory function (range of mean increase 3.5-4.5%, depending on the variable), functional capacity (range of mean increase 18-40%, depending on the variable), lower and upper libs maximal strength (range of mean increase 10-25%, depending on the variable), subjective vitality (41.3%) and life satisfaction (21.5%); while significantly decreased (p < 0.001) heart rate during submaximal test (- 14%), body fat and blood pressure (range of mean decrease - 3.5% to - 5.5%, depending on the variable). In CG, all the above variables did not change. Furthermore, a great percentage of employees (95%) reported high levels of enjoyment.

CONCLUSION

A workplace exercise program may be safely used for the promotion of employees' physical and mental health.

What do Brazilian health professionals know about the frailty syndrome? A cross-sectional study

Background

The growing care demand for frail older adults and those at risk of frailty in primary health care (PHC) requires professionals trained in the subject to promote adequate care. This study aimed to analyze the self-reported, theoretical and practical knowledge of PHC professionals about the frailty syndrome.

Methods

This is an observational cross-sectional study with a sample of 485 Brazilian health professionals (bachelor’s degree) working in PHC with older adults. An electronic questionnaire was used to collect data on professional characteristics and self-reported, theoretical and practical knowledge concerning frailty phenotype. Agreement analysis between types of knowledge and multivariate logistic regression were performed to show the factors associated with knowledge about frailty.

Results

Theoretical knowledge showed the worse result, with 87.5% of the professionals describing the syndrome incorrectly. Roughly half the professionals self-reported (52.6%) very little/no knowledge concerning the syndrome and demonstrated low practical knowledge (55.1%) when identifying clinical cases. There were misconceptions about the syndrome, like it is natural from the aging process (83.3%) and is synonymous with disability and comorbidity (51.2%). The majority of the professionals were unaware of instruments for assessing frailty (77.9%) and the phenotype criteria (68.2%). No agreement was observed between the types of knowledge. Professionals specialized in or who had taken training courses in older adult health were 6.1 and 2.7-fold more likely, respectively, to self-reported some knowledge on the frailty syndrome.

Conclusions

PHC professionals presented little knowledge on the frailty syndrome. Most professionals were unaware of the frailty definition, its assessments for diagnosis and evidence for its treatment. The lack of knowledge on frailty could affect the care provided to older adults in primary care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-02927-6.

Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil

BACKGROUND

Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence of trauma. Additionally, little is known about the perceived applicability among clinicians of the new ICD-11 diagnosis of complex PTSD (CPTSD), despite its potential relevance for contexts of chronic trauma. The current study investigated local understandings of PTSD and CPTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city.

METHODS

Semi-structured interviews were conducted with 58 health professionals working at both the primary care and specialized mental health levels in two areas of São Paulo city with high levels of community violence.

RESULTS

Most participants knew about PTSD, but most did not know about CPTSD. There were mixed views concerning the commonality of PTSD among adolescents exposed to community violence. Many participants reported having no experience working with patients with the PTSD diagnosis. According to some, community violence was normalized by adolescents and health professionals, and did not result in PTSD. Others highlighted how they did not use psychiatric diagnoses in their practice, had critical perspectives towards psychiatric diagnoses and/or PTSD, or simply knew little about PTSD. Furthermore, many highlighted how the chronic nature of multiple traumas experienced by adolescents often resulted in complex clinical presentations characterised by many symptoms beyond PTSD. The diagnosis of CPTSD was considered appropriate to the context by many participants as it captured the complex traumatic histories and symptom presentations of adolescents exposed to community violence in Brazil.

CONCLUSIONS

These findings have important implications for the assessment and treatment of mental health among adolescents exposed to community violence in Brazil.

Sensitivity and specificity of a brief scale to evaluate psychological violence at work in Peruvian health professionals

Objective

Most studies in Latin America that evaluate psychological violence at work (PVW) focus on measuring occurrences of PVW. However, the discriminative validity and randomness of instruments used for evaluating incidents of PVW that are generated by agents internal to the workplace in the Peruvian health sector have not yet been studied. The objective of this study was to determine the sensitivity and specificity of the Scale of Psychological Violence in Health Professionals (SVP-Health) in the Peruvian population. For this purpose, a cross-sectional study based on the two-stage administration of guided surveys and ROC (receiver operating characteristic) curve analysis was performed.

Results

The study included 188 professionals from ten care centres in Peru. The professionals were divided into two groups of 94 subjects: those who had experienced PVW and those who had not. The average age of the participants was 36.8 ± 10.5 years; their work experience ranged between one and 35 years; and 59% of the sample were women. According to an analysis based on the ROC curve, (a) there was a significant area under the curve (AUC = 0.899) with adequate randomness; and (b) the SPV-Health adequately distinguished subjects with PVW from those without PVW (89% versus 94%).

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-05959-8.

A Qualitative Study Regarding COVID-19 Inpatient Family Caregivers' Need for Supportive Care

Background:

Family caregivers of COVID-19 inpatients are exposed to multiple sources of distress. These include not only losing friends, colleagues and members of the family, but also the fear of possible losses in sociality, finances and, impoverished communication with sick family members and health care providers.

Objective:

This study describes the psychological experience of COVID-19 inpatient family caregivers to highlight the main sources of distress, issues, concerns and unmet needs.

Methods:

Two focus groups were independently organized with COVID-19 inpatient family caregivers and health care personnel of COVID-19 wards in order to highlight family caregivers’ practical and psychological burden and related needs. A thematic analysis was conducted to analyze the data.

Results:

Family caregivers mentioned they needed more information about the patient’s condition with more attention being paid to their own emotional state. Feelings of impotence, concerns about how to deal with patient’s discharge, significant psychological distress, and anxiety were frequently reported by study participants.

Conclusion:

Study findings suggest the need to strengthen the assistance of COVID-19 patient family caregivers. In the pandemic scenario, family caregivers might represent a crucial resource, which can guarantee rapid discharges, support home health care and thus relieve pressure on hospital systems.

Risk of COVID-19 in Health Professionals: A Case-Control Study, Portugal

Introduction

Health professionals face higher occupational exposure to SARS-CoV-2. We aimed to estimate the risk of COVID-19 test positivity in health professionals compared to non-health professionals.

Methods

We conducted a test-negative case-control study using Portuguese national surveillance data (January to May 2020). Cases were suspected cases who tested positive for SARS-CoV-2; controls were suspected cases who tested negative. We used multivariable logistic regression modelling to estimate the odds ratio of a positive COVID-19 test (RT-PCR; primary outcome), comparing health professionals and non-health professionals (primary exposure), and adjusting for the confounding effect of demographic, clinical, and epidemiological characteristics, and the modification effect of the self-reported epidemiological link (i.e., self-reported contact with a COVID-19 case or person with COVID-19-like symptoms).

Results

Health professionals had a 2-fold higher risk of a positive COVID-19 test result (aOR = 1.89, 95% CI 1.69-2.11). However, this association was strongly modified by the self-report of an epidemiological link such that, among cases who did report an epidemiological link, being a health professional was a protective factor (aOR = 0.90, 95% CI 0.82-0.98).

Conclusion

Our findings suggest that health professionals might be primarily infected by unknown contacts, plausibly in the healthcare setting, but also that their occupational exposure does not systematically translate into a higher risk of transmission. We suggest that this could be interpreted in light of different types and timing of exposure, and variability in risk perception and associated preventive behaviours.

Do patients and family carers have different concerns about the use of medicines compared with healthcare professionals? A quantitative secondary analysis of healthcare concerns relating to adults with complex needs

OBJECTIVE

To identify concerns related to the use of medicines for adults with complex needs and explore whether these differed between healthcare professionals and patients/carers, in order to inform development of interventions to increase medication adherence.

METHODS

A quantitative secondary analysis of a database of healthcare professionals' and patients'/carers' healthcare concerns, related to adults with complex needs. Categories of concerns related to medicines use were identified and concerns related to medication use coded against these. Data were analysed descriptively, and a Chi-square test conducted to test for differences in responses from healthcare professionals versus patients/carers.

RESULTS

There was a significant difference in the types of medication concern raised by healthcare professionals versus those raised by patients/carers. Patients/carers expressed more concerns about side effects and interactions; healthcare professionals identified more concerns related to patient support and carers' knowledge/training.

CONCLUSION

Healthcare professionals had significantly different concerns about medicines to patients; this may be a potential barrier to medication adherence.

PRACTICE IMPLICATIONS

Healthcare professionals may need to adopt an approach to non-adherence that goes beyond education and counselling and adopts a wider patient perspective. Findings suggest that a greater focus on addressing side effects and interactions may be beneficial in increasing medication adherence.

Levels of vocational satisfaction, burnout and compassion fatigue of health professionals working in pediatric clinics

BACKGROUND

Burnout and compassion fatigue are affecting the quality of professional life.

AIM

To investigate the levels of vocational satisfaction, burnout, and compassion fatigue and factors that may be related to health professionals working in children’s clinics.

METHODS

The study sample was in the west of Turkey. Data were collected using the questionnaire form and the quality of life scale for employees.

RESULTS

The findings obtained in this study showed that the level of vocational satisfaction of female health professionals and the burnout level of male health professionals were higher. The professional satisfaction of the doctors was lower than that of the nurses and midwives, and the mean score of burnout and fatigue was high.

CONCLUSION

Further studies are needed on this topic to help improve the factors that may affect the professional quality of life of health professionals.