Preserving professional identities, behaviors, and values in digital professionalism using social networking sites; a systematic review

BACKGROUND

Despite a rapid rise of use of social media in medical disciplines, uncertainty prevails among healthcare professionals for providing medical content on social media. There are also growing concerns about unprofessional behaviors and blurring of professional identities that are undermining digital professionalism. This review tapped the literature to determine the impact of social media on medical professionalism and how can professional identities and values be maintained in digital era.

METHODS

We searched the databases of PubMed, ProQuest, ScienceDirect, Web of Science, and EBSCO host using (professionalism AND (professionalism OR (professional identity) OR (professional behaviors) OR (professional values) OR (professional ethics))) AND ((social media) AND ((social media) OR (social networking sites) OR Twitter OR Facebook)) AND (health professionals). The research questions were based on sample (health professionals), phenomenon of interest (digital professionalism), design, evaluation and research type. We screened initial yield of titles using pre-determined inclusion and exclusion criteria and selected a group of articles for qualitative analysis. We used the Biblioshiny® software package for the generation of popular concepts as clustered keywords.

RESULTS

Our search yielded 44 articles with four leading themes; marked rise in the use of social media by healthcare professionals and students, negative impact of social media on digital professionalism, blurring of medical professional values, behaviors, and identity in the digital era, and limited evidence for teaching and assessing digital professionalism. A high occurrence of violation of patient privacy, professional integrity and cyberbullying were identified. Our search revealed a paucity of existing guidelines and policies for digital professionalism that can safeguard healthcare professionals, students and patients.

CONCLUSIONS

Our systematic review reports a significant rise of unprofessional behaviors in social media among healthcare professionals. We could not identify the desired professional behaviors and values essential for digital identity formation. The boundaries between personal and professional practices are mystified in digital professionalism. These findings call for potential educational ramifications to resurrect professional virtues, behaviors and identities of healthcare professionals and students.

[Violence of users towards health and non-health professionals in Hospital Emergency Services: descriptive-comparative cross-sectional study.]

OBJECTIVE

Workplace violence is a public health problem that affects professionals in the hospital emergency services, being this environment where there is an intense interaction with users and / or relatives who require critical and / or special care. Given this, the aim of this study was to evaluate the exposure to user violence perceived by different health and non-health professionals in Emergency Services belonging to eleven Spanish hospitals.

METHODS

The design was an associative, descriptive-comparative cross-sectional strategy developed in 2019 with a sample of 584 healthcare and non-healthcare professionals from eleven Spanish hospital emergency services in eight Spanish autonomous communities. Non-parametric statistics were used for between-group comparisons, post-hoc analysis and the calculation of the effect size.

RESULTS

100% of respondents acknowledged having suffered workplace violence at least once in the last year. Specifically, at least eight out of every ten professionals were exposed to non-physical violence (range 85.1%-100%). The group that most perceived this violence was administration, followed by nursing, medicine and auxiliary nursing care technician (T.C.A.E) (H=28.881; p=0.001). While the manifestations of physical violence affected approximately three out of ten professionals (range 22.6%-29.5%), it is more present in the Auxiliary Nursing Care Technicians (T.C.A.E), followed by medical and nursing health professionals, as well as non-health professionals, orderlies and administration (H=9.800; p=0.05).

CONCLUSIONS

Our study shows the high prevalence of a medium or low intensity violent behavior in spanish Emergency Services. In addition, it allows to deepen in the different manifestations of violence received by the main professional groups of these services.

Understanding the Reasons Behind Healthcare Providers' Conscientious Objection to Voluntary Assisted Dying in Victoria, Australia

During the debates about the legalization of Voluntary Assisted Dying (VAD) in Victoria, Australia, the presence of anti-VAD health professionals in the medical community and reported high rates of conscientious objection (CO) to VAD suggested access may be limited. Most empirical research on CO has been conducted in the sexual and reproductive health context. However, given the fundamental differences in the nature of such procedures and the legislation governing it, these findings may not be directly transferable to VAD. Accordingly, we sought to understand how CO operates in the context of VAD. Prior to the implementation of the VAD legislation in June 2019, we conducted semi-structured interviews with seventeen health professionals with a self-declared CO to VAD, to explore what motivated their CO. Participants identified multiple motivations, which can be broadly categorized as: concerns for oneself; concerns for patients; concerns about the current Victorian legislation; and concerns for the medical profession. Participants' moral commitments included personal, professional, and political commitments. In some cases, one's CO was specific to Victoria's current legislation rather than VAD more broadly. Our findings suggest CO motivations extend beyond those traditionally cited and suggest a need to better understand and manage CO in the healthcare context.

The global prevalence of depression, anxiety, stress, and, insomnia and its changes among health professionals during COVID-19 pandemic: A rapid systematic review and meta-analysis

BACKGROUND

During the COVID-19 pandemic, the health professionals who are at the frontline of this crisis have been facing extreme psychological disorders. This research aims to provide an overall scenario of the prevalence of depression, anxiety, stress, as well as insomnia and to inspect the changes in these prevalence over time by analyzing the existing evidence during this COVID-19 pandemic.

METHODS

A systematic search was performed on March 30, 2021, in PubMed, MEDLINE, Google Scholar databases, and Web of Science. To assess the heterogeneity, Q-test,I 2 statistics, and Meta regression and to search for the publication bias, Eggers's test and funnel plot were used. The random-effect model and subgroup analysis were performed due to the significant heterogeneity.

RESULTS

Among eighty-three eligible studies in the final synthesis, 69 studies (n = 144649) assessed the depression prevalence of 37.12% (95% CI: 31.80-42.43), 75 studies (n = 147435) reported the anxiety prevalence of 41.42% (95% CI: 36.17-46.54), 41 studies (n = 82783) assessed the stress prevalence of 44.86% (95% CI: 36.98-52.74), 21 studies (n = 33370) enunciated the insomnia prevalence of 43.76% (95% CI: 35.83-51.68). The severity of the mental health problems among health professionals increased over the time during January 2020 to September 2020.

LIMITATIONS

A significant level of heterogeneity was found among psychological measurement tools and across studies.

CONCLUSIONS

Therefore, it is an emergency to develop psychological interventions that can protect the mental health of vulnerable groups like health professionals.

Clinical Ethics from the Islamic Perspective : A qualitative study exploring the views of Jordanian doctors

Like other Arab countries, Jordan must find ways of responding to the rapid processes of change affecting many aspects of social life. This is particularly urgent in healthcare, where social and technical change is often manifested in tensions about ethical decision-making in the clinic. To explore the attitudes, beliefs and concerns relating to ethical decision-making among health professionals in Jordanian hospitals, a qualitative study was conducted involving face-to-face interviews with medical personnel in four hospitals in Amman, the capital of Jordan. Data were analysed thematically in relation to a pre-existing set of ethical categories. Interviews were conducted with thirty-eight doctors covering most medical specialities. Five major themes emerged from the interviews: ethical awareness, ethical issues, the impact of religion on ethical decision-making, practical and theoretical resources for ethical decision-making, and challenges. While uncertainty was expressed about some aspects of Western approaches to ethics, participants strongly supported adoption of a range of Western bioethical principles, including cultural and ethical diversity, along with adherence to Islamic religious norms. A range of serious ethical challenges facing the Jordanian health system were identified, covering social, legal, managerial, and technical issues. Ethical decision-making in Jordan is complex, having to accommodate the needs of patients, the opinions of doctors and their families, the views of religious authorities, managerial considerations, and both local norms and international standards. Health professionals struggle with three sets of tensions that emerge out of the struggle between traditional, community-embedded forms of social organization and the demands generated by globalization and the influence of Western culture: the tensions between tradition and modernity, conservatism and pragmatism, and religion and secularism. Doctors in Jordan prefer approaches to ethical decision-making that realize a balance between the extremes, although the exact nature of where that balance should lie remains uncertain.

Engaging to innovate: an investigation into the implications of engagement at work on innovative behaviors in healthcare organizations

PURPOSE

Organizational innovation relies on the employees' active participation in improving extant processes and practices. In particular, it has been argued that employees' engagement triggers innovation-oriented behaviors at work. Nevertheless, there is a paucity of evidence of the implications of work engagement on the health professionals' innovation propensity. The article intends to push forward what we currently know about this issue, providing some food for thought to scholars and practitioners.

DESIGN/METHODOLOGY/APPROACH

A path analysis based on ordinary least square (OLS) regression and 10,000 bootstrap samples was designed to investigate the direct and indirect implications of employees' engagement on innovative behaviors at work in a large sample of health professionals operating in Europe. The quality of employee-manager relationships and the organizational climate were included as mediating variables affecting the relationship between work engagement and propensity to innovation-oriented behaviors.

FINDINGS

The research findings highlighted that being engaged at work fosters the willingness of health professionals to partake in the improvement of organizational processes and practices. The positive implications of employees' engagement on innovative behaviors at work are catalyzed by good employee-manager relationships and a positive organizational climate.

PRACTICAL IMPLICATIONS

Healthcare organizations should uphold the health professional's engagement to enhance their innovation potential. Targeted interventions are needed to merge work engagement with the enhancement of the organizational environment in which health professionals accomplish their activities. A positive organizational climate enacts an empowering work environment, which further incentivizes innovation.

ORIGINALITY/VALUE

The article adopts a micro-level perspective to investigate the triggers of innovative behaviors among healthcare professionals, providing evidence which is relevant for theory and practice.

Spiritual care in critically ill patients during COVID-19 pandemic

Introduction

Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic.

Purpose

The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic.

Methods

A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals.

Findings

During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare.

Discussion

These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Attitude and associated factors of COVID-19 vaccine acceptance among health professionals in Debre Tabor Comprehensive Specialized Hospital, North Central Ethiopia; 2021: cross-sectional study

Control of coronavirus disease through vaccination is not merely dependent on vaccine efficacy and safety. Professional and general public acceptance is vital for the successful control of the virus. This study aimed (1) to assess health professionals' attitude towards COVID-19 vaccine acceptance; (2) to identify factors associated with health professional's attitude towards COVID-19 vaccine acceptance. An Institutional based cross-sectional study was conducted on health professionals working at Debre Tabor Comprehensive Specialized Hospital. A structured questionnaire containing 16 items was used to assess the attitude of health professionals on vaccine acceptance. Bivariable and multivariable logistic analysis was done to identify factors associated with the attitude of health professionals. In this study, 42.3% [95% CI (36.7-47.6)] participants had positive attitude to COVID-19 vaccine acceptance. Age 30-39 years [AOR 2.23; (CI 1.23-4.04)] and ≥ 40 years [AOR 5.51; (CI 2.47-12.30)] of respondents have positive attitude than their counterparts. Also physicians [AOR 3.67; (CI 1.90-7.09)], pharmacists [AOR 4.27; (CI 1.39-13.09)] and laboratory professionals [AOR 4.56; (CI 1.34-15.39)] have higher attitude to COVID vaccine acceptance than nurses. In conclusion, the attitude level of health professionals on COVID-19 vaccine acceptance was poor. Age and profession were factors significantly associated with the attitude level of health professionals for COVID-19 vaccine acceptance.

Educating health professionals to implement evidence-based falls screening in hospitals

OBJECTIVE

International evidence-based guidelines advise traditional Falls Risk Assessment Tools (FRATs) should not be routinely used to predict the risk of a patient falling in hospital. However, disinvestment from existing services can be challenging. This study applied evidence-based approaches to education design to implement best practice guidelines.

DESIGN

Mixed methods using questionnaires to evaluate health professionals' knowledge of evidence-based falls risk assessment and mitigation, followed by semi-structured interviews with individual health professionals.

SETTING

Five Australian hospitals.

PARTICIPANTS

There were two cohorts per hospital; Cohort 1 (C1) comprised 10 clinical leaders from nursing and allied health professions. Cohort 2 (C2) included clinicians involved in routine hospital falls screening and prevention.

METHODS

46 clinical leaders received a 3-h high quality education workshop on the latest evidence in hospital falls risk assessment and how to implement a new falls screening and management tool. They were also taught the practical skills to deliver a 1-h education session to C2 (n = 129).

RESULTS

The education workshop significantly changed C1's views about evidence-based guidelines for falls screening and prevention. C1 were significantly more likely than C2 to feel confident in assessing falls risk and judging and implementing the best mitigation strategies. After the workshop, C1 were prepared and motivated to educate others on falls prevention and were satisfied with the skills gained. Six months after the workshop, C1 reported feeling more prepared for preventing falls.

CONCLUSION

Health professionals benefitted from an interactive education workshop on how to use a new evidence-based hospital falls screening tool to help mitigate risk. An abridged version of the workshop did not result in long lasting effects. Education is an important element aiding disinvestment from non-evidence-based services, and implementation of clinical guidelines.

Health-Related Lifestyles and Cancer-Preventive Behaviors of Medical and Nursing Students and Family Medicine Residents in Relation to the European Code Against Cancer

Family medicine (FM) residents and medical and nursing students play an important role in the development of preventive and health-promoting activities. The objective was to evaluate the health-related lifestyles and cancer-preventive behaviors of medical and nursing students and FM residents in relation to the European Code Against Cancer (ECAC). This was a descriptive, cross-sectional study performed in Spain. Medical and nursing students and FM residents completed a self-administered questionnaire focused on health-related habits and clinical behaviors related to the ECAC. A total of 740 participants completed the questionnaire. About 12.2% (95% CI [9.8-14.5]) were smokers, and 77.3% (95% CI [74.3-80.3]) sporadically consumed alcohol; 34.2% (95% CI [30.8-37.6]) practiced physical activity 2-3 times a week, and 12.1% (95% CI [9.8-14.5]) were overweight or obese. About 54.2% (95% CI [50.6-57.8]) regularly consumed vegetables. Differences were detected in the completion of screening tests for colorectal cancer (p < 0.001), breast cancer (p = 0.023), cervical cancer (p = 0.006), and prostate-specific antigen determination (p < 0.001) in relation to the participants' academic profiles. Our results reveal heterogeneous practices between the participants in terms of health-related habits. Awareness about the risks of smoking and being overweight were high; however, the perception of the risks associated with solar exposure and alcohol consumption was poor. There was general agreement upon the importance of performing screening tests for breast, cervical, and colorectal cancer, but there were discrepancies related to the need to perform the prostate cancer screening test.

Detection of SARS-CoV-2 virus using an alternative molecular method and evaluation of biochemical, hematological, inflammatory, and oxidative stress in healthcare professionals

In early December 2019, an outbreak of coronavirus disease 2019 caused by a new strain of coronavirus (SARS-CoV-2), occurred in the city of Wuhan, Hubei Province, China. On January 30, 2020, the World Health Organization (WHO) declared the outbreak a public health emergency of international concern. Since then, frontline healthcare professionals have been experiencing extremely stressful situations and damage to their physical and mental health. These adverse conditions cause stress and biochemical, hematological, and inflammatory changes, as well as oxidative damage, and could be potentially detrimental to the health of the individual. The study population consisted of frontline health professionals working in BHU in a city in southern Brazil. Among the 45 participants, two were infected with the SARS-CoV-2 virus and were diagnosed using immunochromatographic tests such as salivary RT-LAMP and qRT-PCR. We also evaluated biochemical, hematological, inflammatory, and oxidative stress markers in the participants. The infected professionals (CoV-2-Prof) showed a significant increase in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), cholesterol, lactic dehydrogenase, lymphocytes, and monocytes. In this group, the levels of uric acid, triglycerides, leukocytes, neutrophils, hemoglobin, hematocrit, and platelets decreased. In the group of uninfected professionals (NoCoV-2-Prof), significant increase in HDL levels and the percentages of eosinophils and monocytes, was observed. Further, in this group, uric acid, LDH, triglyceride, and cholesterol levels, and the hematocrit count and mean corpuscular volume were significantly reduced. Both groups showed significant inflammatory activity with changes in the levels of C-reactive protein and mucoprotein. The NoCoV-2-Prof group showed significantly elevated plasma cortisol levels. To our kowledge, this study is the first to report the use of the RT-LAMP method with the saliva samples of health professionals, to evalute of SARS-CoV-2.

"This may be a really good opportunity to make the world a more autism friendly place": Professionals' perspectives on the effects of COVID-19 on autistic individuals

BACKGROUND

The COVID-19 (C-19) pandemic affects everyone. Autistic individuals may be at increased risk of experiencing difficulties coping with the impact of C-19 (e.g. due to unexpected changes to usual activities and routines, and the general sense of uncertainty). This preliminary study gathered the perspectives of health and social care professionals, and researchers, about: (1) vulnerability factors for coping with the pandemic; (2) the impact of the pandemic; (3) service provision during the pandemic; and (4) interventions to support reintegration during and post the pandemic.

METHOD

We conducted an online survey, comprising Likert-scale and free text responses. Quantitative data were analysed descriptively, and qualitative data thematically.

RESULTS

Thirty-seven participants, working in clinical, education and academic settings with autistic individuals, completed the survey. C-19 had substantially impacted service provision, causing major disruption or loss of services. Thematic analysis indicated six overarching themes: (1) vulnerability factors for coping with C-19 and lockdown; (2) positive and negative impact of lockdown (for autistic individuals, families and professionals); (3) public health response to C-19; (4) service provision during the pandemic; (5) inequalities; and (6) looking to the future.

CONCLUSIONS

Professionals, across disciplines and settings, must now work together with autistic individuals and their families, to understand the impact of these extraordinary circumstances and develop ways everyone can be supported more effectively.

Health professional's willingness to advocate for strengthening global commitments to the Paris climate agreement: Findings from a multi-nation survey

Health professionals have the potential to address the health threats posed by climate change in many ways. This study sought to understand the factors that influence health professionals' willingness to engage in climate advocacy. We hypothesized and tested a model with six antecedent factors predicting willingness to engage in advocacy for strengthening global commitments to the Paris Agreement. Using survey data from members of health professional associations in 12 nations (n = 3,977), we tested the hypothesized relationships with structural equation modeling. All of the hypothesized relationships were confirmed. Specifically, higher rates of perceived expert consensus about human-caused climate change predicted greater climate change belief certainty and belief in human causation. In turn, all three of these factors, including higher levels of perceived health harms from climate change, positively predicted affective involvement with the issue. Affective involvement positively predicted the feeling that health professionals have a responsibility to deal with climate change. Lastly, this sense that climate advocacy is a responsibility of health professionals strongly predicted willingness to advocate. As a unique study of predictors of health professionals' willingness to advocate for climate change, our findings provide unique insight into how an influential set of trusted voices might be activated to address what is arguably the world's most pressing public health threat. Limitations of the study and suggestions for future research are presented, and implications for message development are discussed.

[The wish to hasten death: Definition, determinants, issues and perspectives]

In palliative care, it is not uncommon for people with serious illnesses to wish to hasten their death. These wishes present considerable challenges for health care professionals. The purpose of this review is to support healthcare professionals in their understanding and apprehension of patients' wishes to hasten their death. In order to do so, we will present the definition of this wish, and then we will study it, based on three main components, which are intentions, motivations and interactions. The common thread of this review lies in the following question: how to best support the human who faces death?

A Latent Class Analysis of Attitudes Towards Asylum Seeker Access to Health Care

In the past decade there has been an increase in focus on the concept of deservingness and how it plays out in debates around health care for migrant populations with precarious legal status. This study uses latent class analysis to identify subtypes of attitudes regarding asylum seeker access to health care and endorsement of support for asylum seeker access to care among 4066 employees of health care institutions in Montreal and Toronto, Canada. Authors identified four classes of attitudes towards asylum seeker access to care named 'Favorable,' 'Opposed,' 'Ambivalent/Reactive,' and 'Unconcerned/Status quo'. The odds of endorsing access to health care depended on the individual's class membership of asylum seeker attitude. Although there are segments of the population that overwhelmingly endorse, or reject, asylum seeker access to care, there are important variants in opinions and beliefs. Interventions are needed to engage professionals more ambivalent or opposed to asylum seeker access to care.

[I don't know whether I'm coming or going-Challenges of part-time students during the COVID-19 pandemic]

BACKGROUND

Due to the COVID-19 pandemic, universities had to switch to online teaching as quickly as possible. Part-time students who work in the healthcare sector have to manage the balancing act between an invariably online education and a mandatory physical attendance in a profession that maintains the system.

AIM

The aim of the study was to explore the challenges faced by part-time students working in the healthcare sector, to identify the need for change and to derive recommendations for action for the university.

METHODS

The data were collected using an open response online questionnaire. The obtained data were evaluated according to the qualitative content analysis of Mayring.

RESULTS

Probably the greatest challenges that part-time students have to deal with, are the self-organized learning or the (on time) accomplishment of work assignments, which are often perceived as too extensive, and the independent development of teaching content. Furthermore, part-time students reported about the difficultness to reconcile e‑learning and work and/or family.

CONCLUSION

These perceived challenges are not new but since additional family commitments and uncertainty of daily work routine are added, these challenges are gaining in importance during COVID-19. Therefore, learning environments, which are currently offered to part-time students, must be understood as caring spaces. In addition to new didactic concepts, universities should invest in the promotion of students' personal and social competencies.

Online respondent-driven detection for enhanced contact tracing of close-contact infectious diseases: benefits and barriers for public health practice

BACKGROUND

Online respondent-driven detection (RDD) is a novel method of case finding that can enhance contact tracing (CT). However, the advantages and challenges of RDD for CT have not yet been investigated from the perspective of public health professionals (PHPs). Therefore, it remains unclear if, and under what circumstances, PHPs are willing to apply RDD for CT.

METHODS

Between March and April 2019, we conducted semi-structured interviews with Dutch PHPs responsible for CT in practice. Questions were derived from the 'diffusion of innovations' theory. Between May and June 2019, we distributed an online questionnaire among 260 Dutch PHPs to quantify the main qualitative findings. Using different hypothetical scenarios, we assessed anticipated advantages and challenges of RDD, and PHPs' intention to apply RDD for CT.

RESULTS

Twelve interviews were held, and 70 PHPs completed the online questionnaire. A majority of questionnaire respondents (71%) had a positive intention towards using RDD for CT. Anticipated advantages of RDD were 'accommodating easy and autonomous participation in CT of index cases and contact persons', and 'reaching contact persons more efficiently'. Anticipated challenges were 'limited opportunities for PHPs to support, motivate, and coordinate the execution of CT', 'not being able to adequately convey measures to index cases and contact persons', and 'anticipated unrest among index cases and contact persons'. Circumstances under which PHPs anticipated RDD applicable for CT included index cases and contact persons being reluctant to share information directly with PHPs, digitally skilled and literate persons being involved, and large scale CT. Circumstances under which PHPs anticipated RDD less applicable for CT included severe consequences of missing information or contact persons for individual or public health, involvement of complex or impactful measures for index cases and contact persons, and a disease being perceived as severe or sensitive by index cases and their contact persons.

CONCLUSIONS

PHPs generally perceived RDD as a potentially beneficial method for public health practice, that may help overcome challenges present in traditional CT, and could be used during outbreaks of infectious diseases that spread via close contact. The circumstances under which CT is performed, appear to strongly influence PHPs' intention to use RDD for CT.

[Collaboration experience between hospitals and long-term care facilities for the care of COVID-19 patients.]

OBJECTIVE

The disease produced by SARS-CoV-2 has led to severe situations and mortality in elderly people. The objective of this study was to describe the collaboration between hospital professionals and nursing homes when applying preventive measures for the transmission of COVID-19 and in the assistance of institutionalized patients.

METHODS

A descriptive study was carried out in 4 centers with information collected by researchers in two moments of the COVID-19 pandemic. The information collected was related to the resources and knowledge of infection prevention, details about face-to-face and telematic assistance from the hospital team, as well as material, drugs provided, and clinical results. The variables studied were described by means of percentages, absolute frequencies and ratios; statistical chi-square tests and McNemar'test were used.

RESULTS

The study was conducted in 4 centers with a total of 640 residents and an initial occupancy between 62% and 85%. Differences were found regarding the ratio of staff and knowledge of preventive measures of the transmission of SARS-CoV-2 infection, which was improved in the second period of the study. The number of face-to-face visits (from 5 to 22) and telematic visits (between 42 and 109 patients) were different in the 4 nursing homes, as well as the material provided, adapted to the needs of each center. The percentage of infected patients ranged from 6.1% to 90.2%, and the accumulated mortality in the second period ranged from 15.38% to 38.35% of the residents at the beginning of the pandemic.

CONCLUSIONS

The collaboration between the professionals of healthcare centers and the hospital, adapted to the needs of each center, has allowed to improve the assistance to the residents and the coordination between the professionals, optimizing the available resources.

Knowledge, attitude, practice and associated factors of health professionals towards podoconiosis in Gamo zone, Ethiopia, 2019

Background

Podoconiosis is entirely preventable, non-communicable disease with high potential of elimination. The prevalence of podoconiosis in Ethiopia was 7.45%. One of the pillars for elimination of podoconiosis is morbidity control and management. Therefore, the present study aimed to assess the knowledge, attitude, practices and associated factors of health professionals towards podoconiosis cause, prevention and treatments.

Methods

Facility based cross-sectional study was conducted. The source population was all health professionals currently working in public health facilities. The final estimated sample size was 349. A pretested self-administrated structured questionnaire was used to collect the data. The data were coded, entered, and cleaned by using Epi.info version7, and analyzed by using SPSS version 20.

Result

A total of 320 health professionals participated in the study. Sixty eight (23.1%) health professionals had poor knowledge towards podoconiosis. Seventy (21.9%) identified podoconiosis as infectious disease. Profession, address of health facility, service year and attitude of participants were significantly associated with knowledge towards podoconiosis. More than half (56%) had favorable attitude towards podoconiosis patients. Knowledge score (95%CI: 1.389, 4.059, p-value = 0.002) was the independent predictor for attitude status. Very few (11.6%) respondents treated podoconiosis patients. Age group 45 years old and above and training on lymphedema morbidity management and disability prevention were significantly associated with clinical experience in treating affected patients, (AOR = 17.345; 95%CI: 4.62, 65.119) and (AOR = 7.385; 95%CI: 2.5, 21.797), respectively.

Conclusion

Despite, high percent of good knowledge of health professionals towards podoconiosis, clinical experience of health professionals in treating podoconiosis patients was very low. In-service trainings will be given for health professionals to improve treatment. In podoconiosis endemic districts hygiene supplies and other referencing materials should be made available for podoconiosis case management.

What Is Frailty? Perspectives from Chinese Clinicians and Older Immigrants in New Zealand

This qualitative study explores the meanings of frailty held by Chinese New Zealanders and Chinese health care professionals with the aim of identifying commonalities as well as potential differences. Two guided focus groups with Mandarin and Cantonese speaking older adults (n = 10), one individual interview with a English speaking older Chinese, and one focus group with Chinese New Zealand health care professionals (n = 7) were held to obtain views on frailty in older adults, followed by transcribing and a thematic qualitative analysis. Three main themes emerged: (1) Frailty is marked by ill-health, multiple chronic and unstable medical comorbidities, and is a linked with polypharmacy; (2) Frailty can involve physical weakness, decline in physical function such as reduced mobility or poor balance, and declining cognitive function; and (3) Frailty is associated with psychological and social health including depression, reduced motivation, social isolation, and loss of confidence. The perspectives of frailty that emerged are congruent with a multi-dimensional concept of frailty that has been described in both Chinese and non-Chinese medical research literature.

Applying systematic review search methods to the grey literature: a review of education and training courses on breastfeeding support for health professionals

BACKGROUND

Currently, lactation training courses aimed at health professionals are important for informing and supporting mothers who are breastfeeding. In this review, we seek to analyze similarities and/or variations in course content, modes of delivery, costs, teaching style and learning strategies among courses. To our knowledge, a review of lactation training courses available worldwide is lacking. Thus, the aim of this review is to describe course models aimed at training health professionals in lactation support for mothers.

METHODS

Through searching grey literature, training courses were obtained from several directories, including the Alaska Breastfeeding Coalition, International Board of Lactation Consultant Examiners (IBLCE), International Lactation Consultant Association (ILCA), Lactation Education Accreditation Association and Approval Review Committee (LEAARC), World Alliance for Breastfeeding Action (WABA), World Health Organization (WHO), and United Nations Children's Fund (UNICEF).

RESULTS

Descriptions of ten training programs were included in the final review. Our group found variations in costs, modes of delivery and duration among courses.

CONCLUSIONS

Certified training for health professionals in lactation is a promising approach for increasing and protecting breastfeeding. Breastfeeding mothers might also benefit from specifically trained health professionals, yet, well-conducted research on such training courses is still required. The variability in the mode of teaching, tuition costs and course content in breastfeeding education programs around the globe must be kept in mind when considering providing training on the optimal competency for health professionals.

Family planning practices and opinions on population growth of family planning healthcare providers in Turkey

The purpose of this study was to investigate the opinions of health professionals (HPs) who provide family planning counselling (FPC) within the scope of primary health care services since they are perceived as role models by the society. The number of HPs providing family planning counselling in primary health services in Turkey was 43,000 and 40,000 of these individuals were invited to participate in this observational, cross-sectional study via e-mail and social media. There were 740 responders and all were included in the study. Physicians providing FPC within the scope of primary health care services consisted of 45.1% of the responders and the remaining were nurses. Among all HPs, 59.7% had insufficient awareness regarding Turkey's population growth. Most of the HPs (52.4%) believed that the ideal number of children was 2 or less. The abortion rate was 9.1% in all pregnancies of HPs. The rate of caesarean section was 56% in all live births. According to responses, 75.6% of all pregnancies experienced by HPs were planned. According to 42.1% of the HPs, abortion must be performed if there is a life-threatening situation for the mother or if the fetus has some abnormalities. The most common method of birth control used by married HPs between the ages of 18 and 49 was male condoms (39.9%), while the pull-out method ranked first in the general population (25.5%). It was found that HPs, who had different opinions and practices about family planning than the general population, had insufficient awareness regarding population growth. Increased awareness of demography and FPC among HPs will likely contribute to the quality of service and the general wellbeing of the population.

Improving community-based care for children with a rare condition: The example of long-segment congenital tracheal stenosis and perceptions of health professionals, parents and teachers

BACKGROUND

Long segment congenital tracheal stenosis (LSCTS) is a rare, complex condition which is often poorly understood by community-based health professionals (HPs). Anecdotally, such HPs often lack confidence providing care for children, resulting in children being brought to the tertiary centre more frequently than necessary. We wanted to identify the information and support needs of HPs in primary and secondary care looking after a child with LSCTS, the views of those providing education to these children, and elicit parents' perceptions about community-based services, to improve overall care for children and families.

METHOD

Questionnaires were sent to 175 community-based HPs and 34 teachers involved in the care of children with LSCTS. Face-to-face or telephone interviews were conducted with 12 parents of patients with LSCTS to establish their perceptions of community-based services.

RESULTS

Ninety (51%) completed questionnaires were returned from HPs and 18 (53%) from teachers. Responses indicated low levels of knowledge of LSCTS. Physical, practical and communication information needs were identified by all respondent groups, together with general and condition-specific concerns. Interviews with parents indicated that they thought the level of knowledge about LSCTS in the community was low, which had a negative impact on their willingness to consult local services. Better information provision for HPs, teachers and parents was identified as a means of improving outcomes.

CONCLUSION

Professionals caring for children with LSCTS in the community and in schools have unmet information and support needs, with consequences for children, families, HCPs in both the community and tertiary hospital, and teachers.

Perceptions, attitudes and training needs of primary healthcare professionals in identifying and managing frailty: a qualitative study

PURPOSE

Although frailty can be delayed or prevented by appropriate interventions, these are often not available in countries lacking formal education and infrastructure in geriatrics. The aim of this study was to: (a) explore ideas, perceptions and attitudes of primary health care (PHC) professionals towards frailty in a country where geriatrics is not recognised as a specialty; (b) explore PHC professionals' training needs in frailty; and (c) define components of a frailty educational programme in PHC.

METHODS

Qualitative design, using two focus groups with PHC professionals conducted in Thessaloniki, Greece. Focus groups were audio recorded and transcribed. Data were analysed with thematic analysis.

RESULTS

In total 31 PHC professionals (mean age: 46 years; gender distribution: 27 females, 4 males) participated in the study (physicians n = 17; nurses n = 12; health visitors n = 2). Four main themes were identified: (1) Perceptions and understanding of frailty; (2) Facilitators and barriers to frailty identification and management; (3) Motivation to participate in a frailty training programme; (4) Education and training. The main barriers for the identification and management of frailty were associated with the healthcare system, including duration of appointments, a focus on prescribing, and problems with staffing of allied health professionals, but also a lack of education. Training opportunities were scarce and entirely based on personal incentive. Professionals were receptive to training either face-to-face or online. A focus on learning practical skills was key.

CONCLUSION

Education and training of professionals and interdisciplinary collaboration are essential and much needed for the delivery of person-centred care for people with frailty living in the community.

Staff Experiences at a New York City Medical Center During the Spring Peak of the Covid-19 Pandemic: A Qualitative Study

Purpose

In March-April 2020, New York City was overwhelmed by COVID-19 infections, leading to substantial disruptions in nearly all aspects of care and operations at most local hospitals. This qualitative study of a quaternary, urban oncology hospital investigated the effects of these disruptions upon a professionally diverse cohort of its employees, including physicians, nurses, respiratory therapists, pharmacists, security guards, histology technicians, and environmental services workers.

Methods

The participant pool were selected through a combination of purposive and random sampling methodology and coders performed a thematic content analysis of open-ended responses.

Results

Analysis revealed several important themes, including concerns about exposure for self and others; patient care as a source of both satisfaction and stress; psychological consequences of uncertainty and ambiguity; family as sources of both comfort and apprehension; the importance of adequate institutional communication; and support from colleagues.

Conclusion

Results and analysis provide suggestions for institutional policies and initiatives in the event of a COVID-19 surge or another public health crisis. Administrative efforts should aspire to establish, strengthen, and promote interdisciplinary and interdepartmental efforts to address, and mitigate workplace and personal stressors. through timely and transparent communications, consistent clinical guidance and information about changes in hospital policies and supplemental employee assistance.