Use of the Internet for health information by physicians for patient care in a teaching hospital in Ibadan, Nigeria

Modelling of physicians' clinical information-seeking behaviour in Iran: a grounded theory study

OBJECTIVES

Exploring clinical information-seeking behaviour (CISB) and its associated factors contributes to its theoretical advancement and offers a valuable framework for addressing physicians' information needs. This study delved into the dimensions, interactions, strategies and determinants of CISB among physicians at the point of care.

DESIGN

A grounded theory study was developed based on Strauss and Corbin's approach. Data were collected by semistructured interviews and then analysed through open, axial and selective coding.

SETTING

The study was conducted at academic centres affiliated with Isfahan University of Medical Sciences.

PARTICIPANTS

This investigation involved recruiting 21 specialists and subspecialists from the academic centres.

RESULTS

The findings revealed that physicians' CISB encompassed multiple dimensions when addressing clinical inquiries. Seven principal themes emerged from the analysis: 'clinical information needs', 'clinical question characteristics', 'clinical information resources', 'information usability', 'factors influencing information seeking', 'action/interaction encountering clinical questions' and 'consequences of CISB'. The core category identified in this study was 'focused attention'.

CONCLUSIONS

The theoretical explanation demonstrated that the CISB process was interactive and dynamic. Various stimuli, including causal, contextual and intervening conditions, guide physicians in adopting information-seeking strategies and focusing on resolving clinical challenges. However, insufficient stimuli may hinder physicians' engagement in CISB. Understanding CISB helps managers, policy-makers, clinical librarians and information system designers optimally implement several interventions, such as suitable training methods, reviewing monitoring and evaluating information systems, improving clinical decision support systems, electronic medical records and electronic health records, as well as monitoring and evaluating these systems. Such measures facilitate focused attention on clinical issues and promote CISB among physicians.

Learning outcomes from a systematic review workshop series for junior doctors

BACKGROUND

Systematic reviews provide the highest level of evidence about a topic. Ten-week workshops in conducting systematic reviews were held with hospital doctors in 2019 and 2020.

AIM

This study analysed participants' feedback about the systematic review workshops to improve how we teach clinicians about conducting systematic reviews.

METHODS

Attendees completed a post-workshop survey (with multiple-choice and free-text items) to assess knowledge and skills gained. We compared the responses of senior and junior doctors. We used descriptive statistics for the quantitative data and compared groups using Χ2 testing. Qualitative data were analysed using conceptual content analysis.

RESULTS

Of 81 attendees, 52% completed the survey. Of those, 69% had no prior experience with systematic reviews, 93% reported increased knowledge and ability to conduct research and 69% reported increased ability to conduct systematic reviews. More senior than junior clinicians reported gaining knowledge about writing and publishing (37% vs 11%, P = 0.047) and making greater use of skills gained to conduct research (56% vs 23%, P = 0.029). Five themes were identified: learning through course structure; learning through course organisation; teaching style; flexible learning; and suggestions for progression and improvement. Respondents suggested running the workshops during protected teaching time, more time for some sessions, conducting the workshop series more often and making clinicians aware of the workshop series at hospital orientation.

CONCLUSION

The skills learnt from the systematic review workshop series impacted not only participants' research knowledge and skills, and plans to conduct future research, but also facilitated looking up medical literature in daily clinical work, supporting evidence-based clinical practice.

Use of social media for COVID-19-related information and associated factors among health professionals in Northwest Ethiopia: A cross-sectional study

Background

Social media has become an alternative platform for communication during medical crises like the COVID-19 pandemic. This study aimed to assess social media usage for COVID-19-related information among health professionals.

Method

A quantitative cross-sectional study design was conducted among 370 health professionals. The data were analyzed using SPSS version 25 software. Data were collected using a semi-structured, self-administered, and pre-tested questionnaire. Descriptive and binary logistic regression analysis techniques were used to describe respondents’ social media usage for COVID-19 information and identify its associated factors.

Results

About 54% (95% CI: 48–58%) of the participants had good social media usage for COVID-19-related information. Age≤30 (AOR = 2.02, 95% CI: 1.14–3.58), Wi-Fi/broadband Internet access (AOR = 2.45, 95% CI: 1.38–4.33), taking computer training (AOR = 2.58, 95% CI: 1.37–4.85), basic computer skill (AOR = 3.28, 95% CI: 1.71–6.29), and usefulness of social media (AOR = 3.56, 95% CI: 1.57–8.04) were found to be the significant factors associated with usage of social media for COVID-19-related information.

Conclusion

The present study confirms that more than half of health professionals had good social media usage for COVID-19-related information. This shows that social media platforms can be used as a source of COVID-19-related information for health professionals if basic computer training is offered, internet connection is available in the workplace, and the usefulness of social media is emphasized.

Analysis of Reference Practices among Practicing Orthopaedicians in India

PURPOSE

On-The-Go (OTG) references are those that clinicians make within a tight deadline at the point of patient care to direct critical decisions. We conducted this study to assess the knowledge level of orthopaedicians on clinical usefulness and quality appraisal of different reference methods along with their attitude towards its utility for practice.

MATERIALS AND METHODS

A web-based survey was administered through Google Forms among the members of the Tamil Nadu Orthopaedic Association (TNOA) by snowball sampling method. The survey was designed by the Quality Appraisal Committee (QAC) of Orthopaedic Research Group (ORG) with 17 items. Association and correlation analysis were done between different responses in the survey to find out ways to improve the reference practices.

RESULTS

177 participants with a mean age of 43.5 years completed the survey. About 45.8% (n = 81) of participants had prior knowledge on  the Oxford Levels of Evidence. However, they were not familiar with using them for critical appraisal of evidence. About 86.5% (n = 153) of participants were worried about the quality of the content they seek for reference. Among the reference sources, online research articles were used by 54.2% (n = 96), digital applications by 21.4% (n = 38), digital textbooks by 15.2% (n = 27), and other methods like peer discussion by 5.1% (n = 9). A significant association was noted between the participants who chose level I studies for their reference and their familiarity with the concept of fragility (p = 0.006) and heterogenicity (p = 0.021) and types of bias (p = 0.003). A significant association was noted between participants with active journal subscription and their familiarity with the concept of spin (p = 0.016) and their knowledge of the heterogeneity of study results (p = 0.019). We found a significant association between age (< 40 years of age) and knowledge on various types of bias (p = 0.032), heterogenicity (p = 0.01), and fragility (p = 0.021).

CONCLUSION

This is the first study on the information-seeking behaviour of the orthopaedicians. OTG references remain a part of the orthopaedic practice and are made mostly by accessing online research articles. Imparting knowledge of their quality appraisal should be an active part of the orthopaedic curriculum. This will, in turn, improve the attitude and reference practices leading to better decision-making towards patient care.

Personal, technical and organisational factors affect whether physicians seek answers to clinical questions during patient care: a literature review

BACKGROUND

Numerous questions are generated for physicians during patient care. Facilitators and barriers affect the physicians' clinical information-seeking behaviour. While most health studies have focused on barriers, few have dealt with facilitators.

OBJECTIVE

This review aimed to identify facilitators in physicians' information-seeking behaviour to help respond to clinical questions raised during patient care.

METHODS

A narrative review was conducted, and 9 databases were searched. Selection criteria included original articles in the context of patient care and full-text articles published in the English language from 2002 to 2019. The articles were selected and analysed by group discussions.

RESULTS

Analysis of studies disclosed personal, technical and organisational facilitators including 26 themes. Internet utilisation and information searching skills, more available time, personal interests and knowing preferred sites or textbooks were among the personal factors. The most common technical factors included providing navigation support, and ease of searching and finding needed information. The most commonly reported factors at the organisational level are closeness to Internet facility and access during the consultation.

CONCLUSION

Information systems designers, health service managers and librarians may need to work together to provide systems and settings that encourage doctors to seek information to answer their clinical questions during patient care.

Clinical information seeking behavior of physicians: A systematic review

INTRODUCTION

Physicians encounter a large number of questions during patient care. Therefore, finding high-quality evidence provides a good opportunity to improve patient care and continue learning.

OBJECTIVES

The present study aims to obtain a comprehensive understanding of the physicians' clinical information-seeking behavior.

METHODS

A systematic review was conducted according to the PRISMA guidelines. The Web of Science, PubMed, Scopus, ProQuest, Emerald, Wiley Online Library, Science Direct, Cochrane Library, and Embase databases were systematically searched based on the defined criteria. The inclusion criteria were the original articles in the context of patient care and full-text articles published in English from 2002 to 2017. The articles were reviewed, selected, and analyzed in group discussions.

RESULTS

Seventy-three articles met the study criteria. Therapy, diagnosis, and epidemiology ranked the highest ones among physicians' information needs. The mean frequency of questions raised during patient care was varied from 0.18 to 1.5 per patient, and the percentage of questions answered ranged between 22.8 and 93 %. The time taken to find the answers to the questions was between 2 to 32 min. Consultation with colleagues, alongside reviewing journal articles, Internet websites, textbooks, and MEDLINE/PubMed were the most frequently used sources reported in the retrieved articles. Further, common search strategies used by physicians included keywords, Boolean operators, similar medical terms, and advanced search. In addition, lack of time, and information searching skills and the unawareness of accessible sources were the most frequent barriers while easily searching and finding information and summaries and synthesized evidence-based materials mainly facilitated information seeking.

CONCLUSIONS

Physicians increasingly encounter clinical point-of-care questions. However, the facilitation of accessing online information sources has not enabled the physicians to find answers to many of their questions. Considering the fact that they often refer to colleagues, Internet websites, and databases to find answers, the quality of information should be improved by evaluating the physicians' information-seeking behavior in the first stage, and developing information technology in a point-of-care environment, integrating EHR systems to communicate with colleagues, and accessing databases in the second stage.

Frequency of Use, Perceptions and Barriers of Information and Communication Technologies Among Latin American Physicians: An Ecuadorian Cross-Sectional Study

Objective

In recent years, the use of information and communication technologies (ICTs) has increased in various sectors, among which the healthcare service is no exception. However, studies have mostly focused on the use of ICTs among patients with chronic diseases, with few reports on the advantages and barriers of these technologies among physicians, particularly in Latin America. We designed this study to fill in the gap, as an objective assessment of the frequency of use, perceptions, and barriers of ICTs among physicians remains crucial for a successful implementation of these technologies into the mainstream medical practice.

Methods

We conducted an anonymous cross-sectional survey-based study in 640 Ecuadorian physicians. The survey used consisted of 13 items and evaluated the frequency of use, perceptions, and barriers of ICTs among physicians. Chi-square tests for goodness of fit and independence were performed, whilst Phi coefficient was interpreted to assess the strength of associations. Fisher exact test was performed when required.

Results

Over 90% of physicians reported the use of ICTs to message other colleagues and patients (p=0.000). While 89.5% of physicians used social media to interact with other colleagues, only 58.1% used them to interact with patients (p=0.000). Most participants reported the use of ICTs to search for academic information (p=0.000). Moreover, more than 80.0% agree that ICTs may be used to promote health and medical services, search new job opportunities, get involved in research projects and promote teamwork with colleagues. However, 83.6% of physicians expressed concerns about privacy and patient confidentiality, while 53.8% stated that they lacked the time to use ICTs.

Conclusion

High usage of ICTs was found among Ecuadorian physicians. Younger physicians, with less postgraduate years, and non-specialists were more likely to have a positive perception toward ICTs. Privacy and patient confidentiality, followed by time management, were the most reported barriers in our study.

Cochrane, evidence-based medicine and associated factors: A cross-sectional study of the experiences and knowledge of Ethiopian specialists in training

INTRODUCTION

Evidence-based healthcare is a core competency for practicing healthcare practitioners and those in speciality training. In sub-Saharan Africa, little is known about the teaching of evidence-based medicine (EBM) in residency program. This survey evaluated the experiences and knowledge of Cochrane, EBM and associated factors among Ethiopian specialists in training.

METHODS

A convenient sample of trainee specialists completed a pretested self-administered survey. The majority (93%) were ≤30 years old, males (63%) and 41% in paediatrics speciality. The associations of categorical variables with EBM knowledge was assessed by Fisher's exact or Chi-Square tests. Covariates contributing to EBM knowledge were identified using multivariate logistic regression analysis.

RESULTS

Eighty-three trainees participated in the survey (response rate 88.2%). About 75% have heard about Cochrane but no one recognized Cochrane South Africa. Only 25% of the trainees knew the Cochrane Library but none used it in clinical practice. Most (78%) have heard of EBM, 15% had attended EBM course, 96% wanted to attend EBM course and 81% had positive attitudes to EBM. Trainees EBM knowledge was associated with awareness of Cochrane [Adjusted odds ratio (AOR) = 8.5, 95% Confidence interval (CI) 1.3-54.6, P = 0.02], EBM (AOR = 51.2, 95% CI 2.7-960.8, P = 0.009), and being in third year training (AOR = 28.4, 95% CI 1.9-427.2, P = 0.02). The promotion of EBM in residency hospital (AOR = 22.2, 95% CI 2.2-223.8, P = 0.008) and being aware of Cochrane (AOR = 4.8, 95% CI 1.1-21.7, P = 0.04) were predictors of positive attitude. Familiarity with Cochrane Library was influenced by EBM knowledge (AOR = 6.6, 95% CI 1.4-31.5, P = 0.02) and perceived organization barrier to accessing the resource (AOR = 3.2, 95% CI 1.03-10.1, P = 0.04).

CONCLUSION

Ethiopian trainee specialists lacked formal EBM training, awareness and use of the Cochrane Library. To improve the healthcare quality and patient outcomes, EBM education should be integrated into residency curricula.

Assessing factors militating against the acceptance and successful implementation of a cloud based health center from the healthcare professionals' perspective: a survey of hospitals in Benue state, northcentral Nigeria

Background

Cloud based health platforms (CBHP) have tremendous capacity to meet patient’s health needs. The benefits inherent in CBHP position it to be relevant for efficient healthcare delivery. Nonetheless, studies have shown that the adoption of new technologies is sometimes a challenge especially in developing nations. This study, therefore, aim to examine, identify and evaluate the factors affecting healthcare professionals’ intention to accept the cloud-based health center (CBHC) in developing countries. The research study focuses on hospitals in North-central of Nigeria.

Methods

Using questionnaire adopted from related studies, a cross-sectional study was carried out of 300 healthcare professionals selected from medical health institutions in Benue State Nigeria. The study adopted the Unified Theory of Acceptance and use of Technology Extended (UTAUT2). Data analysis was carried out using SPSS (V20.0) and LISREL (V9.30) generally employed in Structural Equation Modeling to examine components and path model. The Socio technical design method was used to develop the CBHC.

Results

Findings portrays performance expectancy, cloud based health knowledge, IT infrastructure and social influence to have significant effects on the intentions of healthcare professionals to accept and use the CBHC. These findings, agrees with prior related studies.

Conclusions

Our findings impacts the body of knowledge in that it identifies important areas the studies can be useful, especially, to managers and healthcare policy makers in the planning/implementation of health cloud. Research findings from the theoretical acceptance model identifies the factors and barriers towards sustainable cloud based health center solutions to meet the healthcare needs of people in remote communities.

Internet use for patient care and health research: A cross-sectional study among physicians in a teaching hospital of Eastern India

Background:

Internet is the world's largest network of information and communication services. The internet is widely used in medicine and had a significant impact on research, training, and patient care.

Objectives:

(1) To assess internet use to obtain health information for patient care among physicians of a medical college hospital. (2) To investigate the utilization of the internet during their daily practice and to know the reasons for its use and nonuse.

Materials and Methods:

A hospital-based cross-sectional study was conducted for a period of 2 months of May and June 2015 in a Medical College Hospital of Eastern India. A convenient sample of 200 physicians was included in the study. Data regarding access of internet in workplace, time spent on the internet for medical and nonmedical purposes, opinions regarding use of the internet to update medical knowledge, obstacles that affect its use, etc., were collected. The data were analyzed using SPSS software version 20.

Results:

It was seen that 47% doctors use laptop for accessing internet, followed by mobiles (34%). E-mail was the main purpose (41%) of internet use, followed by research (32.5%). Majority told that e-mail was the main purpose of last internet use (46.5%), followed by browsing medical resources (23%), research (15.5%), and patient care (12.5%). 97.5% agreed that they had ever browsed internet for patient care and 85.5% doctors agreed that they had obtained relevant information. 26.5% told that they need training for accessing free full-text electronic journals and 25% need training to access the sources for best clinical evidence for patient care. Other training needs were literature search (18%), downloading textbooks and other resources (15.5%), and searching internet sites for medical information (10%).

Conclusion:

Providing training for improvement of searching skills for obtaining up-to-date medical information, and evidence-based medicine from internet will improve their practice of medicine.

Internet use and eHealth literacy among health-care professionals in a resource limited setting: a cross-sectional survey

BACKGROUND

Health-care professionals should be able to identify and use reputable health care-information sources from the Internet and other relevant sources of information, in order to make good medical decisions. The level in health professional eHealth literacy and the extent of Internet use in a resource-constrained setting is not well documented. The aim of this study was to assess the extent of Internet use and eHealth literacy among a cross section of health-care professionals at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia.

METHODS

An institution-based cross-sectional study was conducted to assess Internet use and eHealth literacy among health professionals working at the hospital from November 20 to January 17, 2018. Descriptive analysis was used to describe Internet use and eHealth literacy. Multivariable logistic regression was done to identify which factors were associated with the eHealth literacy of participants.

RESULTS

In total, 291 study subjects were approached and included in the study, with a response rate of 98.6%. The majority of respondents were female (53.7%) and the mean age was 30.09±5.025 years. Only 47.4% of survey respondents said that they used the Internet regularly for professional/medical updates. The mean eHealth literacy was 27.840±5.691. The majority of participants with high eHealth literacy were aged 21-29 years. and females were slightly more literate regarding eHealth than males (33.1%). Age, type of profession, salary, and years of experience were significantly associated with eHealth literacy.

CONCLUSION

The present data confirm that Internet use and eHealth literacy of health professionals is noticeably good, which clearly suggests that there is an opportunity for eHealth to be integrated in the health-care system in tertiary-health facilities in northern Ethiopia if appropriate training and education is provided.

Knowledge and experience with cochrane and evidence based medicine among health professionals in Debreberhan Referral Hospital in Ethiopia: a cross-sectional survey

Introduction

Cochrane generates and disseminates high-quality systematic reviews through the cochrane library. We surveyed Ethiopian health professionals' knowledge and experience with cochrane, the cochrane library and Evidence Based Medicine (EBM).

Methods

A cross-sectional survey was conducted using a convenient sample of health professionals in DebreBerhan Referral hospital in Ethiopia. Participants completed a pre-tested self-administered survey before EBM training. Data were analyzed using Fisher's exact or Chi-Squared test with Yates' correction. The strength of association between variables was quantified using odds ratios with 95% confidence intervals.

Results

The response rate was 71.4% (35/49). Over half (54.3%) of the sample were males; 68.6% aged ≤ 30 years; 54.3% were physicians and 37.1% were nurses. Up to 65.7% had heard about Cochrane and only two knew cochrane South Africa as their reference centre. Nearly 48.6% were aware of the cochrane library, of whom 46% accessed it however; none used it for lacking awareness, search skills, access to internet and time constraints. Majority had a positive attitude towards EBM; 45.7% had heard of EBM; 74.3% rated their EBM knowledge as low; 74.3% lacked EBM training; and 88.6% were keen to attend EBM course. Adequate EBM knowledge was correlated with prior training (OR = 3.7, 95% CI 1.9-6.9, P<0.001], high self-assessment of EBM knowledge (OR = 0.27, 95% CI 0.14-0.51, P<0.001), male gender (P = 0.04), a positive attitude towards EBM (P = 0.001) and awareness of Cochrane (P = 0.004).

Conclusion

Ethiopian health professionals have unmet training needs and want support through professional development workshops and an improved education system to provide high-quality evidence-based healthcare.

Health Libraries and Information Services in Tanzania: A Strategic Assessment

BACKGROUND

The intention of the Government of Tanzania is to establish more health information resource canters in all health facilities. With this regard, health information science personnel are needed to provide adequate and accurate health information services. However, availability of these personnel remains to be a challenge because of their non-existence.

OBJECTIVE

To identify the current status and local impact of health sciences libraries and user perception of these libraries, as a prerequisite to the development of a competence-based curriculum for health information science training in Tanzania.

METHODS

A needs assessment was carried out using a convenience sample of local respondents, including librarians, trainers, academicians, students, health care providers, and patients and families, drawn from national, referral, regional, district hospitals, health training institutions, and universities from both government and nongovernment entities in Tanzania. A focus group approach was used to gather data from respondents.

RESULTS

Results from this assessment revealed that health science libraries in Tanzania are faced with the challenges of insufficient infrastructure, old technology, limited facilities and furniture, inadequate and incompetent library staff, lack of health sciences librarians, outdated and insufficient resources, and low knowledge and use of information technologies by library clients. Most respondents would prefer to have both physical and electronic libraries, as well as librarians with specialized health information science skills, to cope with changing nature of the medical field.

CONCLUSIONS

The findings obtained from this assessment are strong enough to guide the development of a curriculum and training strategy and an operational plan and training packages for health information professionals. The development of a training curriculum for health information science professionals will mean better health information service delivery for Tanzania.

Evidence-based medicine for all: what we can learn from a programme providing free access to an online clinical resource to health workers in resource-limited settings

The rapidly changing landscape of medical knowledge and guidelines requires health professionals to have immediate access to current, reliable clinical resources. Access to evidence is instrumental in reducing diagnostic errors and generating better health outcomes. UpToDate, a leading evidence-based clinical resource is used extensively in the USA and other regions of the world and has been linked to lower mortality and length of stay in US hospitals. In 2009, the Global Health Delivery Project collaborated with UpToDate to provide free subscriptions to qualifying health workers in resource-limited settings. We evaluated the provision of UpToDate access to health workers by analysing their usage patterns. Since 2009, ∼2000 individual physicians and healthcare institutions from 116 countries have received free access to UpToDate through our programme. During 2013-2014, users logged into UpToDate ∼150 000 times; 61% of users logged in at least weekly; users in Africa were responsible for 54% of the total usage. Search patterns reflected local epidemiology with 'clinical manifestations of malaria' as the top search in Africa, and 'management of hepatitis B' as the top search in Asia. Our programme demonstrates that there are barriers to evidence-based clinical knowledge in resource-limited settings we can help remove. Some assumed barriers to its expansion (poor internet connectivity, lack of training and infrastructure) might pose less of a burden than subscription fees.

Health Information and Global Health Inequity: Point-of-Care Knowledge Systems as a Foundation for Progress

Point-of-care clinical knowledge systems play an increasingly important role in providing information for health care providers in high-resource settings, and there is evidence of strong interest among providers within low-resource settings. Unfortunately, systems developed for high-resource settings have a range of elements that make them suboptimal for low-resource settings. We discuss what a point-of-care clinical knowledge system designed for low-resource settings would ideally contain, and argue that such a system is worthy of further study and funding, towards the overarching goal of reducing global health inequity.

Quality of Breast Cancer Information on the Internet by African Organizations: An Appraisal

Objective. The aim of this study was to appraise the quality of information on BC available at websites run by organizations in Africa. Methods. Three searches were conducted using Google search engine to generate a list of websites. The identified websites were assessed using European Commission (EC) quality criteria for health-related websites, which comprises different assessment areas including, completeness, transparency and honesty, authority, privacy and data protection, updating of information, accountability, and accessibility. Results. Thirteen (13) websites were included in the evaluation. Majority of the websites evaluated had low scores on the completeness and transparency of their websites. Scores on accessibility were however moderate and high for most of the websites. Breast cancer-specific organizations provided the highest quality information, particularly in terms of completeness. The overall lowest and highest quality scores were 9 and 43 out of 63, respectively, and 77% of the included websites scored less than 50% of the total quality score. Conclusion. This review has provided evidence of inadequate and inaccurate BC information provided by some cancer organizations in Africa. Considerable effort is required to make BC information on the Internet a valuable and up-to-date source for both professionals and patients.

Institutional factors influencing utilisation of Research4Life databases by National Agricultural Research Institutes scientists in Nigeria

This study is part of a doctoral thesis aimed at investigating the influence of institutional factors on utilisation of Research4Life databases by NARIs scientists in Nigeria. The study adopted the descriptive survey design of the correlational type. The study population consists of 1,205 research scientists in the 15 NARIs from which a total of thirteen (13) institutes and 1,062 research scientists were selected adopting cluster, simple random and stratified random sampling techniques. The questionnaire was the main instrument for data collection. It consists of 105 questions arranged in five sections. Simple percentage, mean, Pearson’s Product Moment Correlation, multiple regression analysis and analysis of variance were used to analyse the data. Result indicates that the six institutional factors were significant and the institutional factors influenced utilisation of Research4Life databases. Accessibility of databases, availability of password and fast Internet access made significant contributions to utilisation of Research4Life databases. NARIs management has critical roles to play in providing access to Research4Life databases in research scientists’ offices and their libraries as well as providing fast Internet access and in-house-training in the institutes. The librarians should register for Research4Life databases and make the user names and passwords available to all their bona fide users.

Information needs of Botswana health care workers and perceptions of wikipedia

BACKGROUND

Since the UN Human Rights Council's recognition on the subject in 2011, the right to access the Internet and information is now considered one of the most basic human rights of global citizens [1,2]. Despite this, an information gap between developed and resource-limited countries remains, and there is scant research on actual information needs of workers themselves. The Republic of Botswana represents a fertile ground to address existing gaps in research, policy, and practice, due to its demonstrated gap in access to information and specialists among rural health care workers (HCWs), burgeoning mHealth capacity, and a timely offer from Orange Telecommunications to access Wikipedia for free on mobile platforms for Botswana subscribers.

OBJECTIVES

In this study, we sought to identify clinical information needs of HCWs of Botswana and their perception of Wikipedia as a clinical tool.

METHODS

Twenty-eight facilitated focus groups, consisting of 113 HCWs of various cadres based at district hospitals, clinics, and health posts around Botswana, were employed. Transcription and thematic analysis were performed for those groups.

RESULTS

Access to the Internet is limited at most facilities. Most HCWs placed high importance upon using Botswana Ministry of Health (MoH) resources for obtaining credible clinical information. However, the clinical applicability of these materials was limited due to discrepancies amongst sources, potentially outdated information, and poor optimization for time-sensitive circumstances. As a result, HCWs faced challenges, such as loss of patient trust and compromises in patient care. Potential solutions posed by HCWs to address these issues included: multifaceted improvements in Internet infrastructure, access to up-to-date information, transfer of knowledge from MoH to HCW, and improving content and applicability of currently available information. Topics of clinical information needs were broad and encompassed: HIV, TB (Tuberculosis), OB/GYN (Obstetrics and Gynecology), and Pediatrics. HCW attitudes towards Wikipedia were variable; some trusted Wikipedia as a reliable point of care information resource whereas others thought that its use should be restricted and monitored by the MoH.

CONCLUSIONS

There is a demonstrated need for accessible, reliable, and up-to-date information to aid clinical practice in Botswana. Attitudes towards Wikipedia as an open information resource tool are at best, split. Therefore, future studies are necessary to determine the accuracy, currency, and relevancy of Wikipedia articles on the health topics identified by health care workers as areas of information need. More broadly speaking, future efforts should be dedicated to configure a quality-controlled, readily accessible mobile platform based clinical information application tool fitting for Botswana.

Electronic Information Sources Access and Use for Healthcare Services in Governmental and Non-Governmental Hospitals of Western Oromia, Ethiopia: A Cross Sectional Study

BACKGROUND

Access to and use of electronic information sources for clinical decision is the key to the attainment of health related sustainable goals. Therefore, this study was to assess Electronic Information Sources (EIS) access and use for healthcare service among hospitals of Western Oromia, Ethiopia, 2013.

MATERIALS AND METHODS

A descriptive study design with quantitative and qualitative data collection methods was employed. Study subjects were selected by using simple random sampling technique. Quantitative data were entered and analyzed using SPSS version 16.0. Moreover, multiple logistic regression was fitted to identify independent predictors, and qualitative data were transcribed and analyzed thematically.

RESULTS

A total of 590 health professionals were participated in the study with response rate of 95%. Forty-two percent of health professionals had used Electronic Information Sources (EIS). Out of them, more than half used to get latest health information. About three-fourth of health professionals had no formal training on how to use EIS. Moreover, there is a significant association between use of electronic information source and information literacy training, computer literacy level, access to internet connection and access to computers.

CONCLUSION

In this study, it was determined that more than half of health professionals in the study area were not using EIS. Information literacy training, self-stated computer literacy level, access to internet connection and access to computers with in hospitals were found to be statistically significant factors affecting use of EIS.

Nigeria's National Health Act: An assessment of health professionals' knowledge and perception

Background:

Nigeria's National Health Act 2014 (NHA 2014) was signed into law on October 31, 2014. It provides a legal framework for the regulation, development, and management of Nigeria's Health System. This study assessed the knowledge and perception of the NHA 2014 by health professionals.

Materials and Methods:

This was a descriptive, cross-sectional, questionnaire-based study conducted in December 2015, in Ota, Ogun State, Nigeria. Data entry and analysis were done using the Statistical Package for the Social Sciences version 16 (IBM SPSS, Chicago, IL, USA) statistical software, with Pearson's Chi-square, which is used to determine the associations between variables. Statistical significance was set at a P < 0.05.

Results:

The study population comprised 130 health professionals (medical doctors/dentists, nurses, pharmacists, laboratory scientists, and other health-related professionals) in attendance at a medical conference. The respondents' age ranged from 21 to 75 years with a mean age of 44.53 ± 12.46 years. Medical practitioners accounted for 82.3% of the respondents. Although most (79.2%) respondents had a good perception of the NHA 2014 with majority (86.2%) claiming they were aware of the act, majority (73.8%) exhibited poor knowledge of the act. A little more than half (53.1%) of the respondents believed that the NHA 2014 will help to reduce strike actions in the health sector.

Conclusion:

Although health professionals in Nigeria have good awareness and perception of the NHA 2014, their knowledge of the Act is poor.

Strengthening capacity to apply health research evidence in policy making: experience from four countries

Increasing the use of evidence in policy making means strengthening capacity on both the supply and demand sides of evidence production. However, little experience of strengthening the capacity of policy makers in low- and middle- income countries has been published to date. We describe the experiences of five projects (in Bangladesh, Gambia, India and Nigeria), where collaborative teams of researchers and policy makers/policy influencers worked to strengthen policy maker capacity to increase the use of evidence in policy. Activities were focused on three (interlinked) levels of capacity building: individual, organizational and, occasionally, institutional. Interventions included increasing access to research/data, promoting frequent interactions between researchers and members of the policy communities, and increasing the receptivity towards research/data in policy making or policy-implementing organizations. Teams were successful in building the capacity of individuals to access, understand and use evidence/data. Strengthening organizational capacity generally involved support to infrastructure (e.g. through information technology resources) and was also deemed to be successful. There was less appetite to address the need to strengthen institutional capacity—although this was acknowledged to be fundamental to promoting sustainable use of evidence, it was also recognized as requiring resources, legitimacy and regulatory support from policy makers. Evaluation across the three spheres of capacity building was made more challenging by the lack of agreed upon evaluation frameworks. In this article, we propose a new framework for assessing the impact of capacity strengthening activities to promote the use of evidence/data in policy making. Our evaluation concluded that strengthening the capacity of individuals and organizations is an important but likely insufficient step in ensuring the use of evidence/data in policy-cycles. Sustainability of evidence-informed policy making requires strengthening institutional capacity, as well as understanding and addressing the political environment, and particularly the incentives facing policy makers that supports the use of evidence in policy cycles.

Influence of motivational factors on utilisation of Internet health information resources by resident doctors in Nigeria

Purpose

– This study aims to determine the influence of motivational factors: perceived ease of use (PEU), perceived enjoyment (PEJ) and perceived usefulness (PU) on utilisation of Internet health information resources among resident doctors in tertiary health-care institutions in Nigeria. The Internet has become a major source of health information for practitioners and the general public. Despite the availability of health information resources on the Internet, some resources are underutilised. There are numerous studies on Internet use among health-care workers; however, there is a dearth of information on motivational factors influencing utilisation of Internet health information resources among resident doctors in Nigeria.

Design/methodology/approach

– A descriptive survey design was used. Total enumeration technique was adopted to cover 1,280 resident doctors in 13 tertiary health-care institutions in southwestern Nigeria. A validated, self-administered questionnaire was used for data collection. The questionnaire has four sections covering the demographic profile of the respondents, PEU, PEJ and PU. Four hypotheses were tested at the p < 0.0 1 level of significance. Data were analyzed using descriptive statistics, Pearson product-moment correlation and multiple regression analysis.

Findings

– There were more males (69.0 per cent) than females (31 per cent); respondents mean age was 34 years. The result revealed that PEU(r = 0.181, p < 0.01), PEJ(r = 0.166, p < 0.01) and PU(r = 0.121, p < 0.01) have significant relationship with utilisation of Internet health information resources by the respondents. Also, PEU, PEJ and PU collectively (F = 15.366, df = 3; 897, p < 0.01) have significant influence on utilisation of Internet health information resources of the respondents. Individually, PEU (B = 0.864, df = 897, t = 3.90, p < 0.01) and PEJ (B = 0.349, df = 897, t = 3.060, p [lt] 0.01) were found to have significant influence on utilisation while PU (B = 0.232, df = 897, t = 1.328, p > 0.01) does not significantly influence the utilisation of Internet health information resource of the respondents.

Research limitations/implications

– One major implication of this study is that system designers and web content developers should design programs and websites that are compatible with the user’s abilities. Medical librarians have a role to play in providing quality health content that is easy to navigate and pleasurable to use. Both the institutions and the government have a role to play in providing information and communication technology facilities to enable doctors access relevant health information resources easily.

Practical implications

– Introduction of information literacy training in the residency programme or inclusion as a component of the continuing professional development will enable resident doctors to know relevant online searching tools and search techniques for accessing health information resources which will be useful to their work. This will in turn increase their PU of Internet resources. Health sciences librarians (medical librarians) in the various institutions/centres have a role to play in training resident doctors on how to access, retrieve and evaluate online health information. Librarians should also train resident doctors on how to search evidence-based Medicine resources such as the Cochrane Library and PubMed Clinical Queries and Critical Appraisal of the medical literature to make informed decision in the management of their patients and for research purposes. They should be trained on how to organise bibliographic references using reference manager tools such as Endnote, Zotero or Mendeley.

Social implications

– The social implication of this findings is that systems that are easy to use should be designed, so that doctors will be able to access relevant information for research and patient care for better health outcomes. The easier and enjoyable the system is to use, the more resident doctors will access and use health information resources to improve their service and save more lives.

Originality/value

– This study examined three motivational factors (PEU, PEJ and PU) that influence the utilisation of Internet health information resources by resident doctors in tertiary health-care institutions in Nigeria. The result revealed that collectively PEU, PEJ and PU have significant relationship with the utilisation of Internet health information resources, but PEU and PEJ are the main drivers of use of Internet health information resources among the resident doctors studied. This study adds to the literature of motivational factors influencing utilisation of Internet health information resources by resident doctors in southwestern Nigeria. This paper is original because, to the best of our knowledge, there is no other study on motivational factors influencing Internet use among resident doctors in Nigeria.

Influence of Internet Accessibility and Demographic factors on utilization of Web-based Health Information Resources by Resident Doctors in Nigeria

BACKGROUND

The internet is a huge library with avalanche of information resources including healthcare information. There are numerous studies on use of electronic resources by healthcare providers including medical practitioners however, there is a dearth of information on the patterns of use of web-based health information resource by resident doctors in Nigeria. This study therefore investigates the influence of internet accessibility and demographic factors on utilization of web-based health information resources by resident doctors in tertiary healthcare institutions in Nigeria.

METHODS

Descriptive survey design was adopted for this study. The population of study consisted of medical doctors undergoing residency training in 13 tertiary healthcare institutions in South-West Nigeria. The tertiary healthcare institutions were Federal Medical Centres, University Teaching Hospitals and Specialist Hospitals (Neuropsychiatric and Orthopaedic). A pre-tested, self-administered questionnaire was used for data collection. The Statistical Package for the Social Sciences (SPSS) was used for data analysis. Data were analyzed using descriptive statistics, Pearson Product Moment correlation and multiple regression analysis.

RESULTS

The mean age of the respondents was 34 years and males were in the majority (69.0%). A total of 96.1% respondents had access to the Internet. E-mail (X̄=5.40, SD=0.91), Google (X̄=5.26, SD=1.38), Yahoo (X̄=5.15, SD=4.44) were used weekly by the respondents. Preparation for Seminar/Grand Round presentation (X̄=8.4, SD=1.92), research (X̄=7.8, SD=2.70) and communication (X̄=7.6, SD=2.60) were ranked high as purposes for use of web-based information resources. There is a strong, positive and significant relationship between internet accessibility and utilization of web-based health information resources (r=0.628, p<0.05). Internet accessibility (B=0.911) and demographic factors: gender (B=-2.027), designation (B=-0.343) educational qualification (B=2.411) significantly influence utilization of web-based health information resources of the respondents.

CONCLUSION

A great majority of the respondents have access to the Internet and used web-based health information resources more for academic purposes than patient care. Training is required to promote use of internet health information resources among resident doctors. The findings of this study will be useful to the management of the 13 healthcare institutions regarding provision of appropriate internet facilities that will enhance access and use of web-based health information resources by resident doctors.

Information needs and seeking behaviour among health professionals working at public hospital and health centres in Bahir Dar, Ethiopia

BACKGROUND

Universal access to information for health professionals is a need to achieve "health for all strategy." A large proportion of the population including health professionals have limited access to health information in resource limited countries. The aim of this study is to assess information needs among Ethiopian health professionals.

METHODS

A cross sectional quantitative study design complemented with qualitative method was conducted among 350 health care workers in February 26-June 5/2012. Pretested self-administered questionnaire and observation checklist were used to collect data on different variables. Data entry and data analysis were done using Epi-Info version 3.5.1 and by SPSS version19, respectively. Descriptive statistics and multivariate regression analyses were applied to describe study objectives and identify the determinants of information seeking behaviours respectively. Odds ratio with 95% CI was used to assess the association between a factor and an outcome variable.

RESULTS

The majority of the respondents acknowledged the need of health information to their routine activities. About 54.0% of respondents lacked access to health information. Only 42.8% of respondents have access to internet sources. Important barriers to access information were geographical, organizational, personal, economic, educational status and time. About 58.0% of the respondents accessed information by referring their hard copies and asking senior staff. Age, sex, income, computer literacy and access, patient size, work experience and working site were significantly associated with information needs and seeking behaviour.

CONCLUSIONS

The health information seeking behaviour of health professional was significant. The health facilities had neither information center such as library, nor Internet facilities. Conducting training on managing health information, accessing computer and improving infrastructures are important interventions to facilitate evidence based decisions.

Search strategies to identify reports on "off-label" drug use in EMBASE

BACKGROUND

Medications are frequently prescribed outside their regulatory approval (off-label) by physicians particularly where appropriate therapies are not available. However, the risk/benefit ratio of drugs in off-label use needs to be critically appraised because it may differ from approved on-label usage. Therefore, an extensive exploration of current evidence on clinical data is well-advised. The objective of this study was to develop a search strategy that facilitates detection of the off-label drug use documents in EMBASE via OvidSP.

METHODS

We constructed two sets of gold standards from relevant records to off-label drug use by a sensitive search of MEDLINE and EMBASE. Search queries, including search words and strings, were conceived based on definition of off-label use of medications as well as text analysis of 500 randomly selected relevant documents. The selected terms were searched in EMBASE (from 1988 to 2011) and their retrieval performance was compared with the gold standards. We developed a sensitivity-maximizing, and a sensitivity- and precision-maximizing search strategy.

RESULTS

From 4067 records relevant to off-label drug use in our full gold standard set, 3846 records were retrievable from EMBASE. "off label*.af." was the most sensitive single term (overall sensitivity 77.5%, sensitivity within EMBASE 81.9%, precision 88.1%). The highest sensitive search strategy was achieved by combining 36 search queries with overall sensitivity of 94.0% and precision of 69.5%. An optimal sensitive and precise search strategy was yielded precision 87.4% at the expense of decreasing overall sensitivity to 89.4%.

CONCLUSION

We developed highly sensitive search strategies to enhance the retrieval of studies on off-label drug use in OvidSP EMBASE.

Physicians reading and writing practices: a cross-sectional study from Civil Hospital, Karachi, Pakistan

BACKGROUND

To determine the behavior of physicians regarding medical literature reading and participation in research activities at one of the largest teaching hospitals in Pakistan.

METHOD

This descriptive, cross-sectional study was conducted by interviewing the house officers, residents and fellows of six major specialties (Medicine, Surgery, Pediatrics, Psychology, Obstetrics & Gynecology and Anesthesia) in Civil Hospital, Karachi between August and December, 2011. The questionnaire elicited responses regarding the reading habits of physicians, preferred sources of information, their participation in research activities (publication & supervision) and views regarding journal club. SPSS 17.0 was used for data entry and analysis.

RESULT

A total of 259 completely filled questionnaires were returned with a response rate of 85.19%. Mean age of the participants was 29.67 ± 7.65 years. Books were selected by 71.4% doctors as their preferred source of information, regardless of their clinical specialties. (p < 0.05). E-journals were preferred by 75.7% of the doctors over printed journals. This holds true for doctors from all specialties (p < 0.05). The ease of searching for relevant articles was the major contributor (50.5%) in preference of e-journals. 137 (52.9%) doctors read 5 or less articles per week. 30 (11.6%) doctors have subscription of journals (printed or electronic). At least one research paper has been published by 151 (58.3%) of the physicians interviewed. Most common reason for not participating in research activities was busy schedule (56.4%). Almost half (49.4%) doctors reported lack of journal club in their units. Of these, majority (88.35%) wanted a journal club in their respective units.

CONCLUSION

Urgent intervention is required to promote healthcare literature reading and writing practice in our physicians. Easy access to workplace computers with internet and subscription of paid journals will facilitate physicians. Lack of supervisors and busy schedule were reported to be important contributors for not participating in research. Addressing these issues will encourage doctors to participate more in research activities.

Physicians utilisation of internet medical databases at the tertiary health institutions in Osun State, south west, Nigeria

OBJECTIVES

To determine the extent, purpose, determinants and the impact of the utilization of Internet medical databases among the respondents.

METHODOLOGY

A descriptive cross sectional survey of 540 randomly selected physicians at the two tertiary health institutions in Osun State, south west, Nigeria.

RESULT

A total of 444 (82.2%) physicians completed the questionnaires. All the respondents have used the internet medical databases within the last 4 weeks of the study. Majority, (53.8%) used the internet resources at least once in 2 weeks, while 12.2% used the resources every day. The online resources are mainly sought for Routine patient care and for Research purposes. pubmed (70.3%), hinari (69.0%), and Free medical journals (60.1%) are the frequently used online databases/digital archives. The internet resources has positively impacted the Clinical practice (40.0%) and Research output (65.5%) of the physicians.

CONCLUSION

There had been considerable increase in the extent and quality of utilization of online medical databases which has positively impacted on the Clinical practice and Research output of the physicians. Ease of finding the needed information and the availability of evidence based resources are the major determinants of the databases utilized.

The level of Internet access and ICT training for health information professionals in sub-Saharan Africa

BACKGROUND

Information and Communication Technologies (ICTs) are important tools for development. Despite its significant growth on a global scale, Internet access is limited in sub-Saharan Africa (SSA). Few studies have explored Internet access, use of electronic resources and ICT training among health information professionals in Africa.

OBJECTIVE

The study assessed Internet access, use of electronic resources and ICT training among health information professionals in SSA.

METHODS

A 26-item self-administered questionnaire in English and French was used for data collection. The questionnaire was completed by health information professionals from five Listservs and delegates at the 10th biannual Congress of the Association of Health Information and Libraries in Africa (AHILA).

RESULTS

A total of 121 respondents participated in the study and, of those, 68% lived in their countries' capital. The majority (85.1%) had Internet access at work and 40.8% used cybercafes as alternative access points. Slightly less than two-thirds (61.2%) first learned to use ICT through self-teaching, whilst 70.2% had not received any formal training in the previous year. Eighty-eight per cent of respondents required further ICT training.

CONCLUSIONS AND RECOMMENDATIONS

In SSA, freely available digital information resources are underutilized by health information professionals. ICT training is recommended to optimize use of digital resources. To harness these resources, intergovernmental and non-governmental organizations must play a key role.