Sources of Health care providers' Self-efficacy to deliver Health Education: a qualitative study

Examining the educational experiences of Behvarzes from the insufficient participation of some people in preventive measures against the COVID-19 pandemic: a lesson for the future

BACKGROUND

This study aims to explore the experiences of Behvarzes regarding the reasons behind the insufficient participation of some individuals with the preventive protocols established during the COVID-19 pandemic.

METHODS

A qualitative study was conducted from July 2021 to December 2022 using the conventional content analysis method. Purposive sampling was employed to select 14 Behvarzes working in villages covered by Kashan University of Medical Sciences. Data were collected through semi-structured in-depth individual interviews and analyzed using conventional content analysis.

RESULTS

The study identified seven subcategories which were grouped into two main categories of reasons for inadequate compliance with health protocols by some individuals. These include: (1) Intentional non-compliance with preventive protocols, with the following subcategories: perceived obligation and adherence to social customs, denial of risk, belief in external health locus of control, and fear and distrust of prevention and treatment methods. (2) Unintentional non-compliance with preventive protocols, with the following subcategories: insufficient or contradictory information, negligence, and inevitability.

CONCLUSION

The findings suggest that ensuring compliance with health guidelines is not a one-size-fits-all approach. providing empowerment and obstacle removal solutions to those forced to violate preventive protocols for various reasons are all critical components of successful interventions. Also, cultural familiarity can aid in the design of appropriate interventions to address these challenges.

Random forest model used to predict the medical out-of-pocket costs of hypertensive patients

Background

Precise prediction of out-of-pocket (OOP) costs to improve health policy design is important for governments of countries with national health insurance. Controlling the medical expenses for hypertension, one of the leading causes of stroke and ischemic heart disease, is an important issue for the Japanese government. This study aims to explore the importance of OOP costs for outpatients with hypertension.

Methods

To obtain a precise prediction of the highest quartile group of OOP costs of hypertensive outpatients, we used nationwide longitudinal data, and estimated a random forest (RF) model focusing on complications with other lifestyle-related diseases and the nonlinearities of the data.

Results

The results of the RF models showed that the prediction accuracy of OOP costs for hypertensive patients without activities of daily living (ADL) difficulties was slightly better than that for all hypertensive patients who continued physician visits during the past two consecutive years. Important variables of the highest quartile of OOP costs were age, diabetes or lipidemia, lack of habitual exercise, and moderate or vigorous regular exercise.

Conclusion

As preventing complications of diabetes or lipidemia is important for reducing OOP costs in outpatients with hypertension, regular exercise of moderate or vigorous intensity is recommended for hypertensive patients that do not have ADL difficulty. For hypertensive patients with ADL difficulty, habitual exercise is not recommended.

Validation of the Self-Efficacy Questionnaire (SE-12-Gr) Assessing the Healthcare Professionals' Self-Reported Communication Skills with Older Healthcare Users in Greece

Patients' satisfaction with their interaction with the healthcare providers has been found to correlate with adherence to therapeutic plans and better health outcomes. Healthcare providers are experiencing barriers when communicating with specific population subgroups, such as people with low health literacy, low education, and older age. Enhancing the communication skills of the healthcare providers working with older adults could facilitate their interaction with the patients. This study presents the validation of the Self-efficacy-12 (SE-12) in Greek. This is an instrument measuring healthcare providers' self-efficacy of communication skills used during their interaction with older patients. A sample of 230 healthcare providers working with older adults participated in the study. The scale showed good psychometric properties (S-CVI=.97, Cronbach a = .95, ICC = .81). A medium to high correlation was found with the generalized self-efficacy questionnaire. Exploratory Factor Analysis (EFA) yielded two factors ("Self-efficacy in communication skills and strategies" and "Self-efficacy of successful interaction") with good psychometric properties. The SE-12-GR is a brief, valid, and reliable tool for assessing self-efficacy of communication skills and it could be integrated as part of the health literacy tools for healthcare providers working with older people in Greece.

Helpful explanatory models for persistent somatic symptoms (HERMES): Results of a three-arm randomized-controlled pilot trial

OBJECTIVE

This three-arm randomized controlled trial aimed to test the efficacy of an etiological model for persistent somatic symptoms (PSS) translated into video-animated explanatory models in comparison to a control group, and to examine additional value of personalization of the explanatory models (i.e. possibility to choose information based on mechanisms of symptom persistence).

METHODS

Outpatients with PSS were shown one of three 15-min video animations: a) explanatory model without personalization, b) explanatory model with personalization, c) no explanatory model control group. Changes in somatic symptom severity (PHQ-15) and psychological burden related to somatic symptoms or associated health concerns (SSD-12) from baseline to one-month follow-up were the primary outcome. Health-related quality of life (SF-12) and perceived usefulness (USE) were also assessed.

RESULTS

Seventy-five patients with PSS were allocated to the study arms (Mage = 44.2 ± 13.3 years, 56% female). The study arms did not differ significantly on the primary outcomes. However, no explanatory model participants reported significantly greater mental quality of life improvements than explanatory model without personalization participants (Mdiff = 7.50 [0.43; 14.56]). Further, explanatory model with personalization participants rated the individual fit of the intervention significantly higher than no explanatory model participants (Mdiff = 2.05 [0.17; 3.93]). All groups rated credibility of the intervention as very high.

CONCLUSION

The HERMES materials seemed to have been too brief to improve symptom related outcomes. However, all three interventions were positively evaluated regarding their usefulness, particularly in case of additional personalization. Future studies should investigate potential effects of an increased intervention dose.

TRIAL REGISTRATION

DRKS00018803.

Nurses´ Performance: The Importance of Personal Resources for Coping with Stressors

The health crisis caused by the COVID-19 pandemic has negatively influenced the work of health staff, especially nurses. Stressors that affect nurses have been intensified and new stressors have also emerged, threatening their well-being and job performance. The main objective of this study is to analyze the role of nurses´ personal resources in the relationship between job stressors and job performance during the COVID-19. Sample is composed of 438 nurses from 39 Spanish cities. This is a cross-sectional study. The results confirm the full mediation of resilience in the relationship between stressors and job performance, and the moderation of self-efficacy in the relationship between resilience and job performance, and in the full mediation. This study highlight the role played by self-efficacy as the main personal resource in buffering the effect of stressors on nurses´ performance. Resilience only becomes crucial in individuals with low levels of self-efficacy beliefs. Managers of health institutions and hospitals are invited to invest resources in strengthening the personal resources of health staff, especially self-efficacy beliefs, and resilience to ensure that their performance remains adequate.

Situational Analysis of Healthcare Delivery and User Perspectives of Mobile Diagnostics (mDiagnostics) in Chennai, Tamil Nadu, India: A Mixed-Method Study

Introduction Situational analysis of exciting infrastructure including mobile health services is crucial for comprehensive healthcare delivery. The concept of mDiagnostics has gained traction as it addresses the challenges of accessibility, affordability, and availability of healthcare services in remote regions. Purpose The study was to do a situational analysis of the availability of medical diagnostic facilities and identify the challenges and barriers faced in the implementation and utilisation of mDiagnostics. Material and methods The present study was a mixed mixed-method study conducted in rural and urban areas of Chennai, Tamil Nadu, India. A total of 1,489 households were included. Situational analysis of existing healthcare facilities and the availability of Ayushman Bharat Health Account (ABHA) numbers for study participants in both urban and rural areas was assessed. In-depth interviews on user perspective, affordability, awareness of existing health services, and perception of the utility of mobile lab services and focus group discussions with healthcare professionals, community members, and key stakeholders were carried out. Thematic analysis for qualitative data, proportion, and means were calculated for the quantitative component. Result Out of 1,489 households included, 711 were from rural areas, and 778 were from urban areas. The distance traveled from their residence to both the lab and health facility was less than 5 km in urban areas, while it is more than 5 km in rural areas. The mean expenditure in availing healthcare services is above five thousand rupees per annum in nearly half of the rural households (46%) and 60% of urban. The analyses of interviews explored the availability, acceptability, and affordability under seven thematic areas for situational analysis of healthcare facilities, and a focused group discussion was held to explore the community member's barrier to healthcare services. Conclusion The study reveals a comprehensive understanding of healthcare delivery access disparities between rural and urban areas in Tamil Nadu. The findings highlighted the potential benefits of mobile lab initiatives in improving healthcare access and early disease detection in underserved rural communities.

Predictors of fear control related to COVID-19 among older population: an investigation on COVID-19 risk perception and health related quality of life during the pandemic

BACKGROUND

The aim of this study was to examine the role of demographic characteristics, general health and health related quality of life on the fear control. Also, the aim of study was to explore how older people percept the COVID-19 pandemic by using the component of the expanded parallel process model (EPPM), and how the possible perception may contribute to probable behavior responses to prevention and control of COVID-19.

METHODS

The present study is a cross-sectional study that was conducted in Tabriz, a city in north of Iran from February to April 2021, the period that correspond with the fourth wave of COVID-19. To collect information, the Covid-19 risk perception questionnaire (based on EPPM model including efficacy, defensive responses, and perceived threat) and health related quality of life (HQOL) Short Form-36 questionnaire were used. Discriminate value was calculated to estimate fear control and danger control. Univariate and multivariable logistic regression were calculated to examine the effect of demographic characteristics, general health and health-related quality of life on the fear control.

RESULTS

The mean age of the 350 participants was 67.9 (6.4) years. A total of 83.1% of participants were engaged in danger control processes and 16.9% in fear control processes. According to the multivariable results, significant predictors for fear control were: gender 1.57 (95% CI 1.05-2.34, 0.025), education 7.38 (1.42-38.35, p = 0.017), economic status 1.31 (0.4-0.63, p = 0.029), and significant protective factors for fear control were: body pain 0.97 (0.94-0.99, p = 0.041), general health 0.96 (0.93-0.98, p = 0.032), physical health 0.94 (0.90-0.98) and total quality of life 0.024 (0.89-0.98).

CONCLUSIONS

Strong associations of fear control were found with being female, being illiterate, and having a good economic status and also body pain, general health, physical health and total HQOL were significantly associated with danger control. Since, most of elderly populations have adequately higher perceptions of efficacy to counteract their threat perceptions to continue motivating these older people to engage in COVID-19 self-protective behaviors, it is necessary to emphasis on the susceptibility of target population and the severity of the COVID-19 threats.

Feasibility of a Virtual Educational Programme for Behaviour Change in Cardiac Patients from a Low-Resource Setting

Patient education is an integral part of recovery from a critical cardiac life event and a core component of cardiac rehabilitation (CR) programmes. This study addressed the feasibility of a virtual educational programme for behaviour change in CR patients from a low-resource setting in Brazil. Cardiac patients from a CR programme closed due to the pandemic received a 12-week virtual educational intervention (WhatsApp messages and bi-weekly calls from healthcare providers). Acceptability, demand, implementation, practicality, and limited efficacy were tested. Overall, 34 patients and 8 healthcare providers agreed to participate. The intervention was considered practical and acceptable by the participants, who reported a satisfaction median of 9.0 (7.4-10.0)/10 (patients) and 9.8 (9.6-10.0)/10 (providers). The main difficulties in carrying out the intervention activities were related to technology, motivation to self-learning, and a lack of in-person orientation. All the patients reported that the information included in the intervention was aligned with their information needs. The intervention was associated with changes in exercise self-efficacy, sleep quality, depressive symptoms, and performance of high-intensity physical activity. In conclusion, the intervention was considered feasible to educate cardiac patients from a low-resource setting. It should be replicated and expanded to support patients that face barriers to onsite CR participation. Challenges related to technology and self-learning should be addressed.

Self-management education for children with epilepsy and their caregivers. A scoping review

Self-management education programs have been highly successful in preparing people to manage medical conditions with recurring events. A detailed curriculum for epilepsy patients, and their caretakers, is lacking. Here we assess what is available for patients who have disorders with recurring events and offer an approach to developing a potential self-care curriculum for patients with seizures and their caregivers. Among the anticipated components are a baseline efficacy assessment and training tailored to increasing self-efficacy, medication compliance, and stress management. Those at risk of status epilepticus will also need guidance in preparing a personalized seizure action plan and training in how to decide when rescue medication is appropriate and how to administer the therapy. Peers, as well as professionals, could teach and provide support. To our knowledge, no such programs are currently available in English. We encourage their creation, dissemination, and widespread use.

Evaluation of counselling materials for hybrid cardiac rehabilitation in a low-resource setting: Perceptions of patients and providers

OBJECTIVE

This study evaluated the usefulness of a booklet as support material for counseling focused on self-efficacy and therapist interaction in the course of counseling in a hybrid CR program (i.e., supervised and unsupervised sessions) developed for low-resource settings.

METHODS

Counseling material was developed by a multidisciplinary team, with patient input. Using multi-methods, first input from patients from six centers in Chile was sought through a telephone survey (cross-sectional). Second, input from physiotherapists delivering the intervention at all centres was solicited qualitatively through a focus group on Zoom. Content analysis was performed using a deductive-thematic approach.

RESULTS

Seventy-one patients were included. All (100 %) participants responded that the materials were easy to understand, contained suggestions applicable to daily life, captured their attention and was useful for future questions. The booklet overall was rated 6.7 ± 0.6/7 %, and 98.2 % were satisfied with the counselling. Overall themes from the six deliverers related to the CR intervention (e.g., well manualized protocols for counselling), the deliverer (e.g., expertise to deliver) and patients (e.g., found information useful).

CONCLUSION

The usefulness of the counseling together with the supporting booklet was established by patients and delivering professionals.

PRACTICE IMPLICATIONS

Thus, with some final refinement, this resource can be disseminated for use by other Spanish CR programs.

Explaining the experiences of health care providers regarding organizational factors affecting health education: a qualitative study

BACKGROUND

Health education is considered the most important component of primary health care. Paying attention to organizational factors can help to improve the quality of health education. Therefore, the present study was conducted to explain organizational factors affecting health education among health care providers.

METHOD

This is a qualitative, descriptive, and phenomenological study that was conducted between 2020 -2022 on 50 health care workers who had been selected by purposeful sampling method in different settings including hospitals, GP office, behavioral disease counseling center, universities, and comprehensive health centers in the south and the center region of Iran. Data were collected by in-depth, semi-structured, and individual interviews, as well as focus group discussion, and continued until data saturation. Data were analyzed by MAXQDA software using qualitative content analysis in three stages: preparation, organization, and reporting. To evaluate the scientific accuracy of the findings in this study, 4 criteria of Lincoln & Guba were used.

RESULTS

The results revealed that every practice and policy in a health care organization from assessing needs, setting goals, planning activities, implementations and measurement outcome could affect health education practice and subsequently the health of population; nevertheless, the crucial role of health education practice is being neglected in health organizations. Organizational factors affecting health education were classified into three categories of planning, organizing, and also monitoring and evaluating. The category of planning had three subcategories of infrastructure planning, manpower planning, and design and planning for implementation of health education programs. The categories of organizing had two subcategories of coordination between different units of the Minister of Health and coordination between the health sector and other sectors of society. The categories of monitoring and evaluation had three subcategories of proper feedback, bureaucracy system, reward or reinforcement, failure to define health education as part of the job description, and the impact of electronic health records on the quality of evaluation.

CONCLUSION

The results offer expertise and preliminary tools to help with evidence-based health education program planning and evaluation. The Support of managers, like providing manpower in accordance with the target population and infrastructure, can improve health education in the health system. In addition, intra- and inter-sectoral coordination at different levels of the health system to implement tailored programs according to the needs of clients by health education professionals, and the use of health education theories seem necessary. It is also recommended to review the monitoring system with appropriate feedback, define health education as a healthy activity, and develop appropriate criteria for better implementation of health education.

The School-Based Speech-Language Pathologist and Students With Concussion: An Examination of Evolving Knowledge and Confidence

PURPOSE

This study examines school-based speech-language pathologists' (SLPs') experience, knowledge, and confidence in supporting students as they return to the classroom following concussion, with a particular focus on knowledge of new management guidelines over the last decade.

METHOD

Participants were 74 school-based SLPs who completed an electronic survey about their knowledge and experiences serving students with concussion. We examined participants' accuracy and confidence across knowledge questions using Kruskal-Wallis tests. We also conducted linear regression to explore the relationships between training, work experiences, knowledge, and confidence.

RESULTS

Nearly half of participants who are currently working with students with concussion reported having no clinical or training experiences related to concussion. Participants who had more concussion-related training or working experiences reported higher confidence. Participants were confident about general concussion knowledge but less confident about providing assessment and supporting students with concussion as they returned to school. Participants had the lowest confidence and accuracy for the most recent guidelines around rest and activity, as well as the differential impact of concussion on children as compared to adults.

CONCLUSIONS

Many school-based SLPs have limited training around concussion management and are often not specifically consulted to work with students following concussion. Despite this, SLPs have good awareness of their knowledge about concussion, but show gaps in knowledge surrounding more recent evidence-based guidelines. Additional investigation is needed to determine better ways to move research into clinical practice and to increase the involvement of SLPs in school-based concussion teams.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20361969.

Role of Self-Efficacy and Resistance to Innovation on the Demotivation and Insufficient Learning Capabilities of Preservice English Normal Students in China

Learning capabilities among students are the crucial element for the student's success in learning a particular language, and this phenomenon needs recent studies. The current study examines the impact of self-efficacy and resistance to innovation on the demotivation and insufficient learning capabilities of preservice English normal students in China. The current research also investigates the mediating impact of demotivation among self-efficacy, resistance to innovation, and insufficient learning capabilities. The questionnaires were employed by the researchers to gather the data from chosen respondents. The preservice English students are the respondents of the study. These are selected using purposive sampling. These questionnaires were forwarded to them by personal visits. The researchers have sent 690 surveys but only received 360 surveys and used them for analysis. These surveys represented a 52.17% response rate. The SPSS-AMOS was applied to test the relationships among variables and also test the hypotheses of the study. The results revealed that self-efficacy and resistance to innovation have a significant and a positive linkage with demotivation and insufficient learning capabilities. The findings also indicated that demotivation significantly mediates self-efficacy, resistance to innovation, and insufficient learning capabilities. The article helps the policymakers to establish the regulations related to the improvement of learning capabilities using innovation adoption and motivation of the students.

Understanding Medical Students’ Perceptions of and Behavioral Intentions toward Learning Artificial Intelligence: A Survey Study

Medical students learning to use artificial intelligence for medical practices is likely to enhance medical services. However, studies in this area have been lacking. The present study investigated medical students’ perceptions of and behavioral intentions toward learning artificial intelligence (AI) in clinical practice based on the theory of planned behavior (TPB). A sum of 274 Year-5 undergraduates and master’s and doctoral postgraduates participated in the online survey. Six constructs were measured, including (1) personal relevance (PR) of medical AI, (2) subjective norm (SN) related to learning medical AI, (3) perceived self-efficacy (PSE) of learning medical AI, (4) basic knowledge (BKn) of medical AI, (5) behavioral intention (BI) toward learning medical AI and (6) actual learning (AL) of medical AI. Confirmatory factor analysis and structural equation modelling were employed to analyze the data. The results showed that the proposed model had a good model fit and the theoretical hypotheses in relation to the TPB were mostly confirmed. Specifically, (a) BI had a significantly strong and positive impact on AL; (b) BI was significantly predicted by PR, SN and PSE, whilst BKn did not have a direct effect on BI; (c) PR was significantly and positively predicted by SN and PSE, but BKn failed to predict PR; (d) both SN and BKn had significant and positive impact on PSE, and BKn had a significantly positive effect on SN. Discussion was conducted regarding the proposed model, and new insights were provided for researchers and practitioners in medical education.

Effects of Occupational Stress, Self-Efficacy and Mental Health During the Pandemic on Hospital Sanitation Workers in Malaysia

COVID-19 rapidly spread across the world, constituting a public health disaster unlike any other experienced in decades. The impact exerted on workplaces and their employees was dramatic, and an immense burden fell on healthcare provision globally. Along with "front-line" healthcare staff, sanitation workers at hospitals also had to cope with additional workloads, making them vulnerable to psychological trauma and affecting their quality of life at establishments. This study investigated how the factors of occupational stress, self-efficacy (belief in the capacity to carry out a task well) and mental health altered the WRQoL (Work-Related Quality of Life) of employees carrying out sanitation duties at hospitals in Malaysia. To this end, a survey translated into the Malay language was conducted among 449 such workers during a so-called "recovery movement control order", i.e. quarantine and control measures pertaining to an outbreak of Coronavirus disease. Research involved co-variance-based structural equation modeling, performed in IBM-AMOS-26 software, in order to discern the causal relationship of the aforementioned factors on WRQoL. Results revealed a high level of occupational stress, diminished self-efficacy and poor mental health among the employees surveyed. Such stress directly impacted the WRQoL of the second factor alongside an indirect effect on that of the third, i.e. anxiety stemming from potentially catching the virus and the experience of having to disinfect facilities for treating patients, undertake cleaning duties, and move corpses.

Clinical associates and access to healthcare in the Eastern Cape province of South Africa

Background

Clinical associates (ClinAs) were introduced into South Africa as part of the remedy for the severe shortage of healthcare workers in rural areas. Walter Sisulu University (WSU) graduated 100 ClinAs between 2011 and 2014. These ClinAs were expected to be based at district hospitals where they would work under the supervision of doctors, reduce the workload of doctors and increase access to healthcare in the Eastern Cape.

Aim

This study aimed to examine the role played by ClinAs in healthcare delivery in Eastern Cape district hospitals, and to determine whether the training of ClinAs adequately prepared them for this role.

Setting

The study was conducted in the Eastern Cape province of South Africa amongst ClinAs who graduated from WSU between 2011 and 2014, and healthcare workers from Madzikane KaZulu Memorial Hospital.

Methods

This was an exploratory cross-sectional mixed methods study with a convergent design. Surveys and in-depth interviews were conducted amongst ClinAs, nurses, doctors and one pharmacist. Both qualitative and quantitative data were analysed and reported.

Results

Clinical associates are seen to improve the workload of doctors, and to increase access to healthcare. Thirty-four percent of ClinAs were no longer contributing to healthcare in the Eastern Cape.

Conclusion

Clinical associates are making a significant contribution to access to healthcare in the Eastern Cape. Their supervision regimen needs to be revisited and factors that contribute to the attrition of ClinAs in the Eastern Cape need to be addressed.

Significant Improvement of Somatic Symptom Disorder With Brief Psychoeducational Intervention by PMHNP in Primary Care

OBJECTIVE

Patients with somatic symptom disorders (SSD) are prevalent in primary care, urgent care, and emergency rooms and present with reduced quality of life, increased disability, and suicidality . Criteria for SSD include (1) somatic symptoms that cause distress and disrupt life; (2) concurrent physical illness with thoughts and feelings that are disproportionate to the seriousness of the illness; and (3) distress which is persistent and causes suffering. The frequency of SSD in the general population is 5% to 7%; however, in primary care, it is 5% to 35% . Because patients present with anxiety, depression, and/or pain, providers are flummoxed when diagnostic findings do not match symptom intensity. The purpose of this project was to provide an intervention for patients with SSD and measure its effectiveness on their somatic symptoms.

METHOD

This study provided a single-session, 30-minute psychoeducational intervention for patients to explain brain pathways for pain and the body's response to stress, including scientific benefits of exercise and healthy diet. Patients were asked questions using the motivational interviewing technique OARS (open-ended question, affirmation, reflection, summary) and were encouraged to talk about their concerns. The study used a pre- and post-intervention visual analogue scale and a self-reported Patient Health Questionnaire-15 both before and 3 weeks post-intervention.

RESULTS

Measurements showed significant symptom improvement immediately after the intervention with sustained improvement 3 weeks post-intervention.

CONCLUSIONS

This intervention demonstrates an effective treatment for this insidious illness, which plagues up to 35% of patients in primary care.

Evaluation of a Genetics Education Program for Health Interpreters: A Pilot Study

Health Interpreters enable effective communication between health practitioners and patients with limited knowledge of the predominant language. This study developed and evaluated a training session introducing Health Interpreters to genetics. The online training was delivered multiple times as a single 2-h session comprising lectures and activities. Participants completed questionnaires (pre-, post-, and 6-months follow-up) to assess the impact of training on knowledge, attitude, self-efficacy, and self-reported practice behaviour. Questionnaires were analysed using descriptive statistics, Fisher’s Exact, or independent t-test. In total, 118 interpreters participated in the training sessions. Respondent knowledge improved, with gains maintained at 6-months (p < 0.01). There were no changes in self-efficacy, and attitudes. Training did not change self-reported practice behaviour, but there was notable pre-existing variability in participants’ methods of managing unknown genetic words. Most respondents agreed that training was useful (93%) and relevant (79%) to their work. More respondents reported learning more from the case study activity (86%) than the group activity (58%). Health Interpreters found the training acceptable and demonstrated sustained improvement in knowledge of genetic concepts. Increased delivery of this training and associated research is needed to assess findings in a larger cohort and to measure the impact on patients.

Knowledge and anxiety for dental treatments due to COVID-19 among general public

Introduction:

The fears, anxiety, and worries created among general population by COVID-19 are severe. The procedures which generate aerosols transmit most of COVID-19 transmission and we know one such procedure is dental treatment. After the COVID-19 pandemic, there is a change in health-care services; hence, this droplet transmission in dentistry became an issue which needs to be addressed.

Methodology:

A descriptive, online questionnaire survey was conducted among adults above 20 years. The questionnaire consisted of demographic details and questions related to anxiety and fear of considering dental treatment during this pandemic situation.

Results:

680 people responded for the study, among which 32% had COVID symptoms. 27% of them said that they are afraid of dental treatment during the pandemic whereas 47% said that they will accept if there is an emergency. The main reason for this fear was droplet infection in dental clinics.

Conclusion:

The fear of dental treatment during pandemic is moderate. This may be due to the self-care, positive behavior toward oral care by the people, and fear of cross-contamination due to airborne infections though the personal protective measures were followed.

Palliative Care Always: Hepatology-Virtual Primary Palliative Care Training for Hepatologists

Palliative care (PC) benefits patients with serious illness including end-stage liver disease (ESLD). As part of a cluster randomized trial, hepatologists were trained to deliver primary palliative care to patients with ESLD using an online course, Palliative Care Always: Hepatology (PCA:Hep). Here we present a multimethod formative evaluation (feasibility, knowledge acquisition, self-efficacy, and practice patterns) of PCA:Hep. Feasibility was measured by completion of coursework and achieving a course grade of >80%. Knowledge acquisition was measured through assessments before and throughout the course. Pre/post-course surveys were conducted to determine self-efficacy and practice patterns. The hepatologists (n = 39) enrolled in a 12-week online course and spent 1-3 hours on the course weekly. The course was determined to be feasible as 97% successfully completed the course and 100% passed. The course was acceptable to participants; 91.7 % reported a positive course experience and satisfaction with knowledge gained (91.6%). The pre/post knowledge assessment showed an improvement of 6.0% (pre 85.9% to post 91.9%, 95% CI [2.8, 9.2], P = 0.001). Self-efficacy increased significantly (P < 0.001) in psychological symptom management, hospice, and psychosocial support. A year after training, over 80% of the hepatologists reported integrating a variety of PC skills into routine patient care. Conclusion: PCA:Hep is feasible, acceptable, and improves learner knowledge and confidence in palliative care skills. This is a viable method to teach primary PC skills to specialists caring for patients with ESLD.

Occupational stress, mental health, and self-efficacy among community mental health workers: A cross-sectional study during COVID-19 pandemic

BACKGROUND

During the COVID-19, community mental health care workers (CMHWs) faced much heavier workloads, which make them vulnerable to mental problems.

AIM

This study aims to investigate coronavirus disease-related occupational stress and its single and cumulative effect on mental health and self-efficacy among CMHWs.

METHODS

A quick-response online cross-sectional survey WA conducted during the coronavirus disease outbreak. A total of 536 CMHWs were recruited in March 2020, in China. Demographics, occupational stress, depression, anxiety, positive and negative emotions, and self-efficacy were collected. Logistic regression analysis was employed to test the single and cumulative effect of occupational stress on mental health and self-efficacy.

RESULTS

CMHWs did not show high level of depression or anxiety in this study. Those who provided service for suspected people who were quarantined reported higher risk of depression and anxiety. Staying out for more than 3 days was a risk factor of depression while cleaning/sterilising streets or communities was a protective factor of depression. Those who received psychiatric training showed higher positive emotion and self-efficacy, and providing psychological assistance online increased the self-efficacy. CMHWs with two different types of work had 0.996 times more risk of depression than those with only one type of work.

CONCLUSION

The potential cumulative effect of occupation stress suggested that reasonable job assignment and organisational support are necessary safeguards for CMHWs.

Analysis of the psychometric properties of the five-factor self-concept questionnaire (AF-5) in Spanish students during the COVID-19 lockdown

The present research aims to analyse the psychometric properties of the AF5 questionnaire for its adaptation for use with young people during a lockdown period. Research was conducted with a sample of 534 students aged between 13 and 17 years (M = 14.49; SD = 1.805). Exploratory factor analysis was conducted using the FACTOR program and confirmatory factor analysis was conducted using the M-PLUS 7 program. Results indicate that a four-dimensional model is most appropriate for bringing together the emotional and physical dimensions. Further, 11 items were removed due to poor factor loadings. The majority of factors were directly and positively correlated (99%; p < .01). The data obtained supports conclusions that the AF-5 meets validity and reliability requirements for it to be considered a useful instrument for use with young people during the COVID-19 lockdown period.

Factors Affecting Resilience of Nursing, Optometry, Radiography and Medical Laboratory Science Students

Background: The concern over the high level of stress experienced by students of the caring professions has led to increased attention being paid to the promotion of their resilience. Most earlier studies have focused on the resilience of medical and nursing students. There has been little exploration of the resilience and associated factors of students of other health-care disciplines. The aim of this study was to gather data from students of pre-registration health-care disciplines to identify the factors that influence their resilience. Method: Valid questionnaires were used to assess respondents’ resilience, self-efficacy, mindfulness, coping and trait positive and negative affect. The data were analyzed using descriptive statistics and univariate and general linear regression. Results: A total of 1320 university students from nursing, medical laboratory science, radiography and optometry were recruited. The results showed that the subjects’ resilience scores were lower than those of students in Western countries. We found self-efficacy and denial to be the common predictors for students of all disciplines. Conclusion: The resilience of students in the four disciplines was predicted by a combination of predictors. Faculties of universities and clinical mentors should collaborate in building resilience in their health-care students and support them to grow both personally and professionally during their careers.

Predictor of self-efficacy in individuals with chronic disease: Stress-coping strategies

AIMS AND OBJECTIVES

This study aims to investigate the relationship between stress-coping strategies of individuals with chronic diseases and their self-efficacy.

BACKGROUND

Self-efficacy and coping with stress in chronic diseases affect the course of the disease.

DESIGN

The sample of this methodological study consisted of 178 patients who were hospitalised in a university hospital between November 2017 and November 2018.

METHODS

Data were collected by the face-to-face interview method using a Patient Information Form, Stress-Coping Styles Scale and Self-Efficacy Scale. This study followed STROBE checklist for cross-sectional studies.

RESULTS

The study found that there was a strong relationship between patients' coping strategies and their self-efficacies and that the variables that predict self-efficacy in order of importance were self-confident approach (β = .41), the helpless approach (β = -0.24) and the submissive approach (β = -0.15), respectively. The study also found that the optimistic approach and the seeking social support approach had no significant contribution to the model.

CONCLUSIONS

The most important predictor of self-efficacy in individuals with chronic disease was the self-confident approach, which was one of the problem-oriented coping strategies. Therefore, patients should be taught to use effective methods to cope with stress to increase their self-efficacy, and their self-confidence should be supported.

RELEVANCE TO CLINICAL PRACTICE

In individuals with chronic disease, self-efficacy has an important role to get better psycho-social adaptation. To determine patients' self-efficacy levels and predictors will guide nursing initiatives.

ECHO Autism: Evaluation of Participants’ Perceptions of Collaborative Telementoring Network

Introduction: Primary care clinicians report inadequate training and lack of support regarding identification of early signs of Autism Spectrum Disorder (ASD), resulting in later diagnosis and poor outcomes. The objective of this study was to evaluate the perception of participants in ECHO Autism project regarding the value of the virtual collaborative as a mentoring tool. Methods: We completed a retrospective cross-sectional study of post-virtual clinic surveys of all participants who attended Autism ECHO from September 2, 2015 to June 5, 2019. Results: There were 87 Autism ECHO sessions held, with 83 didactic presentations. A total of 92 de-identified patient cases were discussed with 490 unique learners in attendance. Participants reported increase in self-efficacy in identifying ASD symptoms in children, assessing medical comorbidities, and learning new information. Discussion: Continuing education platforms in healthcare professions are increasingly embracing virtual live-interactive conferences. They provide opportunities to connect with experts, but also hear from peers regarding real-life case examples. During COVID-19 pandemic ECHO Autism was a lifeline for rural providers and will likely continue to increase in participation.

Knowledge, attitude and self-efficacy program intended to improve public health professionals' ability to identify and manage perinatal depressive symptoms: a quasi-experimental study

BACKGROUND

During the perinatal period women lack screening and treatments for perinatal depressive symptoms, while public health professionals (PHPs) in primary care centres (PCCs) need training for identification and management of such symptoms. This quasi-experimental study was aimed at evaluating knowledge, attitudes and self-efficacy among PHPs after participating in a Knowledge, Attitude, and Self-efficacy (KAS) program for identification and management of perinatal depressive symptoms.

METHOD

The KAS-program, carried through in Sakonnakhon in north-eastern Thailand, comprised one day of theory and a four-week period of field practice. Thirty-three PHPs from PCCs participated in the program. Twenty-three of them participated in focus group discussions (FGDs). Chi-square for trend, paired-sample T-tests and content analysis were used.

RESULTS

Knowledge, attitude and self-efficacy scores increased after the PHPs had fully participated in the KAS-program. Four categories emerged from the FGDs: increased understanding and knowledge, being aware and having a positive attitude, having confidence and ability to work, and need of regular training and feedback.

CONCLUSION

The KAS-program may contribute to giving PHPs in PCCs the knowledge, positive attitude and self-efficacy they need to identify and manage perinatal depressive symptoms. Implementation of the KAS-program to other healthcare professionals such as nurses/midwives is great of interest.

Epidemiologic assessment of self-concept and academic self-efficacy in Iranian high school students: Multilevel analysis

INTRODUCTION

In social cognitive theory, self-efficacy and self-concept (SC) have been introduced as important constructs that associate with adolescents' achievements. The aim of this study was to investigate the determinant factors of academic self-efficacy (ASE) and SC in Iranian high school students based on the multilevel analysis.

MATERIALS AND METHODS

In this descriptive-analytical cross-sectional study, 1740 students from 53 high schools selected with stratified random sampling method in 2018 in Qazvin, Iran. Data collection tools were the Morgan and Jinks Self-Efficacy Scale and the Piers-Harris Children's SC Scale-Second Edition. The association between some of the students and school variables with ASE and SC was analyzed by hierarchical linear regression models.

RESULTS

The score of the students' standardized ASE was lower than SC. ASE and SC had a strong positive significant association with economic status, grade point average, and the educational period of high school. Sex had no association with any of them. Physical activity had a positive significant association with SC but was no found association by ASE.

CONCLUSION

These findings revealed that for improving the adolescents' ASE and SC should be attention to the adolescents' family condition and school-related factors. Proper educational, sports, and supportive programs can be effective on the adolescents' self-efficacy and SC.

Risk and Protective Factors of Well-Being among Healthcare Staff. A Thematic Analysis

The purpose of this study was to identify physical and psychosocial working conditions to improve well-being at work among healthcare staff. This is a potent area of inquiry given the relationship between healthcare staff well-being and service quality and other key organizational characteristics. However, while numerous studies in this area have used a quantitative methodology, very few have applied qualitative methodologies gathering subjective descriptions of the sources of well-being, providing in so doing significant data to explore in depth the factors that influence well-being in healthcare systems. We gathered qualitative data analyzing open-ended questions about risk and protective factors of well-being at work. The sample was made of 795 professionals answering an online questionnaire. Answers were coded and analyzed using the thematic analysis with an inductive approach (data-driven). We identified four themes strongly affecting professional well-being in health-care staff: Interactions, Working Conditions, Emotional Responses to Work, and Competence and Professional Growth. Our findings suggest possible strategies and actions that may be effective in helping to calibrate case-specific support and monitoring interventions to improve health and well-being of healthcare staff. We also discuss the implications of the study and suggest possible avenues for future empirical research.

Cross-Sectional Study of Self-Concept and Gender in Relation to Physical Activity and Martial Arts in Spanish Adolescents during the COVID-19 Lockdown

The COVID-19 lockdown has negatively affected individuals’ welfare. However, there has been no research published heretofore about the levels of self-concept (SC) in adolescents, nor how having practised martial arts (MA) or any physical activity (PA) before the lockdown may have influenced the SC in that time. Hence, this study aimed to analyze some demographic, physical, and psychosocial parameters in Spanish adolescents throughout the COVID-19 quarantine through a cross-sectional investigation, establishing correlations among these factors. Methods: The present study had a descriptive, comparative, and cross-sectional design. The sample comprised of 54 (39.7%) male and 82 (60.3%) female Spanish adolescents aged 12–18 (M = 14.49; SD = 1.80). An ad-hoc questionnaire collected sociodemographic data; the self-concept Form 5 (AF5) questionnaire obtained data on SC dimensions. Results: There were some differences among the SC dimensions, with family and academic dimensions having higher values than the physical and emotional ones. Females’ academic SC was higher than that of males (p = 0.019). The practice of PA before the lockdown was positively associated with physical (p < 0.001) and social (p = 0.012) SC, yet there was no significant association between the previous practice of MA and SC (p > 0.050). Conclusions: the findings suggest that the COVID-19 lockdown negatively affected Spanish adolescents by decreasing their total SC and some dimensions of it, although PA may buffer psychological harmfulness in adolescents.

Fear control and danger control amid COVID-19 dental crisis: Application of the Extended Parallel Process Model

OBJECTIVES

There is high risk of contamination with COVID-19 virus during routine dental procedures and infection control is crucial. The aim of this study was to determine the factors associated with Covid-19 preventive behaviors among oral health care providers using an extended parallel process model (EPPM).

METHODS

In a cross-sectional study, short text message invite surveys were sent to 870 oral health care providers in west part of Iran. Data were collected through validated self-report EPPM questionnaires. Descriptive statistics, Chi-square and Fishers exact tests were used for data analysis.

RESULTS

In total, 300 completed questionnaires were received and the mean age of respondents was 29.89 ± 11.17 years (range: 20-75 years). Among the study population, 284 (94.67%) perceived the threat of infection highly. Washing hands frequently with water and soap and use of hand sanitizer was reported by 93.33%, of participants. Age (P = 0.010), sex (P = 0.002) and occupation field (P = 0.010) were significantly associated with danger control responses. Data identified that those oral health care providers that were on the danger control response adopted preventive behaviors more strictly than those on fear control response.

CONCLUSION

The results of this study showed how degrees of perceived threat and perceived efficacy influenced oral health providers' willingness to perform recommended health behaviors. These findings can assist public health agencies in developing educational programs specifically designed for promoting preventive behaviors among oral health providers in pandemic situations.

The Mediating Role of Psychological Capital in the Relationship Between Occupational Stress and Fatigue: A Cross-Sectional Study Among 1,104 Chinese Physicians

Purpose: This study aimed to explore the association of occupational stress with fatigue and to examine the mediating role of psychological capital (PsyCap) among Chinese physicians. Materials and Methods: A cross-sectional study was conducted in Liaoning province, China, in 2018. Using a multistage stratified sampling method, a total of 1,500 physicians participated and 1,104 (73.6%) physicians responded effectively. The study used a self-administered questionnaire consisting of the 14-item Fatigue Scale (FS-14), the Effort-reward Imbalance questionnaire (ERI), the Psychological Capital Questionnaire (PCQ) and items about demographic and working characteristics. Hierarchical multiple regression analyses were performed to explore the association of occupational stress, PsyCap, and fatigue among physicians. Asymptotic and resampling strategies were used to examine the mediating effect. Results: The incidence of fatigue among Chinese physicians was 83.70%. The average level of fatigue was 7.96 ± 3.95 (mean ± SD). Occupational stress and PsyCap were significantly associated with fatigue. PsyCap significantly mediated the association of ERR (a × b = 0.106, bias-corrected and accelerated 95% confidence interval [BCa 95% CI]: 0.078, 0.138) and overcommitment (a × b = 0.068, BCa 95% CI: 0.044, 0.092) with fatigue. Two important components of PsyCap, self-efficacy and resilience, play more important roles in the mediating effect. Conclusions: The level of fatigue among Chinese physicians was high, which should be taken seriously by management. PsyCap could mediate the association between occupational stress and fatigue. The intervention strategies and measures to relieve fatigue could be focused on physicians' positive PsyCap improvement.

Intervention intended to improve public health professionals' self-efficacy in their efforts to detect and manage perinatal depressive symptoms among Thai women: a mixed-methods study

Background

Targeting perinatal depressive symptoms among women can reduce premature mortality. However, public health professionals (PHPs) in primary healthcare settings often have low self-efficacy for detection and management of perinatal depressive symptoms among women. This mixed-methods study was aimed at developing and evaluating a self-efficacy improvement programme (SIP) intended to increase PHPs’ self-efficacy in efforts to detect and manage perinatal depressive symptoms.

Methods

The SIP consisted of 1 day of theory and 4 weeks of practice. Sixty-six PHPs from sub-district health promotion hospitals (primary health care level) in Sakonnakhon, a north-eastern province in Thailand, were randomised into an intervention group (n = 33) and a control group (n = 33). Twenty-three of the intervention group participants also took part in focus group discussions (FGDs). Multiple linear regression and qualitative content analysis were used to analyse the data.

Results

After the SIP, the intervention group participants had higher self-efficacy score than those in the control group (p = 0.004). The FGDs resulted in four categories emerging: Having confidence, Changing knowledge and attitudes, Increasing perception of an important role, and Increasing awareness of performed function.

Conclusions

To enhance the ability of PHPs to detect and manage perinatal depressive symptoms, an intervention programme based on self-efficacy modification is recommended.

Development and testing of an instrument (HeSoEduCo) for health and social care educators' competence in professional education

BACKGROUND

Health and social care education is highly important for preparing future professionals for their future roles in sustainable health and social care. However, previous studies have emphasized that health and social care educators' competence is complex and poorly defined. Thus, there is a clear need for a psychometrically validated instrument to enable clarification and assessment of the required skills.

OBJECTIVE

To develop and psychometrically validate an instrument (the HeSoEduCo) for assessing health and social care educators' competence in higher and professional education.

DESIGN

Cross-sectional study.

METHODS

A HeSoEduCo instrument, with items inviting 1-4 Likert scale responses, was developed, based on one systematic review and one qualitative study, then validated in terms of face, content and construct validity and internal consistency (Cronbach's alpha values). All health and social care educators based in all 21 universities of applied sciences in Finland and seven vocational colleges were subsequently invited to participate in a large-scale application of the instrument in fall 2018. In total, responses of 390 of these educators are analyzed here.

RESULTS

The face and content validity of 71 newly developed items were assessed by experts in two evaluation rounds. The final content validity showed high scores for the instrument's relevance and clarity. Confirmatory factor analysis (to test construct validity) yielded eight factors (43-items remaining), defining the following competence areas of educators: evidence-based practice, digital collaborative learning, student-centered pedagogy, collaboration & societal, leadership & management, cultural & linguistic diversity, mentoring student into professional competence development and subject & curriculum. Cronbach's alpha values for the factors ranged from 0.70 to 0.89.

CONCLUSION

The instrument can be used to obtain self-evaluations of educators' competence when assessing their general competence levels and help human resources departments and managers to identify suitable continuous education programs for their staff.

Training programs in communication skills to improve self-efficacy for health personnel: Protocol for a systematic review and meta-analysis

BACKGROUND

Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel.

METHODS

This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible.

RESULTS

This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy.

DISCUSSION

This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care.

DISSEMINATION AND ETHICS

The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42019129384.

Effectiveness of an Oral Health Promotion Program for the Elderly in Khiri Mat District, Sukhothai Province: A Randomized Control Trial

Objectives:

Oral disease is one of the most common health problems among the elderly, which impacts the quality of life. Applying the Health Belief Model (HBM) in oral health promotion is expected to improve the effectiveness of prevention and promotion that restricts oral health problems. The aim of the present study was to determine the effectiveness of an oral health promotion program on oral health behavior and oral status among the elderly in Khiri Mat, Thailand.

Materials and Methods:

A prospective randomized control trial was carried out among 162 elderly people for 6 months. They were interviewed to gather oral health behaviors and perception information, followed by an oral health examination. The experimental group received oral health education based on the HBM theory and tooth brushing practice in a small group of 4–5 persons, and then they were remotivated to support behavior change at 1 and 3 months. The control group received traditional oral health activity. All the elderly were followed up at 6 months. Data were analyzed using the t-test, Mann–Whitney test, Chi-square, and logistic regression.

Results:

The elderly in the experimental group had significantly higher oral health perception, lower plaque scores, lower gingival inflammation, and lower clinical attachment loss than those in the control group (P < 0.05).

Conclusion:

This oral health promotion program improved oral health perception, behavior, and oral health status of the elderly.