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Talat N, Khan RA, Khan KA, Aziz MU, Tahir W, Mirza MB. Reliability and validity of Urdu PARENTS for assessing non-technical skills of paediatric residents in a teaching hospital in Pakistan. BMC MEDICAL EDUCATION 2023; 23:951. [PMID: 38087274 PMCID: PMC10717365 DOI: 10.1186/s12909-023-04938-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE The primary objective of our study is twofold. First, we assessed nontechnical skills (NTSs), such as the cognitive, social, and personal skills of postgraduate residents (PGRs), from paediatric caregivers' perspectives in a paediatric emergency department (PED) of a tertiary care hospital. Second, we evaluated the reliability and validity of the 'Parents' Assessment of Residents Enacting Non-Technical Skills' (PARENTS) instrument in its Urdu-translated version, ensuring its applicability and accuracy in the Pakistani context. MATERIALS AND METHODS This mixed-method study used an instrument translation and validation design. We translated an existing instrument, PARENTS, into Urdu, the national language of Pakistan, and administered it to paediatric caregivers in the PED of a tertiary care hospital. We collected data from 471 paediatric caregivers and coded them for analysis in AMOS and SPSS. RESULTS The Urdu-translated version of the PARENTS demonstrated reliability and internal validity in our study. The findings from the assessment revealed that paediatric caregivers expressed satisfaction with the knowledge and skill of residents. However, there was comparatively lower satisfaction regarding the residents' display of patience or empathy towards the children under their care. CONCLUSION The study findings support the validity and reliability of the PARENTS as an effective instrument for assessing the NTS of PGRs from the perspective of paediatric caregivers. With its demonstrated efficacy, medical educators can utilize PARENTS to pinpoint specific areas that require attention regarding the NTS of PGRs, thus facilitating targeted interventions for enhanced patient care outcomes.
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Affiliation(s)
- Nabila Talat
- Department of Paediatric Surgery, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan.
| | - Rehan Ahmed Khan
- Department of Medical Education, Riphah International University, Islamabad, Pakistan
| | - Khalid Ahmad Khan
- Department of Management Sciences, Riphah International University, Lahore, Pakistan
| | - Muhammad Usama Aziz
- Department of Paediatric Surgery, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | - Warda Tahir
- Department of Paediatric Surgery, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
| | - Muhammad Bilal Mirza
- Department of Paediatric Surgery, University of Child Health Sciences, The Children's Hospital, Lahore, Pakistan
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Iskandar D, Suryanegara FDA, van Boven JFM, Postma MJ. Clinical pharmacy services for tuberculosis management: a systematic review. Front Pharmacol 2023; 14:1186905. [PMID: 37484021 PMCID: PMC10360183 DOI: 10.3389/fphar.2023.1186905] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Objective: This study aims to systematically review the content and potential effects of clinical pharmacy services in tuberculosis (TB) care management. Methods: Searches were performed in PubMed, Embase, Cochrane, Scopus, and Web of Science databases following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Study characteristics and outcomes were extracted, and clinical pharmacy service components were characterized using the Descriptive Elements of Pharmacist Intervention Characterization Tool. Results: Twenty articles were included for full-text assessment, of which 10 fulfilled inclusion criteria, comprising 1,168 patients (N = 39 to 258 per study). These articles included five prospective cohort studies, two case-control studies, two quasi-experimental studies, and one cross-sectional study. Intervention foci within clinical pharmacy services were medication adherence (50%), medication safety (40%), education to patients/caregivers regarding needs/beliefs (30%), optimizing medication/therapy effectiveness (30%), emphasizing HRQoL (10%), and drug selections (10%). The three most frequently applied interventions were drug information/patient counseling (80%), adverse drug reaction monitoring (50%), and drug use evaluation (20%). Based on the World Health Organization (WHO) outcome classification, treatment success ranged from 72% to 93%, with higher cure outcomes (53%-86%) than treatment completion (7%-19%). Other outcomes, including isoniazid metabolites, medication counts, sputum conversion, adherence/compliance, knowledge, and quality of life, were better in the intervention group than those in comparator groups, and/or they improved over time. Risk of bias analysis indicated that the included studies were not comparable to a randomized clinical trial. Conclusion: Clinical pharmacy services as single or composite interventions potentially improve TB outcomes, but its evidence is still inconsistent and limited due to the lack of randomized controlled studies using the WHO outcome classification. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=199028, identifier CRD42020199028.
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Affiliation(s)
- D. Iskandar
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Faculty of Pharmacy, Bhakti Kencana University, Bandung, Indonesia
| | - F. D. A. Suryanegara
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Islam Indonesia, Yogyakarta, Indonesia
| | - J. F. M. van Boven
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
| | - M. J. Postma
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Economics, Econometrics, and Finance, Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
- Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
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Khan FU, Asghar Z, Tipu MK, Rehman AU, Khan A, Ur-Rehman T. Effect of Displacement on Adherence to TB Treatment: An Observational Study in TB Patients from Internally Displaced Persons of Pakistan. Pak J Med Sci 2021; 37:675-679. [PMID: 34104146 PMCID: PMC8155409 DOI: 10.12669/pjms.37.3.2992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: This study was aimed to investigate TB patients adherence and treatment outcomes among internally displaced patients in comparison with adjacent settled areas. Methods: The study was designed as an observational cross-sectional study among the TB patients of internally displaced populations (IDPs) of North Waziristan Agency (NWA) and adjacent settled areas of Bannu and Lakki Marwat (NIDPs). Based on the study inclusion and exclusion criteria 330 patients fullfilled the inclusion criteria and were assigned equally to both IDPs and NIDPs study groups. Odds ratio (OR) with 95% confidence interval was calculated and p-values, 0.05 were considered statistically significant. Results: The treatment outcomes with the status of “cured” and “completed treatment” were better among NIDPs as compared to IDPs. Patients with treatment outcome status of “defaulted treatment”, “without documentary evidence, and “failure” were high in IDPs as compared to NIDPs. Adherence to TB treatment was better among NIDPs (50.9%) as compared to IDPs (39.4%). The patients showing non-adherence to TB treatment were more among IDPS (27.3%) than NIDPs (10.9%). Conclusion: Overall results of this study revealed a poor adherence to the TB treatment medications with an odds ratio of 0.286, (p<0.05) among IDPs as compared with NIDPs.
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Affiliation(s)
- Farman Ullah Khan
- Farman Ullah Khan, Department of Pharmacy, Faculty of Biological Science, Quaid-i-Azam University, 45320 Islamabad, Pakistan
| | - Zahid Asghar
- Zahid Asghar, School of Economics, Faculty of Social Sciences, Quaid-i-Azam University, 45320 Islamabad, Pakistan
| | - Muhammad Khalid Tipu
- Muhammad Khalid Tipu, Department of Pharmacy, Faculty of Biological Science, Quaid-i-Azam University, 45320 Islamabad, Pakistan
| | - Asim Ur Rehman
- Asim.ur.Rehman, Department of Pharmacy, Faculty of Biological Science, Quaid-i-Azam University, 45320 Islamabad, Pakistan
| | - Asif Khan
- Asif Khan, District TB Control Program, Bannu, 28100 Khyber PakhtunKhwa, Pakistan
| | - Tofeeq Ur-Rehman
- Tofeeq Ur-Rehman, Department of Pharmacy, Faculty of Biological Science, Quaid-i-Azam University, 45320 Islamabad, Pakistan
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