A seesaw of equilibrium, midwives' experiences of infection prevention and control guideline adherence: A qualitative descriptive study

Background

Infection prevention and control guidelines play a key role in preventing infections which can impact mothers and their newborn's quality of life. Despite the presence of evidenced-based infection prevention and control guidelines, midwives' adherence can be suboptimal internationally. The identification of facilitators and barriers to infection prevention and control guidelines can support practice and facilitate midwifery care.

Aim

To understand midwives' experiences of the barriers and facilitators when adhering to infection prevention and control guidelines.

Methods

A qualitative descriptive study using semi-structured interviews with 10 midwives from February to March 2022. The interviews were audio recorded, transcribed verbatim, and analysed utilising Braun and Clarke's thematic analysis framework involving the six steps of becoming familiar with the data, generating initial codes, generating themes, reviewing themes, defining and naming the themes, and presenting themes.

Findings

Two themes developed; seesaw for equilibrium and back to basics: learning on your feet. Midwives experienced conflicting emotional motivators in the need for professional integrity towards infection prevention and control guideline adherence. The work environment impacts on midwives' ability to adhere to guidelines and communication and education have a vital role to play in infection prevention and control guideline adherence.

Conclusions

While midwives have a strong sense of protection of professional integrity, work conditions such as environment, organisational structures, and management systems affect midwives' adherence to infection prevention and control guidelines. Effective education, training, and communication are required to promote infection prevention and control guideline adherence.

Evaluating Patients' Health Literacy to Improve Thyroid Pathology Reports

INTRODUCTION

As our growing population demonstrates a significant increase in the incidence of thyroid cancer, so does patient access to their medical records. Poor health literacy and understanding of disease severity, underscores the importance of effective and accessible patient-doctor communication. No previous studies on patient understanding of thyroid pathology reports exist; therefore, we sought to characterize health literacy in this population.

METHODS

Using a modified Delphi technique, a 12-question multiple-choice survey regarding common pathology terms with possible definitions for each term was synthesized and administered to patients in a high-volume endocrine surgery clinic. Survey results, patient demographics, history of prior thyroid procedure (biopsy or surgery), and self-reported health literacy were collected. Data analysis included t tests, chi-squared, and multivariable linear regression using R.

RESULTS

The survey was completed by 54 patients (response rate: 69.8%). On univariate analysis, White race, previous thyroid procedure, and at least a high school level education were all more likely to score higher on the survey than their counterparts (P < 0.05). On multivariable logistic regression for predicting a higher survey score, only race (est: 2.48 [95% confidence interval: 1.01-3.96]) and higher educational attainment (est: 3.98 [95% confidence interval: 2.32-5.64]) remained predictive (P < 0.05). The remaining demographic groups (age, health literacy confidence, and previous thyroid procedure) did not show a statistically significant difference.

CONCLUSIONS

Overall, terms on a thyroid pathology report are poorly understood by patients. This is exacerbated by non-White race and low educational attainment. There is a need for patient-facing pathology education.

Finding a path in a methodological jungle: a qualitative research of resilience

Qualitative research provides an in-depth understanding of lived experiences. However, these experiences can be hard to apprehend by using just one method of data analysis. A good example is the experience of resilience. In this paper, the authors describe the chain of the decision-making process in the research of the construct of "resilience". s The authors justify the implications of a multi-method, pluralistic approach, and show how the triangulation of two or more qualitative methods and integration of several qualitative data analysis methods can improve a deeper understanding of the resilience among people with chronic pain. By combining the thematic analysis, narrative analysis, and critical incident technique, lived experiences can be seen from different perspectives.Therefore, the thematic analysis describes the content and answers to "what" regarding resilience, the narrative analysis describes the dynamics of resilience, and answers to "how", while the critical incident technique clarifies the most significant experience and the answers to "why" changes happen. This integrative approach could be used in the analysis of other psychological constructs and can serve as an example of how the rigour of qualitative research could be provided.

Factors affecting digital technology access in vocational education

If policies are not thoroughly designed, technology integration may fail. As a result, users' perceptions of technology, especially access to digital technology, are critical for technology integration in education. This study aimed to develop and validate a scale to model factors affecting digital technology access for instructional use in Indonesian vocational schools. The study also reports the structural model of the path analysis and tests of differences based on geographical areas. A scale adapted from prior studies was established, validated, and examined for its validity and reliability. A total of 1355 responses were measurable; partial least squares structural equation modeling (PLS-SEM) and t-test procedures were applied for the data analysis. The findings informed that the scale was valid and reliable. For the structural model, the strongest relationship emerged between motivational access and skills access, while the lowest existed between material access and skills access. However, motivational access has an insignificant effect on instructional use. The t-test results show that geographical areas were significantly different regarding all involved variables.

Developing an Anxiety Screening Tool for Children in South Africa: Protocol for a Mixed Methods Study

BACKGROUND

Early childhood experiences such as trauma, exposure to violence, and poverty can significantly contribute to childhood anxiety, which is viewed as the most common mental health issue among children. In South Africa, there is no uniform tool to screen for anxiety during early childhood. This study aims to develop a tool to screen for anxiety in children aged 4 to 8 years, which could be utilized by preschool and foundation phase teachers to aid in the early identification of childhood anxiety.

OBJECTIVE

The overall objective of this study is to explore understanding and perceptions of childhood anxiety among teachers, parents, and experts and to develop a tool to screen for anxiety in children aged 4 to 8 years.

METHODS

This project will use a mixed method design that will consist of 4 stages. Stage 1 will consist of a scoping review. In Stage 2, data will be collected via semistructured interviews with 60 participants, including parents, teachers, and experts, and will be thematically analyzed. Stage 3 will consist of 20 experts and the researcher collaboratively formulating the proposed screening tool in the form of an e-Delphi component. Once the tool is refined, it will be piloted in Stage 4 with 20 teachers, and data will be analyzed with the Shapiro-Wilk test to test for normality. Additionally, factor analysis will be done to refine and restructure the tool as necessary.

RESULTS

This project was funded from April 2020 to December 2021. Data collection began in September 2022 and is projected to conclude in December 2022 for the qualitative component. The e-Delphi component is expected to be carried out from March to November 2023. Ethical approval was obtained from the Biomedical Research Ethics Committee in November 2021.

CONCLUSIONS

Anxiety in early childhood has been linked to various repercussions in adolescence and adulthood, such as school dropout, substance abuse, anxiety disorders, depression, and suicide ideation. Therefore, identifying the presence of anxiety earlier on and providing the necessary referral services could aid in reducing the negative consequences of unidentified and untreated anxiety in early childhood.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/37364.

Student use of digital libraries during COVID-19: structural equation modelling in Indonesian and Malaysian contexts

Purpose

This paper aims to examine the determinants that drive digital library use by university students in Indonesia and Malaysia during COVID-19. A proposed model based on the unified theory of acceptance and use of technology model-2 was implemented.

Design/methodology/approach

A pilot study was conducted prior to the main data collection to examine the reliability of the instrument. For the structural model assessment, 1,168 responses were analysed through partial least square structural equation modelling (PLS-SEM) and importance and performance analysis (IPMA). A t-test was also conducted to support the main findings.

Findings

Most hypotheses are confirmed by the significant results reported through the PLS-SEM. The strongest determinant of behavioural intention is habits. Digital library use is most significantly predicted by behavioural intention. Through IPMA, habits are reported to be the most important determinant for behavioural intention. Performance expectancy obtains the highest performance in the IPMA procedure. Behavioural intention and digital library use are significantly different based on the respondents’ location.

Originality/value

This study addresses the research gap (comparative studies between two countries) by evaluating digital library use among students in two universities in Indonesia and Malaysia during COVID-19. Findings could facilitate policymakers with insights into digital library use determinants and initiate effective and efficient policies to improve digital library use, especially during school closures due to certain situations or conditions.

The Role of the Cultural and Creative Industries in Sustainable Development of Small Cities in Latvia

While sustainability is a much-researched issue, little has been written about the role of cultural and creative industries (CCIs) in implementing sustainable development, specifically in small cities. The authors pose the following questions: What is the interrelation between CCI practices and the four pillars of sustainability (economic, environmental, cultural, and social) in small cities? What are the practices that CCIs use, and which they perceive as contributions to sustainable development? The authors use a single case study strategy, methods including a theoretical study, a quantitative pilot survey, a focus group discussion, semi-structured interviews, and content analysis. Overall, the article indicates that there is a varied and diverse repertoire of small- and large-scale practices carried out by CCIs in small cities in Latvia, and thus contributes to the existing scholarly literature by “teasing out” those practices. The study indicates that each of the practices may contribute to two or more sustainability pillars, thus they are analyzed in pairs to find out what traits are reflected in these practices. Notably, CCI entrepreneurs believe that sustainable development is important and that they contribute to it.

A Nationwide Evaluation of the Prevalence of Human Papillomavirus in Brazil (POP-Brazil Study): Protocol for Data Quality Assurance and Control

BACKGROUND

The credibility of a study and its internal and external validity depend crucially on the quality of the data produced. An in-depth knowledge of quality control processes is essential as large and integrative epidemiological studies are increasingly prioritized.

OBJECTIVE

This study aimed to describe the stages of quality control in the POP-Brazil study and to present an analysis of the quality indicators.

METHODS

Quality assurance and control were initiated with the planning of this nationwide, multicentric study and continued through the development of the project. All quality control protocol strategies, such as training, protocol implementation, audits, and inspection, were discussed one by one. We highlight the importance of conducting a pilot study that provides the researcher the opportunity to refine or modify the research methodology and validating the results through double data entry, test-retest, and analysis of nonresponse rates.

RESULTS

This cross-sectional, nationwide, multicentric study recruited 8628 sexually active young adults (16-25 years old) in 119 public health units between September 2016 and November 2017. The Human Research Ethics Committee of the Moinhos de Vento Hospital approved this project.

CONCLUSIONS

Quality control processes are a continuum, not restricted to a single event, and are fundamental to the success of data integrity and the minimization of bias in epidemiological studies. The quality control steps described can be used as a guide to implement evidence-based, valid, reliable, and useful procedures in most observational studies to ensure data integrity.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR1-10.2196/31365.

Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research

OBJECTIVES

To capture the extent and nature of intellectual disability nursing publications in Ireland.

DESIGN

Scoping review using Arksey and O'Malley approach.

DATA SOURCES

Six databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were searched along with a web-based search of the eight academic institutions delivering intellectual disability nurse education in Ireland for publications indexed from the earliest available date to the 31 December 2020.

ELIGIBILITY CRITERIA

Publications by an academic, practitioner or student working in intellectual disability practice or education in Ireland relating to intellectual disability nursing, care or education.

DATA EXTRACTION AND SYNTHESIS

Data pertaining to type of paper/design, authors (academic/professional/student), year, collaboration (national/international), topic/content area and title were extracted from each paper. Data were analysed by two authors using Colorafi and Evans content analysis steps where data was tabulated, and a narrative synthesis undertaken.

RESULTS

The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and PRISMA extension for Scoping Reviews Checklist. Database and web-based searching resulting 245 articles meeting the criteria for this review. Through content analysis the 245 articles were mapped onto six themes: supporting inclusion, future planning, aspects of health, interventions, education, professional development and research, and personal and professional accounts of caring.

CONCLUSIONS

This review highlights the extent and nature of intellectual disability publications by academic, practitioner or student working in intellectual disability nursing in Ireland together with opportunities for future growth and development. From the findings it is apparent that there is an ongoing need for intellectual disability nurses to define their role across the full trajectory of health provision and to make visible their role in person-family centred support, inclusion, and contributions in health education, health promotion and health management.

Are professional pharmacy services being offered for free in pharmacies? A feasibility study exploring the use of a time motion study in New Zealand

Background

Pharmacists report to be providing patient-focused clinical services for which they receive no remuneration. Limited literature exists about unfunded services leading to difficulties in ascertaining an appropriate study design for such research.

Objective

This study aims to assess the appropriateness of a proposed study design before launching a nationwide study to investigate the provision of unfunded patient care services.

Methods

A multi-methods approach was utilised consisting of (1) continuous time motion study in community pharmacies (2) semi structured patient interviews (3) patient follow up (4) semi structured interviews with pharmacy owners/managers. All observations of unfunded patient care services were recorded, numerically coded and descriptively analysed. Semi structured interviews were audio recorded and transcribed verbatim. A semantic thematic analysis was carried out. Appropriateness of study design was dictated by the ability to characterise services and obtain patient perceptions.

Results

Ten pharmacies took part in the feasibility study, across the city of Dunedin, New Zealand, representing a range of different practice settings and demographics. Ten patients were interviewed and six responded to follow up. Both pharmacy and patient recruitment proved challenging due to concerns around disruption to workflow and patient privacy. A continuous observation time motion study was found to be appropriate as it minimises disruption to workflow with no additional work required from the pharmacy teams.

Conclusions

A continuous observation time motion study proved to be an appropriate method to investigate the provision of unfunded services on a national scale. The findings of the study suggest design changes such as length of observation time, increasing patient recruitment and additional patient questions to enhance the nationwide study.

Perspectives of illicit marijuana growers and traders on commercial legalisation of marijuana in South Africa: considerations for policy formulation

Background

Over the years, there has been a clarion call for legalising marijuana cultivation and trading for commercial purposes in South Africa. Proponents of the call argue that the criminalisation of commercial marijuana cultivation and trading has failed to halt illicit marijuana cultivation and trading. However, the views of those who economically benefit from the illicit marijuana trade on its legalisation remain empirically unsolicited.

Objective

This study aimed to solicit the views of illegal marijuana growers and traders from two selected communities in the Eastern Cape Province of South Africa regarding the commercial legalisation of marijuana cultivation and trading to inform policy on the debate.

Methods

In-depth key informant interview approach was used to interview 18 purposively sampled participants that were selected through the snowball sampling technique. The data were analysed using the thematic content analysis approach.

Results

Participants had both positive and negative perceptions of the possible legalisation of marijuana cultivation and trading. On the positive side, participants indicated freedom from police, the opportunity to grow marijuana on a larger scale, capital acquisition for commercial marijuana cultivation and trading, and regulation of marijuana prices through unionisation as some of the benefits they would derive from the commercial legalisation of marijuana cultivation and trading. On the negative side, loss of their source of livelihood, fall in the price of marijuana and perceived increase in school drop-out rates were the concerns raised.

Conclusion

While participants relished improvement in their economic fortunes upon commercial legalisation of marijuana cultivation and trading, they were also apprehensive about this policy due to the perceived consequences it may have on their livelihoods and communities. We, therefore, recommend that future discussions of the commercial legalisation of marijuana cultivation and trading in South Africa should be done in consultation with illicit marijuana growers and traders to ensure that their interests are safeguarded by such a policy.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13011-021-00391-w.

Mental health research studies in Saudi Arabia for the years 2009-2019; a systematic scoping review

BACKGROUND

An updated systematic scoping review and narrative analysis of all possible mental health studies done during the concerned immediate years clarifies its present condition and status for all professionals, and concerned researchers.

AIMS

To synthesize published mental health research studies in and for Saudi Arabia for the years 2009-2019 with the confidence to evaluate current situation, identify research gaps and limitations (if any), and assist in conceptualizing the forthcoming directions of future mental health research activities.

METHODS

Scoping systematic review and modified narrative analysis were the methods utilized to achieve the aim and objective set for this formal academic endeavor.

RESULTS

Of the 1006 published studies identified from chosen databases, a total of 241 papers were included and had passed the stringent criteria set for the scoping review process. Basic characteristics of the reviewed studies were quantitative survey type with about 101-500 size range of respondents, utilizing non-patients and adults for participants which were common and randomly chosen from selected population, and most research activities were self-funded. Four major research themes were found including a list of research limitations.

CONCLUSIONS

This systematic scoping review identified a wide range of results characterizing the different studies that qualified using pre-determined inclusion-exclusion criteria. Though of increasing publication volume in the past decade, most researches done were quantitative survey type whose themes seemed to show no drastic difference or change from the previous years of output. More variety in research themes would further improve the over-all quality of mental health publications.

Methods in population study of orofacial injuries in Victorian family violence homicides

This study standardized the methods used in the determination of orofacial injuries in Victorian family violence homicides and informed potential control selection for an analytic study. Dental service contacts with family violence victims may be intervention avenues due to the presence of abusive injuries in the orofacial region. All Victorian family homicides from January 2000-September 2018 were identified by determining the kinship/relationship and grouped by age. A 20% random sample of adult cases, aged 18-64 years was selected. The median number of orofacial injuries in categories of injury mechanisms/age/gender and the nature of abusive orofacial injuries was reported for the sample. Of 357 closed cases of family homicide, 261 were adults aged 18-64 years. Offender information and injury mechanism data was available for all closed cases, enabling case selection. Of a random sample of 50 adults, 8 cases were excluded. After 2006, CT scans and photos were present in 20 (91%) and 19 (86.4%) of 22 cases, respectively. The nature and median number of orofacial injuries showed correlation to the reported injury mechanism. Strengths and limitations of the used methods were assessed. Not all cases were compatible for assessment of orofacial injuries, thus serving as an additional criterion for exclusion in our methodology. Further detailed study of the whole population of adults should be limited to the period 2006-2018 where the data is more complete. The mechanism of injury may influence control selection for analytic studies. We present preliminary evidence of the frequent occurrence of orofacial injuries in family violence homicides.

Delivering Tobacco Cessation Through Community Health Workers: Curriculum and Training Considerations

Texas faces unique barriers in health status and risk behaviors such as smoking. To address tobacco use, community health workers (CHWs) are a resource for disseminating education among a population. To promote smoking cessation in Texas, there is a need for the development of a smoking cessation training program for CHWs. The National Community Health Worker Training Center used an approach with CHWs to develop a curriculum. From the curriculum development and with feedback from CHWs, 4 training courses were produced: online and in person, and in English and Spanish. The curriculum meets a need that disseminates smoking cessation strategies through peer-led, culturally relevant messages.

Design and psychometric testing of instruments to measure qualified intensive care nurses' attitudes toward obese intensive care patients

The purpose of this pilot study was to design and test research instruments to measure qualified intensive care nurses' implicit and explicit attitudes and behavioral intentions toward obese intensive care patients. In previous studies researchers have demonstrated that some health professionals hold negative attitudes toward obese patients; however, little is known about qualified intensive care nurses' attitudes toward these patients. Our cross-sectional pilot study involved Implicit Association Tests, the Anti-fat Attitude questionnaire, an explicit bias scale comprising ratings of explicit beliefs and feelings, assessment of behavioral intentions based on vignettes, and demographic questions. Thirty qualified intensive care nurses from a general intensive care unit in Norway (80% female; age range 31-62 years) completed the study. Nurses reported implicit and explicit preferences for thin over thick patients and found obese patients lazier than normal-weight patients. Measures of behavioral intentions and anti-fat attitudes were reliable. Generally, the nurses intended to help obese patients immediately. Nevertheless, explicit anti-fat attitudes (rho = -0.49) as well as implicit anti-obese stereotypes (rho = -0.40) were negatively correlated with such intentions. Data supported satisfactory face validity, and convergent and discriminant validity within and between implicit and explicit attitudes and stereotypes. The set of research instruments were reliable, valid, and suitable tools to measure qualified intensive care nurses' implicit and explicit attitudes; however, the present findings need to be replicated in a larger-scale study.

Exploring nursing staff views of responsive behaviours of people with dementia in long-stay facilities

WHAT IS KNOWN ON THE SUBJECT?: Caring for people with dementia and responsive behaviours is challenging; however, little is known of nurses' experiences of responsive behaviours. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: To demonstrate understanding nurses need to be aware of their own actions, thoughts, attitudes and reactions. Time, education and management support are essential in enabling a person-centred approach. A decision regarding the place of care is difficult to come to, and given the drive to a person-centred approach, there is a need to consider the views of people with dementia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing staff supporting people with dementia should engage more frequently in reflective practice, ongoing education and decision-making. Service providers/managers need to have an understanding of the complexities of caring for a person with dementia and responsive behaviours and provide their staff with relevant supports and education that is accessible to all staff.

ABSTRACT

Introduction Caring for people with dementia and responsive behaviours can challenge nurses, and little is known of their experiences. Aims To explore nurses' views of supporting people with dementia and responsive behaviours in long-stay facilities. Methods A qualitative descriptive study utilizing in-depth audio-recorded interviews of nine nurses, recruited from private and public care facilities. Qualitative content analyses conducted involving iterative comparisons of transcripts, summaries and memos, where coding, key quotes and tables were developed to determine themes. Results Four themes emerged: recognizing and understanding responsive behaviour, resources and interventions to support people with dementia and responsive behaviour, the impact of education on nursing practice and the care environment. Discussion Availability of staff, adequate time and financial restraints hinder nurses' ability to provide care. Access to ongoing education and being able to provide one-to-one care was valued as dementia-specific education changed nursing practice. Implications for practice Place of care was seen as dependent on the type of responsive behaviour in question, the duration of the behaviour and the impact of the behaviour on the person, other residents and staff. Dementia education needs to be accessible to all staff, and a collaborative approach is necessary in order to develop management guidelines and support strategies.

Development of a Pilot Grants Program in Social Determinants of Health in American Indian Health: A Program for Increasing the Representation of Underrepresented Groups in Funded Research

The problem statement for this manuscript is to describe the literature on grant funding for underrepresented investigators, particularly American Indians, and detail the CRCAIH Pilot Grant Program and its success in developing underrepresented researchers (e.g. American Indian, early stage investigators). Grant funding is increasingly difficult to receive and the demographics of NIH grant awardees have shifted in recent decades to funding investigators that are more experienced. Additionally, racial disparities in awardees exist, particularly among American Indian (AI) researchers. Pilot grant funding mechanisms can be used by early stage investigators to collect preliminary data, which is beneficial for applying for NIH grants. The Collaborative Research Center for American Indian Health (CRCAIH) Pilot Grant Program (PGP) was aimed to increase research on the topic of social determinants of health in AI population health. Since there are no existing procedures for creating a PGP, CRCAIH created a PGP, and the processes are detailed here. Over four years, the CRCAIH PGP funded 15 projects with 47% of PIs or Co-PIs self-reporting as AI. Future directions for the CRCAIH PGP, including a mentoring program to provide more guidance and capacity building to the investigators, are also detailed.