Predictors of medical staff's knowledge, attitudes and behavior of dysphagia assessment: A cross-sectional study

PURPOSE

This study aimed to explore the predictors of medical staff's Knowledge, Attitudes and Behavior of dysphagia assessment, to provide reference suggestions for constructing the training program and improving the rate of dysphagia assessment.

METHODS

This study was a cross-sectional study. A total of 353 nurses and doctors from four provinces (Guangdong, Hunan, Guangxi, and Shaanxi) who were selected by convenience sampling and invited to complete the questionnaire through WeChat, DingTalk, and Tencent instant messenger from May 23 to 31, 2022. A self-reported questionnaire was used to assess participants' Knowledge, Attitude and Behavior regarding dysphagia assessment. Participants' sociodemographic, training, and nursing experience were measured using the general information sheet and analyzed as potential predictors of medical staff's Knowledge, Attitudes and Behavior of dysphagia assessment. A multiple linear regression model was used to identify the predictors.

RESULTS

The mean scores for Knowledge, Attitudes and Behavior of dysphagia assessments were (15.3±2.7), (35.9±4.9) and (41.4±14.4) respectively. Knowledge and Behavior of medical staff were medium, and attitude was positive. Multiple linear regression results indicated that experience in nursing patients with dysphagia, related training for dysphagia, working years in the field of dysphagia related diseases, specialized training (geriatric, swallowing and rehabilitation) and department (Neurology, Rehabilitation, Geriatrics) were significant predictors of Behavior, accounting for 31.5% of the variance. Working years in the field of dysphagia related diseases, department (Neurology, Rehabilitation, Geriatrics) and title were significant predictors of medical staff's knowledge, accounting for 7.8% of variance. Education, experience in nursing patients with dysphagia, department (Neurology, Rehabilitation, Geriatrics) and related training for dysphagia were significant predictors of medical staff's attitude, accounting for 12.9% of variance.

CONCLUSIONS

The study findings implied that nursing experience, training, and work for patients with swallowing disorders could have positive effects on the Knowledge, Attitudes and Behavior of medical staff regarding dysphagia assessment. Hospital administrators should provide relevant resources, such as videos of dysphagia assessment, training centers for the assessment of dysphagia, and swallowing specialist nurses.

Measurement of Hp(10), Hp(3) and Hp(0.07) to medical staff in endoscopic retrograde cholangiopancreatography, using thermoluminescence dosimetry

Endoscopic retrograde cholangiopancreatography (ERCP) is widely used in the diagnosis and treatment of pancreatic and bile duct disorders. The procedure is performed under the guidance of fluoroscopy. This study aims to investigate the dose received by staff in the Endoscopy Department of AbuAli Sina Medicine and Organ Transplant Hospital in Shiraz. The dosimetry was performed using thermoluminescent dosemeters (TLD), type TLD-100. The values of Hp(10), Hp(3) and Hp(0.07) were estimated for the staff for 2 months. According to the results obtained in this study, the equivalent dose of the gastroenterologist's body, eye lenses and hands was 0.045 ± 0.001 mSv, 0.111 ± 0.014 mSv and 0.357 ± 0.034 $\mathrm{mSv}$, respectively. This study showed that the annual radiation exposure for ERCP department staff of Abu Ali Sinai Hospital is less than the annual dose limit. However, if the principles of proper radiation protection and individual dosimetry are followed, the dose to staff members can be reduced.

Delirium is not dementia: Delirium Awareness Day-related event at the University Hospital in Krakow

PURPOSE

To present the two-day Delirium Awareness Day-related event held at the University Hospital, Kraków, Poland.

METHODS

Activities included a lecture, a multimedia presentation, meetings with healthcare workers at their respective wards, and distribution of information posters about delirium. Local news outlets were also engaged.

RESULTS

We reached out to approximately 300 persons in the hospital itself and several thousand via TV and radio broadcasts. We prompted interdisciplinary discussions about delirium, especially concerning preventive measures. The most common questions were how to alleviate symptoms as soon as possible, with the expectation of straightforward solutions for the non-geriatrician staff. Patient distress and burden on caregivers were important topics brought-up in the discussions.

CONCLUSION

We demonstrated that our educational initiative was feasible and well-accepted among medical staff. Local media helped in building public understanding of delirium. Education about the syndrome should be one of the key societal tasks of geriatricians.

Assessment of knowledge, attitude and practice for oxygen therapy among medical staff at the Colonial War Memorial Hospital in Fiji

BACKGROUND

Oxygen therapy (OT) is a commonly prescribed essential medicine for people of all ages in the management of hypoxia. The adverse effects of inappropriate OT supplementation may be underestimated by health professionals and lead to poor health outcomes among hospitalised patients. Knowledge, attitude and practice (KAP) assessments of medical staff members to OT guidelines are essential to ensure optimal patient care.

AIMS

To perform a KAP assessment of OT administration among doctors and nurses employed at the national hospital of Fiji in 2021.

METHODS

Prospective cross-sectional study design. KAP assessment was performed with an online questionnaire and clinical observation.

RESULTS

The study population (N = 116) consisted of doctors (20.7%) and nurses (79.3%) representing the acute medical, burns, cardiac care, intensive care, surgical and postanaesthetic recovery units. Overall, the proportion of participants who obtained a good score (>70%) was 87% for knowledge, 87.93% for attitudes and 84% for practice. Best knowledge scores were obtained for general OT indications (71%) and scenarios where immediate oxygen application is required (70%). Lowest knowledge scores were for OT contraindications (14%) and oxygen saturation for acute myocardial infarction (32%), asthma (36%) and healthy newborns (43%). The most positive attitudes were in response to the statement that OT guidelines are essential (96%). A total of 78 (80.4%) patients were being cared for with good OT practice.

CONCLUSIONS

Good KAP scores were obtained for medical staff in Fiji regarding OT administration. Ongoing professional education activities should include updated training of OT contraindications and optimal oxygen saturation levels for special patient groups.

Warzone pediatric trauma care: Lessons from civilian medical staff in Kyiv

INTRODUCTION

The article discusses the challenges faced by civilian healthcare providers in Kyiv, Ukraine, during the conflict in treating pediatric trauma resulting from war-related incidents.

METHODS

The authors share their experiences and insights from managing a series of 12 pediatric patients admitted to the Ohmatdyt children's hospital between February 25 and April 1, 2022. During this period, the hospital was under constant threat due to the military conflict.

RESULTS

The patients, ranging in age from 3 months to 17 years, suffered injuries from various causes, including vehicle shootings, explosions, and other traumatic events. The interventions and timely management are discussed, and two detailed clinical cases are presented to illustrate the complexities of treating pediatric trauma in a warzone.

CONCLUSION

In summary, the article sheds light on the unique challenges faced by healthcare providers in a warzone when treating pediatric trauma. It underscores the importance of timely intervention, effective triage, and the utilization of advanced medical techniques to improve patient outcomes in such challenging circumstances.

The Impact of high-performance work system perceived by medical staff on job satisfaction: the mediating role of self-efficacy

As the mainstay of healthcare, the job satisfaction of medical staff deserves attention. This study aimed to explore the correlation between the perception of the high-performance work system (P-HPWS) and job satisfaction of medical staff in public hospitals and to further investigate the mediating effect of self-efficacy. From November 2019 to January 2020, a cross-sectional survey on working doctors and nurses was conducted in five tertiary public hospitals in China. A total of 520 participants were surveyed. The P-HPWS, job satisfaction, and self-efficacy were assessed using the 25-item self-administered scale, six-item job satisfaction questionnaire, and the General Self-Efficacy Scale, respectively. Linear regression and mediation effects models were used to identify the associations between primary variables. The results showed a significant positive correlation between P-HPWS and job satisfaction (P < 0.01), while self-efficacy played a mediating role between P-HPWS and job satisfaction. This finding reveals the benefits of improving employees' P-HPWS and self-efficacy on their job satisfaction, and that hospitals can improve their management systems by implementing and refining HPWS.

Barriers and facilitators to feeling safe for inpatients: a model based on a qualitative meta-synthesis

Objectives

To review and synthesize qualitative research exploring patients' safe experience and construct a model to present barriers and facilitators to feeling safe for inpatients.

Design

A qualitative met-synthesis.

Methods

We conducted a systematic electronic search of articles published in English with no date limitation across five databases (Ovid MEDLINE, EMBASE, Web of Science, CINAIL via EBSCO, and PsyINFO) in May 2023. Qualitative research focused on the safe experiences of inpatients was considered. Systematic searches yielded 8,132 studies, of which 16 articles were included. Two reviewers independently extracted and analyzed data. Qualitative meta-synthesis was performed through line-by-line coding of original texts, organizing codes into descriptive themes, and generating analytical themes.

Results

We identified four themes and 11 sub-themes. Across the four themes, control included a barrier (Uncertainty) and two facilitators (Patient participation and safe care); responsible included three facilitators (Confidence in the profession, care for, and responsive); dignity included two barriers (Privacy and Neglect); stability included a barrier (Potential risk), and two facilitators (Harmonious and safe culture). We constructed a model to present the logical connection between these themes and related barriers and facilitators.

Conclusion

Feeling safe for inpatients is a complex perception, including four themes: control, responsible, dignity, and stability. Surrounding four themes and related barriers and facilitators, we outline principles for creating a safe environment and present strategies for improving patients' hospitalization experience and ensuring patient safety.

Clinical relevance

This review provides valuable insight into the clinical practice and health policy and helps medical staff to identify and overcome the potential barriers to implementing interventions in safe care. In addition, the model comprehensively describes the nature and dimensions of feeling safe, informing high-quality care service and related research.

Systematic review registration

Identifier, CRD42023435489.

Investigation of obesity and its related factors among Chinese medical staff: a cross-sectional pilot study

BACKGROUND

Many studies have covered the prevalence of obesity in different populations. However, studies on the prevalence and predictors of obesity among medical staff are lacking. The aim of our study is to investigate the prevalence of obesity among medical staff and to identify the related predictors.

METHODS

Using a snowballing recruitment strategy in the form of an electronic questionnaire, a cross-sectional survey was conducted among 1201 medical staff from cooperative hospitals between January and March 2022. We designed a questionnaire to investigate the participants' demographic, lifestyle, diet, physical activity, and work status.

RESULTS

The overall prevalence of obesity was 8.5%, with males (13.7%) having a greater incidence than females (5.7%) (p < 0.001). Multiple logistic regression analyses showed that alcohol drinking (OR, 2.34; 95% CI 1.23-4.42, p = 0.01), sugar-sweetened beverages consumed > 3/week (OR, 2.50; 95% CI 1.02-6.15, p = 0.046), and working a night shift > 1/week (OR, 2.17; 95% CI 1.02-4.61, p = 0.043) were independent predictive factors for obesity in men. For women, having midnight snack having midnight snack (OR, 2.93;95% CI 1.24-6.96, p = 0.015), good sleep quality (OR, 4.47; 95% CI 1.10-21.70, p = 0.038), and working a night shift > 1/week (OR, 3.62; 95% CI 1.73-7.57, p = 0.001) were independently associated with obesity.

CONCLUSIONS

Obesity presented a low prevalence among medical staff. Alcohol drinking, drinking sugar-sweetened beverages > 3/week, and night shift > 1/week predicted a higher risk of obesity in males. In females, having midnight snack, good sleep quality, and night shift > 1/week were independently associated with obesity.

LEVEL OF EVIDENCE

V, descriptive study.

Posttraumatic growth of medical staff during COVID-19 pandemic: A scoping review

BACKGROUND

The COVID-19 pandemic has imposed unprecedented stress and challenges upon medical staff, potentially resulting in posttraumatic growth (PTG). This scoping review aims to synthesize the existing knowledge on PTG among medical staff during the pandemic by identifying its current status and potential influencing factors. The findings may provide a foundation for future research and interventions to enhance the medical staff's psychological resilience and well-being.

METHODS

Literature was systematically searched on PTG among medical staff during the COVID-19 pandemic from 01 January 2020 to 31 December 2022. The following databases were searched: PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Data. Eligibility criteria included: (1) medical staff as research subjects; (2) a focus on "posttraumatic growth" or "alternative posttraumatic growth" related to the COVID-19 outbreak and pandemic; (3) discussion of the situation and influencing factors of PTG; and (4) study types, such as qualitative, quantitative, and mixed methods. Two researchers independently selected and extracted study characteristics (study design, study population, region, measurement instruments, and primary outcomes) from the included literature. The data were synthesized qualitatively and descriptively.

RESULTS

Thirty-six papers from 12 countries met the inclusion criteria. Moderate PTG levels were observed among healthcare workers during the COVID-19 pandemic, with emphasis on "interpersonal relationships," "changes in life philosophy," and "growth in personal competence." Influencing factors included trauma exposure, sociodemographics, psychological characteristics (resilience and positive qualities), coping, and social support.

CONCLUSIONS

This review discovered moderate PTG levels among medical staff during the COVID-19 pandemic, with critical areas in interpersonal relationships, life philosophy, and personal competence. The identified influencing factors can inform future research and interventions to enhance healthcare workers' psychological resilience and well-being.

Effects of intensive care unit quality assessment on changes in medical staff in medical institutions and in-hospital mortality

BACKGROUND

Quality assessments are being introduced in many countries to improve the quality of care and maintain acceptable quality levels. In South Korea, various quality assessments are being conducted to improve the quality of care, but there is insufficient evidence on intensive care units (ICUs). This study aims to evaluate the impact of ICU quality assessments on the structural indicators in medical institutions and the resulting in-hospital mortality of patients.

METHODS

This study used data collected in the 2nd and 3rd ICU quality assessments in 2017 and 2019. A total of 72,879 patients admitted to ICUs were included during this period, with 265 institutions that received both assessments. As for structural indicators, changes in medical personnel and equipment were assessed, and in-hospital deaths were evaluated as patient outcomes. To evaluate the association between medical staff and in-hospital mortality, a generalized estimating equation model was performed considering both hospital and patient variables.

RESULTS

Compared to the second quality evaluation, the number of intensivist physicians and experienced nurses increased in the third quality evaluation; however, there was still a gap in the workforce depending on the type of medical institution. Among all ICU patients admitted during the evaluation period, 12.0% of patients died in the hospital. In-hospital mortality decreased at the 3rd assessment, and hospitals employing intensivist physicians were associated with reduced in-hospital deaths. In addition, an increase in the number of experienced nurses was associated with a decrease in in-hospital mortality, while an increase in the nurse-to-bed ratio increased mortality.

CONCLUSIONS

ICU quality assessments improved overall structural indicators, but the gap between medical institutions has not improved and interventions are required to bridge this gap. In addition, it is important to maintain skilled medical personnel to bring about better results for patients, and various efforts should be considered. This requires continuous monitoring and further research on long-term effects.

Intention to sign an advance directive among nephrology medical staff and its related factors

BACKGROUND

Advance care planning enables people to record their future health and care wishes and appoint someone as an advocate. An advance directive can be made in the event that a person is incapacitated, so that their wishes are still upheld. The beliefs of the nephrology team might affect patients' choices and willingness to sign an advance directive. To increase the number of dialysis patients who have signed an advance directive, it is necessary to educate the nephrology medical staff.

AIM

To explore the intention to sign an advance directive and its related factors among nephrology medical staff.

METHODS

A cross-sectional and correlational design was used. This study recruited 160 nephrology medical staff. Data were analysed by using the Statistical Package for Social Science 21.0 for Windows.

FINDINGS

The results found that the longer someone has worked as part of the nephology medical staff, the more knowledgeable they were about an advance directive. This led to them being more likely to want to sign an advance directive for themselves.

CONCLUSION

In order to improve the knowledge and awareness of advance directives among nephrology medical staff, hospital managers should provide continuing education on this topic.

AI triage or manual triage? Exploring medical staffs' preference for AI triage in China

OBJECTIVES

The introduction of AI technology in healthcare presents both opportunities and challenges. The aim of this study was to investigate medical staffs' preference for AI triage and the influencing factors.

METHODS

A survey was conducted online among medical staffs in China from March 4th to April 28th, 2021. Participants were recruited through multiple channels, including medical professional platforms and social media. A total of 677 valid responses were obtained from medical staff members located in 28 provinces across China.

RESULTS

The results showed that AI triage had an overall acceptance rate of 77.1%, and 45.2% of the medical staffs surveyed preferred "AI triage exclusively." Direct experience was positively associated with medical staffs' preference for AI triage (β = 0.223, p < .001). Additionally, greater exposure to a variety of media was positively associated with the perceived value of AI technology, which, in turn, increased preference for AI triage (β = 0.040, SE = 0.013, p < .001, 95% CI = [0.017, 0.067]).

CONCLUSION

Medical staffs generally hold a favorable attitude towards AI triage, particularly in areas with a high medical burden and during pandemics. In a multimedia environment, media exposure variety impacts medical staffs' preferences through their perceived value of AI technology. This study has implications for the implementation of AI triage on a larger scale.

A Qualitative Study on the Psychological Experience of Emergency Department Medical Staff Caring for Patients with Suicide Attempts in Northeastern Sichuan

The purpose of this study was to explore the psychological experiences of emergency department staff in northeastern Sichuan when treating patients with suicide attempts and to provide a theoretical basis for developing appropriate clinical interventions and improving mental health services for suicidal patients. Sixteen emergency department staff members who met recruitment requirements at two hospitals in Nanchong, China, were interviewed using Colizzi descriptive phenomenological analysis. The interviews were in-depth and semi-structured. The qualitative analysis of this study revealed three main themes: (1) aspects of the emotional experience that may be detrimental to helping people in crisis (e.g., sympathy and regret, confusion and bewilderment, worry and stress); (2) aspects of the cognitive experience (e.g., inability to deal with patients' psychological issues and having new perspective on the medical profession); and (3) raising awareness of mental health services. Future reform efforts should consider training medical staff in suicide prevention knowledge and communication skills, using a compassion-centered approach to alleviate the suffering of patients who attempt suicide, using the Safety Screening Scale (PSS-3), providing counselors for patients, developing family-focused interventions, and involving family members in suicide risk prevention and treatment.

Influencing factors of life satisfaction among medical staff of rehabilitation departments based on a structural equation model

Life satisfaction (LS) exhibited gender differences and was associated with age, income, and negative emotions. There is no research on the relationship between professional values and LS, although professional values are essential for medical staff and correlate with negative emotions. This study aimed to explore the relationship between professional values and LS, the action mechanism of influencing factors of LS, and gender differences among medical staff of rehabilitation departments in China. A total of 284 participants (108 men and 176 women) completed the questionnaires. Data were analyzed using SPSS19.0 and Amos21.0. Age, length of service, and anxiety differed significantly between genders. Professional values had a direct effect on LS and an indirect effect on LS via anxiety and depression. Therefore, enhancing professional values and reducing anxiety and depression could increase the medical staff's LS. Moreover, the LS of female medical staff improved with age.

Pandemic fatigue and clinical front-line medical staff health, job status during the COVID-19 pandemic: A cross-sectional survey after the lifting of epidemic restrictions

AIM

This study aimed to measure pandemic fatigue, physical and mental health, and job status of front-line medical staff in Ningbo. And to identify factors associated with pandemic fatigue.

BACKGROUND

There was an acute increase in fatigue symptoms at the COVID-19 pandemic onset. The front-line medical staff is particularly vulnerable to fatigue due to their high-intensity work.

DESIGN

This was a descriptive, cross-sectional study conducted using an online survey that included demographic data, investigation of COVID-19 history and job status. The Fatigue Assessment Scale, GAD-7 score and Sleep Quality Scale were used to collect data from 479 front-line medical staff.

METHODS

The study involved 479 front-line medical staff in Ningbo, China. The survey was conducted using an online questionnaire that included demographic data, investigation of COVID-19 history and job status. The Fatigue Assessment Scale, GAD-7 score and Sleep Quality Scale were used to collect data.

RESULTS

The results showed that of the 479 participants, 393 (82%) reported pandemic fatigue, 393 (82%) reported job satisfaction and 433 (90.4%) identified with their sense of job value. Sleep quality, work with a fever, economic subsidies for fighting COVID-19 and recognizing professional value were significantly correlated with pandemic fatigue.

CONCLUSIONS

As the COVID-19 pandemic challenges front-line medical workers, implementing measures is essential. Health policy implementers could provide sufficient front-line medical staff to ensure rest in case of infection, promote sleep quality and foster professional value and financial subsidies in units.

RELEVANCE TO CLINICAL PRACTICE

The study shows how pandemic fatigue affects front-line medical staff during the COVID-19 pandemic and suggests measures to support them, including promoting sleep quality, providing rest for infected staff, fostering professional value and financial subsidies. The recommendations are relevant to clinical practice as they help support medical staff and ensure high-quality care for patients during the pandemic.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution. Not applicable.

Factors Affecting Women's Assessment and Satisfaction with Their Childbirth

Background and Objective: Childbirth is one of the most significant experiences in a woman's life. The manner in which childbirth unfolds and is experienced can be influenced by various factors, including the birthing environment and the woman's attitude and preparation. Taking a holistic view of childbirth, it becomes apparent that addressing the basic physiological needs during childbirth can significantly influence the comfort and sense of security of laboring women. The aim of this research was to assess the level of satisfaction among women with their experience during childbirth and to identify its determinants. Materials and Methods: This study included 275 women who had given birth within the past 15 years and were up to 40 years of age. The research method employed was a diagnostic survey, involving a self-designed questionnaire. Results: discussing the birth plan with the midwife, the ability to ask questions during labor, consuming meals during labor, water immersion, listening to music during labor, assuming vertical positions during the second stage of labor, and skin-to-skin contact are associated with increased satisfaction with the childbirth experience. Conclusions: The study findings revealed that the highest levels of satisfaction were reported in connection with the interactions with medical staff during childbirth and the quality of facilities available during delivery. Conversely, the lowest levels of satisfaction were associated with the possibility of using pain relief methods during labor.

Clinical academics' experiences of REF2021

The UK Research Excellence Framework (REF) is an assessment of the quality of research carried out in UK Higher Education Institutions (HEIs), performed in 7-year cycles. The outcome impacts the rankings and funding of UK HEIs, which afford the exercise high priority. Much of what REF measures is known to be biased against academics with protected characteristics: for example, women and ethnic minority researchers are less likely to win grants or be published in prestigious journals. Despite changes to REF since 2014, the risk remains that the process might amplify well-recognised existing disparities. The BMA Women in Academic Medicine and Medical Academic Staff Committee carried out a survey of UK clinical academics' experiences of REF2021. The data indicated the persistence of activities previously characterised as 'extremely harmful' in Research England-commissioned work, affecting up to 10% of clinical academics. While acknowledging the limitations of the data, women appeared to be disproportionately affected.

Attitude of cardiac surgery nurses on kinesiophobia management: a qualitative study

OBJECTIVES

This study aimed to investigate the knowledge, attitudes and practical experiences of cardiac surgery nurses regarding kinesiophobia management during early mobilisation.

DESIGN

Using a descriptive qualitative research method, 21 cardiac surgery nurses participated in this study from October 2022 to January 2023, and the interview data were analysed using the Colaizzi 7-step analysis method.

SETTING

Data were collected through in-depth face-to-face or online interviews in a tertiary hospital located in Nanjing, China.

PARTICIPANTS

21 cardiac surgery nurses were interviewed from October 2022 to January 2023.

RESULTS

Two themes were summarised: knowledge, attitude and practice of nurses (high recognition and low participation; low knowledge reserve; low willingness); the promotion and essential elements of kinesiophobia management (efficient health education model; stable medical staff-family caregiver collaboration; simplified clinical protocol; specialist nursing team; clarify the multidisciplinary division of labour).

CONCLUSION

The management of kinesiophobia in patients undergoing cardiac surgery is currently in the developmental phase. It is advisable to give due consideration to emotional support and cognitive training for medical staff. In addition, a workable management plan, consistent with clinical practice, should be formulated through multidisciplinary and medical staff-family caregiver collaboration to optimise patient outcomes.

[Investigation on occupational burnout among medical staff of tuberculosis control in Beijing]

Objective: To understand the occupational burnout status of tuberculosis prevention and treatment medical staff in Beijing, and analyze the influencing factors of different degrees of occupational burnout. Methods: From April to May 2021, an anonymous questionnaire survey was conducted among the medical staff of tuberculosis prevention and control in Beijing and 16 districts under its jurisdiction. A total of 313 questionnaires were issued, 311 were recovered, and 311 were valid, with an effective recovery rate of 99.36%. The General Information Questionnaire and Maslach Burnout Inventory Generalized Scale (MBI-GS) were used to collect social demographic data and the occurrence of occupational burnout, analyze the occurrence degree of occupational burnout, and identify the influencing factors of the occurrence degree of occupational burnout by using the orderly multiple logistic regression model. Results: Among 311 tuberculosis prevention and control medical staff, the total detection rate of occupational burnout was 62.70% (195/311), and the detection rates of mild, moderate and severe occupational burnout were 22.19% (69/311), 38.59% (120/311) and 1.93% (6/311), respectively. Orderly multiple logistic regression analysis showed that medical staff in prevention and control positions (OR=1.616, 95% CI: 1.030-2.534, P=0.037) and not meeting expectations for title promotion (OR=2.969, 95%CI: 1.675-5.262, P<0.001), and not getting along well with colleagues (OR=2.177, 95%CI: 1.362-3.480, P=0.001) were the main factors affecting the occurrence and severity of occupational burnout among tuberculosis prevention and treatment medical staff. Conclusion: The main manifestations of tuberculosis prevention and control medical staff in Beijing are mild to moderate occupational burnout. It is suggested to pay attention to the occupational needs of different positions of tuberculosis prevention and control medical staff, cultivate professional achievement, carry out psychological counseling, and reduce the degree of occupational burnout.

Influence of a sexism and sexual harassment prevention course on medical students' perceptions of and responses to problematic situations

BACKGROUND

Issues of sexism and sexual harassment within the medical field are widespread. The aim of his study was to describe the influence of a training course on the prevention of sexism and sexual harassment on medical students' perceptions and responses to problematic situations in the workplace.

METHODS

We performed a secondary analysis of the transcripts of 16 medical students' interviews. The data were initially gathered as part of an external evaluation of the course. We decided to further explore these with a focus on potential changes about sexism and sexual harassment awareness induced by the course. Data were analyzed using qualitative thematic analysis.

RESULTS

Most medical students were aware of the existence of sexism and sexual harassment in the medical environment before the course but were not always able to delineate what could be considered as such or not. The course allowed them to broaden their ability to identify problematic situations, that were somewhat "trivialized" before, and to set a lower cut-off when judging what constitutes sexism or sexual harassment. It also provided them with tools on how to react when confronted to these situations, as well as resources to seek help. However, students stressed the importance of such courses also being offered to medical staff higher up in the hierarchy, as they are the ones in a position of power.

CONCLUSIONS

The course helped students to better identify and react to sexism and sexual harassment. However, given students' lack of power within the hierarchy, efforts to prevent sexism and sexual harassment must be undertaken at an institutional level to allow for change in the system as a whole.

Effect of precision management scheme based on the best evidence summary on reducing catheter-associated urinary tract infection

OBJECTIVES

Catheter-associated urinary tract infection (CAUTI) is an important cause of prolonged hospital stay, which increases economic and medical burden for patients and hospitals, and it is a key focus of hospital infection prevention and control. However, there are currently few studies that convert evidence-based scientific evidence on CAUTI prevention and control into clinical applications and evaluation on its practical effects in combination with standardized infection ratio (SIR), the critical indicator of infection prevention and control. This study aims to establish a precision management plan for reducing the incidence of CAUTI, driven by the findings of a comprehensive evidence summary, to apply this plan across all the nursing units within the entire hospital, followed by a comparative analysis of CAUTI incidence, SIR, the average duration of indwelling urinary catheter for each patient, and the compliance rate on hand hygiene protocols for medical staff before and after the implementation of the precision management plan.

METHODS

Based on a comprehensive review of the best evidence for preventing CAUTI, a precision management plan was meticulously developed through panel discussions and 2 rounds of expert consultations using Delphi technique. Subsequently, a historical control study was conducted to evaluate the plan's effectiveness. A total of 17 658 patients with indwelling urinary catheter in inpatient departments from January to December 2021 comprised the control group. These patients received standard nursing measures for CAUTI. Another 18 753 patients with indwelling urinary catheters in the inpatient departments from January to December 2022 comprised the intervention group, underwent the precision management scheme based on the best available evidence, to enhance CAUTI prevention. The incidence and SIR of CAUTI, the average duration of indwelling urinary catheter for each patient, and the compliance rate on hand hygiene protocols for medical staff were compared between the 2 groups.

RESULTS

Compared with the control group, the incidence of CAUTI in the intervention group was significantly decreased (0.48‰ vs 1.12‰, χ2=20.814, P<0.001), SIR was decreased in the intervention group (0.55 vs 1.37); the average duration of indwelling urinary catheter for each patient was significantly decreased [(4.33±1.55) d vs (4.43±1.79) d, t=11.941, P<0.001]. The ratio of compliance rate of medical staff with strict hand hygiene protocols higher than 95% in the intervention group was significantly higher than that in the control group (93.3% vs 83.3%, χ2=5.822, P=0.016).

CONCLUSIONS

The implementation of the precision management plan for reducing CAUTI based on a summary of the best available evidence on CAUTI prevention and control in patients with indwelling urinary catheters has found to be effective. This approach significantly reduces the incidence of CAUTI, reduces the average duration of indwelling urinary catheter, and enhances hand hygiene compliance among medical staff. It provides a scientific and efficient strategy for preventing and controlling CAUTI in the hospital, ultimately saving patients from unnecessary medical expense.

The association between adverse ergonomic factors and work-related musculoskeletal symptoms among medical staff in China: a cross-sectional study

We investigated the prevalence of work-related musculoskeletal symptoms (WMSs) among medical staff and evaluated the associations of different levels of adverse ergonomic factors with WMSs. A total of 6099 Chinese medical staff were asked to complete a self-reported questionnaire to assess the prevalence and risk factors of WMSs from June 2018 to December 2020. A prevalence rate of 57.5% was observed for WMSs among overall medical staffs, which mainly affected the neck (41.7%) and shoulder (33.5%). 'Keeping sitting for long hours very frequently' (OR = 1.26, 95% CI: 1.04, 1.53) was positively associated with WMSs in doctors, while 'keeping sitting for long hours occasionally' (OR = 0.91, 95% CI: 0.85, 0.97) was identified as a protective factor of WMSs in nurses. The associations of adverse ergonomic factors, organisational factors, and environmental factors with WMSs were different among medical staff in different positions.Practitioner summary: We conducted a multi-city study concerning the risk factors of WMSs by carrying out a face-to-face one-to-multiple questionnaire survey among medical staff in China. As a risk factor of WMSs in medical staff, adverse ergonomic factors should be paid more attention by the standard setting department and policy makers.Abbreviations: WMSDs: work-related musculoskeletal disorders; WMSs: work-related musculoskeletal symptoms; MSDs: musculoskeletal disorders; NMQ: Nordic Musculoskeletal Questionnaires; DMQ: Dutch Musculoskeletal Questionnaires; NIOSH: National Institute for Occupational Safety and Health; ORs: odds ratios.

Stigmatized attitudes of medical staff toward people who use drugs and their determinants in Japanese medical facilities specialized in addiction treatment

AIM

Stigma within healthcare settings significantly impact the lives of people who use drugs (PWUD). Given the lack of quantitative data on stigma toward PWUD in healthcare settings and the unknown factors that contribute to it in the Japanese context, this study aimed to investigate the current status of stigma toward PWUD and its determinants.

METHODS

We conducted a survey in five specialized addiction medical facilities across three prefectures in Japan. The survey included questions related to stigmatizing attitudes toward PWUD, knowledge about illicit drug use, and personal and professional interactions with PWUD.

RESULTS

A substantial portion of respondents rejected the notion that drug addiction can be overcome through sheer willpower or attributed it solely to moral failings. However, the majority still considered them untrustworthy and viewing drug use as unacceptable and incomprehensible. Many respondents perceived PWUD as dangerous, despite the limited occurrence of hostile behavior from PWUD in clinical practice. A considerable proportion of respondents did not seek support for their own or their relatives' drug-related issues, and less than half had collaborated with recovered PWUD, which serves as potential indicators of reduced stigma. While healthcare professionals recognized that involving law enforcement does not contribute to the recovery of PWUD, a considerable number still believed it was necessary to report them to the authorities.

CONCLUSION

Healthcare professionals in specialized addiction medical facilities demonstrate strong stigmatizing attitudes toward PWUD. Comprehensive educational programs and large-scale awareness campaigns are necessary to address and mitigate stigma in this context.

Perceived knowledge, attitudes and practices regarding the medical consortium among medical staff in Sichuan, China: a cross-sectional survey

BACKGROUND

In China, fragmented and inefficient health care systems are common while quality resources are limited. To promote an organized, efficient system, the government launched a medical consortium policy to vertically integrate health care through the collaboration of different levels of medical care. Logically, medical staff's knowledge, attitudes and practices (KAP) regarding the consortium are critical for its development. The objective of this study was to explore the KAP regarding the medical consortium among medical staff in a medical consortium in Sichuan Province, China.

METHODS

A cross-sectional survey was conducted. In total, 690 medical staff members in 3 cities of Sichuan Province, China, were interviewed from November 2018 to December 2018. The questionnaire consisted of 18 items, including 4 items related to perceived knowledge, 4 items related to attitudes and 2 items related to practices, and was rated on a 5-point Likert scale (one = strongly disagree/do not know, five = strongly agree/know).

RESULTS

The effective response sample was 640 copies of the questionnaire, and most medical staff members (92.50%) knew about the cooperation with other hospitals in the medical consortium. Medical staff scored differently on each item in the questionnaire, with the highest score being the item 'agreeing with the ward rounds and clinical teaching and training organized by the leading hospital' (4.54 ± 0.76), and the lowest score being the item 'frequency in participating in ward rounds and clinical teaching organized by the leading hospital' (2.83 ± 1.36). In addition, the effect of demographic characteristics on KAP was evaluated by stepwise multiple regression analysis, and a significant positive correlation was found between all the studied variables by Spearman's correlation (p < 0.05).

CONCLUSIONS

This study showed that the attitudes toward and knowledge of the medical consortium significantly contribute to practices, satisfaction with the support work performed by the leading hospital and agreement of improvement after joining the medical consortium. Thus, to improve medical staff's KAP and satisfaction, publicity and educational programs in medical consortia are necessary, and the leading hospital should attach importance to the informatization construction and demand of different medical staff members.

CLINICAL TRIAL REGISTRATION

There are no clinical trials in this study.

Construction of a standardized training system for hospital infection prevention and control for new medical staff in internal medicine ICUs based on the Delphi method

In China, studies have shown nosocomial infections contribute to increased mortality rates, prolonged hospital stays, and added financial burdens for patients. Previous studies have demonstrated that effective infection control training can enhance the quality of infection control practices, particularly in intensive care unit (ICU) settings. However, there is currently no universally accepted training mode or program that adequately addresses the specific needs of ICU medical staff regarding nosocomial infection control. The objective of this study was to develop a standardized training system for preventing and controlling hospital-acquired infections among new medical staff in the internal medicine ICU. Our methodology encompassed an extensive literature review, technical interviews focusing on key events, semi-structured in-depth interviews, and two rounds of Delphi expert correspondence. We employed intentional sampling to select 16 experts for the Delphi expert consultation. Indicators were chosen based on an average importance score of >3.5 and a coefficient of variation of <0.25. The weight of each indicator was determined using the analytic hierarchy process. The efficacy of the two rounds of questionnaires was also evaluated. Our findings revealed that the questionnaires achieved a 100% effective recovery rate, with expert authority coefficients of 0.96 and 0.90. The Kendall coordination coefficients for the first-, second-, and third-level indicators in the initial round of expert consultation questionnaires were 0.440, 0.204, and 0.386 (P < 0.001), respectively. In the second round of expert consultation questionnaires, the Kendall coordination coefficients for the first, second, and third-level indicators were 0.562, 0.467, and 0.556 (P < 0.001), respectively. The final training model consisted of four first-level indicators (hospital infection prevention and control training content, training methods/forms, assessment content, and evaluation indicators), 26 second-level indicators, and 44 third-level indicators. In conclusion, the proposed standardized training system for infection prevention and control among new medical staff in the internal medicine ICU is both scientifically sound and practical, which can contribute to improved patient safety, reduced healthcare costs, and enhanced overall quality of care in internal medicine ICUs. Moreover, it can serve as a framework for future training projects.

Medical staff's emotional exhaustion and its relationship with patient safety dimensions

PURPOSE

Medical staff's emotional exhaustion increases cynical attitudes and behaviors about work and patients and leads medical staff to become detached from work. This may decrease patients' trust and satisfaction and even endanger patients' lives. There is a need to examine the critical factors affecting the medical staff's emotional exhaustion by investigating its relationship with the patient-safety dimensions based on the safety attitudes questionnaire (SAQ).

DESIGN/METHODOLOGY/APPROACH

A case study is conducted from the viewpoints of physicians and nurses to examine the relationship between emotional exhaustion and six dimensions of the SAQ from 2016 to 2020 from a regional teaching hospital in Taiwan. Linear regression with forward selection is employed. Six dimensions of the SAQ are the independent variables, whereas emotional exhaustion is the dependent variable for each year.

FINDINGS

Stress recognition is the most important variable to influence emotional exhaustion negatively, while job satisfaction is the second important variable to affect emotional exhaustion positively from 2016 to 2020. On the contrary, working conditions do not influence emotional exhaustion in this hospital from medical staff's viewpoints.

ORIGINALITY/VALUE

This study uses longitudinal data to find that both stress recognition and job satisfaction consistently influence emotional exhaustion negatively and positively, respectively, in this five-year period. The third dimension to impact emotional exhaustion varies from time to time. Thus, the findings from a cross-sectional study might be limited. The authors' findings show that reducing stress recognition and enhancing job satisfaction can lead to the improvement of emotional exhaustion from medical staff's viewpoints, which should be monitored by hospital management.

The effects of COVID-19 event strength on job burnout among primary medical staff

BACKGROUND

As a global pandemic, The Corona Virus Disease 2019 (COVID-19) has brought significant challenges to the primary health care (PHC) system. Health professionals are constantly affected by the pandemic's harmful impact on their mental health and are at significant risk of job burnout. Therefore, it is essential to gain a comprehensive understanding of how their burnout was affected. The study aimed to examine the relationship between COVID-19 event strength and job burnout among PHC providers and to explore the single mediating effect of job stress and work engagement and the chain mediating effect of these two variables on this relationship.

METHODS

Multilevel stratified convenience sampling method was used to recruit 1148 primary medical staff from 48 PHC institutions in Jilin Province, China. All participants completed questionnaires regarding sociodemographic characteristics, COVID-19 event strength, job stress, work engagement, and job burnout. The chain mediation model was analyzed using SPSS PROCESS 3.5 Macro Model 6.

RESULTS

COVID-19 event strength not only positively predicted job burnout, but also indirectly influenced job burnout through the mediation of job stress and work engagement, thereby influencing job burnout through the "job stress → work engagement" chain.

CONCLUSIONS

This study extends the application of event systems theory and enriches the literature about how the COVID-19 pandemic impacted PHC medical staff job burnout. The findings derived from our study have critical implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.

Current situation and needs analysis of medical staff first aid ability in China: a cross-sectional study

OBJECTIVES

We aim to understand the current situation of the first aid ability and training needs of Chinese medical personnel to provide a scientific basis for formulating the contents and methods of emergency medical rescue training and thereby improve the first aid level of Chinese medical personnel.

METHODS

A cross-sectional survey was conducted between June 2022 and February 2023 using a two-stage cluster sampling method with a structured questionnaire sent to medical workers in 12 provinces in China. 14,527 questionnaires were included in this study. Data were collected on demographic characteristics, first aid knowledge and skills, and training needs. Variance analysis was used to compare the difference between the first aid ability and training needs of medical staff in different hospitals, and multiple linear regression analysis was carried out to evaluate first aid ability and training needs.

RESULT

The study included 6041 patients (41.6%) in tertiary hospitals, 5838 patients (40.2%) in secondary hospitals, and 2648 patients (18.2%) in primary hospitals. There were significant differences in the first aid ability and training needs of medical staff in hospitals of different levels (p < 0.001). The score of first aid knowledge and skills in tertiary hospitals was the highest (209.7 ± 45.0), and the score of training needs in primary hospitals was the highest (240.6 ± 44.0). There was a significant correlation between first aid ability and training needs score (p < 0.001). Multiple linear regression analysis shows that geographic region, age, work tenure, gender, job title, department, professional title, monthly income, and hospital level are the influencing factors of training demand.

CONCLUSION

Medical staff in primary hospitals generally have low first aid knowledge and skills and a strong willingness to train. Therefore, it is imperative to strengthen the training of first aid ability and research training strategies. The level of the hospital is closely related to the level of first aid, so it is necessary to recognize the commonalities and differences in medical staff's demand for first aid knowledge and skills and carry out targeted education and training.

The workload change and depression among emergency medical staff after the open policy during COVID-19: a cross-sectional survey in Shandong, China

Introduction

In the middle of December 2022, the Chinese government adjusted the lockdown policy on coronavirus disease 2019 (COVID-19), a large number of infected patients flooded into the emergency department. The emergency medical staff encountered significant working and mental stress while fighting the COVID-19 pandemic. We aimed to investigate the workload change, and the prevalence and associated factors for depression symptoms among emergency medical staff after the policy adjustment.

Methods

We conducted a cross-sectional online survey of emergency medical staff who fought against COVID-19 in Shandong Province during January 16 to 31, 2023. The respondents' sociodemographic and work information were collected, and they were asked to complete the 9-item Patient Health Questionnaire (PHQ-9) then. Univariate and multivariate logistic regression analyses were applied to identify the potential associated factors for major depression.

Results

Nine hundred and sixteen emergency medical personnel from 108 hospitals responded to this survey. The respondents' weekly working hours (53.65 ± 17.36 vs 49.68 ± 14.84) and monthly night shifts (7.25 ± 3.85 vs 6.80 ± 3.77) increased after the open policy. About 54.3% of the respondents scored more than 10 points on the PHQ-9 standardized test, which is associated with depressive symptoms. In univariate analysis, being doctors, living with family members aged ≤16 or ≥ 65 years old, COVID-19 infection and increased weekly working hours after the open policy were significantly associated with a PHQ-9 score ≥ 10 points. In the multivariate analysis, only increased weekly working hours showed significant association with scoring ≥10 points.

Conclusion

Emergency medical staff' workload had increased after the open policy announcement, which was strongly associated with a higher PHQ-9 scores, indicating a very high risk for major depression. Emergency medical staff working as doctors or with an intermediate title from grade-A tertiary hospitals had higher PHQ-9 scores, while COVID-19 infection and weekly working hours of 60 or more after the open policy were associated with higher PHQ-9 scores for those from grade-B tertiary hospitals. Hospital administrators should reinforce the importance of targeted emergency medical staff support during future outbreaks.

Low prevalence of communication between intensive care unit medical staff and general practitioners: A single-centre retrospective study

BACKGROUND

General practitioners (GPs) have a central role in delivering care to the Australian community, which includes coordinating management of chronic diseases and treatment of patients after admission to intensive care units (ICUs). Consultations between ICUs and GPs may become increasingly relevant as patients of advancing age and chronic disease burden are admitted to ICUs. However, how frequently and for what reason such consultations occur remain unclear.

OBJECTIVES

The objective of this study was to determine the prevalence and themes of consultations between ICU medical staff and GPs.

METHODS

Ten years of electronic medical records in the ICU of a regional Australian hospital were searched for patient admissions documenting the terms "gp", "general p∗", or "primary care∗" anywhere throughout the record. The proportion of ICU admissions in which a consultation between ICU staff members and GPs was documented was recorded along with the reason/s for the consultation and designation (resident, registrar, consultant) of those who communicated with the GP.

MAIN OUTCOME MEASURES

Main outcome measures included the proportion of ICU admissions with a documented consultation between ICU staff and GPs, theme of the consultation, and designation (resident, registrar, consultant) of those who communicated with the GP.

RESULTS

Of 13 402 admissions to the ICU, 137 (1.02%) had a documented consultation between ICU medical staff and GPs. Most consultations (n = 116, 85%) were initiated by junior ICU medical staff members seeking clinical information from the GPs. Few consultations were to discuss goals of care (n = 10, 7.3%) or care following ICU discharge (n = 15, 11%).

CONCLUSIONS

Consultations between ICU medical staff and GPs were infrequent. Further research is required on how best to integrate the health care provided by ICUs and GPs.

Transportation of Medical Staff by Helicopter to Manage a Concealed Delivery at Home

An unmarried pregnant woman felt lower abdominal pain. She rested in bed in her room on the second floor in her home. The next day she performed a delivery by herself. After the neonate cried, her parents noticed the birth and called an ambulance. After receiving the first call, the fire department decided to request the dispatch of a physician-staffed helicopter emergency medical service in Eastern Shizuoka, in addition to dispatching an ambulance. After receiving the request, the helicopter emergency medical service transported 1 neonatal intensive care unit physician along with the original medical staff members of the fire department. Then, the 3 medical staff members were transported to the home by another ambulance. When emergency medical technicians climbed up a steep narrow ladder to enter the room, both the mother and female neonate were connected by the umbilical cord. Their vital signs were stable. At 30 minutes after delivery, the medical staff reached the mother and neonate and cut the umbilical cord. The mother and neonate were evacuated separately from the room but transported in the same ambulance. The ambulance transported them with the medical staff members to our hospital directly. Their postadmission courses were uneventful, and they were discharged. This is the first case report to send medical staff members to the patient's home by helicopter and ambulance to provide medical intervention for the neonate and her mother. Further prospective studies are needed in the future to determine whether this action could lead to favorable outcomes in both neonates and maternal bodies.

The use of sand as an alternative surface for training, injury prevention and rehabilitation in English professional football and barriers to implementation: a cross-sectional survey of medical staff

PURPOSE

The purpose of the present study was to investigate the use of sand as an alternative surface for training, injury prevention and rehabilitation interventions in English professional football. A Secondary aim was to explore the potential barriers to implementation.

MATERIALS AND METHODS

All 92 teams from the male English professional football pyramid during the 2021-22 season were eligible to take part. A cross-sectional survey of the medical personnel (one per club) was conducted between June 2021 and December 2021 based on the RE-AIM framework. A total of 58 respondents (63% of all clubs) completed the survey.

RESULTS AND CONCLUSIONS

Only 18 (31%) of the clubs surveyed used sand-based interventions across the last 3 seasons. Respondents felt sand-based interventions would be effective at improving physiological gains (median 4, interquartile range [IQR] 4-5) and as part of injury prevention and rehabilitation strategies (4, IQR 3-4) but were indifferent in relation to its potential to improve sporting performance (3, IQR 3-4). Barriers to implementation of sand-based interventions within wider football were a lack of facilities, lack of awareness of its potential benefits, lack of high-quality evidence and the surface not being specific to the sport. Medical staff also did not perceive that coaches' positively viewed sand interventions as a training or injury management strategy.

Assessment of extremity dose for medical staff involved in positron emission tomography/computed tomography imaging: Retrospective study

There has been an increase in positron emission tomography (PET)/computed tomography (CT) imaging procedures, and medical workers involved in PET/CT are at increased risk of occupational exposure. Data on extremity dose exposure are limited globally. The current study aimed to evaluate the occupational radiation dose for extremities for medical workers (nurses, radiographers/radiologic technologists, and nuclear medicine physicians) working in PET/CT scanners at 5 large hospitals in Turkey. Optically stimulated luminescence (OSL) and Thermoluminescent dosimeter (TLD) ring dosimeters were used to measure equivalent dose values. Hospitals 1, 2, and 5 used OSL, and 3 and 4 used TLD. A total of 502 readings were obtained from 55 workers. In millisievert (mSv), the average annual effective dose for all workers was 14.5 ± 17.7 (0.2-157.2). A radiography technologist received a maximum dose of 157.21. Nurses received the highest average annual effective dose (15.2 ± 19.46) (0.32-65.58), followed by radiography technologists (14.7 ± 18.03) (0.4-157.2), and nuclear medicine physicians demonstrated the least dose (8.6 ± 10.5) (1.2-24.4). The results show that the extremity dose is well below the annual dose limit of 500 mSv. However, there is a wide variation in dose among the workers, underlining a need for careful assessment of working conditions to ensure safe practices for all workers.

The occupational burnout among medical staff with high workloads after the COVID-19 and its association with anxiety and depression

Objective

After the end of COVID-19, medical staff were immediately faced with a high workload, leading to widespread occupational burnout. This study aims to explore the level and influencing factors of burnout among medical staff during this period, as well as its relationship with anxiety and depression.

Methods

The participants' levels of burnout were assessed using Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the reliability and validity of the questionnaire were evaluated through Cronbach's α and Confirmatory Factor Analysis (CFA). Independent sample t-test, chi-square test, and Pearson analysis were employed to determine the correlation between two sets of variables. Univariate and multivariate logistic regression analyses were conducted to identify significant factors influencing burnout. Finally, nomograms were used to predict the probability of burnout occurrence.

Results

This study collected a total of 1,550 questionnaires, and after excluding 45 questionnaires that were duplicates or incomplete, a sample of 1,505 (97.1%) participants were included in the final statistical analysis. Both Cronbach's α and the fit indices of CFA demonstrated excellent adaptability of the Chinese version of MBI-HSS in this study. The overall prevalence rates for emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA) were 52.4, 55.3, and 30.6%, respectively. Obtaining psychological support, health condition, relationship with family members, and insufficient sleep were identified as common contributing factors to burnout among medical staff. Additionally, age and promotion pressure were also associated with burnout among doctors, and exceeding legal working hours was an important factor for nurse burnout. The C-index for the nomograms predicting burnout among doctors and nurses was 0.832 and 0.843, respectively. Furthermore, burnout exhibited a significant linear correlation with anxiety and depression.

Conclusion

After the end of COVID-19, medical staff in high workload environments were facing severe burnout, which might lead to anxiety and depression. The occupational burnout of medical staff needed to be taken seriously and actively intervened.

Causes and Risk Factors for Absenteeism among Medical Staff in German Specialized Lung Clinics during the COVID Pandemic

BACKGROUND

Staff shortages pose a major challenge to the health system.

OBJECTIVES

The objective of this study was to clarify the role of different causative factors we investigated on staff absenteeism during the COVID pandemic.

METHODS

The prospective multicentre cohort study assessed the private and professional impact of the pandemic on health care workers (HCWs) using a specially developed questionnaire. HCWs from 7 specialist lung clinics throughout Germany were surveyed from December 1 to December 23, 2021. The current analysis addresses pandemic-related absenteeism.

RESULTS

1,134 HCW (55% female; 18.4% male, 26.3% not willing to provide information on age or gender) participated. 72.8% had received at least one vaccination dose at the time of the survey, and 9.4% reported a COVID infection. Of those with positive tests, 98% reported home quarantine for median (IQR) 14 (12-17) days; 10.3% of those who ultimately tested negative also reported quarantine periods of 14 (7-14) days. 32.2% of vaccinated respondents reported absenteeism due to vaccine reactions of 2 (1-3) days. Overall, 37% (n = 420) of HCW reported pandemic-related absenteeism, with 3,524 total days of absenteeism, of which 2,828 were due to illness/quarantine and 696 to vaccination effects. Independent risk factors for COVID-related absenteeism ≥5 days included already having COVID, but also concern about long-term effects of COVID (OR 1,782, p = 0.014); risk factors for vaccine-related absenteeism ≥2 days included concerns of late effects of vaccination (OR 2.2, 95% CI: 1.4-3.1, p < 0.000).

CONCLUSION

Staff shortages due to quarantine or infections and vaccine reactogenicity have put a strain on German respiratory specialists. The fact that staff concerns also contributed to absenteeism may be helpful in managing future pandemic events to minimize staff absenteeism.

Occupational radiation dose on the hand of assisting medical staff in diagnostic CT scans

Chronic radiation exposure increases the risk of skin damage of medical personnel engaged in radiology. However, hand dose measurements in computed tomography (CT) for diagnostic purposes have not been evaluated. The occupational radiation dose to the hands of CT assistants was herein investigated to evaluate its compliance with the equivalent dose limit for the hand (500 mSv/year). The occupational doses of nine CT assistants were measured in 89 cases (April 2017-May 2018) by installing radio-photoluminescence glass dosemeters (GD-302 M) (70-μm dose-equivalent conversion coefficient = 0.37) on the dorsal aspect of both hands. The occupational dose to the hand was the highest with head holding (right: 1.14 mSv/CT scan, left: 1.07 mSv/CT scan). Considering the results for annual work, even for head holding, the hand dose of the CT-assisting personnel was insignificant. However, CT assistants should be mindful of the possibility of locally higher doses to hands.

Barriers to and facilitators of advance care planning implementation for medical staff after the COVID-19 pandemic: an overview of reviews

OBJECTIVE

The COVID-19 pandemic has impacted the capacity for advance care planning (ACP) among patients, families and healthcare teams. We sought to identify and review the barriers to and facilitators of ACP implementation for medical staff in different settings (eg, hospitals, outpatient palliative care, nursing and care homes) during the pandemic.

DESIGN

This study employed an overview of reviews design. We searched the MEDLINE, CENTRAL, Web of Science and Embase databases for studies published between 8 December 2019 and 30 July 2023. We used AMSTAR 2 to assess the risk of bias.

RESULTS

We included seven reviews. Common barriers to ACP implementation included visitation restrictions, limited resources and personnel and a lack of coordination among healthcare professionals. In care and nursing homes, barriers included a dearth of palliative care physicians and the psychological burden on facility staff. Using telemedicine for information sharing was a common facilitator across settings. In hospitals, facilitators included short-term training in palliative care and palliative care physicians joining the acute care team. In care and nursing homes, facilitators included ACP education and emotional support for staff.

CONCLUSIONS

Visitation restrictions and limited resources during the pandemic posed obstacles; however, the implementation of ACP was further hindered by insufficient staff education on ACP in hospitals and facilities, as well as a scarcity of information sharing at the community level. These pre-existing issues were magnified by the pandemic, drawing attention to their significance. Short-term staff training programmes and immediate information sharing could better enable ACP.

PROSPERO REGISTRATION NUMBER

CRD42022351362.

Exploring the training of chinese medical staff oriented to the need for clinical drug information services: from the perspective of drug information patients obtained and need

BACKGROUND

There are some gaps between the training of drug information service competencies for medical staff and drug information patients need in China.

OBJECTIVE

To investigate drug information patients obtained and need for further providing directions for the training of drug information service competencies among medical staff in China from patients' perspectives.

METHODS

A face-to-face nationwide survey was conducted using a stratified sampling method. Data were analyzed descriptively using frequencies, percentages and mean. Several subgroup analyses using Chi-square tests were conducted to identify patients' need for drug information in China.

RESULTS

A total of 1994 questionnaires from medical institutions in China were returned. Most of the drug information obtained by patients came from physicians, and different types of drug information were important to patients. Additionally, patients had different needs for drug information due to age, gender, diagnosis and treatment status, and education level.

CONCLUSIONS

The training of medical staff needs to increase the presence of nurses and pharmacists in drug information services, enhance the awareness of "patient-centered" services, and improve the ability to provide information services specific to the characteristics of patients.

Actual situation of decision-making support from medical staff when cancer patients make treatment choices

Background: We investigated factors involved in decision-making support provided by physicians, nurses, pharmacists and medical and psychiatric social workers involved in cancer care. Materials & methods: A questionnaire survey on decision-making support was conducted. The level of clinician support was classified as 'supporting patients' 'decision-making process regarding cancer treatment', 'no support for patients' 'decision-making process regarding cancer treatment' or 'team-based support for patients' 'decision-making process regarding cancer treatment'. Results: Physicians estimated that 83.7% of patients made a cancer treatment decision within 1 week, but 45.4% of patients had difficulty making a decision. Conclusion: Medical personnel should support patients who have difficulty making decisions, establish a screening method to identify those needing support and develop a system providing decision-making support through interprofessional work.

FIGO good practice recommendations for cesarean delivery on maternal request: Challenges for medical staff and families

Elective cesarean delivery on maternal request is a challenging topic of discussion for patients, their families, and clinicians. Efforts to reduce the rate of cesarean deliveries should include the proportion of cesarean deliveries at term that occur solely due to maternal request rather than a maternal or fetal indication. Additionally, clinicians should follow good clinical practice, which includes family counseling, discussions on the benefits and potential risks of elective cesarean delivery, timing of delivery, and ethical and legal considerations. Furthermore, there is the need for a sustained workforce of perinatal clinicians and staff trained in the appropriate technique and management of operative complications. This article reviews global rates of elective cesarean on maternal request and outlines FIGO's good practice recommendations for counseling expectant mothers and the conduct of elective cesarean versus vaginal delivery.

The working experience of medical staff in the hospital-wide bed-sharing mode: A qualitative study

AIM

The purpose of this study was to provide a comprehensive understanding of the attitudes and experiences of the medical staff regarding the hospital bed-sharing model.

DESIGN

The present research was a qualitative study.

METHODS

This qualitative study used in-depth individual interviews with 7 doctors, 10 clinical nurses and 3 head nurses, which were then transcribed and analysed thematically.

RESULTS

The study identified six overall themes. Issues were raised about the efficient utilization of hospital bed resources, greater challenges for nursing work, adjustment of doctors' work modes, barriers to communication between doctors, nurses, and patients, potential medical risks, and differentiation of patients' medical experience.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital administrators and nurse managers should work together to solve the challenges that medical staff face, including strengthening nursing training, improving medical-nursing collaboration models, standardizing and effective communication strategies, and improving patient experiences.

Prediction of outpatients with conjunctivitis in Xinjiang based on LSTM and GRU models

BACKGROUND

Reasonable and accurate forecasting of outpatient visits helps hospital managers optimize the allocation of medical resources, facilitates fine hospital management, and is of great significance in improving hospital efficiency and treatment capacity.

METHODS

Based on conjunctivitis outpatient data from the First Affiliated Hospital of Xinjiang Medical University Ophthalmology from 2017/1/1 to 2019/12/31, this paper built and evaluated Long Short-Term Memory (LSTM) and Gated Recurrent Unit (GRU) models for outpatient visits prediction.

RESULTS

In predicting the number of conjunctivitis visits over the next 31 days, the LSTM model had a root mean square error (RMSE) of 2.86 and a mean absolute error (MAE) of 2.39, the GRU model has an RMSE of 2.60 and an MAE of 1.99.

CONCLUSIONS

The GRU method can better predict trends in hospital outpatient flow over time, thus providing decision support for medical staff and outpatient management.

The development and validation of the hospital organizational environment scale for medical staff in China

Objectives

There is currently no measure of the hospital organizational environment targeting both clinicians and nurses in China. This study was conducted with the aim of developing and testing an instrument to assess the properties of the hospital organizational environment that is applicable to Chinese medical staff.

Methods

Items were developed based on a literature review, semi-structured interviews and an expert review and finalized based on corrected item-total correlation, content validity, construct validity, convergent validity, discriminant validity and reliability. The two samples for testing the first and final version of the Hospital Organizational Environment Scale (HOES) included 447 and 424 participants, respectively.

Results

The primary test, which comprised 18 items, contained four factors: hospital culture, work situation, organizational support and scientific research situation. The Cronbach's alphas were 0.935, 0.824, 0.943, and 0.920, respectively. The results of the validation test showed that the questionnaire had good validity and reliability.

Conclusion

The HOES is a comprehensive instrument with demonstrated validity and reliability that can be adopted among medical staff to assess the organizational environment in hospitals.

[The mediating role of resilience between social capital at work and anxiety of medical staff]

Objective: To explore the influence of social capital at work on anxiety of medical staff, and the mediating role of resilience. Methods: From March to May 2022, a total of 201 medical staff in the Affiliated Hospital of Jining Medical University were investigated with the General Information Questionnaire, Workplace Social Capital Scale, Connor-Davidson Resilience Scale (CD-RISC-10) and Generalized Anxiety Disorder-7 (GAD-7) . K-S method was used for normdity test of econometic voriobles, and normal distribution data were represented by Mean±SD, Pearson correlation analysis and linear regression analysis were used to test correlation between variables and mediating effect, and Bootstrap method was carried out by SPSS macro program PROCESS v3.5 to verify the mediating effect. Results: The detection rate of anxiety was 59.20% (119/201) in medical staff. The scores of social capital at work (28.90±5.83) and resilience (31.55±4.98) were negatively correlated with the score of anxiety (7.20±2.06) (r=-0.338, -0.510, P<0.001) , while the score of social capital at work was positively correlated with resilience (r=0.392, P<0.001) . Workplace social capital positively predicted resilience (β=0.392, P<0.001) , and both workplace social capital (β=-0.222, P=0.001) and resilience at work (β=-0.423, P<0.001) negatively predicted anxiety score. The direct effect of social capital in the workplace of medical staff on anxiety was -0.222 (95%CI: -0.349~-0.095, P=0.001) , and the indirect effect of resilience on anxiety was -0.166 (95%CI: -0.265~-0.080) . The resilience of medical staff had a partial mediating effect between workplace social capital and anxiety, which accounted for 42.78% of the total effect. Conclusion: The resilience of medical staff has a partial mediating effect between workplace social capital and anxiety. Workplace social capital can not only directly affect the anxiety of medical staff, but also indirectly affect it through resilience.

Examining the impact of perceived stress, anxiety, and resilience on depression among medical staff after COVID-19 quarantine: a chain mediation analysis

Introduction

The COVID-19 pandemic and subsequent quarantine measures have led to a significant impact on mental health worldwide. Medical staff, in particular, have been exposed to high levels of stress due to their frontline work during the crisis. However, there is still limited research on the psychological mechanism among medical staff after quarantine.

Methods

In this cross-sectional observational study, 150 medical staff from Shanghai YangZhi Rehabilitation Hospital, Shanghai, China, were enrolled in October 2022. SPSS 26.0 and PROCESS 4.0 model 6 were used to analyze the chain mediating effect of perceived stress, anxiety, resilience and depression among medical staff after quarantine. Anxiety and depression were compared during and after the quarantine. All scales have high validity and reliability in a Chinese population.

Results

Our findings revealed a positive correlation between perceived stress and anxiety (r = 0.60, p < 0.001) and depression (r = 0.60, p < 0.001) levels among medical staff. Conversely, resilience was found to have a negative correlation with perceived stress (r = -0.67, p < 0.001), anxiety (r = -0.57, p < 0.001) and depression (r = -0.61, p < 0.001). The score of depression during the quarantine was higher than the score after the quarantine, but the p-value is only marginally significant (p = 0.067). The score of anxiety during the quarantine was significantly higher than the score after the quarantine (p < 0.05). Moreover, the chain mediation model suggested that anxiety and resilience could mediate the association between perceived stress and depression among medical staff following quarantine. Specifically, perceived stress had no direct effect on depression (β = 0.025, t = 0.548, p = 0.59) but positively predicted anxiety (β = 0.381, t = 8.817, p < 0.001) and resilience (β = -1.302, t = -6.781, p < 0.001), which influenced depression levels indirectly through multiple pathways. The three indirect paths: the mediating role of anxiety, the mediating role of resilience, and the chain mediating role of both anxiety and resilience.

Discussion

This study emphasizes the importance of psychological interventions aimed at protecting medical staff's psychological resilience and promoting coping mechanisms to manage stress during and after crises such as the COVID-19 pandemic. Additionally, our findings suggest that both anxiety and resilience play critical roles in mitigating the detrimental effects of perceived stress on mental health and further highlight the need for continued research to better understand the complex interplay of these factors.

Adverse event signal extraction from cancer patients' narratives focusing on impact on their daily-life activities

Adverse event (AE) management is important to improve anti-cancer treatment outcomes, but it is known that some AE signals can be missed during clinical visits. In particular, AEs that affect patients' activities of daily living (ADL) need careful monitoring as they may require immediate medical intervention. This study aimed to build deep-learning (DL) models for extracting signals of AEs limiting ADL from patients' narratives. The data source was blog posts written in Japanese by breast cancer patients. After pre-processing and annotation for AE signals, three DL models (BERT, ELECTRA, and T5) were trained and tested in three different approaches for AE signal identification. The performances of the trained models were evaluated in terms of precision, recall, and F1 scores. From 2,272 blog posts, 191 and 702 articles were identified as describing AEs limiting ADL or not limiting ADL, respectively. Among tested DL modes and approaches, T5 showed the best F1 scores to identify articles with AE limiting ADL or all AE: 0.557 and 0.811, respectively. The most frequent AE signals were "pain or numbness", "fatigue" and "nausea". Our results suggest that this AE monitoring scheme focusing on patients' ADL has potential to reinforce current AE management provided by medical staff.

Evaluation of dressings preventing facial medical device-related pressure injury in medical staff during the COVID-19 pandemic: A systematic review and network meta-analysis

AIM

This study systematically compared the efficacy of various dressings that may prevent facial medical device-related pressure injury (MRDPI) in medical staff during the COVID-19 pandemic.

BACKGROUND

During the COVID-19 pandemic, medical staff who are required to wear masks, goggles and other personal protective equipment (PPE) are susceptible to facial MRDPI, which exacerbates working conditions. Dressings can effectively prevent or alleviate MRDPI, but it is unclear which dressings are most effective.

DESIGN

A systematic review and network meta-analysis, in accordance with PRISMA.

METHODS

A comprehensive literature search was conducted in four English and four Chinese databases to identify relevant studies published up to 8 September 2022. The selected studies were randomised controlled trials, with populations comprising medical staff who wore PPE during the COVID-19 pandemic and included an observation and control group.

RESULTS

The network meta-analysis of the 12 selected articles showed that foam dressing, hydrocolloid dressing and petrolatum gauze were better than conventional protection for preventing MRDPI. The surface under the cumulative ranking curve indicated that foam dressing was the best preventative.

CONCLUSION

Foam dressing is more effective than other dressings in preventing facial MRDPI in medical staff. When PPE must be worn for many hours, such as during the COVID-19 pandemic, medical staff can use foam dressings to prevent MRDPI.

RELEVANCE TO CLINICAL PRACTICE

The results support the use of dressings, especially foam dressings, to prevent MRDPI in healthcare workers. The appropriate dressings are recommended to prevent MRDPI associated with wearing PPE.