What parents tell us about the complex reality of lethal means restriction

BackgroundThe integration of digital technologies is becoming increasingly essential in cancer care. However, limited digital health literacy among clinical and nonclinical cancer health care professionals poses significant challenges to effective implementation and sustainability over time. To address this, the European Union is prioritizing the development of targeted digital skills training programs for cancer care providers, the TRANSiTION project among them. A crucial initial step in this effort is conducting a comprehensive gap analysis to identify specific training needs.ObjectiveThe aim of this work is to identify training gaps and prioritize the digital skill development needs in the oncology health care workforce.MethodsAn importance-performance analysis (IPA) was conducted following a survey that assessed the performance and importance of 7 digital skills: information, communication, content creation, safety, eHealth problem-solving, ethics, and patient empowerment.ResultsA total of 67 participants from 11 European countries completed the study: 38 clinical professionals (CP), 16 nonclinical professionals (NCP), and 13 patients or caregivers (PC). CP acknowledged the need for a comprehensive training program that includes all 7 digital skills. Digital patient empowerment and safety skills emerge as the highest priorities for both CP and NCP. Conversely, NCP assigned a lower priority to digital content creation skills, and PC assigned a lower priority to digital information and ethical skills. The IPA also revealed discrepancies in digital communication skills across groups (H=6.50; P=.04).ConclusionsThe study showcased the pressing need for comprehensive digital skill training for cancer health care professionals across diverse backgrounds and health care systems in Europe, tailored to their occupation and care setting. Incorporating PC perspectives ensures a balanced approach to addressing these training gaps. These findings provide a valuable knowledge base for designing digital skills training programs, promoting a holistic approach that integrates the perspectives of the various stakeholders involved in digital cancer care.

BackgroundArtificial intelligence–based clinical decision support systems (AI-CDSSs) have enhanced personalized medicine and improved the efficiency of health care workers. Despite these opportunities, trust in these tools remains a critical factor for their successful integration into practice. Existing research lacks synthesized insights and actionable recommendations to guide the development of AI-CDSSs that foster trust among health care workers.ObjectiveThis systematic review aims to identify and synthesize key factors that influence health care workers’ trust in AI-CDSSs and to provide actionable recommendations for enhancing their trust in these systems.MethodsWe conducted a systematic review of published studies from January 2020 to November 2024, retrieved from PubMed, Scopus, and Google Scholar. Inclusion criteria focused on studies that examined health care workers’ perceptions, experiences, and trust in AI-CDSSs. Studies in non–English languages and those unrelated to health care settings were excluded. Two independent reviewers followed the Cochrane Collaboration Handbook and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Analysis was conducted using a developed data charter. The Critical Appraisal Skills Programme tool was applied to assess the quality of the included studies and to evaluate the risk of bias, ensuring a rigorous and systematic review process.ResultsA total of 27 studies met the inclusion criteria, involving diverse health care workers, predominantly in hospitalized settings. Qualitative methods were the most common (n=16, 59%), with sample sizes ranging from small focus groups to cohorts of over 1000 participants. Eight key themes emerged as pivotal in improving health care workers’ trust in AI-CDSSs: (1) System Transparency, emphasizing the need for clear and interpretable AI; (2) Training and Familiarity, highlighting the importance of knowledge sharing and user education; (3) System Usability, focusing on effective integration into clinical workflows; (4) Clinical Reliability, addressing the consistency and accuracy of system performance; (5) Credibility and Validation, referring to how well the system performs across diverse clinical contexts; (6) Ethical Consideration, examining medicolegal liability, fairness, and adherence to ethical standards;(7) Human Centric Design, pioritizing patient centered approaches; (8) Customization and Control, highlighting the need to tailor tools to specific clinical needs while preserving health care providers’ decision-making autonomy. Barriers to trust included algorithmic opacity, insufficient training, and ethical challenges, while enabling factors for health care workers’ trust in AI-CDSS tools were transparency, usability, and clinical reliability.ConclusionsThe findings highlight the need for explainable AI models, comprehensive training, stakeholder involvement, and human-centered design to foster health care workers’ trust in AI-CDSSs. Although the heterogeneity of study designs and lack of specific data limit further analysis, this review bridges existing gaps by identifying key themes that support trust in AI-CDSSs. It also recommends that future research include diverse demographics, cross-cultural perspectives, and contextual differences in trust across various health care professions.

Many professionals have limited knowledge of how to address health literacy; they need a wider range of health literacy competencies to enhance empowerment and person-centred prevention. We evaluated whether: (1) a comprehensive health literacy training increased self-rated competencies of health professionals to address health literacy related problems and support the development of people’s autonomy and self-management abilities after training and 6–12 weeks later, (2) professionals were satisfied with the training, (3) outcomes differed for the three participating European countries. Health professionals (N = 106) participated in a multicentre pre-post intervention study in Italy, the Netherlands and Northern Ireland. The 8-hour training-intervention involved health literacy knowledge, the practice of comprehensible communication skills, shared decision-making, and enhancing self-management. Self-rated health literacy competencies and training satisfaction were assessed at baseline, immediately after training and 6-12 weeks later, and analysed by multi-level analysis. Professionals’ self-rated health literacy competencies significantly improved following training in all three countries; this increase persisted at 6-12 weeks follow-up. The strongest increase regarded professional’s skills to enhance shared-decision making and enabling self-management after training and follow-up respectively. Professionals perceived the training as relevant for practice. Competency increases seemed to be consistent across countries. In three countries, professionals’ self-rated health literacy competencies increased following this comprehensive training. These promising findings should be confirmed in a further full effect study. Implementation of this training in European education and health care may improve person-centred communication by professionals and might help to tackle health literacy related problems and to strengthen people’s abilities in achieving better health outcomes.

Firearms have been noted as a risk factor in youth suicide, but this has not necessarily translated effectively into the clinical setting. There is little information from the mental health field on firearm counseling interventions with parents of adolescents. The intent of this study was to uncover adolescent mental health clinicians' endorsements of specific messaging strategies on firearm access and safety counseling geared toward parents of depressed and suicidal adolescents. A total of 24 clinicians from a rural area took part in a focus group study. As part of the focus group, mental health counselors looked at six short paragraphs that phrased counseling parents on suicide and firearms. They were asked to identify three sentences across these paragraphs that they felt would be useful with parents of depressed or suicidal adolescents in counseling. Results found 66 responses that resulted in the recognition of 16 common statements across participants. The frequency of statements was examined, qualitatively analyzed and grouped according to messaging concept. The results indicated that the sentences the counselors identified fit into five concepts: Risk, Empathy, Impulsivity, Lethal Means Restriction Counseling, and Parental Responsibility. The present study provides insight into message strategies identified as helpful in engaging parents in discussions of firearms when the risk of adolescent suicide is present.

The future of health professions education: Emerging trends in the United States.

Healthcare workers are at an increased risk of hepatitis B virus infection due to potential exposure to blood and other infectious materials. The infection can lead to acute liver disease and chronic liver complications such as cirrhosis and liver cancer. It can impact workforce health, leading to absenteeism, and increased healthcare costs. Hence, this study aimed to determine the seroprevalence and risk factors of the hepatitis B virus among healthcare workers in Africa. The protocol for this systematic review and meta-analysis was registered on PROSPERO with the registration number CRD42024556654. Literatures were searched from PubMed, Science Direct, HINARI, African Online Journal, Google Scholar, Google, Semantic Scholar, and Directory of Open Access Journals using relevant search terms. The process of searching relevant articles was completed on 1 August 2024. Studies with a quality evaluation indicator score of 50% or above were included in this study. The random effect model was used to measure the pooled seroprevalence and associated factors of hepatitis B virus infection among healthcare workers in Africa. The finding of the meta-analysis was presented using forest plots with a 95% confidence interval. Among 26 studies selected for meta-analysis, 6983 participants were included. The inclusion of 26 studies showed that the pooled prevalence of hepatitis B virus infection among healthcare workers was 17.2% (95% CI: 8.36, 26.04). Healthcare workers diagnosed with liver disease were 5.01 times more likely to having hepatitis B virus infection compared to those who were not diagnosed (POR = 5.01: 95% CI; 2.25,7.77). In addition, healthcare workers who did not receive technical training were 2.70 times more likely to having HBV infection than those who received training (POR = 2.70:95% CI; 1.10, 4.30). Furthermore, healthcare workers aged 40 years and above were 2.53 times more likely to having hepatitis B virus infection than young healthcare workers (POR = 2.53: 95% CI; 1.29,3.77). The pooled prevalence of hepatitis B virus infection was high. Previously diagnosed liver diseases, the absence of technical training, and the age of healthcare workers were the factors influencing the pooled prevalence of HBV infection among healthcare workers. Hence, providing appropriate medical follow-up for healthcare workers diagnosed with liver disease, comprehensive training and education, and early detection and diagnosis of healthcare workers aged 40 years and above are the most important interventions to prevent the risk of hepatitis B virus infection.

Background A good interpersonal patient-provider relationship is crucial for quality care, still patients frequently perceive interface as discriminatory and marginalizing, reinforcing societal gender roles and hindering healthcare quality. This becomes even more critical for healthcare systems with limited resources and prolonged emergencies, such as Ukraine during the COVID-19 pandemic and full-scale war. We explore gender stereotypes of healthcare workers in Ukraine. Methods This mixed-methods study was conducted in August-September 2022, and included: 1)16 online focus group discussions with 93 healthcare workers; 2)survey conducted face-to-face with 1,529 physicians and 502 nurses; modified Nijmegen Gender Awareness in Medicine Scale questionnaire was used. Qualitative data was transcribed and inductively analyzed. Survey results were analyzed in SPSS using descriptive statistics and correlation analyses. Results Healthcare workers perceived women patients as ‘more demanding’ and ‘less accommodating’ compared to men. Thus, 64% of healthcare workers perceived female patients as overusing health services; 44%-believed women have higher expectations than male patients; 61%-thought they expected excessive empathy; and 58%-noticed women veering off-topic during consultations. Also, respondents who supported the belief that male patients better understand doctors’ recommendations were more likely to also support the statement that female patients, compared to male patients, more often have higher expectations from doctors (rs = 0.4, p < 0.001). With age prevalence of gender stereotypes increased among healthcare workers; there were no significant differences by sex of healthcare workers, healthcare facility type, position, or geographical location. Conclusions It is crucial to develop and implement gender-sensitive approaches in Ukrainian health facilities, rooted in comprehensive training and continuous professional development targeting prevalent gender stereotypes. Key messages • Gender stereotypes are prevalent among healthcare workers in Ukraine. • Gender-sensitive approaches and comprehensive training should target prevalent gender stereotypes.

ObjectiveTo explore the experiences and perceptions of health workers and implementers of task-shifting in rural health facilities in Upper East Region, Ghana.MethodsData was collected through field interviews. A total of sixty eight (68) in-depth interviews were conducted with health workers’ in primary health care facilities (health centres); Four in-depth interviews with key persons involved in staff management was conducted to understand how task-shifting is organised including its strengths and challenges. The health workers interview guide was designed with the aim of getting data on official tasks of health workers, additional tasks assigned to them, how they perceive these tasks, and the challenges associated with the practice of task-shifting.FindingsTask-shifting is a practice being used across the health facilities in the study area to help reduce the impact of insufficient health workers. Generally, health workers had a comprehensive training that supported the organisation of task-shifting. However, staff members’ are sometimes engaged in tasks above their level of training and beyond their actual job descriptions. Adequate training is usually not provided before additional tasks are assigned to staff members. Whilst some health workers perceived the additional tasks they performed as an opportunity to learn new skills, others described these as stressful and overburdening.ConclusionTask-shifting has the potential to contribute to addressing the insufficient health workforce, and thereby improving health delivery system where the procedures are well defined and staff members work in a coordinated and organised manner. The provision of adequate training and supervision for health workers is important in order to improve their expertise before additional tasks are assigned to them so that the quality of care would not be compromised.

n the not-so-distant future, the professionals who keep medical devices humming might not have the job title or responsibilities of today’s “clinical engineer” (CE) or “ biomedical equipment technician (BMET).” That’s because working with medical devices increasingly requires a skill set that goes beyond those of many medical technology professionals in the field today. Hospitals and manufacturers are responding by creating new, hybrid jobs that require a broader range of skills. Moreover, more institutions are realigning their organizational, operational, and reporting structures to reflect the changing nature of job roles and responsibilities. In this environment, the days of carving a career out of “fixing boxes,” in the words of several medical technology professionals, is giving way to an era of new opportunities for careers focused on integrating, managing, and servicing highly sophisticated and interconnected systems.

Developing and pilot testing a comprehensive health literacy communication training for health professionals in three European countries

A Global Call for Action to Prioritize Healthcare Worker Suicide Prevention During the COVID-19 Pandemic and Beyond.

Smoking remains a leading public health issue and health care practitioners (HCPs), who play an important role in supporting and promoting patients' cessation efforts, need educational initiatives that improve their ability to provide effective clinical care. The objective of this study was to compare patient-reported abstinence from smoking following treatment by HCPs trained in an intensive tobacco cessation program and those trained in less intensive programs. A secondary data analysis of two overlapping samples of patients who received most of their treatment from one identifiable HCP (n = 26,590) or all of their treatment from one identifiable HCP (n = 20,986) was assessed. Patients were residents of Ontario, Canada, who enrolled in a publicly funded smoking cessation treatment program between 01 May 2014 and 31 October 2016 and completed the7-day point prevalence of smoking questionat 6-month follow-up. Treatment was provided by HCPs who engaged in the intensive Training Enhancement in Applied Counselling and Health (TEACH) Core course, or those who engaged in one or more other training programs. Generalized estimating equation (GEE) logistic regression was used to compare smoking abstinence between groups. After adjustment for both patient- and practice-level covariates, a significant association was found between being treated by a TEACH-trained HCP and the likelihood of smoking abstinence at 6-month follow-up in both analytic samples (most care sample: OR = 1.10, 95% CI = 1.01, 1.20; all care sample: OR = 1.12, 95% CI = 1.02, 1.24). Implementation of comprehensive cessation training to support HCP delivery of smoking cessation treatment should be considered to improve patient outcomes.

A key limiting factor in the scale up and sustainability of HIV care and treatment programmes is the global shortage of trained health care workers. This paper discusses why it is important to move beyond conceptualising health care workers simply as 'inputs' in the delivery of HIV treatment and care, and to also consider their roles as partners and agents in the process of health care. It suggests a framework for thinking about their roles and responses in HIV care, considers the current evidence base, and concludes by identifying key areas for future research on health care workers' responses in HIV treatment and care in low and middle income settings.

The researchers explore the stigma of postpartum depression and role of lady health workers in bringing the women to the health facility and following up on their treatment. In-depth interviews were conducted from the registered patients (n = 22), Lady Health Visitors (n = 2) and Lady Health Workers (LHWs) (n = 2) in a public primary and tertiary healthcare facility in peri-urban areas of district Rawalpindi, Pakistan. Stigma of depression and lack of awareness was perceived as one of the major reasons for women to struggle with the label of postpartum depression and seeking medical treatment. Lady health workers played a significant role in health education and bringing them to the health facility. The services rendered by LHWs can be enhanced through comprehensive training as they can play an effective role in spreading awareness and educating the patients of postpartum depression in peri-urban areas and their families, consequently, ensuring their treatment and its follow-up.

ABSTRACTBackground: Communication is a central part of providing family centred care in neonatal nurseries and is associated with a range of positive outcomes for families. However, previous research has indicated that communication is more problematic between health professionals and minority groups of patients and families, although much of this research is atheoretical. The current study used communication accommodation theory to examine nurses’ perceptions of effective and ineffective interactions with typical parents, culturally and linguistically diverse parents (CALD), and adolescent parents in neonatal nurseries.Method: We conducted semi-structured interviews with nurses from two tertiary hospitals in Australia. Twelve nurses from one hospital were asked about interactions with typical parents, and twenty-nine nurses from the other hospital were asked about interactions with CALD and adolescent parents. Interviews were coded for communication strategy and accommodative stance, using a coding system based on communication accommodation theory.Results: Descriptions of interactions with typical parents (who were perceived as Anglo-Australian) differed from those with CALD and adolescent parents. Interactions with CALD parents focused mostly on comprehension and cultural differences, with limited mention of other strategies. Interactions with adolescent parents were regarded as particularly problematic, and involved greater focus on face management than for other groups of parents. Generally, interactions with minority groups were based on a narrower range of strategies, and were more intergroup than interpersonal in focus.Conclusions: Our findings show the importance of studying health professionals’ perceptions of interactions with people from different minority groups. We discuss the implications for our understanding of communicating with diverse patients and families, and educating health professionals, including the utility of communication accommodation theory as a guiding framework for training.