Staff Attitudes Research Articles

Ward atmosphere for inpatients with intellectual disability and mental illness: family members’ perceptions and experience

Inpatient admission may be necessary and effective in treatment of mental illness in people with intellectual disabilities. Although risk of mental illness is increased in this population, adaptations of inpatient treatment and ward atmosphere for this population remain sparsely described. For the current qualitative study, family members were interviewed about their experiences of ward atmosphere and mental health nursing in a specialised inpatient ward for adults with intellectual disabilities. Using thematic analysis, four themes were identified. Two concerned participants’ perceptions of the patient’s experience (patients’ therapeutic relationships with staff members, and staff attitudes and specific expertise in working with people with intellectual disabilities), while two concerned the patients’ own experiences (feeling safe and involved, and gaining new knowledge and understanding). These findings indicate that trust in staff is important for family members to feel safe, and that extra effort may be necessary to build such trust among the families of inpatients with intellectual disabilities. Developing good 1:1 therapeutic relationships with the patient, helping the patient feel safe and understood, demonstrating specific experience and skills relating to mental health care for this specific population, family involvement, and understanding inpatient treatment as a collaborative effort, may all contribute to facilitating this trust.

Childhood Autism Spectrum Disorder: Knowledge, Attitudes, and Practice of Health Professionals in Togo

Background. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in behavior, social communication, and interaction. Objectives. To describe health staff's knowledge, attitudes, and practices regarding ASD in Lomé. Methods. From January to March 2020, we conducted a multicenter, cross-sectional, descriptive, and analytical study on ASD in childhood. A survey was administered to a sample of healthcare professionals in 5 facilities in Lomé, Togo. A questionnaire assessed the knowledge, attitudes, and practices of ASD among 139 participants (pediatricians, neurologists, general practitioners, psychologists, speech therapists, and nurses). Results.The participation rate was 84.2 % (117 / 139). One hundred seven health workers (91.5 %) had heard of ASD. Inaccurate knowledge was observed: 65.4 % gave a good definition of autism, 73.2 % did not know the autistic triad, the early warning signs (64.6 %), or the age of onset (61.0 %). Only 22.0 % of staff were familiar with autism screening tools. The highest knowledge was significantly associated with being a speech therapist or pediatrician practicing in a tertiary health facility (p < 0,0001). Higher-graded staff also observed better knowledge levels (p = 0, 0128). Concerning attitudes or practices regarding autistic children, 26 of those surveyed (22,2 %) had already screened for ASD, of whom 23 (88,5 %) worked with other specialties in case management. Conclusion. This study highlights inappropriate knowledge, attitudes, and practices among health staff. These findings warrant the need for good initial training on ASD, awareness campaigns, and the setting up a specialized center in Togo.

Improving Environmental Sustainability of Operating Theatres: A Systematic Review of Staff Attitudes, Barriers, and Enablers.

To understand views of staff in relation to attitudes, enablers, and barriers to implementation of environmentally sustainable surgery in operating theatres. This will ultimately help in the goal of successfully implementing more sustainable theatres. Global healthcare sectors are responsible for 4.4% of greenhouse gas emissions. Surgical operating theatres are resource intensive areas and improvements will be important to meet Net-Zero carbon emissions within healthcare. Three databases were searched (Web of Science, Ovid and PubMed), last check January 2024. We included original manuscripts evaluating staff views regarding sustainable operating theatres. The Mixed Methods Appraisal Tool was used for quality appraisal and data analysed using thematic synthesis. 2933 articles were screened and 14 fulfilled inclusion criteria, using qualitative (1), quantitative (2), and mixed methods (11). Studies were undertaken in a variety of clinical (Department of Anaesthesia, Surgery, Otolaryngology, Obstetrics & Gynaecology and Ophthalmology) and geographical settings (Australia, Canada, France, Germany, New Zealand, USA, UK & Ireland,). Across studies there was a lack of evidence exploring enablers to implementation, but barriers mainly related to the following themes: education and awareness, leadership, resistance to change, facilities and equipment, time, and incentive. This systematic review identified attitudes and barriers perceived by clinicians towards improving environmental sustainability within operating theatres, which may inform future strategy towards sustainable surgery. Most studies used a survey-design, whereas use of interviews may provide deeper insights. Future work should be extended to wider stakeholders influencing operating theatres. Additionally, implementation studies should be carried out to examine whether barriers do change in practice. This systematic review identified attitudes and barriers perceived by clinicians towards improving environmental sustainability within operating theatres, which may inform future strategy towards sustainable surgery. Most studies used a survey-design, whereas use of interviews may provide deeper insights. Future work should be extended to wider stakeholders influencing operating theatres. Additionally, implementation studies should be carried out to examine whether barriers do change in practice.

Emergency department staff experiences of working with people who self-harm: A qualitative examination of barriers to optimal care.

For people who seek help for self-harm, emergency departments (ED) are often the first point of contact, making them a suitable setting for intervention. In Australia, base rates of self-harm presentations to ED are increasing, while the quality of care these people receive is often considered sub-optimal. This study used qualitative interviews to explore potential barriers ED staff face in delivering best possible self-harm care. Seventeen staff across two EDs in the state of Victoria, Australia, were interviewed regarding their perceptions of barriers to providing optimal self-harm care and suggestions for improvement. Three themes were identified: (1) system-related challenges when managing self-harm in ED, including the shortage of hospital resources, challenges of ED as a physical environment, and insufficient education, training and guidelines about self-harm care for staff; (2) human-related challenges regarding management of self-harm in ED, which encompassed the nature of a person's circumstances and presentation, and staff attitudes towards self-harm; and (3) staff suggestions for improving self-harm care in ED. Specific recommendations that were proposed based on these findings included introducing a separate ED area for mental health-related presentations, provision of specialised education and training about self-harm care to staff, better implementation of guidelines on treating self-harm in ED, and employing mental health educators to provide on-the-floor mentoring to nurses. The relevance of these barriers and recommendations to the wider healthcare sector is also discussed. Together, these findings may inform improvements to the quality of care provided to those who engage in self-harm.

Preparedness and training needs of a regional public mental health service to support people with intellectual disability.

To explore the preparedness and training needs of a regional public mental health workforce to support people with intellectual disability and mental ill health. Staff from a regional public mental health service in Victoria, Australia. A mixed-methods design comprised a survey, interviews and a focus group to collect data about staff attitudes, confidence, education and professional development regarding supporting people with intellectual disability and mental ill health. Descriptive and thematic analyses were used. Data from 31 survey respondents, seven interviews and one focus group were analysed. Survey descriptive analyses showed participants believed treating people with intellectual disability was part of their role but reported areas of low confidence along with insufficient education and training in intellectual disability mental health. Thematic analyses from interviews showed that underpinning confidence, education and training were the themes (1) need for flexibility, such as having more time and (2) solutions but with challenges, such as limited opportunity to upskill and availability of experts. A need for collaborative problem-solving where staff share skills and information to work towards person-centred solutions was a key theme from the focus group analysis. Professional development in intellectual disability mental health is required for the regional public mental health workforce but needs to account for the challenges experienced and reflect how teams function. Exploration of described preparedness offered a possible learning approach informed by workforce members. Collaborative learning approaches to supporting people with intellectual disability and mental ill health are suggested.

Lived experiences of women with spontaneous abortion at a district hospital, South Africa.

Spontaneous abortions occur in 12.5% of pregnancies and have a significant impact on the well-being of women. Dissatisfaction with health services is well-documented, but no studies have been conducted in district health services of the Western Cape. The aim was to explore the lived experiences of women presenting with spontaneous abortions to the emergency department at Helderberg Hospital. A descriptive phenomenological qualitative study used criterion-based purposive sampling to identify suitable participants. Data were collected through semi-structured individual interviews. Atlas-ti (version 22) software assisted with data analysis using the framework method. A total of nine participants were interviewed. There were four main themes: a supportive environment, staff attitudes and behaviour, the impact of time, and sharing of information. The comfort, cleanliness and privacy of the environment were important. COVID-19 had also impacted on this. Showing interest, demonstrating empathy and being nonjudgemental were important, as well as the waiting time for definitive treatment and the time needed to assimilate and accept the diagnosis. In addition, the ability to give relevant information, explain the diagnosis and help patients share in decision-making were key issues. This study highlighted the need for a more person-centred approach and managers should focus on changes to organisational culture through training and clinical governance activities. Attention should be paid to the physical environment, availability of patient information materials and sequential coordination of care with primary care services.Contribution:This study identifies issues that can improve person-centredness and women's satisfaction with care for spontaneous abortion.

Invigorating principal/assistant principal relationships

Relationships between and among school administrative team members are critical components of school culture. They serve as a guidepost for the behaviors and attitudes of staff and students. To invigorate these relationships, three embodied practices have high yield not only for the relationships among administrators, but also for fostering a healthy school climate. These practices include intellectual work, communicative collaboration, and inspiration-seeking practices. Sonja Gedde, a high school assistant principal, describes how these practices have been central to the administrative team’s professional relationship with their principal.

Knowledge, attitude, practice, needs, and implementation status of intensive care unit staff toward continuous renal replacement therapy: a survey of 66 hospitals in central and South China

BackgroundContinuous renal replacement therapy (CRRT) is a commonly utilized form of renal replacement therapy (RRT) in the intensive care unit (ICU). A specialized CRRT team (SCT, composed of physicians and nurses) engage playing pivotal roles in administering CRRT, but there is paucity of evidence-based research on joint training and management strategies. This study armed to evaluate the knowledge, attitude, and practice (KAP) of ICU staff toward CRRT, and to identify education pathways, needs, and the current status of CRRT implementation.MethodsThis study was performed from February 6 to March 20, 2023. A self-made structured questionnaire was used for data collection. Descriptive statistics, T-tests, Analysis of variance (ANOVA), multiple linear regression, and Pearson correlation coefficient tests (α = 0.05) were employed.ResultsA total of 405 ICU staff from 66 hospitals in Central and South China participated in this study, yielding 395 valid questionnaires. The mean knowledge score was 51.46 ± 5.96 (61.8% scored highly). The mean attitude score was 58.71 ± 2.19 (73.9% scored highly). The mean practice score was 18.15 ± 0.98 (85.1% scored highly). Multiple linear regression analysis indicated that gender, age, years of CRRT practice, ICU category, and CRRT specialist panel membership independently affected the knowledge score; Educational level, years of CRRT practice, and CRRT specialist panel membership independently affected the attitude score; Education level and teaching hospital employment independently affected the practice score. The most effective method for ICU staff to undergo training and daily work experience is within the department.ConclusionICU staff exhibit good knowledge, a positive attitude and appropriately practiced CRRT. Extended CRRT practice time in CRRT, further training in a general ICU or teaching hospital, joining a CRRT specialist panel, and upgraded education can improve CRRT professional level. Considering the convenience of training programs will enhance ICU staff participation. Training should focus on basic CRRT principles, liquid management, and alarm handling.

A compulsory school in need of a physiotherapist - an interview study

ABSTRACT Physical activity among schoolchildren is declining. Increased physical activity and motor training in school have shown good effects on health, learning and school performance. Physiotherapists can cooperate with school staff, but there are challenges in terms of environment and working methods. The study aim was to explore the attitude of compulsory school staff to physiotherapeutic competence in school and in student health care. Interviews were conducted with school staff and student health care team members. Data were analysed with qualitative content analysis. Based on categories and subcategories, a theme was identified as The physiotherapist as a piece of the student health care team puzzle. The staff were positive about the competence, gave suggestions on work areas, and could see advantages to including a physiotherapist on staff. More studies are needed in the field, especially regarding inclusion of physiotherapists in teams that work to promote health and prevent illness and injury.

Development and validation of Malaysian one stop crisis center service quality instrument (OSCC-Qual) for domestic violence management

One Stop Crisis Center (OSCC) is a multi-sectorial center aimed to provide medical, social, legal, police and shelter services to survivors of domestic violence, rape, sexual assault, sodomy and child abuse. Although OSCCs have been established for almost three decades in different parts of the world including in Malaysia, there is a lack of a validated instrument to measure the service quality rendered in OSCCs. A validated instrument known as OSCC-Qual was developed using a 5-stage approach where (1) in stage 1, group discussions were conducted among all authors to identify potential items for the instrument; (2) in stage 2, content validation was performed by 13 experts using content validity index and modified kappa; (3) in stage 3, exploratory factor analysis was performed by 141 healthcare staff with experience in managing OSCC cases to validate the items as well as to identify the number of factors in the instrument; (4) in stage 4, confirmatory factor analysis was performed by 110 domestic violence survivors to ascertain the validity of the factors and items retained in stage 3 and (5) in stage 5, forward and backward translation into local Malay and Chinese languages was performed. Results: In stage 1, a total of 42 items were identified. No item was deleted in stage 2. In stage 3, a total of 7 factors (i.e., “information provision”, “competency of staff”, “professionalism”, “supportive environment”, “attitude of staff”, “multi-sectorial coordination” and “tangibles”) were identified. Four items were deleted due to poor factor loading. In stage 4, another 3 items were iteratively removed due to poor factor loading. Discriminant validity was good. Conclusion: With the availability of the 7-factor and 35-item OSCC-Qual instrument, it is hoped that the efficiency of OSCC in achieving its philosophical objectives after three decades of implementation can be unraveled and remedial actions can be taken, if necessary.

P056 Patient Satisfaction Survey of a Newly Set-Up Fast Track Giant Cell Arteritis Service in a District General Hospital

Abstract Background/Aims Giant Cell Arteritis (GCA) is a multisystem, large and medium artery vasculitis, which results in significant comorbidity, even mortality. Prompt diagnosis is a pivotal first step in its effective management. To that effect, we set up a fast track service in Eastbourne District General Hospital (EDGH) for a one-stop-shop assessment of GCA referrals with Ultrasound Doppler. Fifteen months from service commencement, we embarked on assessing patient satisfaction of our service users. This exercise could provide vital insight into the effectiveness of our new service, and thus drive improvement. Furthermore, it is well established that patient satisfaction is associated with improved outcomes in patient care, be it due to improved compliance, engagement with the service, or overall better understanding of the underlying condition. Aims 1. To assess overall level of patient satisfaction of our new fast track GCA service against a number of internally set criteria; 2. To improve the effectiveness of the service based on feedback from the actual service users; 3. To improve the level of satisfaction of patients coming through the GCA service. Methods We set up a dedicated GCA clinic aiming to see patients within five days of referral. In order to assess overall patient satisfaction of the service, we formulated a questionnaire-based survey that was posted to 99 service users. We assessed five areas overall: appointment allocation process; staff attitude; information supplied; advice line effectiveness; overall satisfaction. Data were collected and analysed on Microsoft Excell. No patient identifiable details were collected. Results Out of the 99 feedback forms that were sent out, 51 were returned completed within the survey period. The appointment allocation process was assessed as “excellent” by 95% of responders, and “satisfactory” by 5%. Staff received 98% “excellent” rating. Information provided to the patient was assessed as 91% “excellent”, 8% “satisfactory”, and 1% “poor”. Response to advice line inquiries received 54% “excellent”, 18% “satisfactory”, and 2% “poor” rating (26% of responders answered “non-applicable”). Finally, overall satisfaction was rated at 93%, with, crucially, no service user providing a “poor” rating. Conclusion We conducted a patient survey to assess overall satisfaction of our new fast track GCA pathway, ultimately aiming at improving our service. The overwhelming majority of the feedback was positive, but we focused and acted on suggestions. Following the survey, we have a) designed a GCA “passport” with useful information for newly diagnosed patients; b) revisited the advice line with a modified information leaflet for this service; c) endeavoured to optimise the referrals process via education sessions on GCA for Hospital and Primary Care clinicians. Following a period of intervention, we will be reassessing patient satisfaction, aiming to continue improving our service. Disclosure A. Hall: None. P. Kamperidis: None. H. Perera: None. S. Panthakalam: None.

Evaluation of the Status of Knowledge, Attitude, and Performance of Radiology Department Staff Regarding Radiation Safety Principles at Hospitals in the North and Northeast of Iran

Purpose: Although ionizing radiation is useful in diagnosing various diseases, it can cause potential biological damage such as cancer, cataracts, and fetal damage for patients and staff working in radiology departments. Therefore, knowledge and practice about applying radiation protection principles are essential. This research investigates radiology personnel's knowledge, attitude, and performance regarding radiation protection in the north and northeast of Iran.
 Materials and Methods: This descriptive-analytical cross-sectional study was conducted using a 30-item questionnaire among 435 radiology personnel in North Khorasan, Razavi Khorasan, Golestan, and Mazandaran provinces. This questionnaire included questions related to demographic information and the level of knowledge, attitude, and performance of radiology personnel regarding radiation protection. Data was also analyzed using SPSS-19 software.
 Results: The participation rate of radiology personnel was 80.55%, and the mean and standard deviation of their knowledge, attitude, and performance regarding radiation protection were 45.9907 ± 1.294, 78.1531 ± 4.707, and 44.9368 ± 6.88, respectively. Based on the results of the study, there is no significant relationship between gender and knowledge (P = 0.781), attitude (P = 0.156), and performance of personnel (P = 0.87); however, a significant relationship was observed between education degree and attitude of personnel (P = 0.026), between working years and knowledge of personnel (P = 0.019), and also between job title and attitude of personnel (P = 0.003).
 Conclusion: The results of this study revealed that there is a significant relationship between education degree and attitude of personnel, working years, and knowledge of personnel, and also between job title and attitude of the personnel. According to these results, our population, both personnel and patients have relatively poor performance and poor knowledge about radiation safety principles. Therefore, formal training in the use of ionizing radiation equipment is necessary for radiation safety.

Internationalization strategies for non-Western higher educational institutions: a systematic literature review and conceptual framework

PurposeInternationalization has been a paramount objective for higher education institutions (HEIs) for decades. However, the landscape of education underwent significant transformation due to the COVID-19 pandemic, leading to altered contexts, challenges and opportunities for HEI internationalization. This paper aims to critically evaluate the dimensions of internationalization strategies in HEIs and the opportunities within each dimension. Adopting a reflexive approach, the study focused on non-Western HEIs, recognizing the diverse approaches to internationalization within higher education contexts.Design/methodology/approachUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, this paper covered 74 articles published in Web of Science database from January 2019 to December 2023.FindingsThe study organized dimensions related to internationalization strategies in non-Western HEIs, offering a comprehensive framework comprising six dimensions: students, programs, faculty, research, international ventures and other sources; and nine internationalization facilitators: international partnerships, funding, government education, international policies, technology, internationalization culture, diversity and inclusion, staff competence and attitude, student/faculty engagement, intercultural experience and satisfaction, English as a medium of instruction (EMI), and knowledge transfer mechanisms. Furthermore, the study delineated strategies within each dimension and highlighted prevalent performance indicators utilized by HEIs.Originality/valueThe study’s primary contribution is a conceptual framework designed to assist HEI directors and academics. This framework delves into dimensions, strategies and indicators of internationalization particularly relevant in the post-pandemic era.

Experience of violence and attitudes of staff members towards coercion in psychiatric settings: observational study.

Among important dimensions related to the use of coercive measures, professionals' attitude towards coercion is of particular interest. Little is known about how experiences of violence in the workplace might influence these attitudes. The present study aimed to investigate potential correlates of attitudes towards coercion, especially experiences of violence in the workplace. Mental health professionals were contacted through an online survey to assess their attitudes towards coercion using the Staff Attitude to Coercion Scale (SACS). The three subscales of the SACS (critical, pragmatic and positive attitudes) were analysed in a multivariate multiple linear regression, using a set of covariates including experiences of violence in the workplace. We hypothesised that experience of violence in the workplace would correlate with less critical attitudes of staff members towards coercion. A total of 423 professionals were included in the regression analysis. Age, professional category, feeling of insecurity, having witnessed or used coercion, and the emotional burden associated with coercive measures had a joint significant effect on the three SACS subscales. A feeling of insecurity, but not the experience of violence, was associated with a less critical, more positive appraisal of coercive measures. The emotional burden related to the use of coercion was associated with a more critical attitude. The present results highlight the importance of considering staff members' training and well-being regarding their feelings of insecurity when addressing attitudes towards coercion. The experience of patients should be integrated into staff training and coercion reduction programmes.

A Scoping Review on Attitudes towards Sexuality in Residential Aged Care

Objectives. Sexuality in residential aged care is a complex and often overlooked aspect of aged care. The attitudes of both staff and residents significantly influence how sexuality is perceived and addressed in these settings. This scoping review aims to compile, analyse, and identify gaps in the existing research concerning the attitudes of residents and staff towards sexuality within the context of residential aged care. Methods. The scoping review involved a systematic search across eight databases, yielding 469 unique articles, with 29 included studies. Results. Thematic synthesis within the selected studies disclosed three themes: hollow attitudes, postsexual residents, and organizational setbacks. Discussion. The results emphasize the significance of treating sexuality as a fundamental right, emphasizing that it should be not only acknowledged in theory but also implemented in practice.

Academic Motivation and Quality of Life of Polish Medical Students.

The skills and attitudes of medical staff affect the quality of the healthcare system, hence the study of academic motivation and quality of life of medical students. The study involved 203 students of the Jagiellonian University Medical College. Academic motivation was assessed using the Academic Motivation Scale and quality of life using the World Health Organization Quality of Life-BREF questionnaire. Academic Motivation Scale is based on the Self-Determination Theory, which distinguishes several dimensions of motivation arranged along self-determination continuum from amotivation, through extrinsic, controllable motivation, to intrinsic, autonomous motivation. For our students, the main reason for taking up studies was identified regulation, it means that they perceive studying as something important for them, giving more opportunities in the future. Next was intrinsic motivations to know, where gaining knowledge is a value in itself. The third was external regulation, which indicate that the choice of studies was regulated by the dictates of the environment or the desire to obtain a reward. Female students showed a more intrinsically motivational profile than male students. Motivation became less autonomous as the years of study progressed. Most students rated their quality of life as good or very good. There was weak correlation between students' good quality of life and more self-determined academic motivation. Our students are mainly intrinsically motivated, most of them positively assess the quality of life. A more autonomous approach to learning coexisted with a positive assessment of quality of life.

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

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. 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. 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. 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.

Implementation barriers and facilitators of Moyo foetal heart rate monitor during labour in public hospitals in Nepal

ABSTRACT Background Globally, every year, approximately 1 million foetal deaths take place during the intrapartum period, fetal heart monitoring (FHRM) and timely intervention can reduce these deaths. Objective This study evaluates the implementation barriers and facilitators of a device, Moyo for FHRM. Methods The study adopted a qualitative study design in four hospitals in Nepal where Moyo was implemented for HRM. The study participants were labour room nurses and convenience sampling was used to select them. A total of 20 interviews were done to reach the data saturation. The interview transcripts were translated to English, and qualitative content analysis using deductive approach was applied. Results Using the deductive approach, the data were organised into three categories i) changes in practice of FHRM, ii) barriers to implementing Moyo and iii) facilitators of implementing Moyo. Moyo improved adherence to intermittent FHRM as the device could handle higher caseloads compared to the previous devices. The implementation of Moyo was hindered by difficulty to organise training ondevice during non-working hours, technical issue of the device, nurse mistrust towards the device and previous experience of poor implementation to similar innovations. Facilitators for implementation included effective training on how to use Moyo, improvement in intrapartum foetal monitoring and improvement in staff morale, ease of using the device, Plan Do Study Act (PDSA) meetings to improve use of Moyo and supportive leadership. Conclusion The change in FHRM practice suggests that the implementation of innovative solution such as Moyo was successful with adequate facilitation, supportive staff attitude and leadership.

Examination of Cyber-Physical System Applications in Manufacturing Enterprises with the Unified Technology Acceptance and Utilization Theory

In this study, the perception, acceptance and usage status of Cyber Physical Systems (CPSs) which seem likely to become a more dominant tool in the industrial sector in the coming years, in manufacturing industry enterprises, and the advantages it provides to small and medium-sized enterprises (SMEs) in the manufacturing sector are examined in line with the requirements of the sector. In this regard, the study will offer comprehensive insights to researchers, scientists, and decision-makers within industrial sectors, as well as institutions and organizations tasked with making strategic decisions. In addition, as with any new technology, the importance of determining the attitudes of staff and managers, who are the users of the technology, towards CPS was evaluated with an acceptance model developed by considering industrial conditions. By applying a questionnaire with open-ended questions including the opinions of SMEs, it is aimed to examine the factors in the Unified Technology Acceptance and Utilization Theory (UTAUT) model whose effects on usage are advocated. analysis demonstrate that the major hesitations of the enterprises are concentrated on the high costs of the technology, the lack of human resource competence to use the systems and the lack of solution partners in case of possible failures, but they still have positive opinion about the use. The study's findings shed light on the factors influencing the feasibility of CPS technology in the industrial sector. These results can serve as a guide for conceptualization, policy support, planning, and the development of new management strategies that will be essential in this field in the forthcoming years.

Making Digital Technology Return to The Essence of Government Affairs: Generative Logic and Resolution Strategy of Digital Administrative Burden

Along with the continuous advancement of the digital government construction in our country, in order to effectively build a service-oriented government that the people are truly satisfied with, this article discusses the administrative burden that the digital government brings to the citizens in the implementation process, analyzes the reasons and proposes the solution path, and provides the reference for future research.Based on the interview method, the experience and feelings of different groups in the process of interacting with the digital government are intuitively obtained. The research finds that the learning cost, obedience cost and psychological cost borne by different groups are slightly different, which is related to the service attitude of government staff and the friendliness of product development and design. Relevant departments should improve the working system to improve the quality of the team. Improve the response mechanism and the product temperature; Strengthen digital empowerment, optimize government services and other measures to reduce the administrative burden of citizens in the implementation of digital government.