Practice Behaviors Research Articles

Experienced Clinical Decision-Making in Physical Therapist Management of Concussion: A Qualitative Study.

The recent publication of the Physical Therapy Evaluation and Treatment After Concussion Clinical Practice Guideline is intended to assist clinicians in their decision-making specific to evaluation and intervention. Clinical practice guidelines are supported by best available evidence, though it is unknown what other factors drive clinical decision-making in the realm of concussion management. The purpose of this study was to explore factors related to the process of clinical decision-making of experienced physical therapists who treat individuals with concussion. This grounded theory approach used semi-structured interviews of physical therapists who have practiced concussion management ≥3years and have treated ≥15 individuals for postconcussion symptoms in the last year. Following the inductive approach, deductive qualitative methodology was used to explore alignment with recent guidelines. Member checking was used to ensure trustworthiness. Ten therapists' experience in treating concussion ranged from 5 to 20years. Four overarching themes were identified that contribute to clinical decision-making: expert practice behaviors through use of reflection in action, clinical reasoning, collaboration, and evidenced informed practice; therapeutic alliance building using individualized education, reassurance, and relationship building; adaptability in prioritizing, assessing, and responding to patients' needs; and listening and observing. Clinician decision-making statements showed alignment with clinical practice guideline recommendations. Experienced therapists demonstrate a consistent approach that parallels the current clinical practice guideline while building off clinical experience to tailor individualized care focusing on patient centeredness. These factors may assist more novice clinicians to develop and improve their management strategies for optimal outcomes. Identified themes may broaden frameworks and guidelines for the management of individuals postconcussion specific to the field of physical therapy.

The mediating role of academic support perception in the relationship between emotional intelligence and bullying behaviours in clinical practice: A cross-sectional study

BackgroundBullying behaviours experienced by nursing interns in clinical practice are a considerable and serious concern. Understanding the factors that influence such behaviours in clinical practice is crucial for developing effective preventive measures and fostering a supportive learning environment. PurposeThis study aims to investigate the prevalence and influencing factors of bullying behaviours experienced by nursing interns and examine the mediating role of academic support perception in the relationship between emotional intelligence and bullying behaviours in clinical practice. MethodsThis is a cross-sectional study that used convenience sampling. A socio-demographic information questionnaire, Bullying Behaviours in Nursing Education Scale, Wong and Law's Emotional Intelligence Scale, and Academic Support in the Practicum Scale were used to collect data from nursing interns (n = 813) at seven tertiary hospitals in Changsha, China. Binary logistic regression and mediating analyses were used to explore the factors influencing bullying behaviours in nursing practice and examine the potential mediating role of academic support perception. ResultsThe prevalence of bullying behaviours in clinical practice among 813 nursing interns was 82.7 %. Binary logistic regression analyses indicated that attitude toward the nursing profession, emotional intelligence, and academic support perception were significantly associated with bullying behaviours in clinical practice. Academic support perception (β = 0.375, p < 0.001) played a significant mediating role in the relationship between emotional intelligence and bullying behaviours in clinical practice, accounting for 55.7 % of the total effect. ConclusionNursing educators and administrators should recognise that improving emotional intelligence and enhancing academic support perception among nursing interns can reduce the occurrence of bullying behaviours in clinical practice.

What next for behaviour change professional development in general practice? Insights from an environmental scan and workshops.

A key role of general practice professionals (that is, GPs, and general practice nurses [GPNs]) is to support patients to change behaviours. Traditional approaches to assisting patients with, and learning about, behaviour change have modest outcomes. To explore behaviour change with GPs and GPNs and the availability of related professional development (PD) opportunities. Multi-methods study comprising an environmental scan survey of behaviour change tools and PD opportunities, and online workshops with Australian GPs and GPNs. Survey data were analysed using qualitative content analysis, informing the design of the workshops. Workshop data included observation, note-taking, and collaborative reflection, which were analysed thematically and synthesised with survey data. The survey had 18 complete responses. For the two virtual workshops, workshop 1 had 16 participants and workshop 2 had eight participants. There was diversity in awareness of existing behaviour change tools and resources. Preferences for future tools and PD opportunities related to specific aspects of its design, content, activities, and delivery. The following three themes developed from the workshop data: recognising the importance of relationships; recognising the importance of continuity; and keeping context in mind. In the absence of tools and resources, GPs and GPNs discussed behaviour change as something that occurs best through a patient-centred alliance that is continuing, respectful, grounded in trust and an understanding of their patient, and prioritises patient autonomy. Future general practice behaviour change PD should support clinicians to 'assist' patients and recognise the social and contextual influences on behaviour.

A Multi-Institutional Survey of Radiation Oncology Professionals’ Knowledge, Attitudes, and Practice Behaviors Toward Sexual and Gender Minority Patients With Cancer

Sexual and gender minority (SGM) individuals have an increased risk of poor health outcomes, in part due to knowledge and training gaps in health care education. This study sought to evaluate the knowledge, attitudes, and practice behaviors of various health care role groups within radiation oncology toward SGM patients. A 38-item web-based survey was emailed to 1045 staff across 2 large radiation oncology departments. The survey assessed demographics, attitudes, knowledge, and practice behaviors. χ2 tests were performed to explore differences in survey responses by age, political affiliation, religious identity, year since graduation, and role groups. One-way analysis of variance tests were conducted to determine differences between respondents' confidence in knowledge and performance on the knowledge section of the survey. Thematic analysis was applied to the open discussion section. Of the 223 respondents, 103 clinicians (physicians/advanced practice providers/nurses) and 120 nonclinicians (administrative staff, medical assistants, and other nonmedical staff) participated in the survey (21.3% response rate): 72.6% answered the knowledge questions; 93.5% stated they were comfortable treating sexual minorities, or lesbian, gay, bisexual, and queer + patients; 88% indicated comfort in treating transgender patients; 36.6% stated they were confident in their knowledge of the health needs of transgender patients; and 50.3% expressed confidence in treating lesbian, gay, bisexual, and queer + patients. Fewer nonclinicians than clinicians thought that gender identity, sexual orientation, and sex assigned at birth were important to provide the best care (P < .05). The open comments section identified key themes, including the belief that current educational tools are not helpful, desire for more educational formats (lectures, case-based learning, seminars), and an overall interest in SGM health education. Most staff feel comfortable in treating SGM patients but are less confident in the distinct needs of this population. Knowledge gaps persist for both clinicians and nonclinicians, indicating a need for further training specific to oncology care.

Effect of monthly reminders by telephone message on women's beliefs and practice behaviours regarding breast self-examination: A randomized controlled study.

This study was conducted to examine the effect of monthly telephone message reminders after training on women's beliefs and practice behaviours regarding breast self-examination. This randomized controlled study was conducted with 83 women aged 20-69 years living in Turkey between September 2021 and July 2022. Women were randomly assigned (1:1) to the intervention (n = 41) or control group (n = 42), both groups received online breast self-examination training, and the intervention group received monthly reminders on their mobile phones for 3 months. Participants completed the Champion's Health Belief Model Scale and breast self-examination practice evaluation form at baseline and 3 months after intervention. After the intervention, the mean scores of the benefits and self-efficacy subscales of Champion's Health Belief Model Scales were significantly higher in the intervention group compared to the control group, and the mean score of barriers was lower. The rate of performing breast self-exam regularly and at the appropriate time was higher in the intervention group. The rate of forgetting to perform breast self-examination was higher in control group. A monthly reminder message may be recommended to increase women's belief in breast self-examination and increase regular practice.

Moderating Role of Gender and Job Position in the Relationship between Compensation Practice and Organizational Citizenship Behaviour

This article aims at investigating how the binary dummy-coded gender (female = 1, male = 0) and job position (operator = 1, supervisor = 0) moderate the direct relationship between compensation practice and organizational citizenship behaviour (OCB) in the ready-made garments manufacturing industry of Bangladesh. The present study employed the PLS-SEM (partial least square-structural equation modelling) technique to test the reliability and validity (convergent and discriminant) of the measurement scales and to verify the study hypotheses. The study used SPSS version 20 for descriptive analysis and SmartPLS version 3.3.9 for inferential statistical analysis. The results of this cross-sectional study of 121 employees revealed the significant moderating effect of gender and job position in the positive relationship between compensation practice and OCB. The study results also evidenced that the positive relationship between compensation practice and OCB showed stronger for female employees compared to males. Besides, the results equally confirmed that the compensation practice–OCB relationship became stronger for operator-level employees than supervisors. Findings are discussed in consistency with the previous studies and suggestions for future researchers and practitioners are highlighted at the end of this study.

Improving the Capacity of Non-Physician Primary Care Providers to Address Child and Youth Mental Health Through Mental Health Literacy Approaches.

Canadians rely on their primary care providers to address their mental health needs, but there are longstanding system gaps that must be addressed to enhance their ability to deliver mental health care. The present study addressed the gap in pediatric mental health care through the development, delivery, and evaluation of a mental health literacy training among non-physician primary care providers. We delivered the training among 97 participants, with all completed the pre-test survey, and 74 completed the post-test survey on knowledge, attitudes toward mental health, and help-seeking intentions. Additionally, participants explained why they attended the training and shared how they would apply the knowledge learned into their practice (behaviors). Participants improved their knowledge significantly from pre-test to post-test, P < .001, d = 2.51. We didn't find any statistical significance between pre-test and post-test on attitudes, P = .067, nor on help-seeking intentions, P = .274. However, participants' scores were exceedingly high on both outcomes, indicating positive attitudes and intentions at 2 time points and implying a ceiling effect of both outcomes. We did not find outcome differences by demographics, practice year, practice zone, or professional role. While knowledge, years of practice and prior mental health training predicted participants attitudes at pre-test, they didn't at post-test. Attitudes toward mental health predicted help-seeking intentions. Participants indicated this training will change their practice behaviors. This mental health literacy training for primary care providers demonstrated strong evidence of the need to integrate mental health and addiction support into primary care practice.

Building Client Networks and Maximising Your Resources

A report on how an Irish professional dog behavior consultant created a social media based network of past clients who were able to provide opportunities to learn and practice behavior modification skills without the direct supervision of the consultant. The structure of “The Alumni”’ is discussed alongside observations of the beneficial role such a network plays in a particularly challenging semi-rural Irish environment.

Should I speak up? How trust in leaders and leader-leader exchanges influence nurses' voice behaviour.

Discussing the nurses' voice behaviour could support the managers in making the right decisions and solve problems. This was a discursive paper. The discursive was based on reviewing the literature. Nurses play a critical role in offering useful constructive advice, which leads to management figuring out and solving problems immediately for the purpose of bettering the working environment. Therefore, we assert that trust in leadership and the leader-leader exchange system also plays a critical role in enforcing voice behaviour. Trust is a crucial aspect of voice behaviour, and integrated trust in leadership and leader-leader exchange as a possible practical suggestion for the fostering of voice behaviour are proposed. Nurse managers must maintain a sense of reciprocal moral obligation in order to nurture value-driven voice behaviour. It is important that open dialogue, active listening and trust in leadership exist. Nurse managers must consider ways to foster mutual trust, and support and enable nurses to use voice behaviour in everyday practice.

Criteria and levels of development of the reflexive competence in a foreign language teacher

Relevance. The relevance of the study is conditioned by the fact that pedagogical education faces huge problems, since modern changes impose higher requirements on future foreign language teachers, where special attention is paid to the development of reflexive competence in the context of a continuous learning system. Reflexive competence is an important driving force of pedagogical activity, through which internal experience is reflected upon when one's own knowledge can be sublimated and one's practical behaviour tends to be deliberate. Purpose. The purpose of the study is to reveal the problems of university preparation of future teachers of a foreign language for reflexion and to consider the main aspects of the development of a future teacher's reflexive competence. Methodology. To achieve research goals, the following methods were used: structural and functional, theoretical, and experimental. Results. The results of the study have determined that the training of a future foreign language teacher with reflexive competence today is one of the most important and significant tasks of pedagogical universities and the education system in general. The analysis showed that future foreign language teachers are not sufficiently prepared to work with reflection methods, and universities have serious shortcomings in understanding the essence of this concept. The development and improvement of the ability of future foreign language teachers to recognise problems and reflect on them play an important role in changing educational concepts, which contributes to their growth and development. Conclusions. The practical significance lies in the analysis of the current state of teaching, the formulation of criteria and levels of development of reflexive competence in a future foreign language teacher, and the formulation of criteria and appropriate levels of development of reflexive competence in the process of professional education in higher education, which determines the level of development of self-reflection.

Glucose management in critically ill adults: A qualitative study from the experiences of health care providers

Aims and objectiveTo explain the components and elements of glucose management in critically ill adult patients from the healthcare providers’ experiences. BackgroundCritically ill adults are highly susceptible to stress-induced hyperglycaemia due to glucose metabolic disorders. Healthcare workers play a key role in the glycaemic management of critically ill patients. However, there is a lack of qualitative studies on the content and elements of glycaemic management and healthcare workers' perceptions about glycaemic management in China. DesignQualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. MethodsIndividual semi-structured interviews were conducted from January to April 2022. Fifteen physicians and nurses were recruited from ten hospitals in mainland China. Data were analysed using inductive thematic analysis. ResultsGlucose management in critically ill adult patients from their experiences included two parts: the inner ring (practice behaviours) and the external space (methods and drivers). The practice behaviours of glucose management include five elements, while the methods and drivers of glucose management focus on three elements. The content covered under each element was identified. ConclusionThis study developed a glycaemic management model for critically ill adult patients, clarified its elements based on the perceptions of healthcare providers and elaborated on the methods and drivers covered under each element to provide a reference for physicians and nurses to develop a comprehensive glycaemic management guideline for critically ill adult patients. Relevance to clinical practiceOur study proposed a glucose management practice model for critically ill adult patients, and the elements and components included in this model can provide a reference for physicians and nurses when performing glucose management in critically ill patients.

Enhancing Family Food Security Through Experiential Learning-Based Training In Organic Food Cultivation

This study aims to assess the impact of an experiential learning based training on organic food cultivation in increasing family food security, while also exploring the potential for behavior change and economic resilience. Employing a qualitative research design, the study used case study method. Participants engaged in an experiential learning program designed to impart skills and knowledge in organic food cultivation. Data were collected through interviews, observations, and documentation study, and analyzed using thematic analysis triangulation. The findings highlight the participants' evolving perceptions of the link between organic food cultivation and family food security within the unique urban environment. The training resulted in shifts in consumption patterns and dietary habits within families, fostering healthier choices. Furthermore, the cultivation of organic produce contributed to family finances, reducing expenditure on purchased produce. The study underscores the impact of experiential learning in fostering practical skills and behavior change in an urban community setting. The research contributes to the understanding of how experiential learning interventions can positively influence family food security within specific urban localities. This study suggests that integrating experiential learning approaches into training initiatives can empower urban families to cultivate their own organic produce.

Understanding the Knowledge, Attitudes, and Practices of Healthy Eating among Adolescents in Chongqing, China: An Empirical Study Utilizing Structural Equation Modeling.

Healthy eating is crucial for optimal growth, development, and the prevention of chronic diseases in adolescents. Our study aimed to develop a comprehensive structural equation model (SEM) to analyze the relationships between knowledge, attitudes, practices (KAP), and healthy eating among adolescents in Chongqing. An online questionnaire was administered to middle school students in 39 districts and counties of Chongqing, China from 2 December to 15 December 2021 to collect sociodemographic and KAP information. SEM models were constructed to examine the relationships between educational environment and healthy eating knowledge, attitudes, and practices. The Monte Carlo test was employed to assess the significance of the mediating effect of relevant variables. The study included 139,832 adolescents aged 14.8 ± 0.7 years, with a 14% rate of overweight and obesity. Health and nutrition knowledge averaged a score of 3.60 ± 1.50 (correct rate: 60%). Participants had positive attitudes (average score: 13.61 ± 2.29) and engaged in healthy eating practices (average score: 12.06 ± 3.08). The results of the SEM revealed a significant influence of the educational environment on adolescents' knowledge (β = 0.235, p < 0.001) and attitude towards healthy eating (β = 0.143, p < 0.001). Knowledge exhibited positive effects on both attitude (β = 0.225, p < 0.001) and practice (β = 0.054, p < 0.001), while attitude exhibited positive effects on practice behavior (β = 0.565, p < 0.001). The indirect effect of knowledge on practices through attitude was more substantial than the direct effect (ratio 2.361). Our study highlights the mediating role of attitude between healthy eating knowledge and practices. A significant association exists between a favorable educational environment and improved knowledge and positive attitudes toward healthy eating among adolescents. In the future, nutrition and health education should prioritize exploring effective ways to translate knowledge into practices.

Pharmacy and nursing students' stigma and perceptions toward individuals with mental illness impacted through interaction with a website featuring lived experiences

AbstractIntroductionDespite its high prevalence and negative impact, mental illness is often sub‐optimally treated, in part, due to stigma among health care professionals. Future health care professionals are at the forefront of a potential solution for the provision of stigma‐free, equitable mental health care. Innovative approaches to reducing the stigma toward individuals with mental illness are needed. One approach is utilization of the SNAP the Stigma website (www.snapthestigma.com), a collection of photos and reflections by individuals with lived experiences with mental illness.ObjectiveThis study was conducted to address the question: Does interacting with the SNAP the Stigma website impact pharmacy and nursing students' perceptions and social distance preference toward an individual with mental illness?MethodsA pre‐ and post‐survey employed the Bogardus social distance scale (SDS) to assess stigma toward a vignette individual before and after website interaction. In the post‐survey, participants reflected on one or more posts from the website that impacted them. A qualitative analysis was performed to identify themes from the responses.ResultsA statistically significant reduction in total SDS scores occurred as a result of interaction with SNAP. Three themes were derived including symbolism of mental illness, increased empathy/reduced stereotyping, and lessons regarding what a health care professional can do and offer.ConclusionThese findings suggest that use of the SNAP website as a stigma‐reduction intervention could be a valuable tool for current and future health care professionals to decrease stigma toward those with mental illness and to build intentionality toward empathic and non‐discriminatory behavior in health care practice.

Bureaucratizing the Clan: Impact of Technology Affordances on Control

ABSTRACT We examine how technology affordances impact clan control mechanisms in organizations. Using an interpretive multisite case study of the use of body-worn cameras in police organizations and technology affordance theory, we identify five technology affordances (Practice Visualization, Behavior Sanitization, Panoptic Supervision, Multiplex Evaluation, and Evidence Persistence). Actualization of these affordances constitutes affordance-based control, which reconfigures clan control mechanisms and extends the scope and intensity of bureaucratic control in our case sites, thereby bureaucratizing the clan. Our study makes significant contributions to affordances, organizational control, and technology-mediated control theory and practice. First, we develop a process model of affordance-based control, demonstrating technology’s role in constraining and enabling employees and supervisors to enact clan and bureaucratic control, respectively. Second, we show how affordance-based control extends the control relationship from traditional dyadic supervisor-employee control to triadic supervisor-technology-employee control. Finally, our study shows how affordance-based control facilitates the co-creation of control mechanisms by actualizing employee and supervisor affordances individually and jointly. Thus, affordance-based control can afford participatory supervision, empowering employees to have an input in control mechanisms that were historically imposed on them.

Impact of an Organizational Climate for Evidence‐Based Practice on Evidence‐Based Practice Behaviour among Nurses: Mediating Effects of Competence, Work Control, and Intention for Evidence‐Based Practice Implementation

Background. Despite the emphasis on the importance of implementing evidence‐based practices, nurses did not adopt this approach as a standard. For those who have attempted to implement evidence‐based practice in health care settings, the behaviour is rarely simple or straightforward. Therefore, exploring the mechanism that motivates nurses’ evidence‐based practice behaviour is essential to promote this practice. Aims. The aim of this study was to investigate the effect of the organizational climate for evidence‐based practice on evidence‐based practice behaviour among nurses through the mediating role of evidence‐based practice competence, work control, and the intention to implement evidence‐based practice. Methods. This study consisted of a cross‐sectional design and convenience sampling to recruit 641 nurses employed in 6 hospitals in China. Five self‐report instruments were used to collect the data. A structural equation model was adopted to verify the research hypotheses. IBM SPSS 26.0 and AMOS 24.0 were used for statistical analysis of the data. Results. The organizational climate for evidence‐based practice was significantly and positively related to the nurses’ evidence‐based practice behaviour (p &lt; 0.01). Direct effects accounted for 45.93% of the total effect. Evidence‐based practice competence, work control, and the intention to implement evidence‐based practice partially mediated the association between the organizational climate and evidence‐based practice behaviour. The indirect effect accounted for 54.07% of the total effect. Conclusion. The organizational climate for evidence‐based practice is critical for predicting and enhancing evidence‐based practice behaviour. Evidence‐based practice competence, work control, and the intention to implement evidence‐based practice are intervening mechanisms that explain how the organizational climate promotes evidence‐based practice behaviour. Implications for Nursing Management. Nursing managers should be aware of the interaction of individual and organizational factors that influence evidence‐based practice behaviours among nurses. Administrators should improve the organizational climate by providing nurses with cultural and team support, mentoring, training projects, resource provisions, and more autonomy and authority at work, which are beneficial to the nurses’ evidence‐based practice competence, work control, and intentions to adopt evidence‐based practices.

VALUE EDUCATION IN LAW SCHOOL CURRICULUM : CULTIVATING MORAL AUTONOMY

According to the EU Justice Scoreboard reports, over 70% of Croatian citizens are dissatisfied with the Croatian judiciary, particularly its independence and efficiency. This paper addresses the deep-rooted challenges in the country’s legal education system. Despite reform initiatives, the current system serially produces ‘legal technicians’ lacking values, critical thinking capacity, and active student engagement. This echoes Montesquieu’s depiction of legal practitioners as ‘mouths that pronounce the words of the law.’ Acknowledging the pivotal role of legal education methodology in the creation of future legal practitioners and legal culture, this contribution explores how an average regular educator can support the development of students’ moral reasoning and values awareness. Through predominantly analytical research methods, we critically examine whether higher education environments should incorporate value education, the feasibility of teaching values in the traditional sense, and the potential of ethical analysis in a classroom to truly influence ethical behaviour in practice. Furthermore, we explore the complex matter of authority to decide on values to be imparted and delve into value education methodology. Concluding with practical suggestions, we propose the integration of the Evocation-Realization of meaning-Reflection (ERR) framework into lectures, as well as various creative tools to enhance moral reasoning.

Does voluntary practice improve the outcome of an OSCE in undergraduate medical studies? A Propensity Score Matching approach.

In Objective Structured Clinical Examinations (OSCE), students have to demonstrate proficiency in a wide array of medical knowledge and different skills, ranging from physical examinations to medical-practical skills and doctor-patient interactions. In this study, we empirically test the concept 'assessment drives learning' and investigate whether an OSCE motivates extracurricular, voluntary free practice (FP) of specific skills in a Skills Lab, and whether this has positive treatment effects on exam success in the respective parts of the OSCE. To explore causal inference with observational data, we used Propensity Score Matching (PSM) to generate a control and a treatment group that only differed in their practice behavior. For internal examinations and practical skills such as venous catheter placement and IM injections, we find strong, positive effects of FP that can result in a grade-jump. We further show that the presence and strength of effects depends on the complexity and type of the task. For instance, we find no effect for practicing venipuncture, and performance in communicative skills is associated with the willingness to repeatedly engage with instructional contents inside and outside the Skills Lab, and not with targeted practice of specific skills. We conclude that the anticipation of the complex OSCE is effective in motivating students to engage with a wide range of competencies crucial to the medical profession, and that this engagement has positive effects on exam success. However, consistent practice throughout the study program is necessary to sustain and nurture the acquired skills.

Australian healthcare professionals' beliefs and practice behaviours in management of chronic pelvic pain: a cross-sectional survey.

Background Chronic pelvic pain (CPP) is a common and debilitating condition, and sufferers present to healthcare professionals with variable complex symptoms and co-morbidities. This study aimed to investigate the current beliefs and practice behaviours of healthcare professionals towards the management of CPP in Australian females. Methods We distributed an online survey to Australian healthcare professionals. Participants were questioned regarding their beliefs, the importance of various contributing factors and assessment variables, and their management preferences for two CPP vignettes. Demographic information and responses were analysed with descriptive statistics. Results Complete data were obtained and analysed from 446 respondents including gynaecologists (n =75), general practitioners (GPs) (n =184) and physiotherapists (n =187). Most of the respondents were female (88.1%), with male (11.7%) and other (0.2%) making up a smaller representation. Physiotherapists rated themselves higher in understanding mechanisms of CPP (64.7% very good to excellent) compared to gynaecologists (41.3%) and GPs (22.8%). Physiotherapists also reported higher levels of confidence in managing patients with CPP (57.8% quite or extremely confident) compared to 41.3% of gynaecologists and 22.3% of GPs who reported being quite or extremely confident. All three professions rated patient's beliefs (89.8%), nervous system sensitisation (85.7%), stress/anxiety/depression (91.9%), fear avoidance (83.3%), history of sexual/emotional/physical abuse (94.1%) and pelvic floor muscle function (85.0%) as very/extremely important factors in the development of chronic pelvic pain. Most gynaecologists (71.0%) and GPs (70.2%) always referred for pelvic ultrasound during assessment. Physiotherapists assessed goal setting (88.8%) and screened for patients' beliefs (80.9%) more often than gynaecologists (30.4% and 39.1% respectively) and GPs (46.5% and 29.0% respectively). Conclusions All three groups of healthcare professionals demonstrated a good understanding of pain mechanisms and incorporated a biopsychosocial and multidisciplinary approach to management of females with chronic pelvic pain. However, both gynaecologists and GPs were less confident in their understanding of and management of CPP, and less likely to consider patient beliefs and goals. The findings of this online survey may assist in the provision of more targeted education to further improve management of this condition.

Occupational Category and Professional Title Influencing the Knowledge, Attitudes and Practice (KAP) of Quality Training: A Cross-Sectional Survey From a Tertiary General Hospital.

Quality improvement is an international priority, and quality education and training are important parts of hospital quality management. The aim of this study was to understand the knowledge, attitudes and practices (KAP) and its influencing factors related to quality training in medical staff. A questionnaire survey was conducted by convenience sampling to assess the KAP of quality training in Taizhou Enze Medical Center. Principal component analysis was used to extract factors from the questionnaire. Descriptive statistics (frequency, median, mean), Kendall grade correlation analysis, and Mann-Whitney U tests were used to analyze the data. A total of 205 staff members participated in the questionnaire survey. For the 5 factors of the KAP scale, the highest score was factor F4, recognition and support for quality training (mean = 90.55, median = 100), followed by factor F3, perceived benefits (mean = 84.46, median = 85.65). Relatively lower scores were found for factor F2, quality knowledge learning and mastery (mean = 63.09, median = 63.89), and F5, quality management practices and sharing (mean = 82.07, median = 75.00). There was a correlation between the 5 factors. The scores of F2 (quality knowledge learning and mastery) for staff with senior professional titles were higher than those for staff with intermediate professional titles or below. The score of F3 (perceived benefits of quality training) in medical technicians and nurses was higher than in doctors and administrative personnel. Our findings showed that the respondents' attitude toward quality training was positive, but their knowledge mastery and practice behaviors should be further improved. Occupational category and professional title were the influencing factors of the quality training KAP. Therefore, hospital should conduct quality management training at a wider scope according to the competency requirements of different groups, and further optimize the improvement and innovation system.