Behaviour Of Healthcare Professionals Research Articles

A multicentre survey investigating the knowledge, behaviour, and attitudes of surgical healthcare professionals to frailty assessment in emergency surgery: DEFINE(surgery).

Screening for frailty in people admitted with emergency surgical pathology can initiate timely referrals to enhanced perioperative services such as intensive care and geriatric medicine. However, there has been little research exploring surgical healthcare professionals' opinions to frailty assessment, or accuracy in identification. This study aimed to assess the knowledge, behaviour, and attitudes of healthcare professionals to frailty assessment in emergency surgical admissions. We designed a cross-sectional multicentre study developed by a multiprofessional team of surgeons, geriatricians, and supported by patients. A semi-structured survey examined attitudes and behaviours. Knowledge was assessed by comparing respondents' accuracy in scoring twenty-two surgical case vignettes using the Clinical Frailty Scale. Eleven hospitals across England, Wales, and Scotland participated. Two hundred and eleven clinicians responded-20.4% junior doctors, 43.6% middle grade doctors, 24.2% senior doctors, 11.4% nurses and physician associates. Respondents strongly supported perioperative frailty assessment. Most were already assessing for frailty, although frequently not using a standardised tool. There was a strong call for more frailty education. Participants scored 2175 vignettes with 55.4% accurately meeting the gold standard; accuracy improved to 87.3% when categorised into "not frail/mildly frail/severely frail" and 94% when dichotomised to "not frail/frail". Frailty assessment is well supported by healthcare professionals working in surgery. However, standardised tools are not routinely being used, and only half of respondents could accurately identify frailty. Better education around frailty assessment is needed for healthcare professionals working in surgery to improve perioperative pathway for people living with frailty.

Behavioral Science: Enhancing Our Approach to the Development of Effective Additional Risk Minimization Strategies.

Additional risk minimization strategies may be required to assure a positive benefit-risk balance for some therapeutic products associated with serious adverse drug reactions/risks of use, without which these products may be otherwise unavailable to patients. The goals of risk minimization strategies are often fundamentally to influence the behavior of healthcare professionals (HCPs) and/or patients and can include appropriate patient selection, provision of education and counselling, appropriate medication use, adverse drug reaction monitoring, and adoption of other elements to assure safe use, such as pregnancy prevention. Current approaches to additional risk minimization strategy development rely heavily on information provision, without full consideration of the contextual factors and multi-level influences on patient and HCP behaviors that impact adoption and long-term adherence to these interventions. Application of evidence-based behavioral science methods are urgently needed to improve the quality and effectiveness of these strategies. Evidence from the fields of adherence, health promotion, and drug utilization research underscores the value and necessity for using established behavioral science frameworks and methods if we are to achieve clinical safety goals for patients. The current paper aims to enhance additional risk minimization strategy development and effectiveness by considering how a behavioral science approach can be applied, drawing from evidence in understanding of engagement with pharmaceutical medicines as well as wider public health interventions for patients and HCPs.

Digital marketing strategies for medical products: A theoretical and practical review

Digital marketing has emerged as a crucial component in the promotion and dissemination of medical products. This theoretical and practical review delves into the strategies essential for navigating this dynamic landscape effectively. The paper begins with an exploration of the target audience, emphasizing the importance of understanding the needs and behaviors of healthcare professionals, patients, and caregivers. Subsequently, it discusses various digital marketing tactics, including content marketing, search engine optimization (SEO), social media marketing, email marketing, and influencer marketing, elucidating their roles in engaging and educating the target audience. Moreover, the review emphasizes the significance of data analytics and optimization for continuous improvement, while also highlighting the necessity of regulatory compliance and ethical considerations. Drawing upon case studies and practical examples, the paper provides insights into successful digital marketing campaigns within the medical products industry, offering valuable lessons and best practices. Ultimately, this review aims to equip stakeholders with the knowledge and strategies needed to harness the full potential of digital marketing in promoting medical products while adhering to regulatory standards and ethical principles.

Development and validation of self-assessment instrument to measure the digital professionalism of healthcare professionals using social media

BackgroundThe use of social media across the globe has risen incrementally. During the COVID-19 pandemic, these sites undeniably provided new avenues for professional networking but also led to a surge in cases of online misconduct. Professionalism instruments and scales do not assess the digital attitude and behaviour of healthcare professionals (HCPs). The purpose of this study was to identify the domains and items of digital professionalism related to social media use and to validate a self-assessment instrument to assess the digital professionalism of HCPs using social media.MethodsAn instrument development multiphase mixed method study (exploratory sequential) was conducted in two phases: item development and qualitative content validation followed by validation of the instrument. Feedback was taken from 15 experts for qualitative content validation in phase 1. In phase 2, content validity was established through three rounds of modified Delphi. Validity evidence was collected for the content (content validity index), response process (cognitive interviews), internal structure (confirmatory factor analysis), and internal consistency (Cronbach’s alpha).ResultsThe 48-item preliminary instrument was reduced to a 28-item instrument with eight domains: self-anonymity, privacy settings, maintenance of boundaries and confidentiality, conflict of interest, accountability, respect for colleagues, and ethics. The content validity index of the scale was 0.91. The reliability and construct validity of the instrument was established by responses from 500 healthcare professionals from multiple hospitals. Confirmatory factor analysis showed a model with a goodness-of-fit index of 0.86, root mean square error of approximation of 0.06, and observed normed χ2 of 2.7. The internal consistency through Cronbach's alpha α was 0.96.ConclusionThe digital professionalism self-assessment instrument (DP-SAI) has an appropriate level of content and measures the construct reliably. It can be used by medical doctors, dental clinicians, nurses, physiotherapists, and clinical pharmacists to self-assess and reflect on their social media practices. This will help to address these issues to enhance the quality of online communication through various social media platforms.

Effectiveness of educational interventions in reducing the stigma of healthcare professionals and healthcare students towards mental illness: A systematic review and meta-analysis.

To examine the effectiveness of educational interventions in reducing stigma among healthcare professionals and students towards people with mental illness. A systematic review and meta-analysis of randomized controlled trials (RCTs) and cluster RCTs. Articles published from database inception to October 2023 were systematically searched from seven databases (CINAHL, Embase, ProQuest Dissertations and Theses Global, PsycINFO, PubMed, Scopus, Web of Science), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Random-effect meta-analyses were conducted. Heterogeneity was evaluated using the I2 statistics and Cochran's Q chi-squared test. A quality appraisal conducted at the study level used the Cochrane risk of bias tool and an outcome-level quality assessment utilized the Grades of Recommendation, Assessment, Development and Evaluation Approach. Publication bias was assessed using the funnel plot. Twenty-five articles were included in this review. Meta-analysis reported statistically significant medium and small effect sizes for attitudes towards mental illness and attitudes towards people with mental illness respectively, showing the association between educational interventions and improved attitudes among healthcare professionals and students. However, a statistically non-significant effect was reported for knowledge of mental illness. Subgroup analyses indicated that face-to-face and contact-based interventions were particularly effective at reducing stigma. Notably, single-session interventions were just as effective as multiple sessions, suggesting a potential for resource-efficient approaches. Educational interventions demonstrate promise in fostering more positive attitudes towards mental health issues. Future research should aim to determine the long-term effects of these interventions and include patient feedback on the stigmatizing behaviours of healthcare professionals and students, to holistically evaluate the effect of interventions. This study is a secondary review and does not require relevant contributions from patients or the public. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Face-to-face contact-based educational sessions have proven to be the most effective. Reinforcing learning may be achieved through a series of repeated single-session interventions.

Using Conversation Analysis to explore assessments of decision-making capacity in a hospital setting.

Healthcare professionals (HCPs) have a responsibility to conduct assessments of decision-making capacity that comply with the Mental Capacity Act 2005 (MCA). Current best-practice guidance, such as the Mental Capacity Code of Practice and National Institute for Health and Care Excellence decision-making and mental capacity guidance, does not stipulate how to accomplish this in practice, for example, what questions should be asked, how options and information should be provided. In addition, HCPs struggle to assess the capacity of individuals with communication difficulties. This study was a service evaluation that aimed to objectively analyse, using Conversation Analysis (CA), how real-life capacity assessments were conducted in a hospital setting with patients with acquired brain injury (ABI)-related communication difficulties. A second aim was to establish the feasibility of using CA to advance knowledge of the conduct of capacity assessment. Four naturally occurring capacity assessments were video-recorded. Recordings involved speech and language therapists, occupational therapists, neuropsychologists and patients with communication difficulties as a result of ABI. The methods and findings of CA were used to investigate the interactional behaviours of HCPs and patients during assessments of decision-making capacity. The analysis was informed by our knowledge of the MCA best practice guidance. An overall structure of capacity assessment that enacted some of the best-practice MCA guidance was identified in one recording, consisting of six phases: (i) opening, (ii) preparation, (iii) option-listing, (iv) test, (v) decision, and (vi) close. The preparation phase consisted of two sub-components: information gathering and information giving. Variation from this structure was observed across the dataset, notably in the way in which options were (or were not) presented. CA is a feasible empirical method for exploring the structure and conduct of capacity assessments. CA identifies and provides ways of describing interactional behaviours that align with and diverge from best-practice MCA guidance. Future CA studies including a wider range of health and social care professionals and patients have the potential to inform evidence based training for HCPs who conduct assessments of decision-making capacity. What is already known on this subject The Mental Capacity Act (MCA) is poorly implemented in practice. Healthcare professionals (HCPs) find it challenging to assess the decision-making capacity of individuals with communication difficulties, and people with communication difficulties are often excluded from or insufficiently supported during capacity assessment. Research is limited to self-report methods. Observational studies of capacity assessment are required. What this study adds This is the first study to use Conversation Analysis (CA) to explore how capacity assessments are conducted in a hospital setting by HCPs with people with communication difficulties as a result of acquired brain injury. One video-recorded capacity assessment was structured in six phases that aligned with best practice MCA guidance. However, other capacity assessments deviated from this structure. One phase, option listing, varied in practice and options were not always presented. What are the clinical implications of this work? CA revealed interactional behaviours that align with and diverge from best-practice MCA guidance. Future CA studies are warranted to inform training for health and social care professionals who conduct capacity assessments.

The Relation between Breast Cancer Fear and Breast Cancer Prevention Behaviors of Female Healthcare Professionals

Objective: The aim of this study was to investigate the relationship between breast cancer fear and breast cancer prevention behaviors of female healthcare professionals (HCPs). Materials and Methods: This descriptive correlational study involved a convenience sample of 338 nurses, midwives and physicians working at a state hospital in Turkey. Data were collected in face-to-face interviews with the participants using Personal Information Form, Breast Cancer Fear Scale (BCFS), and Scale of Factors Affecting Women’s Breast Cancer Prevention Behaviors (ASSISTS).The data were analyzed by using Independent Samples t Test, One-way ANOVA, Tukey and Pearson’s correlation tests. Results: The mean scores on BCFS and ASSISTS were 26.71±7.65 and 123.36±15.49 respectively, indicating breast cancer fear were high and breast cancer prevention behaviors were moderately. The higher breast cancer prevention behavior scores among the HCPs who were working longer years, working longer years in night shift, those having breast problems, and undergone breast biopsy, those performing breast self-examination, undergone clinical breast examination and mammography (p0.05). Conclusion: Professional education in breast cancer prevention behaviors and addressing fear on breast cancer are likely to result in reduced barriers to develop prevention behaviors.

The effect of long-term drug use on rational use of medicines in children with medical illness

Introduction: This study was conducted to investigate the effect of long-term drug use due to medical diseases on rational drug use in children, using data obtained from parents. It is a cross-sectional study. Methods: Among the 288 parents who applied to the pediatric outpatient clinics of Muğla Training and Research Hospital between January 1, 2022 and March 31, 2022; 144 people with children aged 0-12 who have a chronic disease and have been using regular medication for at least three months are included in the research group, 144 people who did not have a chronic disease and did not use medication constantly were determined as the control group. In addition to the form containing sociodemographic data and questions to evaluate rational drug use awareness, knowledge, attitudes and behaviors, the "Parental Attitude Scale For Rational Drug Use (PASRDU)" was answered through a face-to-face interview. Data analysis was conducted with SPSS 26 program with a confidence level of 95%. Parental Attitude Scale For Rational Drug Use scores showed normal distribution in both groups. Independent samples t-test was used to compare Parental Attitude Scale For Rational Drug Use scores according to groups, a chi-square test was used to compare the relationship between groups and categorical (grouped) variables, and a two-way ANOVA test was used to compare demographic characteristics and group variables according to Parental Attitude Scale For Rational Drug Use scores. Results: Of the parents participating in the study, 67.71% were mothers and 32.29% were fathers. The average age was 34.88±6.44 years in the research group and 33.57±6.57 years in the control group. The rates of having chronically ill individuals at home and individuals constantly using medication at home are higher in the research group and are statistically significant. While the presence of leftover or spare medication at home was be similar in the research and control groups, the rate of using these medications when necessary was 45.8% in the research group and 56.3% in the control group. While 43.1% of those in the research group did not give over-the-counter medicine to their children, this rate was 16% in the control group. The control group uses over-the-counter vitamins twice as much as the research group. The most commonly used over-the-counter medication in the entire population is antipyretics with a rate of 44.79%. The scores of the research group in Parental Attitude Scale For Rational Drug Use and its subscales are higher than the control group and are statistically significant. The place of residence for the longest time, educational level, having too much medication at home, and using non-prescription medication statistically affect the scores. In addition, the duration of the disease of the children in the research group significantly affected the Parental Attitude Scale For Rational Drug Use total score and the Accurate and Conscious Use subscale, and the disease group significantly affected the Effective and Safe Use subscale score. Conclusion: According to our research, long-term use of medication in children due to medical illness affects rational drug use. Accurate and current information is required in the preparation and use of drugs used in children due to the change in dosage and pharmaceutical form depending on age. In addition, herbal products and food supplements are also used during childhood. Therefore, the knowledge, attitudes and behaviors of healthcare professionals and parents affect children’s health. As studies on rational drug use in different regions in our country increase, more detailed and separate planning can be made for drugs used in childhood while preparing education and policies for rational drug use.

Reiki intervention for supporting healthcare professional care behaviors in pediatric palliative care: A pilot study.

Pediatric healthcare professionals (HCPs) working in a palliative setting may experience challenges during their clinical practice in addressing the complex end-of-life phase of children and their families. Nurses, especially, have a frontline role in providing assistance, thereby becoming at risk of physical and psychological burden. Pediatric psychologists have an ethical responsibility to help colleagues by proposing self-care interventions that will improve their well-being and, indirectly, the work climate. This study investigated the impact of a complementary therapy, delivered by a pediatric psychologist and a nurse, on physical and psychological variables among nurses at the Paediatric Hospice of the Regina Margherita Children's Hospital in Italy. Thirty-five nurses participated in 5 weeks of Reiki sessions for an overall total of 175 sessions. The effect of the sessions was analyzed through a paired t-test analysis comparing the values of heart rate, oxygen saturation, and systolic and diastolic pressure collected before and after each session. The same test was conducted comparing the values of the 3 burnout subscales for each of the 35 nurses collected before the beginning of the first session with those collected at the end of the last session 2 months later. Results underlined a positive short-term effect with a significant decrease in heart rate before and after each session (t = 11.5, p < .001) and in systolic pressure (t = 2, p < .05). In addition, a decrease in emotional exhaustion symptoms was found (t = 2.3, p < .05) at the end of the intervention. Reiki could be a valid strategy to complement traditional pediatric psychology clinical practice designed to protect HCPs from emotional and physical demands and to create a more supportive workplace for staff and patients alike.

Using the Behavior Change Wheel to Identify and Understand Key Facilitators and Barriers for Lifestyle Care for Postmenopausal Breast Cancer Survivors: A Delphi-Study.

Optimal approaches to promote sustained adherence to lifestyle and bodyweight recommendations in postmenopausal breast cancer (PMBC) survivors are lacking. This Delphi-study aims to identify and understand expert-opinion on potential barriers and facilitators for promoting adherence to these lifestyle and bodyweight recommendations in (clinical) care for PMBC survivors, and to determine potential effective intervention strategies. The expert panel consisted of oncology Health Care Professionals (HCPs) (N = 57), patient advocates (N = 5), and PMBC survivors (N = 38). They completed three questionnaires: Q1-idea generation; Q2-validation and prioritization; Q3-ranking. The Behavior Change Wheel was used as theoretical framework for analysis. Thematic analysis was applied to identify key overarching themes based on the top-ranked facilitators and barriers. Potential Behavior Change Techniques (BCTs) and intervention strategies were identified using the Behavior Change Technique Taxonomy version 1 and the Behavior Change Wheel. Eleven core categories of key barriers/facilitators for the promotion of adherence to recommendations for lifestyle and bodyweight among PMBC survivors were identified. For each core category, relevant BCTs and practical potential intervention strategies were selected based on suggestions from the expert panel. These included: increasing knowledge about the link between lifestyle and cancer; enabling self-monitoring of lifestyle behaviors followed by evaluation; offering group lifestyle counseling for PMBC survivors, enhancing social support for favorable lifestyle behaviors; and stimulating multidisciplinary collaboration among HCPs. Findings provide valuable insight for the development of interventions changing behavior of PMBC survivors and HCPs toward increased healthy lifestyle (support) behavior.

Chinese medical staff's knowledge, attitudes and practices towards breast cancer patients' sexual health management: A cross-sectional study

ObjectiveThe objective of this research was to assess the level and determinants of medical personnel's knowledge, attitudes, and practices regarding the management of sexual health in breast cancer survivors residing in western China. BackgroundSexual well-being is a crucial aspect of one's overall satisfaction with life. Once female sexual dysfunction (FSD) occurs, it will affect patients' satisfaction and life quality seriously. In all healthcare settings, the management of sexual health relies heavily on the vital contribution of medical personnel. Nevertheless, the sexual requirements of individuals with breast cancer are still partially unmet. DesignA web-based questionnaire was used to conduct a multi-centered, cross-sectional study involving medical staff from 26 hospitals in nine cities of Guizhou Province, China. MethodsData was gathered from healthcare professionals using a validated tool, the knowledge, attitudes, practices assessment scale for managing the sexual health of breast cancer patients in medical staff. This tool was used to evaluate the knowledge, attitudes, and practices of medical staff regarding sexual health management. ResultsIn this study, a grand total of 3181 healthcare professionals took part. The overall KAP scores, including knowledge, attitudes, and practices, were 47.15 ± 11.91, 72.55 ± 12.56, and 58.61 ± 11.45, respectively. Three variables exhibited a strong and favorable correlation. The study identified significant concerns regarding the limited understanding of medical personnel regarding effective strategies for enhancing sexual health function in breast cancer patients, as well as their diminished confidence in addressing FSD. The scores of knowledge, attitudes, and practices related to sexual health management were significantly influenced by whether or not training was received. ConclusionsThe study results emphasize the importance of adopting a holistic approach to enhance the understanding, perspectives, and behaviors of healthcare professionals regarding the management of sexual health. In addition to enhancing the standard of care for individuals with breast cancer.

Health sciences lifelong learning and professional development in the era of artificial intelligence

IntroductionIn the field of healthcare, lifelong learning is considered a quality indicator due to its potential to enhance healthcare services and the knowledge and skills of healthcare professionals. The purpose of this research is to investigate and document the attitudes and behavior of healthcare professionals from different healthcare institutions toward lifelong learning using artificial intelligence. The study achieves two objectivesIdentifying healthcare professionals' interest in formal lifelong learning and determining how they engage in lifelong learning. Additionally, this study aims to develop a dynamic web platform with several key features including an introduction page, navigation menu, document download form, document table, and download, delete, and resume buttons. MethodologyThe study was conducted from 07/04/2022 to 19/05/2022 and involved a sample of 114 healthcare professionals from various locations in Morocco. A questionnaire comprising three sections (personal information, lifelong learning for personal development, and lifelong learning for professional development) was used as the research instrument. ResultsThe average age of the participants was 43 years, and 76.8% had more than 11 years of experience in the field. The results indicate a correlation between professional development and lifelong learning among healthcare professionals. The two most important factors driving lifelong learning were identified as the advancement of the healthcare profession and the need to elevate the quality of care. Also, this research objective is to develop a dynamic online platform featuring an introduction page, navigation menu, document download form, document table, and download, delete, and resume buttons. ConclusionsAccording to the findings, healthcare professionals consider lifelong learning an ongoing and continuous process essential to their work.

Novel innovative computer-based test (Inno-CBT) item types for national licensing examinations for health care professionals

BackgroundAn effective test mechanism to evaluate clinical knowledge and skills of the entry-level healthcare professionals is important for providing clinical competency and improving patient care. This study aimed to develop novel, innovative computer-based test (Inno-CBT) item types for application in the national examination of Korean healthcare professionals.MethodsThis exploratory study was conducted from May 2021 to March 2022 by a team of faculty members from pharmacy schools in South Korea. A literature search using PubMed, Google Scholar, RISS, Web of Science, and KoreaMed was performed. Forum presentations, media articles, and previous reports by the Korea Health Personnel Licensing Examination Institute (KHPLEI) were included. Workshops were held, information and ideas were collected and conceptualized, and item types were designed, drafted, and refined. By repeating this process, the Inno-CBT item types were finalized.ResultsForty-one Inno-CBT item types with 28 subtypes were developed. New digital technologies, such as a reactive responsive media interface, an animation insertion, multimedia embedding, and network surfing, were utilized in these novel types. It was anticipated that these Inno-CBT item types would effectively measure abilities in healthcare knowledge, problem-solving skills, and professional behaviors. Some potential barriers to implementing the Inno-CBT item types include item difficulty, operational unfamiliarity, complexity in scoring protocols, and network security.ConclusionsA variety of styles of novel Inno-CBT item types were developed to evaluate the multifaceted and in-depth professional abilities required for healthcare professionals. Prior to implementing these item types in the national examination, item validation and technical support should be conducted.

Social cognitive elements of mental illness stigma among healthcare professionals currently working in general hospitals: A cross-sectional study from Jordan.

To assess the social cognitive elements of the stigma of mental illness (knowledge, attitudes and behaviours) among healthcare professionals (HCPs) in Jordan. A cross-sectional descriptive design. A total of 206 HCPs were conveniently recruited from general hospitals in Jordan. The mental attitude, knowledge and intended behaviours scales were used to measure stigma elements. Participants reported a moderate level of knowledge, a moderate negative attitude and a moderate or not greater interest to deal with people with mental health illnesses. The bivariate correlation revealed a negative significant correlation between HCPs' knowledge and attitude, indicating that HCPs with more knowledge significantly have more positive attitude (lower average score) towards those suffering from the illness. A more significant correlation was found between HCPs' knowledge and behaviour. The HCPs who had more knowledge were holding more interest and willingness towards dealing with persons with mental illness. Negative attitudes among HCPs demand awareness programmes pertaining to the stigma of mental illness to afford higher standards of practice for patients with mental problems.

Human Dignity in Inpatient Care: Fragments of Religious and Social Grounds

Background: Navigating inpatient care can be complex and distressing for patients, particularly as they grapple with the emotional and physical changes brought about by their condition. Ensuring the preservation of human dignity during this period is vital, as it directly influences an individual’s self-esteem and overall quality of life, most prominently during end-of-life care. The hospital milieu and the behaviour of healthcare professionals can significantly affect a patient’s dignity. This paper scrutinized the concept of human dignity in inpatient care, with a primary emphasis on its theological, social, and regional context, drawing particularly on the Eastern Orthodox tradition and the central European, specifically Slovakian, context. Methodology: This study engaged respected authors in theology, social science, and healthcare to present an enriched understanding of the bio-psycho-social-spiritual components of human dignity. The analysis incorporated a blend of theological concepts, empirical findings, and regional insights to provide a nuanced perspective on dignity conservation. Results: The study illuminates the criticality of preserving human dignity from a multi-dimensional perspective, promoting patient autonomy, acknowledging their cultural and spiritual beliefs, and confronting societal attitudes and practices. It draws from theological doctrines and the European Charter of Patient’s Rights to advocate for a nuanced, dignity-conserving approach to patient care. Case studies and practical strategies for preserving human dignity in palliative care contexts, based on clinical guidelines, empirical studies, and theological writings, are presented. Conclusions: This study highlights the integral role of human dignity from both theological and practical perspectives in inpatient care, advocating for a comprehensive, patient-centered approach to care that values the individual’s bio-psycho-social-spiritual facets. It underscores the necessity for a collaborative commitment between healthcare providers, patients, and their families to foster a milieu that unconditionally supports the dignity of the ill person.

The advising behaviour of healthcare professionals; considerations of dieticians and general practitioners regarding dairy and probiotic interventions

Dairy and probiotics are examples of products that contain ingredients that provide health benefits beyond the basic nutritional components of the food itself. However, strong evidence based on randomised controlled trials is generally lacking, which in turn leads to weak guidelines and recommendations for clinical practice. Interestingly, despite the limited regulation of probiotics, for example, a significant proportion of healthcare professionals still recommend these products. We set out studying the advising behaviour of general practitioners (GPs) and dieticians and their underlying motivations whether to advise probiotics, a relatively new intervention, and dairy, an older intervention by conducting interviews and setting out a questionnaire. This study found that the vast majority of GPs and dieticians recommended dairy and probiotics. The proportion of dieticians that do not advise both dairy and probiotics was too small for statistical analysis, therefore, the results are mainly focused on GPs. Considerations that appeared to be associated with GP advising behaviour were related to compliance with protocols and guidelines in regard to both dairy and probiotics. For probiotics in particular, GPs' knowledge and patients' interest in using probiotics was related to advising behaviour of GPs. Considerations solely related to recommending dairy were related to GPs' perceptions about the amount of evidence of dairy efficacy and the recommendation of dairy in scientific journals. The study highlights the influence of authority-driven, expertise-driven and patient-driven considerations on whether or not to proceed with recommending an intervention. Insights into the drivers of GPs to advise, gives input to stakeholders in the nutrition innovation system to understand and allow to use appropriate tools to support GPs in making an informed decision to increase the quality of care provided.

Hand hygiene in emergency care: cross-sectional study on adherence and behavior of the team

Introduction: Healthcare professionals working in emergency care perform hand hygiene on few occasions when in contact with the patient and/or nearby areas. Aim: To verify adherence and behavior of healthcare professionals regarding hand hygiene practices in emergency care. Outlining: Cross-sectional, descriptive, quantitative study conducted with 39 healthcare professionals working in emergency care. Data were analyzed using descriptive statistics and multiple linear regression. Results: A total of 230 observations were made during day and night shifts. The majority did not use adornments during their workday (81.0%). The adherence rate was 33.0%, with the lowest frequency before performing aseptic procedures (24.0%) and before contacting the patient (27.1%). Nurses stood out among the evaluated professionals (39.5%). There was no statistical difference between the products used for handhygiene and the adherence rate (p=0.20). Implications: It is necessary to implement strategies to sensitize healthcare professionals about hand hygiene, as the participants' performance was low.

The effectiveness of clinical guideline implementation strategies in oncology—a systematic review

ImportanceGuideline recommendations do not necessarily translate into changes in clinical practice behaviour or better patient outcomes.ObjectiveThis systematic review aims to identify recent clinical guideline implementation strategies in oncology and to determine their effect primarily on patient-relevant outcomes and secondarily on healthcare professionals' adherence.MethodsA systematic search of five electronic databases (PubMed, Web of Science, GIN, CENTRAL, CINAHL) was conducted on 16 december 2022. Randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) assessing the effectiveness of guideline implementation strategies on patient-relevant outcomes (overall survival, quality of life, adverse events) and healthcare professionals' adherence outcomes (screening, referral, prescribing, attitudes, knowledge) in the oncological setting were targeted. The Cochrane risk-of-bias tool and the ROBINS-I tool were used for assessing the risk of bias. Certainty in the evidence was evaluated according to GRADE recommendations. This review was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the identification number CRD42021268593.FindingsOf 1326 records identified, nine studies, five cluster RCTs and four controlled before-and after studies, were included in the narrative synthesis. All nine studies assess the effect of multi-component interventions in 3577 cancer patients and more than 450 oncologists, nurses and medical staff.Patient-levelEducational meetings combined with materials, opinion leaders, audit and feedback, a tailored intervention or academic detailing may have little to no effect on overall survival, quality of life and adverse events of cancer patients compared to no intervention, however, the evidence is either uncertain or very uncertain.Provider-levelMulti-component interventions may increase or slightly increase guideline adherence regarding screening, referral and prescribing behaviour of healthcare professionals according to guidelines, but the certainty in evidence is low. The interventions may have little to no effect on attitudes and knowledge of healthcare professionals, still, the evidence is very uncertain.Conclusions and relevanceKnowledge and skill accumulation through team-oriented or online educational training and dissemination of materials embedded in multi-component interventions seem to be the most frequently researched guideline implementation strategies in oncology recently. This systematic review provides an overview of recent guideline implementation strategies in oncology, encourages future implementation research in this area and informs policymakers and professional organisations on the development and adoption of implementation strategies.

An Empirical Study Analyzing the Moderating Effect of Supervisor Support and Mediating Effect of Presenteeism among Eustress, Distress, and Innovative Behavior.

This article aims to illustrate that stress is not always a negative experience as it can have both positive and negative outcomes. The term "eustress" describes positive stress, while the term "distress" describes negative stress. To date, research on eustress is in the infancy stage. There are approximately 306 items that can be found in the Web of Science core collection for "eustress", while there are 184,714 items found for "distress". Few studies have examined the relationship between presenteeism, stress, and innovative behavior. Thus, the mechanism underlying this pathway still needs to be fully understood. A survey was conducted among 350 medical healthcare professionals from Pakistan. With the help of SPSS and AMOS, the data were analyzed and the combined effects of the variables were also investigated. According to the current study, a mediation effect has been observed between innovative behavior and stress (eustress and distress). However, supervisor support moderates the relationship between stress and presenteeism and, likewise, between presenteeism and innovative behavior. Our analysis of variables establishes empirically robust relationships between the innovative behavior of medical healthcare professionals and the two different dimensions of stress. In addition, it describes a hypothetical alternative situation that explains how employees' innovative work behavior is affected by eustress and distress in the presence of supervisor support. This study could have implications for improving medical healthcare professionals' ability to incorporate innovative behavior into their practice in an effective manner in the future.

Evaluation of knowledge, attitudes, and behaviors of non-physician healthcare professionals about breast cancer screening program

Cancer screening programs are carried out worldwide and in our country to diagnose breast cancer in its early stage, before the disease shows any symptoms. In this study, we aimed to evaluate the knowledge, attitudes, and behaviors of non-physician healthcare professionals about breast cancer screening programs. This study was planned as a cross-sectional survey study, nurses and female non-physician hospital staff from different professions were included. In addition to primary demographic data, various questions were asked to the participants to evaluate their knowledge about breast cancer screening programs and compliance with breast cancer screening programs, and then the data were analyzed. A total of 332 volunteers were included in our study. 317 (95.5%) of them stated that they had heard of the Cancer Early Diagnosis, Screening, and Education Centers (KETEM) before. When asked whether cancer screenings were essential, 327 (98.5%) of the volunteers answered “Yes,” considering it is essential, and thus it was thought that non-physician healthcare professionals had a high awareness of this issue. Fifty (15.1%) of the non-physician healthcare professionals stated that they regularly performed breast self-exams once a month, 83 (25.0%) did not do any breast examination, and 154 (46.4%) did it sporadically. Of the population, 66 people were 40 years and older. In this population, 33 (50.0%) of the participants answered “Yes” to the question “Have you ever had a mammogram?”; whereas 33 (50.0%) of them answered “No.” In general, the awareness of the participants was high, but it was thought that their level of knowledge about breast cancer screening was insufficient. In addition, it was observed that the compliance rates to cancer screening programs were insufficient. Therefore, an absolute effort should be made to increase the knowledge and awareness of health professionals who play an essential role in public health.