Doctors In Tertiary Care Hospital Research Articles

Perceived implications of COVID-19 on physical, mental and social aspects of resident doctors in a tertiary care hospital.

The COVID-19 pandemic has put health care systems of many countries under major stress. Due to its high transmission capacity, it has spread across the globe at a rampant pace. India is one of the countries which has been severely affected by COVID-19. It has posed onerous tasks in front of doctors. Along with it, it has left physical, social and mental implications on well-being of doctors. The purpose of this study is to get an in-depth understanding about the implications of COVID-19 on physical, social and mental aspects of resident doctors in tertiary care hospital. We performed a qualitative study which involved in-depth interviews of resident doctors who have worked during the COVID-19 pandemic from general medicine department of tertiary care hospital. Interviews were then manually transcribed and analyzed. Data analysis by preparing transcript unveiled that doctors were constantly facing burnout and mental distress along with less social support. Our study also found that there was a shortage of resources and demonstrated poor doctor patient ratio which led to a decrease in efficiency of doctors. Our findings are not only confined to doctors facing burden but has also explored sanguine perceptions of resident doctors. While treating COVID-19 patients, resident doctors suffered a great setback. Providing them with mental aid, social support, ample resources and decreasing their work burden is recommended to effectively manage future pandemic.

Knowledge of Inhaler Therapy among Undergraduates and Resident Doctors in Tertiary Care Hospital, Nepal

Introduction: Inhalation therapy is the administration of the aerosolized medication directly into the lungs and it is the most effective form of management of the obstructive airway disease including chronic obstructive airway disease, asthma and overlap syndrome. There is less data on the knowledge of inhaler therapy among the junior doctors who are managing obstructive airway disease at the first contact point. This study was done to assess the knowledge of undergraduate doctors and resident doctors who are treating the patients before the consultation with senior consultants working in one of the tertiary care hospital . The findings of the study will help find the strategies of filling the gaps of the knowledge of inhalation therapy among junior doctors while managing obstructive airway disease Objective: The primary objective of the study was to find the Knowledge of Inhaler Therapy among Undergraduates and Resident doctors in Bir Hospital. Methods: The study was a cross sectional questionnaire based descriptive study conducted in Bir Hospital, National Academy of medical Sciences. The study included purposeful sampling of the medical officers and residents working in medical ward and emergency. Results: Out of 70 respondents, 79% and 82% percent responded the correct method of the administration of the DPIs and MDIs respectively. Forty percent of the respondents had heard of the breath actuated devices and 88% of the respondents had heard of the spacer device. Forty one percent of the respondents said they teach the patients about the method of inhalation technique while prescribing the inhalation therapy. Seventy three percent of the respondents thought inhaler therapy as the first line therapy for managing COPD and Asthma. Conclusion: Prescription of inhalers, knowledge among junior MBBS undergraduate doctors regarding inhalation therapy, and correct use of inhalers varied, and was generally inadequate. More effort, academic training and exposure is needed to change the attitude of medical officers and residents regarding the concept of inhalation therapy.

Job Satisfaction among Resident Doctors of a Tertiary Care Hospital in South Delhi.

Doctors' job satisfaction is crucial to the health service to ensure commitment, effective training, service provision, and retention. Job satisfaction matters to doctors for their happiness, fulfilment, service to patients, and duty to employers. The quality of performance in the health sector to a large extent depends on whether healthcare providers are job-satisfied or dissatisfied. This study assessed the level and factors determining job satisfaction among resident doctors in a federal tertiary institution. A cross-sectional study was conducted among the resident doctors of a government tertiary care hospital. Data were collected using a self-reported questionnaire consisting of 49 items under seven domains of job satisfaction, where higher values indicated a higher level of satisfaction. The average scores of items were computed to construct factor scores for each individual. A Chi-square test was applied. The proportion of job satisfaction among resident doctors was found to be 80.9%. On adjustment, the odds of being satisfied were found to be higher in the older age groups, among males, and doctors posted in clinical departments. Most respondents in this study were satisfied with their jobs with minorities satisfied with their monetary and infrastructure facilities. There is a need to address these issues to enhance healthcare quality, especially in the public sector.

Knowledge, attitude, and practice about air-borne infection control guidelines: A cross-sectional study among residents doctors of tertiary care hospital in central India

Background: Adherence to National Airborne Infection Control Guidelines (NAIC) by health-care facilities is an effective way of reducing the spread of air-borne infections such as H1N1, drug-resistant tuberculosis, and COVID-19 disease. Aims and Objectives: This study aims to assess the gaps in knowledge, attitude, implementation, and satisfaction regarding resources availability of NAIC among postgraduate resident doctors. Materials and Methods: Across-sectional study was conducted from December 2019 to February 2021 at a medical college in central India. Total 301 interns, postgraduates, and senior residents in surgery and medicine allied clinical departments were included by convenient sampling method. A pre-designed, self-administered questionnaire was used to assess knowledge, attitude, and practice (KAP) and their satisfaction with available resources regarding NAIC. The data collected were tabulated and were analyzed using descriptive test and comparison of means by Analysis of variance test. Results: Almost 95%, 77%, and 74% of study participants were having adequate KAP on NAIC, respectively. Sixty-one percent participants were satisfied with the resources availability in their work area. Statistically significant association was observed between participants age, designation with their KAP score (P<0.05) and between gender and essential resources provided in the hospital. There was an existence of difference between study participants mean KAP score and essential resources score with statistically significance (P<0.05). Conclusion: The overall KAP was adequate, but there was a gap that exists between knowledge, practice, and satisfaction for availability of essential resources. The study findings were useful for healthcare workers in designing interventions to improve the adherence toward the NAIC guidelines and also to benchmark evaluation of interventions.

A cross sectional study on psychological impact of covid19 on post graduate doctors and Compulsory Rotatory Residential interns in COVID isolation ward of a tertiary care centre, Madurai

BackgroundCOVID-19 pandemic causes major impact on economic, physical, mental well-being of people all over the world. Doctors are working in stressful, unprepared, limited resource setting, and they are under the continuous threat of getting infection. Managing mental health of these warriors is great importance. Hence the present study to estimate the psychological impact of COVID-19* and factors associated with it among doctors in tertiary care hospital, Madurai. MethodsA Cross-sectional study was conducted during October–November 2020 using a pre-designed semi structured questionnaire and DASS-21 scale which were sent through Google form to doctors who were in their quarantine period after the COVID duty. Totally 292 responses were received. Descriptive statistics done to find frequencies and percentages. Correlation for continuous variables; Univariate and multivariate regression for categorical variables were used to predict the factors influencing the psychological impact. ResultsIn our study, 42.1% doctors were depressed, 43.8% were stressed and 50.7% had anxiety. Depression*, anxiety*, stress* scores were positively correlated with number of COVID duties(r2 0.163,0.138,0.133), number of elderly persons(r2 0.188,0.169,0.188) in their family and negatively correlated with sleep duration(r 2–0.219,-0.281,-0.239), attitude of study participants(r2-0.319,-0.274,-0.291). Multiple logistic regression showed that disturbed sleep(odd'sratio = 3.931,2.734,3.420) and poor quality of sleep which affect the next day function(odd'sratio = 3.470,2.968,3.122) were significant predictors for all three psychological impacts. ConclusionHigh prevalence of psychological impact estimated, ensures the requirement of early screening with timely psychological intervention and establishment of guideline policies to support mental health of healthcare workers* for maintaining the functionality of healthcare system.

Evaluation of Knowledge of MDR-TB among Medicine Training Doctors in Tertiary Care Hospital, Karachi, Pakistan

Tuberculosis is the oldest documented infectious diseases in humans and they still cause significant morbidity and mortality. Multi-Drug Resistant Tuberculosis (MDR-TB) is a growing hazard to human health worldwide and threat to control of tuberculosis. WHO estimates 3.2% incidence of MDR TB in new cases. MDR-TB new cases are created each year by a combination of poor patient compliance with treatment and physician error. The purpose of the study is to determine the status of knowledge and awareness amongst the medicine resident about the very basic knowledge of MDR-TB and need to strengthen teaching about tuberculosis to postgraduates so the objective of the study is to determine the frequency of knowledge of MDR –TB among medicine residents (postgraduate trainees) at a tertiary health care hospital Karachi. It is a descriptive based cross sectional study. 58 post graduates trainees were included. A simple questionnaire about MDR-TB was asked to fill in 30 minutes, each correct response will be given 10 marks and those who score 70% will be labeled as knowledgeable. The primary outcome measure was the frequency of knowledge of MDR –TB among medicine residents (postgraduate trainees) at a tertiary health care which turned out to be 65.5% knowledge among postgraduate trainees. So we concluded that there is a need of further studies with larger sample size and follow up studies after educating the trainees more of senior levels so that identification of predictors of mortality, so as to timely diagnose, intervene and hence prevent morbidity and fatalities. It is, therefore, important to develop continuous health education to improve TB knowledge and awareness at different levels.

Awareness among Intern Doctors about Medical Records and Duty of Doctors in Tertiary Care Hospital, Valsad

Background:Optimum knowledge of medical records and duty of doctor is must for every doctor to enhance safe health care delivery in an unbiased standardized way. Present study was undertaken with aim to assess awareness of intern doctors towards medical records and duty of doctors. Materials and methods:Present study was undertaken at Gujarat Medical Education and Research Society (GMERS) Medical College, Valsad, Gujarat after obtaining ethical approval from the Institutional Ethical Committee of Valsad. Total 10 questions were prepared and validated on Likert scale (1 to 5, 1 – Strongly Disagree, 5 – Strongly Agree) regarding medical records and duty of doctors. Total 100 intern doctors of GMERS Medical College, Valsad, Gujarat were subjected to pre-tested and pre-validated Likert scale type questionnaire regarding medical records and duty of doctors after obtaining their informed written consent. Data obtained were analyzed via median score and tabulated. Results:Students were well aware about following facts like Maintenance of patients’ record is legal duty of hospital, Every operation required informed written consent of patient, Fail to attend patient during emergency is punishable, Patient has right to refuse treatment, and Carelessly leaving object into patient body during operation is negligent act. Students were not sure of facts like Patients’ records are property of patients, Refusing patient on religious ground is punishable, Not to treat patient due to HIV is punishable, and doctor has right to choose patient. Students were not aware regarding either doctor can refuse to attend medico-legal case or not. Conclusion: Intern doctors had no awareness regarding duration of preservation of hospital records. Students were not sure of various aspects of medical records and duty of doctors. Compulsory internship in Forensic Medicine subject as well as sensitization workshop regarding medical records and duty of doctors for interns at beginning of their internship may build confidence among them to be aware with various duties of doctors.

Ethical principles in Hospital settings - perceptions of intern doctors of tertiary care Hospital

Ethical principles in Hospital settings - perceptions of intern doctors of tertiary care Hospital

Prevalence of Verbal Abuse Among Doctors in Tertiary Care Hospital

Verbal abuse is the act of forcefully criticizing, insulting or denouncing another person. Verbal abuse can be devastating to doctors and may cause long lasting emotional and psychological damage. This study aims to find the prevalence of verbal abuse among doctors in tertiary care hospital. This descriptive cross-sectional study was conducted among doctors in a tertiary care hospitals, Chitwan from January to July, 2019 after taking ethical approval. Convenience sampling was done. Self administered questionnaire was distributed and data was collected. Point estimate at 95% CI was done for binary data along with frequency and proportion. Data were entered and calculations were done in Microsoft excel. Verbal abuse was found among 80 (33.3%) respondents at 95% Confidence Interval (27.51- 39.09%) and most 51 (63.8%) of perpetrators were relatives of the patients. Most 38 (47.5%) of the doctors were often worried in workplace. Incident of the verbal abuse was more 35 (43.6%) in morning and least 14 (17.4%) in night. Most 22 (27.5%) of the doctors did not take any action for incident although most 42 (52.5 %) of the doctors were encouraged by colleagues to take action. Prevalence of verbral abuse among the doctors were found out to be similar as the previous studies conducted in similar settings. This study has shown that doctors were frequently verbal abused by patient's relatives and were abused mostly in morning shift and were often worried in workplace.

Knowledge and management practices regarding dengue fever among doctors of tertiary care hospital

Knowledge and management practices regarding dengue fever among doctors of tertiary care hospital

A questionnaire-based study on knowledge and attitude towards counterfeit medication among the doctors in tertiary care hospital

Background: Counterfeit drugs are a global problem and suffered almost all developing and developed countries worldwide. In India, it is a major problem which results life threatening issues as well as financial loss on health system. So, we conducted a cross sectional questionnaire-based study on knowledge and exposure to counterfeit drugs of doctors at SHKM Govt. Medical College, Nuh, Haryana, India.Methods: A structured questionnaire was distributed to 100 registered doctors. The questionnaire was based on knowledge, attitude and its consequence on the heath system by the practices of counterfeit medication.Results: There were Twenty questionnaires excluded from the study due to incomplete information. Only 57.77% (46/80) subjects having the knowledge of questionnaire correct meaning of counterfeit drug. However, almost 90% (72/80) subjects were aware about its dangerous effects. More than 50% of the subjects have suggested that modern technology is capable to control counterfeiting of the medicine.Conclusions: Counterfeit drugs create a people health hazard and waste to consumer income. The proper knowledge, awareness and modern technological approaches are the devices may helpful in diminution of counterfeit medication practices.

Knowledge, awareness and practice of ethics among doctors in tertiary care hospital.

Introduction:With the advancement of healthcare and medical research, doctors need to be aware of the basic ethical principles. This cross-sectional study is an attempt to assess the knowledge, awareness, and practice of health-care ethics among health-care professionals.Materials and Methods:After taking written informed consent, a standard questionnaire was administered to 117 doctors. No personal information was recorded on the questionnaire so as to ensure the confidentiality and anonymity of participants. Data analysis was done using SPSS version 21 (IBM Corp., Armonk, NY, USA).Results:Statistically significant difference observed between the opinions of consultant and senior resident (SRs) on issues like, adherence to confidentiality; paternalistic attitude of doctors (doctors should do their best for the patient irrespective of patient’s opinion); doctor’s decision should be final in case of disagreement and interest in learning ethics (P < 0.05). However, no difference reported among them with respect to patient wishes, informing patient regarding wrongdoing, informing close relatives, seeking consent for children and patients’ consent for procedures. Furthermore, no significant difference observed between the two with respect to the practice of health-care ethics. Surprisingly, the response of clinical and nonclinical faculty did not differ as far as awareness and practice of ethics were concerned.Conclusion:The significant difference is observed in the knowledge, awareness, and practice of ethics among consultants and SRs. Conferences, symposium, and workshops, on health-care ethics, may act as a means of sensitizing doctors and thus will help to bridge this gap and protect the well-being and confidentiality of the patients. Such an effort may bring about harmonious change in the doctor-patient relationship.

Knowledge attitude and practice of haemovigilance among doctors in tertiary care hospital in Nagpur, Maharashtra, India

Background: Haemovigilance program of India was launched on December 2012 and is a comprehensive, and a well-structured approach to collect, collate, and analyse data to address the issues of adverse reactions associated with blood transfusion. The information thus collected would facilitate corrective and preventive actions to be taken to minimize the potential risk associated blood collection processing and transfusion to patients. Considering the deep concern over the under-reporting of transfusion reactions prevailing among the doctors, the present study was done to know the knowledge attitude and practice (KAP) of haemovigilance among doctors.Methods: The present study was a cross sectional questionnaire based study, which included doctors of a tertiary care hospital. The purpose of the questionnaire was to know awareness of doctors regarding haemovigilance programme of India. With this study we also tried to identify the factors responsible for underreporting of transfusion reactions and to find out the possible ways to improve reporting of transfusion reactions.Results: (38.88%) and (30%) of the responders were aware of the haemovigilance programme and transfusion reaction reporting centre respectively. Reporting of transfusion reaction was poor 22.22% among the respondents. According to respondents creating awareness about haemovigilance by conducting continuing medical education (CMEs), and training to healthcare professionals would lead to improvement in reporting of transfusion reactions. Complacency and ignorance were the main factors which discouraged transfusion reaction reporting by doctors.Conclusions: Increasing awareness of haemovigilance among doctors and training on reporting transfusion reactions would likely improve spontaneous reporting and help to strengthen the blood transfusion system.

Burnout among middle-grade doctors of tertiary care hospital in Saudi Arabia.

Burnout Syndrome is a mental condition caused by chronic exposure to work related stress and is identified by the presence of any of the three distinct elements of emotional exhaustion, depersonalization and lack of personal accomplishment. Middle grade doctors are the backbone of any tertiary care hospital / medical institution, partaking in unscheduled and inpatient care. The aim of this study was to assess the presence of burnout syndrome in the middle grade doctors in a tertiary care hospital in Saudi Arabia. The study was conducted at the Armed Forces Hospital Southern Region, Khamis Mushyt, from August to October 2012 in departments with at least fifty inpatient admissions per month and with at least five middle grade (Resident, Registrar and Senior Registrar) doctors. The departments were Obstetrics and Gynecology, Internal Medicine, Pediatrics, Emergency, General Surgery and Nephrology. This was a cross sectional descriptive and analytical study using the Maslach Burnout Inventory-Health Services Survey and a self-reported stressor-identifying questionnaire to ascertain possible precursors of, or contributing factors to, Burnout Syndrome. A total of 96 proformas/questionnaires were collected anonymously to maintain confidentiality and burnout syndrome was identified in as high as 88.5% of the respondents with high emotional exhaustion in 68.8%, high depersonalization in 63.6% and low personal accomplishment in 38.5%. The authors concluded that burnout syndrome is high among the middle-grade doctors in this medical facility and that urgent steps are needed to address this problem to ensure that these physicians remain physically and mentally healthy.