Frontline Healthcare Professionals Research Articles

Feasibility, Preference, and Impact of a Rapid Multiplexed Point-of-Care Digital Innovation (AideSmart!) to Expedite Screening of Sexually Transmitted Blood-Borne Infections in At-Risk Populations in Canada: Cross-Sectional Study.

With the need to expedite the detection of multiple sexually transmitted blood-borne infections (STBBIs), there is an increased demand for digital innovations and tests that improve the efficiency of point-of-care testing in outreach community settings. Multiplexed testing is being offered to at-risk populations by frontline health care professionals. With this in mind, we evaluated AideSmart! (for health aides or health care workers), an integrated app and platform solution that enables multiplexed STBBI screening at the point of care, for feasibility, preference, accuracy, and impact. With AideSmart!, we provided trained health care workers with the ability to perform rapid multiplexed tests; offer STBBI pre- or posttest counseling; maintain quality assurance of testing; facilitate linkages to care; and enhance health care provider-patient communication, data documentation, and patient engagement through the multiplexed STBBI screening and linkage process. We evaluated the performance of multiplexed tests. In a cross-sectional study conducted during the COVID-19 pandemic, we recruited at-risk populations in Canada from community-based organizations in Montreal, Quebec, and Saint John, New Brunswick, with unknown serostatus for HIV, hepatitis C virus (HCV), and syphilis. Following orientation and pretest counseling with AideSmart!, we performed multiplexed tests, simultaneously screening for HIV, HCV, and syphilis, using 2 rapid investigational multiplexed tests (Chembio for HIV and syphilis and MedMira for HIV, HCV, and syphilis) followed by confirmatory testing from local and national laboratories. Of the 401 participants, all (100%) accepted the AideSmart! multiplexed strategy: 59.4% (148/249) preferred multiplexed rapid tests over laboratory tests, and 56.6% (141/249) preferred receiving same-day test results. Rapid test results were obtained in 15 minutes (vs laboratory tests at 4-24 days). A total of 29 new infections (n=27, 93% HCV; n=1, 3% syphilis; and n=1, 3% HIV) were identified and treated within a week. Feasibility of the strategy (completion of testing and linkages to care) was at 76.1% (305/401). Health care professionals provided positive feedback and emphasized the importance of knowing one's negative or positive serostatus, especially during a pandemic. Multiplexed rapid tests' specificity (against laboratory reference standards) exceeded 98% (98.7%-100%) for all pathogens and devices. An electronic reader, used by the Chembio rapid test, enhanced sensitivity (HIV: 100%, 95% CI 79.4%-100%; syphilis: 86.8%, 95% CI 71.9%-95.6% [Chembio] vs HIV: 100%, 95% CI 78.2%-100%; HCV: 90.3%, 95% CI 80.1%-96.4%; and syphilis: 57.9%, 95% CI 40.8%-73.7% [MedMira]). The AideSmart! digital multiplexed rapid screening strategy for health care workers facilitated STBBI testing for multiple STBBIs and arranged for pre- or posttest counseling and rapid linkages with high feasibility and acceptability. Electronic readers enhanced the diagnostic performance of multiplexed biomarker tests. This study generated data in support of digital multiplexed strategies in digitally enabled settings for at-risk populations nationally and worldwide.

Designing an Intervention to Improve Medication Safety for Nursing Home Residents Based on Experiential Knowledge Related to Patient Safety Culture at the Nursing Home Front Line: Cocreative Process Study.

Despite years of attention, avoiding medication-related harm remains a global challenge. Nursing homes provide essential health care for frail older individuals, who often experience multiple chronic diseases and polypharmacy, increasing their risk of medication errors. Evidence of effective interventions to improve medication safety in these settings is inconclusive. Focusing on patient safety culture is a potential key to intervention development as it forms the foundation for overall patient safety and is associated with medication errors. This study aims to develop an intervention to improve medication safety for nursing home residents through a cocreative process guided by integrated knowledge translation and experience-based codesign. This study used a cocreative process guided by integrated knowledge translation and experience-based co-design principles. Evidence on patient safety culture was used as an inspirational source for exploration of medication safety. Data collection involved semistructured focus groups to generate experiential knowledge (stage 1) to inform intervention design in a multidisciplinary workshop (stage 2). Research validation engaging different types of research expertise and municipal managerial representatives in finalizing the intervention design was essential. Acceptance of the final intervention for evaluation was aimed for through contextualization focused on partnership with a municipal advisory board. An abductive, rapid qualitative analytical approach to data analysis was chosen using elements from analyzing in the present, addressing the time-dependent, context-bound aspects of the cocreative process. Experiential knowledge was represented by three main themes: (1) closed systems and gaps between functions, (2) resource interpretation and untapped potential, and (3) community of medication safety and surveillance. The main themes informed the design of preliminary intervention components in a multidisciplinary workshop. An intervention design process focused on research validation in addition to contextualization resulted in the Safe Medication in Nursing Home Residents (SAME) intervention covering (1) campaign material visualizing key roles and responsibilities regarding medication for nursing home residents and (2) "Medication safety reflexive spaces" focused on social and health care assistants. The cocreative process successfully resulted in the multifaceted SAME intervention, grounded in lived experiences shared by some of the most important (but often underrepresented in research) stakeholders: frontline health care professionals and representatives of nursing home residents. This study brought attention toward closed systems related to functions in medication management and surveillance, not only informing the SAME intervention design but as opportunities for further exploration in future research. Evaluation of the intervention is an important next step. Overall, this study represents an important contribution to the complex field of medication safety. RR2-10.2196/43538.

The effects of work-family conflict, work engagement, and job burnout on self-rated health of public health emergency responders in Jilin Province, China, in the context of the COVID-19.

Amid sudden public health crises, preserving the well-being and optimal working states of frontline healthcare professionals is imperative for efficaciously managing the emergences. However, there is a paucity of research investigating the health status of frontline healthcare professionals through the perspective of work-family conflict. This study sought to elucidate the complex interrelations between work-family conflict, work engagement, job burnout, and self-rated health among public health emergency responders within the context of the COVID-19 pandemic. A convenience sampling method was employed to survey 1,309 public health emergency responders at the Jilin Provincial Center for Disease Control and Prevention. An online survey was administered utilizing a self-constructed questionnaire. The hypothesized relationships between the variables were tested using structural equation modeling. The direct impact of work-family conflict on self-rated health is not significant. The association between work-family conflicts and self-rated health was significantly mediated by work engagement and job burnout, respectively. Meanwhile, work engagement and job burnout had a chain mediating effect on work-family conflict and self-rated health. Work-family conflict plays a critical role in shaping the health and work status of public health emergency responders during public health crises. Organizations and managers should, in their workplace management practices, focus not only on work-related factors but also give due consideration to family-related factors. Supportive policies, including family-friendly initiatives, should be developed to safeguard the health and work engagement of public health emergency responders.

Perceptions and attitudes toward artificial intelligence among frontline physicians and physicians' assistants in Kansas: a cross-sectional survey.

This survey aims to understand frontline healthcare professionals' perceptions of artificial intelligence (AI) in healthcare and assess how AI familiarity influences these perceptions. We conducted a survey from February to March 2023 of physicians and physician assistants registered with the Kansas State Board of Healing Arts. Participants rated their perceptions toward AI-related domains and constructs on a 5-point Likert scale, with higher scores indicating stronger agreement. Two sub-groups were created for analysis to assess the impact of participants' familiarity and experience with AI on the survey results. From 532 respondents, key concerns were Perceived Communication Barriers (median = 4.0, IQR = 2.8-4.8), Unregulated Standards (median = 4.0, IQR = 3.6-4.8), and Liability Issues (median = 4.0, IQR = 3.5-4.8). Lower levels of agreement were noted for Trust in AI Mechanisms (median = 3.0, IQR = 2.2-3.4), Perceived Risks of AI (median = 3.2, IQR = 2.6-4.0), and Privacy Concerns (median = 3.3, IQR = 2.3-4.0). Positive correlations existed between Intention to use AI and Perceived Benefits (r = 0.825) and Trust in AI Mechanisms (r = 0.777). Perceived risk negatively correlated with Intention to Use AI (r = -0.718). There was no difference in perceptions between AI experienced and AI naïve subgroups. The findings suggest that perceptions of benefits, trust, risks, communication barriers, regulation, and liability issues influence healthcare professionals' intention to use AI, regardless of their AI familiarity. The study highlights key factors affecting AI adoption in healthcare from the frontline healthcare professionals' perspective. These insights can guide strategies for successful AI implementation in healthcare.

Canine companionship as a resilience factor: a quantitative inquiry into the impact of pet ownership on burnout mitigation among radiologists and radiographers.

The demanding nature of diagnostic imaging, coupled with the increasing workload and exposure to high-stress scenarios, underscores the pressing concern of burnout among radiologists and radiographers in modern healthcare settings. The objective was to investigate the interplay between family characteristics, workplace characteristics, pet ownership, and the occurrence of burnout. An online, quantitative, cross-sectional study with a non-random, purposive sampling method was carried out among Hungarian radiologists and radiographers from 1st of September to 1st of November 2022. We examined the results of 406 responses predominantly from females (79.8%, n = 324), including 70.7% radiographers (n = 287). Cronbach's alpha values for depersonalization (DP), emotional exhaustion (EE), and personal accomplishment (PA) were 0.74, 0.88, and 0.85, respectively. Average burnout scores were 8.35 (SD = 6.62) for DP, 26.26 (SD = 12.74) for EE, and 32.86 (SD = 9.52) for PA. DP demonstrated a balanced distribution (low: 35.7%, moderate: 27.3%, high: 36.9%). Conversely, EE and PA skewed towards high levels, with 52.5% (n = 213) and 49.5% (n = 201). Significant associations were found between gender and DP (p = 0.006), age (31-40 years) and DP/PA (p < 0.001; p = 0.004), absence of children and all burnout dimensions (p < 0.05), and pet ownership (p = 0.004) with lower EE, particularly for dog owners (p = 0.009). Occupation lacked a significant effect on burnout dimensions (p > 0.05). Employees without a second job had higher EE (p = 0.002) and lower PA (p = 0.008). Increasing healthcare experience correlated with decreased DP values (p = 0.001), while working over 40 h weekly negatively impacted all burnout dimensions (p ≤ 0.05). 15.5% (n = 63) exhibited signs of high burnout, with the age group 31-40 demonstrating the highest proportion (25.4%, n = 27) and significant associations with marital status, absence of children, pet ownership, private healthcare, 10-19 years in healthcare, and working over 40 h weekly. There is a pressing need for evidence-based strategies to alleviate burnout among radiologists and radiographers. There is a growing importance of recognizing the role of pets, especially dogs, as valuable companions for emotional support and stress relief. Implementing pet-friendly policies or therapy programs can contribute to a positive and supportive workplace, potentially mitigating burnout among essential frontline healthcare professionals.

Advance Healthcare Directives: the Irish Implementation Reality from an Interdisciplinary Group Concept Mapping Study

Abstract Background Advance Healthcare Directives became legal in Ireland on 26th April 2023. While Advance Healthcare Directives are primarily rooted in patients’ legally binding refusal of treatments or interventions, they also encourage patients to set out their care preferences for the future (Government of Ireland 2015). Despite care of the older adult broadly transitioning from acute hospital to community, and a greater than ever focus on keeping older adults living at home for longer, low awareness of, and professional uncertainty around, Advance Healthcare Directives and how to integrate them into the care of the older adult has been widely expressed by Irish hospital physicians (Crowley and Doran 2022). Methods In this implementation study, Group Concept Mapping, using the relatively novel ‘GroupWisdom™’ software, is used to collect and analyse data from multiple healthcare professions to identify contextual issues that affect the implementation of Advance Healthcare Directives. 44 frontline healthcare professionals including Hospital Consultants (n=6), General Practitioners (n=5), Paramedics (n=7), Advance Nurse Practitioners (n=4), Clinical Nurse Specialists (n=4), Public Health Nurses (n=5), Critical Care Nurses (n=3), Nurse Managers (n=2), Healthcare Managers (n=2), Occupational Therapists (n=2) and Social Workers (n=4) participate in this mixed method study. Policymakers and other stakeholders are also involved throughout. Results The main implementation issues for Advance Healthcare Directives in order of importance as outlined by Healthcare Professionals are: 1) Public Education; 2) Homecare Services; 3) Timing and Location; 4) Family Members; 5) Lack of Education for the Healthcare Professional; 6) Complications for the Healthcare Professional; 7) Individual and Cultural Beliefs. Conclusion This study contributes a valuable understanding of where the implementation issues reside for healthcare professionals and policymakers, and how these can be addressed to ensure successful implementation. This implementation study focuses on practical considerations, offering multiple workable solutions to help to resolve these implementation issues on the ground.

Borealpox Virus: a Comprehensive Review of its Emergence and Global Recommendations

The emergence of the Borealpox virus (BRPV), formerly known as the Alaskapox virus (AKPV), in 2015 poses an intriguing scientific challenge. Despite being first discovered in Alaska, BRPV is a potential global threat, and reports of instances have raised questions about how serious it can be; especially in those with impaired immune systems. The unique characteristics of BRPV have been clarified through genomic characterization, providing insight into its evolutionary lineage and transmission dynamics. A recent death linked to BRPV highlights the difficulties presented by newly developing infectious illnesses, particularly for individuals who are already at risk. The implications of BRPV for public health call for all-encompassing management approaches; such as creating efficient treatments and customized interventions for various clinical presentations. Research and surveillance initiatives are vital for comprehending ecological reservoirs and patterns of transmission. Additionally, biosafety regulations and immunization programs are critical for controlling outbreaks and reducing the worldwide effects of BRPV. Prioritizing vaccination drive approaches, implementing stringent infection control measures, and reinvigorating disease surveillance systems are imperative for preventing BRPV. In addition, enhancing the training of frontline healthcare professionals and implementing the One Health concept are crucial measures that foster robust cooperation and adaptability, while confronting new public health concerns. A comprehensive review of the emergence and consequences of the Borealpox virus is necessary to direct future investigations and global public health campaigns. By utilizing interdisciplinary approaches and promoting global collaboration, we may successfully alleviate the danger presented by BRPV and protect public health across borders.

Knowledge of antimicrobial stewardship and the Access, Watch and Reserve (AWaRe) classification of antibiotics among frontline healthcare professionals in Akwa Ibom State, Nigeria: a cross-sectional study

BackgroundAntimicrobial stewardship (AMS) aims to improve antibiotic use while reducing resistance and its consequences. There is a paucity of data on the availability of AMS programmes in southern Nigeria. Further, there is no data on Nigerian healthcare professionals’ knowledge of the WHO ‘Access, Watch and Reserve’ (AWaRe) classification of antibiotics. This study sought to assess knowledge of AMS and the AWaRe classification of antibiotics among frontline healthcare professionals in Akwa Ibom State, Nigeria.MethodsThis was a cross-sectional survey of 417 healthcare professionals, comprising medical doctors, pharmacists and nurses, across 17 public hospitals in Akwa Ibom State, Nigeria. A paper-based self-completion questionnaire was used to collect data from the participants during working hours between September and November 2023. Statistical analysis was done using SPSS version 25.0, with p < 0.05 indicating statistical significance.ResultsFour hundred and seventeen out of the 500 healthcare professionals approached agreed to participate, giving an 83.4% response rate. Most of the participants were female (62.1%) and nurses (46.3%). Approximately 57% of participants were familiar with the term antibiotic/antimicrobial stewardship, however, only 46.5% selected the correct description of AMS. Majority (53.0%) did not know if AMS programme was available in their hospitals. 79% of participants did not know about AWaRe classification of antibiotics. Among the 87 (20.9%) who knew, 28.7% correctly identified antibiotics into the AWaRe groups from a given list. Only profession significantly predicted knowledge of AMS and awareness of the AWaRe classification of antibiotics (p < 0.001). Pharmacists were more likely to define AMS correctly than medical doctors (odds ratio [OR] = 2.02, 95% confidence interval [CI] = 1.16–3.52, p = 0.012), whereas nurses were less likely to be aware of the WHO AWaRe classification of antibiotics than medical doctors (OR = 0.36, 95% CI = 0.18–0.72, p = 0.004).ConclusionsThere was a notable knowledge deficit in both AMS and the AWaRe classification of antibiotics among participants in this study. This highlights the need for educational interventions targeted at the different cadres of healthcare professionals on the role of AMS programmes in reducing antimicrobial resistance and its consequences.

Implementation of Physical Activity in the Curricula of Medical Schools and Healthcare Professions Across Europe: The VANGUARD Project Study Protocol.

The 2018 published World Health Organisation (WHO) Europe physical activity factsheet reports, specify agreed targets for physical activity and articulate the need to improve the education of medical doctors and healthcare practitioners in order to increase physical activity and reduce sedentary time in people at risk and/or living with Noncommunicable Diseases (NCDs). Given the dearth of relevant initiatives and the continuous need to increase physical activity participation towards better health management of NCDs, the aim of this study is to embed physical activity in the undergraduate curricula of future frontline healthcare professionals (medical doctors and allied health professions) in European countries. The Virtual Advice, Nurturing, Guidance on Universal Action, Research and Development for physical activity and sport engagement (VANGUARD) project consists of a collaborative partnership Consortium between six European Universities, WHO Europe and Ministry representatives that has been developed to implement physical activity in the curricula of medical schools and healthcare professions. The methodology of the VANGUARD project is informed by the WHO implementation guidance and the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Through a carefully planned implementation process and via using established appropriate implementation evaluation tools, the end result of the VANGUARD project will be the a) implementation of a physical activity module in six different European Universities (five medical schools and one physiotherapy department) and b) development of a toolkit/guide, in order to assist other healthcare systems and European Universities to develop relevant grass-root innovations for addressing the decline in physical activity levels.

Nurses' perspectives on privacy and ethical concerns regarding artificial intelligence adoption in healthcare

BackgroundWith the increasing integration of artificial intelligence (AI) technologies into healthcare systems, there is a growing emphasis on privacy and ethical considerations. Nurses, as frontline healthcare professionals, are pivotal in-patient care and offer valuable insights into the ethical implications of AI adoption. ObjectivesThis study aimed to explore nurses' perspectives on privacy and ethical concerns associated with the implementation of AI in healthcare settings. MethodsWe employed Van Manen's hermeneutic phenomenology as the qualitative research approach. Data were collected through purposive sampling from the December 7, 2023 to the January 15, 2024, with interviews conducted in Bengali. Thematic analysis was utilized following member checking and an audit trail. ResultsSix themes emerged from the research findings: Ethical dimensions of AI integration, highlighting complexities in incorporating AI ethically; Privacy challenges in healthcare AI, revealing concerns about data security and confidentiality; Balancing innovation and ethical practice, indicating a need to reconcile technological advancements with ethical considerations; Human touch vs. technological progress, underscoring tensions between automation and personalized care; Patient-centered care in the AI era, emphasizing the importance of maintaining focus on patients amidst technological advancements; and Ethical preparedness and education, suggesting a need for enhanced training and education on ethical AI use in healthcare. ConclusionsThe findings underscore the importance of addressing privacy and ethical concerns in AI healthcare development. Nurses advocate for patient-centered approaches and collaborate with policymakers and tech developers to ensure responsible AI adoption. Further research is imperative for mitigating ethical challenges and promoting ethical AI in healthcare practice.

Role of frontline healthcare professionals in improving air quality and climate health surveillance in India

Role of frontline healthcare professionals in improving air quality and climate health surveillance in India

Community intervention delivered by frontline healthcare professionals to promote eating self-efficacy

PurposeThe goal of this study was to assess changes in eating self-efficacy after participating in a brief psychoeducational group intervention, grounded in the cognitive-behavioral model, delivered by dieticians in community-based health facilities.Design/methodology/approachThe study was conducted using a quasi-experimental, pre-post design. A total of 110 program participants took part in the study. They were asked to complete the Eating Self-Efficacy Scale before the start of the intervention, at the end of the intervention, and three months after the intervention ended. Data were analyzed using the Linear Mixed Model.FindingsParticipants’ personal sense of control over their eating behaviors significantly increased after they completed the program and continued to increase up to the three-month follow-up. The effect of the intervention remained significant after controlling for differences in age and whether participants had access to other forms of individual support or completed the follow-up during the COVID-19 general lockdown.Practical implicationsBy promoting participants’ sense of eating self-efficacy, this intervention could lead to positive dietary changes, which in turn could promote better health and healthy aging.Social implicationsThis community intervention is readily accessible and represents a cost-effective approach to promote healthy eating, reducing the risk of chronic disease and the need for medical care, thereby cutting costs for the healthcare system.Originality/value(1) This study addresses a gap in the scientific literature as there was limited published research to date that investigated this intervention. (2) The three-month follow-up made it possible to evaluate whether changes in eating self-efficacy were maintained over time. (3) Potential confounding variables, including age, having access to other forms of individual support and the COVID-19 general lockdown, were taken into account.

Pathways of front-line healthcare professionals’ information anxiety during the COVID-19 pandemic: A qualitative study in China

Pathways of front-line healthcare professionals’ information anxiety during the COVID-19 pandemic: A qualitative study in China

Mindfulness-based interventions for improving mental health of frontline healthcare professionals during the COVID-19 pandemic: a systematic review

BackgroundMindfulness-based interventions (MBIs) appear to be effective for improving the mental health of healthcare professionals (HCPs). However, the effectiveness of MBIs on extreme psychological trauma caused by the coronavirus disease 2019 (COVID-19) pandemic is largely unknown. The aim of this paper was to systematically review empirical studies of MBIs for HCPs carried out during the COVID-19 pandemic, to evaluate them and their effectiveness in different areas of mental health.MethodsThe electronic databases searched were Web of Science, Scopus, PubMed, and PsycINFO. The date when each database was last searched was September 15, 2023. Randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and non-randomized non-controlled trials (NRNCTs) focused on MBIs for health care staff who were working in healthcare centers during the COVID-19 pandemic were included. All of them employed standardized measures of mental health. The review followed the best practices and reported using PRISMA guidelines. A data collection form, adapted from the Cochrane handbook for systematic reviews of interventions, was used to extract and synthesize the results. The methods used to assess the risk of bias in the included studies were the Cochrane Risk of Bias Tool and the ROBINS-I Tool.ResultsTwenty-eight studies were included in the systematic review. Overall, the methodological quality of the studies was moderate. The results showed the effectiveness of MBIs in improving levels of stress, mindfulness, and mental well-being. However, no conclusive results were found regarding the effectiveness of MBIs in improving the levels of burnout, anxiety, depression, sleep quality, and resilience of HCPs.ConclusionsThe MBIs for HCPs carried out during the COVID-19 pandemic have mainly contributed to improving stress, mindfulness, and mental well-being at a time of serious health emergency. However, more robust studies at a methodological level would have been desirable.Systematic review registrationPROSPERO CRD42021267621

Signs of front-line healthcare professionals' information anxiety during the COVID-19 pandemic: Grounded theory study in a Wuhan hospital.

Being front-line healthcare professionals is associated with possible severe information anxiety during the COVID-19 pandemic. Investigating signs of information anxiety is the first and key step of its targeted medical intervention. This study aims to explore the signs of front-line healthcare professionals' information anxiety during the COVID-19 pandemic. This study is qualitative research. Grounded theory was used to classify information anxiety signs of front-line healthcare professionals. Twenty-four front-line healthcare professionals from a general hospital with over 5000 beds in Wuhan were recruited to participate in semi-structured interviews. According to the frequency and frequency variation of signs appearing in interviews, the trends of signs during the virus encounter, lockdown, flattening and second wave were compared. Based on the interviews, those signs that were conceptually related to each other were extracted to construct a conceptual model. Psychological signs (emotion, worry, doubt, caution, hope), physical signs (insomnia, inattention, memory loss, appetite decreased) and behavioural signs (panic buying of goods, be at a loss, pay attention to relevant information, change habits) could be generalized from 13 subcategories of information anxiety signs. Psychological signs were the most in every period of the pandemic. Furthermore, psychological signs decreased significantly during lockdown, while behavioural and physical signs increased. Finally, severe psychological and behavioural signs were associated with physical signs.

First Evidence on the Validity of the Complexity Index Derived from the Resident Assessment Instrument for Home Care in Home Care Patients

ObjectivesRecently, a Complexity Index (CI), based on the multidimensional complexity model and derived from the Resident Assessment Instrument for Home Care (interRAI HC) was proposed as a decision-support tool to help frontline health care professionals in their clinical evaluation to identify and analyze complex situations. This study aims to test the CI: (1) concurrent validity with another measure of complexity (ie, the COMID), (2) convergent validity with related constructs assessed by interRAI HC scales (eg, depression), (3) divergent validity (comparison between CI-COMID and scales-COMID correlations), and (4) predictive validity on coordination meetings. DesignA cross-sectional observational design was used for a secondary analysis of interRAI HC and COMID data collected in routine home care nursing practice (July-December 2021). Setting and ParticipantsParticipants were community-dwelling adults receiving home care, with full interRAI HC and COMID assessments (N = 3533). MethodsCorrelational analyses were conducted to test the concurrent validity of the CI (with the COMID) and the convergent and divergent validity of the CI (with interRAI HCSwitzerland scales, eg, Depression Rating Scale, Method for Assigning Priority Levels, and a Frailty Index). A receiver operating characteristic (ROC) analysis was conducted to test the discriminative ability of CI on specific professional team coordination meetings. ResultsResults showed that the CI correlated positively and strongly with the COMID (ρ = 0.691, P < .001, concurrent validity), positively with all the tested scales (P < .001, convergent validity), whereas the CI-COMID correlation was higher than the interRAI HC scales–COMID correlations (divergent validity). The ROC analysis showed the CI had a high area under the curve (AUC = 0.719, predictive validity). Conclusions and ImplicationsThe CI demonstrates good validity properties with a strong correlation with the COMID and a high predictive value for coordination meeting. It is distinct from the other interRAI HC scales and has its place among them to support the clinical analysis of complex situations.

Effect of pranayama on perceived stress, well-being and quality of life of frontline healthcare professionals on COVID-19 duty: A quasi-randomised clinical trial.

Healthcare professionals (HCPs) had to perform their duties under extremely trying circumstances during the COVID-19 pandemic. High expectations further increased HCP's stress, which had an adverse impact on their mental health. The present quasi-randomised clinical trial examined how a specially designed pranayama regimen practised for 4 weeks affected the mental health of frontline, exposed HCPs in terms of perceived stress, wellness and quality of life. A total of 280 frontline HCPs on COVID-19 duties in five public hospitals of Delhi, India participated in this study. The intervention (n = 123) and control (n = 127) groups were alternately allocated. Data on perceived, self-reported mental health of HCPs were collected at baseline and post-test at the end-line (after 28 days of practice). We report that the intervention group (n = 123) had a substantial lower perceived stress at post-test at the end-line in comparison to the control group (n = 127, p-value: .028). Their overall WHO Quality-of-Life score also improved, of which the score on psychological domain increased significantly (p-value: .019). Accordingly, we conclude that a 28-day practice of the pranayama by the frontline HCPs in COVID-19 hospitals significantly decreased their level of perceived stress and enhanced their psychological quality of life.

Aggression and violence in the emergency department: A qualitative study exploring the perspectives of frontline healthcare professionals

BackgroundAggression and violence towards frontline healthcare professionals represents a rapidly increasing strain on hospitals, impacting clinician mental health and the provision of patient care. Little is known about the perceptions of healthcare professionals on current aggression management practices. AimThis study aimed to investigate the perceptions of frontline healthcare professionals on aggression and violence in hospital emergency departments. MethodsEight semi-structured focus groups consisting of 6–10 participants from five hospital emergency departments were held. Participants included medical doctors, nurses, and work health safety staff. Focus groups were audio-recorded and transcribed prior to undergoing thematic analysis. FindingsFour main themes were identified: (1) workplace aggression and violence in healthcare is increasing in frequency and difficulty to manage, (2) local strategies in place to manage workplace aggression and violence are perceived to be insufficient, (3) systemic issues exacerbate the consequences of workplace aggression and violence, (4) staff feel inadequately equipped to manage the impact of workplace aggression and violence on their own wellbeing. DiscussionThere are substantial perceived barriers to the effective management of workplace aggressive and violent behaviour within Australian hospital emergency departments. Participants suggest perceived increases in the prevalence of aggressive incidents and systemic issues surrounding incident reporting and follow-up exacerbate existing deficiencies in workplace aggression and violence management. ConclusionFurther research into risk reduction strategies, investigation of targeted interventions to better prepare staff, and improved reporting processes and pathways are needed to mitigate fallout of workplace exposures to aggression and violence in the emergency department.

Community Inclusion Experiences While Establishing Community Mental Health Clubhouses in Taiwan: Perspectives from Mental Health Professionals.

Community inclusion is a human right for all people, including people with mental illness. It is also an important part of individualized support to enable people experiencing mental illness to live in their preferred communities and to recover. In Taiwan, no study has investigated the social experiences of healthcare professionals. To fill this knowledge gap and inform ongoing mental health system strengthening, this study examined the not-in-my-backyard (NIMBY) phenomenon observed while establishing community mental health clubhouses in Taiwan and corresponding experiences of community inclusion. Data were collected through semi-structured interviews of 16 purposively sampled frontline healthcare professionals from Taiwanese mental health clubhouses. Data were analyzed using qualitative content analysis. Two themes were identified: "NIMBY phenomenon: Community residents' resistance to clubhouses" and "Measures adopted by the clubhouse for community inclusion". Two categories with eleven subcategories emerged. The findings demonstrate the following conclusions. First, the NIMBY phenomenon is related to the stigmatization and discrimination faced by individuals with mental disorders in society. Second, in Asian societies, mental disorders are associated with a particular social and cultural context. Third, the fear and rejection of individuals with mental disorders deepen their social exclusion. Forth, community mental health clubhouse models employ seven strategic approaches to community inclusion, listed as follows: capacity building for individuals, direct interaction with the public through community activities, provision of community services, life skills training, repairing and managing neighborhood relationships, assisting individuals in obtaining community employment, and conducting social education for community residents. Clearly, we need to combat social exclusion of people with mental illness and promote inclusive and accessible services and systems across sectors.

Empathy and Coping Strategies Predict Quality of Life in Japanese Healthcare Professionals.

Burnout and secondary traumatic stress (STS), also referred to as compassion fatigue, are undeniable negative consequences experienced by healthcare professionals when working with patients. As frontline healthcare professionals are essential to communities, it is crucial to understand their mental health and how they cope with negative psychological responses. This study investigated the relationships between burnout, STS, compassion satisfaction, dispositional empathy, and stress management among Japanese healthcare professionals and students taking care of patients in clinical practice. The participants were 506 Japanese healthcare professionals and students (doctors, nurses, medical students, and nursing students) affiliated with Japanese Ministry of Defense Hospitals. The data were collected from March 2020 to May 2021. We assessed burnout, STS, and compassion satisfaction using the Professional Quality of Life Scale, dispositional empathy using the Interpersonal Reactivity Index, and coping with stress using the Coping Orientation to Problems Experienced Inventory (Brief-COPE). Exploratory factor analysis of the Brief-COPE yielded three factors: active coping; support-seeking; and indirect coping. Personal distress, a self-oriented emotional empathy index, was related to higher burnout and STS scores and lower compassion satisfaction. Empathic concern, an other-oriented emotional empathy index, was associated with lower burnout and higher compassion satisfaction. Active coping strategies were associated with lower burnout and higher compassion satisfaction, whereas indirect coping strategies were associated with higher burnout and STS scores. In a comparison of empathy in professional categories, nurses presented higher personal distress than nursing students, and medical doctors showed lower fantasy tendencies than medical students. These results imply the complex relationships between empathy, coping strategies, and psychological responses among healthcare professionals. Further longitudinal study is needed to explore these complex relationships and to develop more precise and effective psycho-educational interventions to prevent burnout and STS.