Views Of Healthcare Professionals Research Articles

Reflections of health inequalities on the covid-19 vaccination process and the views of health care professionals

Objective: Social and economic conditions are the main reasons for the emergence of inequalities. During the COVID-19 pandemic, inequalities were seen to increase further. This study was conducted to evaluate the reflections of health inequalities on the COVID-19 vaccination process and the views and recommendations of health care professionals in this regard.
 Methods: This descriptive research was conducted in eastern Turkey with 344 health care professionals. The research data were collected using a questionnaire and analyzed by using number, mean and percentage.
 Results: Of the health care professionals, 95.9% reported inequality between countries during the COVID-19 vaccination process, 97.1% reported that access to vaccines was a human right, and 96.1% reported that everyone should have access to vaccines without discrimination. According to health care professionals, not releasing the vaccines into the public domain (86.3%), the income of countries (84.3%), and failure to determine vaccination priorities according to public health rules (77.9%) were among the reasons for inequality between countries in COVID-19 vaccination.
 Conclusion: Health care professionals reported that there were inequalities between countries in the COVID-19 vaccination process. Almost all of them are of the opinion that access to vaccines is a human right and that everyone should have access to vaccines without discrimination.

Benefits and Risks of Sharing Genomic Data for Research: Comparing the Views of Rare Disease Patients, Informal Carers and Healthcare Professionals.

Assessing public and patients’ expectations and concerns about genomic data sharing is essential to promote adequate data governance and engagement in rare diseases genomics research. This cross-sectional study compared the views of 159 rare disease patients, 478 informal carers and 63 healthcare professionals in Northern Portugal about the benefits and risks of sharing genomic data for research, and its associated factors. The three participant groups expressed significantly different views. The majority of patients (84.3%) and informal carers (87.4%) selected the discovery of a cure for untreatable diseases as the most important benefit. In contrast, most healthcare professionals revealed a preference for the development of new drugs and treatments (71.4%), which was the second most selected benefit by carers (48.3%), especially by the more educated (OR (95% CI): 1.58 (1.07–2.34)). Lack of security and control over information access and the extraction of information exceeding research objectives were the two most often selected risks by patients (72.6% and 50.3%, respectively) and carers (60.0% and 60.6%, respectively). Conversely, professionals were concerned with genomic data being used to discriminate citizens (68.3%), followed by the extraction of information exceeding research objectives (54.0%). The latter risk was more frequently expressed by more educated carers (OR (95% CI): 1.60 (1.06–2.41)) and less by those with blue-collar (OR (95% CI): 0.44 (0.25–0.77) and other occupations (OR (95% CI): 0.44 (0.26–0.74)). Developing communication strategies and consent approaches tailored to participants’ expectations and needs can benefit the inclusiveness of genomics research that is key for patient-centred care.

The Need for Hospice Care as a Preferred Environment of Death in Terminal Cancers: A Neglected Research Area in Turkey

In the context of end-of-life practices in Turkey, the researchers considered it important to reveal the need for hospice care in Turkey since the number of palliative care units is low and they do not meet the needs, hospice care services are absent, and intensive care units are misused in parallel with these deficiencies. The researchers addressed the subject with a phenomenological qualitative approach. The views of healthcare professionals and patient relatives who cared for terminal cancer patients. In the context of the environment of death preferences were of interest. The study was conducted in the city center of Manisa, one of the 30 metropolitan cities located in the western region of Turkey. Of the 23 participants, 18 were healthcare professionals working in the field of oncology, and five participants were primary caregivers who lost their loved ones with terminal cancer. The caregiver family members were the family members who provided care to the terminal cancer patient with their own means at home and accompanied the patient's treatment process, since there was no hospice care. A semi-structured interview guide was utilized for the in-depth interviews. Data were transcribed by the researchers and coded in MAXQDA 2020, subjected to thematic analysis, and divided into units of meaning. At the final stage of the study, the units of meaning were combined, and four basic themes were revealed: the conceptualization of the environment of death preferences, the problems caused by death in the hospital, the necessity of hospice care, and hospice care for caregivers. The study results demonstrated that hospice care was an essential need in Turkey, and the workload of hospitals would decrease, and hospital resources could be used efficiently in the presence of hospices. At the same time, it was understood that hospices were services making it easier for terminal cancer patients and their caregivers to face death with peaceful expectations.

What’s up, Doc? Views of Healthcare Professionals on Medical Scenes in Television Series

Communication is not the forte of most doctors. A special course was thus created and implemented at the Dijon Medical School to teach medical students the fundamentals of doctor-patient communication in a consultation setting. A study was conducted to assess the effectiveness of using scenes from Anglophone TV shows to teach medical communication in English (Carnet, 2020). Scenes covering the different steps of a consultation were meticulously selected to match the curriculum. The TV shows selected belonged to either the FASP genre (Petit, 1999), or other genres, not specialized in the medical world. This article discusses the way practicing doctors view these scenes and their medical content. First, the way the scenes were selected and assessed by a panel of professionals is explained. Then, the professionals’ view on these scenes, and the medical errors spotted by the panel, are presented. Finally, a discussion is started on the feasibility of using TV series as material for the teaching of English for Medical Purposes (EMP).

A systematic review of obesity as a barrier to accessing cancer screening services.

Obesity is a known risk factor for the development of cancers, and a significant proportion of the population may be at risk of developing cancer owing to their weight status. There is acknowledged societal stigma towards people living with obesity, which can influence health behaviors and deter help seeking, such as cancer screening. Healthcare professionals' attitudes and views toward people living with obesity may adversely affect the patient-professional interface and treatment. A systematic review was carried out which aimed to explore the impact of living with obesity on the uptake of three main cancer-screening services: breast, cervical, and colorectal. Ten studies were included in the review. Three main areas were identified from both a patient and healthcare professional perspective: barriers and challenges to screening, gender issues, and disparities in the population living with obesity. Further research is needed to improve uptake of cancer screening services, and for education on weight bias, which is often unconscious, to be considered for healthcare professionals working in cancer screening services. This may help to increase the incidence of early differential diagnosis of potential cancers and improve health outcomes for people living with obesity.

Clinical management of uterine contraction abnormalities; an evidence-based intrapartum care algorithm.

To develop algorithms as decision support tools for identifying, managing and monitoring abnormal uterine activity during labour. Women with singleton, term (37-42 weeks) pregnancies in active labour at admission. Institutional birth settings in low- and middle-income countries (the algorithm may be applicable to any health facility). PubMed was searched up to January 2020 using keywords. We also searched The Cochrane Library, and international guidelines from World Health Organization (WHO), National Institute for Health and Care Excellence (NICE), American College of Obstetricians and Gynecologists (ACOG) and French College of Gynaecologists and Obstetricians (CNGOF). Algorithms were developed for two case scenarios: uterine hypoactivity and excessive uterine contractions. Key themes in the algorithm are: diagnosis, identification of probable causes, assessment of maternal and fetal condition and labour progress, monitoring and management. The algorithms for uterine hypoactivity and excessive uterine contractions have been developed to facilitate safe and effective management of abnormal uterine activity during labour. Research is needed to assess the views of healthcare professionals and women accessing healthcare to explore the feasibility of implementing these algorithms, and impact on labour outcomes. An evidence-based algorithm to support clinical management of abnormal uterine activity during labour.

Clinical management of deviations in maternal temperature during labour and childbirth: an evidence-based intrapartum care algorithm.

The development of an evidence-based algorithm for the clinical management of deviations in maternal temperature during labour and childbirth. Pregnant women at any stage of labour, with singleton, term (37-42 weeks) pregnancies at low risk of developing complications. Health facilities in low- and middle-income countries. We searched for international guidelines and prioritised WHO guidelines. In addition, we searched for other sources of evidence in the Cochrane Database of Systematic Reviews, EMBASE, MEDLINE and CINAHL until June 2020. Studies were prioritised according to the hierarchy of evidence. Two case scenarios were identified: maternal hyperthermia and hypothermia. We developed a single algorithm including both, due to commonalities in diagnosis, monitoring and management of underlying causes. The underlying conditions covered in the pathway include maternal sepsis and infection, chorioamnionitis, pyelonephritis, lower urinary tract and respiratory infections. Key decision points in the algorithm are suspicion of condition, definition, differential diagnosis, monitoring and management. We present an evidence-based algorithm to assist healthcare professionals in making decisions about appropriate clinical management of deviations in maternal temperature. Research is needed to assess the views of healthcare professionals and women accessing healthcare on the feasibility of implementing the algorithm. An evidence-based intrapartum care algorithm to support management of deviations in maternal temperature in labour and childbirth. #sepsis #maternitycare.

Pulmonary rehabilitation implementation in Northwest Nigeria: A qualitative study of the views of respiratory health-care professionals

Objectives: Pulmonary rehabilitation (PR) service is a comprehensive program comprising both pharmacological and non-pharmacological (exercise training, counseling, nutritional, etc.) treatment options that have been proven to improve physical and psychological conditions of patients with chronic respiratory diseases (CRDs). Nevertheless, PR is non-existent in most parts of Africa. The objective of this study is to report on the views of respiratory health professionals (pulmonologists and allied health) regarding the implementation of PR in Northwest Nigeria. Materials and Methods: Using a qualitative descriptive design, a group of 11 purposively sampled respiratory health professionals working in tertiary hospitals in Northwest Nigeria was contacted to participate in the study. Semi-structured in-depth interviews were conducted with the participants. Information power was used to stop data collection. The data obtained were analyzed using thematic synthesis. Results: Six themes emerged from the interviews as follows: (i) Description of PR as a comprehensive life-saving intervention that involves exercises, education, self-care, and nutrition; (ii) absence of PR units; (iii) possession of knowledge of their roles; (iv) possession of basic knowledge of roles of other team members; (v) lack of specialized workforce; and (vi) lack of facilities and equipment. In general, the results of the study indicated that some respondents were more conversant with PR as an intervention in CRDs than others. Furthermore, the respondents had basic knowledge of the roles of other professionals in the delivery of PR. Finally, the major barriers to the utilization of PR services were poor awareness, lack of equipment, and workforce. Conclusion: There was a general lack of comprehensive PR services in the study area with respiratory health-care professionals demonstrating variable, but mostly good knowledge of PR.

Advance care planning: comparing the views of residents and healthcare professionals in nursing homes in Singapore

With more frail elderly living and likely to die in nursing homes, advance care planning (ACP) is critical in overall efforts to provide good palliative care. However, it is unclear how willing older, vulnerable residents in nursing homes are to take on an active role in care decisions. The objective of this pilot study was to examine nursing homes' healthcare professionals' and residents' views on ACP and the extent of similarities and differences in their views. Our sample of 24 healthcare professionals and 24 residents were identified and recruited through contacts established from existing collaborations with the nursing homes. Surveys were administered to the participants by a trained research assistant between April 2015 and August 2015. Almost all the healthcare professionals (95.8%) would like to make an ACP for themselves in the future, while residents were divided in their choices (P<<0.01). Most residents (79.1%) felt that the most important guide for their surrogate in making decisions for them when they lose decision-making capacity should be based on their best interests. However, most healthcare professionals (75.0%) felt that it should be based on the resident's wishes and values. Healthcare professionals tended to overestimate the importance of patient autonomy compared to the residents. This study demonstrates that as much as advocacy and awareness are ongoing, nursing home residents' motivation to participate in ACP is lacking. The lack of motivation in ACP participation could be due to medical paternalism and familial determination, which have been a cultural norm for older Singaporeans. This study demonstrates there is a lack of cultural sensitivity in this group of healthcare professionals in approaching nursing home residents' end-of-life care decision-making.

Awareness and Views of Pharmacists and Physicians Toward Prescribing of Drugs for Off-Label Use in the Pediatric Population in Saudi Arabia.

Background: Prescribing off-label drugs in healthcare settings is a common practice worldwide. Thus, it is crucial to evaluate the knowledge and views of healthcare professionals regarding the off-label use of drugs in pediatric patients.Methodology: A cross-sectional study was conducted from June to December, 2020, among physicians and pharmacists in the Kingdom of Saudi Arabia (KSA). A 28-item questionnaire was distributed to the healthcare professionals through an electronic link. Descriptive and inferential statistics were used to report the data.Results: A total of 368 questionnaires were included in the final analysis. More than two-thirds of the respondents were aware of the correct definition of off-label drugs. Of the respondents, 37% were satisfied with their knowledge related to the use of off-label drugs in the pediatric population. Approximately half of the healthcare professionals in the study had major concerns about the efficacy and safety of off-label prescribing to children.Conclusion: Off-label drug use among pediatric patients is common practice in the KSA and healthcare professionals providing treatment to the children are also aware of the concept of off-label drugs.

Valuing quality in mental healthcare: A discrete choice experiment eliciting preferences from mental healthcare service users, mental healthcare professionals and the general population

High and sustained healthcare quality is important worldwide, though health policy may prioritise the achievement of certain aspects of quality over others. This study determines the relative importance of different aspects of mental healthcare quality to different stakeholders by eliciting preferences in a UK sample using a discrete choice experiment (DCE). DCE attributes were generated using triangulation between policy documents and mental healthcare service user and mental healthcare professional views, whilst ensuring attributes were measurable using available data. Ten attributes were selected: waiting times; ease of access; person-centred care; co-ordinated approach; continuity; communication, capacity and resources; treated with dignity and respect; recovery focus; inappropriate discharge; quality of life (QoL). The DCE was conducted online (December 2018 to February 2019) with mental healthcare service users (n = 331), mental healthcare professionals (n = 510), and members of the general population (n = 1018). Respondents’ choices were analysed using conditional logistic regression. Relative preferences for each attribute were generated using the marginal rate of substitution (MRS) with QoL as numeraire. Across all stakeholders, being treated with dignity and respect was of high importance. A coordinated approach was important across all stakeholders, whereas communication had higher relative importance for healthcare professionals and service users and ease of access had higher relative importance for the general population. This implies that policy could be affected by the choice of whose preferences (service users, healthcare professionals or general population) to use, since this impacts on the relative value and implied ranking of different aspects of mental healthcare quality.

Electronic Prescribing System and electronic health record priorities for antimicrobial stewardship

Rationale, aims, and objectives: This study provided a platform for electronic prescribing design features that may facilitate antimicrobial stewardship. This study aimed to identify software features within electronic prescribing systems and to assign priorities to these software features according to the opinions of the infection specialist health care professionals. Also, to identify any differences in priorities according to a professional group and experience in using electronic prescribing and communicate research findings to policy-makers and electronic prescribing manufacturers.&#x0D; Methods: The study was conducted in a large (600-bed) governmental tertiary and teaching hospital in Amman, Jordan. The survey was delivered by hand to antimicrobial prescribers (internists, surgeons, paediatricians, infectious diseases specialists, and critical care specialists) and non-prescribers (medical interns, clinical pharmacists, nurses, and other allied health care professionals) who filled out the survey face to face. The delivery of the survey started on March 15, 2020, and was closed on April 7, 2020.&#x0D; Results: Responses were received from 210 individuals. Interns represented more than one-third of respondents (n= 79, 37.6%), with 15.7% were internal medicine physicians. Among the healthcare professionals, around 44.7% (n= 94) are considered prescribers to antimicrobials, while others are considered non-prescribers (n= 116, 55.2%). The majority of respondents (n= 205, 97.6%) reported using an electronic prescribing and electronic health record system for part or all in their hospital, with 35.7% (n= 75) of them reported using these systems for more than one year. The prompt prescribing feature having the highest assigned priority was the allergy checker (n= 193, 91.9%) followed by the dose checker (n= 192, 91.4%).&#x0D; Conclusion: This study demonstrates the first attempt to describe views of healthcare professionals in Jordan about the potential significance of prescribing prompt and active prescription surveillance software features on clinical, microbiological and process outcomes to support antimicrobial stewardship. Findings from this study reveal considerable demand for additional software features expressed by the healthcare professionals charged with promoting rational use of antimicrobials and a consensus of anticipated positive impact on patient safety and efficiency outcomes.

Resilience of Brazilian health-care professionals during the pandemic

PurposeHealth-care professionals are caring for patients in unprecedented circumstances during the COVID-19 pandemic, dealing with scarce resources, higher demand and uncertain outcomes. In this context, the purpose of this study is to explore the views of health-care professionals regarding their work conditions and perceived impacts of the pandemic on their health, as well as the role of resilience and improvisation in face of the new challenges.Design/methodology/approachThis exploratory and qualitative study carried out semi-structured interviews with eleven health-care professionals from three Brazilian states that have been working in intensive care settings during the pandemic.FindingsThe pandemic has posed a great personal and professional burden on the professionals, impacting their physical and mental health. It also has required them greater resilience and improvisation capabilities to adequately perform work-related activities.Practical implicationsIn addition to individual-level attitudes, the results suggest that aspects in the government, society, personal relationships and providers domains influence the effects of the pandemic on the health-care professionals and how they cope with the ongoing crisis. Such a multifactorial approach should therefore be considered by health managers.Originality/valueWith no similar effort identified, this study emphasizes the relevance of discussing the pandemic burden on frontline professionals and intends to be useful for health practitioners, managers, academics and policymakers.

Stakeholders’ views of supporting asthma management in schools with a school-based asthma programme for primary school children: a qualitative study in Malaysia

ObjectiveThe WHO Global School Health Initiative aimed to improve child and community health through health promotion programmes in schools, though most focus on preventing communicable disease. Despite WHO recommendations, no...

A systematic review of the views of healthcare professionals on the scope of preimplantation genetic testing.

Preimplantation genetic testing (PGT) involves testing embryos created through in vitro fertilization for the presence of hereditary genetic disorders and chromosome abnormalities. PGT for monogenic conditions (PGT-M) is generally performed for childhood-onset, lethal disorders, but is increasingly accepted for certain adult-onset conditions, conditions with available treatment options or conditions with lower penetrance. Furthermore, the development of PGT for polygenic conditions (PGT-P) makes ethical questions regarding PGT indications imperative. A systematic review was therefore performed to gather and analyse studies on the perspectives of healthcare professionals on the appropriate scope of PGT, with the aim of getting insights into the concerns about the scope of PGT now and in the near future. PRISMA guidelines were followed. Twelve qualitative articles were included. The main themes extracted were the scope of PGT and decision-making about PGT. Defining 'a serious genetic condition' was seen as complex, but severity, high penetrance and absence of treatability and patients' experience were seen as relevant indications to determine the appropriateness of PGT. In navigating the decision-making processes with patients, professionals experienced friction between setting limits and respecting patients' autonomy. Such friction and ethical dilemmas around seriousness, informed decision-making and preventative medicine show that while expanding the list of possible PGT indications and the development of PGT-P could augment patients' reproductive autonomy, it could also lead to an increased reproductive 'burden' for patients. These insights are crucial for establishing guidelines that help healthcare professionals navigate ethical tensions associated with PGT.

MHRA seeking views on the safety of sodium valproate prescribing

The Medicines and Healthcare products Regulatory Agency (MHRA) has launched a review into safety issues around sodium valproate prescribing and is seeking views of patients and healthcare professionals in advance of a meeting of the Commission on Human Medicines. Sodium valproate — prescribed in the UK under brands including Dyzantil (Aspire Pharma), Epilim (Sanofi), Episenta […]

Remote control of weight loss using the Doctor PM mobile app: the views of patients and healthcare professionals

<h3></h3> Возможности мобильного здравоохранения (mHealth) позволяют повысить качество и доступность оказания медицинской профилактической помощи пациентам с факторами риска развития хронических неинфекционных заболеваний. Интеграция мобильных приложений и устройств mHealth в клиническую практику является важной, но не простой задачей. Факторы, которые медицинские работники и пациенты учитывают при принятии решений об использовании цифровых мобильных приложений для здоровья, изучены недостаточно. <h3>ЦЕЛЬ ИССЛЕДОВАНИЯ</h3> Изучить факторы, влияющие на решение медицинских работников и пациентов контролировать процесс снижения избыточной массы тела с использованием информационных дистанционных технологий<i></i> на примере специально разработанного мобильного приложения «Доктор ПМ». <h3>МАТЕРИАЛ И МЕТОДЫ</h3> В рамках многоцентрового рандомизированного контролируемого исследования проведены опросы пациентов с избыточной массой тела и ожирением, получивших персонифицированное профилактическое консультирование, и опросы медицинских работников, наблюдающих этих пациентов в течение 6 мес дистанционно с помощью мобильного приложения «Доктор ПМ». Данное приложение содержало чат-бот с текстовыми сообщениями мотивационного, информационного и поддерживающего характера, которые пациенты получали автоматически в зависимости от внесенных результатов измерений массы тела, текущей физической активности и информации, заносимой еженедельно в дневник питания. Ответы на вопросы анкет по принципу «согласия—несогласия» с содержанием вопроса оценивали по 5-балльной шкале. Статистическая обработка проведена с использованием пакета программ SPSS (V.23.0). Сравнение качественных показателей выполнено с применением критерия χ². Различия рассматривали как статистически значимые при <i>p</i>&lt;0,05. <h3>РЕЗУЛЬТАТЫ</h3> Уровень удовлетворенности пациентов использованием дистанционных технологий для целей профилактики в процессе снижения избыточной массы тела оказался выше у женщин (зависел от пола), пациентов более старшего возраста (зависел от возраста), среди сельского населения (зависел от места проживания). Оценки текстовых сообщений (удобство и полезность), получаемых пациентами через мобильное приложение, также были статистически значимо выше среди женщин, чем среди мужчин, и среди жителей сельской местности, чем среди городского населения. Технические проблемы с использованием приложения чаще возникали у пациентов, проживающих в сельской местности (<i>p</i>&lt;0,05), а основным барьером дистанционного контроля у жителей сельской местности по сравнению с городскими жителями оказался низкий уровень технической грамотности (4,4 и 3,6 балла соответственно, <i>p</i>=0,048). Оценка мнения и отношения медицинских работников показала, что большинство (68%) оценили технологию дистанционного наблюдения как возможную альтернативу очным визитам, 92% медиков высказали намерение использовать такие технологии для ведения пациентов с факторами риска. Вместе с тем 84% медицинских работников считают необходимым специальное обучение по организации дистанционного наблюдения. Основными преимуществами дистанционного наблюдения врачи назвали возможность контроля параметров здоровья пациентов (72%), визуализации в мобильном приложении динамики этих параметров в оперативном режиме (64%) и экономию рабочего времени (60%). <h3>ВЫВОДЫ</h3> Оценка мнения пациентов и медицинских работников в отношении практического применения технологии mHealth на примере специально разработанного мобильного приложения «Доктор ПМ» впервые выполнена в рамках рандомизированного контролируемого исследования. Полученные результаты могут быть учтены в условиях цифровой трансформации медицинской профилактики и при решении организационных аспектов их внедрения в реальную практику здравоохранения.

Complex surgery and optimal consent: A variety of opinions exist among healthcare professionals

BackgroundEstablishing healthcare professional's views on optimal consent in complex surgery could guide tailored consent policy, improving the process in challenging scenarios. To date, no studies have established if professionals of differing specialities agree on major aspects of consent in areas such as emergency surgery and cancer surgery. MethodsAn anonymous web based survey was distributed to a variety of disciplines in a tertiary referral centre. Questions regarding optimal methods and timing of consent in emergency and cancer surgery were posed. Comparative analyses of quantitative data were performed using chi-squared test. Results57 responses were received from doctors and nurses of varying disciplines. Differences were found between doctors of separate specialities and nurses in opinion of optimal timing of consent (p = 0.02), consent validity over time (p < 0.001) and the utility of introducing more specific consent policy (p = 0.01). Almost all respondents agreed that healthcare professionals have differing ideas of what consent is. ConclusionsThis study demonstrates differences in opinion regarding optimal consent for cancer and emergency surgery. Consideration should be given to developing consensus among healthcare professionals regarding what consent for complex surgery constitutes.

Views of Healthcare Professionals to Traditional and Complementary Medicine

Objective: Although its roots go back centuries, there is still a demand for traditional medicine practices and it is important to know the opinion of the society and healthcare professionals about the subject. Our study aims to determine the attitudes of healthcare professional and non-healthcare hospital staff about traditional medicine.Material-Method: A two-stage questionnaire, a demographic information section, and the Complementary, Alternative, and Conventional Medicine Attitudes Scale (CACMAS) was used to collect the data. Descriptive statistics, Kolmogorov Smirnov, Mann-Whitney U, Kruskal Wallis and chi-square tests were used to analyze the data.Results: A total of 681 staff of nine public and private hospitals participated in the study. 65.4% (n=439) of the participants were healthcare professionals, 34.6% (n=232) were non-healthcare professionals. The mean scores of the healthcare professional respondents were 92.6 (±16.7), of the non-healthcare professional respondents were 126.1 (±11.7).Conclusion: In our study, it was found that healthcare professionals' attitudes towards traditional medicine practices were more negative than non-healthcare professionals. However, as according to the current legislation in many countries around the world, only physicians who receive standard training and other healthcare professionals under their supervision are authorized to perform traditional medicine practices in Turkey. As a result of our study, it was determined that the attitudes of healthcare professionals and other segments of the society should be observed about traditional medicine practices and that measures should be taken to bring together the supply and demand for traditional medicine on a legal basis.

64 MANAGING FRAILTY IN AN IRISH PRIMARY CARE SETTING: A QUALITATIVE STUDY

Abstract Background Frailty is a complex, age-related condition which confers a risk of adverse outcomes. Evidence supports the effectiveness of screening and Comprehensive Geriatric Assessment (CGA) to meet the needs of frail older people. Little is known about the views of key stakeholders on frailty in a Primary Care context. This study explored the views of healthcare professionals and patients on frailty management in Primary Care in Ireland. Methods A qualitative descriptive study using semi-structured interviews was conducted. Healthcare professionals and patients were recruited using purposive sampling. Patients were recruited through the Frailty Intervention Team at the local acute hospital. Patients with cognitive impairment were excluded. Written informed consent was provided. Data were audio-recorded, transcribed and analysed using thematic analysis. The research was approved by the local Ethics Committee. Results Three patients and 17 healthcare professionals from general practice, public health nursing, physiotherapy, occupational therapy and social work participated. Three themes emerged. (i) Perceptions of Frailty (ii) Current Management of Frailty and (iii) CGA in Primary Care. Results demonstrated variability of perspectives on the concept of frailty, with limited knowledge of screening and CGA. Healthcare professionals described a fragmented service with sub-standard care for frail older patients. Critical weaknesses were: absence of essential services, uni-disciplinary working, inadequate IT systems and integration. Support for screening and CGA in Primary Care was evident. The general consensus was that frailty management required an adequately resourced Primary Care and the suitability of the current pathway for patients requiring CGA should be reviewed. Conclusion This study highlights an absence of a complete understanding of frailty among healthcare professionals. Inter-professional training and education is advocated. Further development of a frailty pathway and investment in Primary Care is required to improve care for frail older people. An intermediate interface service with a dedicated frailty management team is suggested.