Perceptions Of Health Care Workers Research Articles

Perception and Role of Indirect and Post-Discharge Surveillance in Predicting Surgical Site Infection in Surgical Patients: An Institutional Experience

Abstract Background: Surgical site infection (SSI) surveillance is a process of observing and reporting of infections following surgery. SSI surveillance studies are few in our country. Objectives: Present study was conducted to know the perception and role of SSI surveillance. Incidence of surgical site infection, identification of risk factors and bacterial spectrum of surgical wounds during surveillance were also studied. Methods: Patients who underwent a surgical procedure between July 2022 and June 2023 at our hospital were included. A prospective incidence surveillance for SSI was done to look for any signs of infection and record them in the surveillance form. Wound swabs or pus aspirates were sent for microbiological culture. Results: A total of 2312 patients underwent surgery during the study period, of whom 61 patients were diagnosed with SSI. The incidence of SSI was 2.6%. SSI was encountered more in female patients (57.3%). Age distribution had a significant association with SSI (P = 0.025). Most operative wounds were clean-contaminated (45.9%). Most SSIs were superficial (91.8%), followed by deep (8.2%). Most patients who developed SSI had a National Nosocomial Infection Surveillance (NNIS) patient risk index of 2 (45.9%). Bacterial growth was observed in 45.9% of cases. Multidrug resistance (MDR) among these isolates was 42.6%. Conclusion: This study helped to determine predictors of SSI like duration of surgery, type of wound, duration of hospital stays, and NNIS risk index. MDR isolates are now contributing to SSI. The perception of healthcare workers about SSI surveillance was that it was feasible to use and practice. Surveillance helped clinicians to strengthen the existing infection prevention and control practices for the future.

Perception of healthcare workers and patients about the impact of health facility infrastructure on healthcare services in eThekwini Municipality, KwaZulu-Natal, South Africa

ABSTRACT Background: Although there are several health facilities with infrastructure to cater to healthcare services, there are still healthcare facilities with inadequate infrastructure in eThekwini Municipality, KwaZulu-Natal Province, South Africa, to provide comprehensive healthcare services. This study investigates the perceptions of healthcare workers and patients about the impact of health facility infrastructure on the provision of healthcare services in KwaZulu-Natal. Objectives: This study aims to determine the perception of healthcare workers and patients about the impact of health facility infrastructure on healthcare services at Goodwins Clinic in eThekwini Municipality, KwaZulu-Natal, South Africa. Method: This qualitative study applied a phenomenological design by conducting in-depth interviews with individual patients (n = 20) and healthcare workers (n = 10) purposively selected in 2022. Data were analysed using Colaizzi’s phenomenological analysis framework. Results: Participants reported that health facility infrastructure affects healthcare services. Furthermore, old facility structures, scattered structures and limited working spaces were found to be the leading factors affecting healthcare services in the facility. Conclusion: The facility’s structural design factors need to be considered to ensure that the health facility structure is adequate to deliver healthcare services and motivate radical transformation in measuring and managing healthcare facilities.

THE EFFECT OF PSYCHOLOGİCAL SAFETY LEVELS OF HEALTH WORKERS ON THEİR PERCEPTİON OF ORGANİSATİONAL JUSTİCE

This study aims to determine the impact of psychological safety levels on healthcare workers' perceptions of organisational justice. The sample consists of 271 healthcare professionals who voluntarily participated in the study. Data were collected online. The study employed a questionnaire as a data collection tool and measured psychological safety and organisational justice using appropriate scales. To determine differences in perceptions of psychological safety and organisational justice among employees based on demographic variables, t-tests and ANOVA tests were conducted. Additionally, regression analysis was performed to investigate the impact of psychological safety on organisational justice perception. The data was analysed using the SPSS software package. The study found that the psychological safety perceptions of healthcare workers were above average and did not vary based on marital status, gender, or age. Additionally, employees' perceptions of organizational justice were slightly below average and did not vary based on the type of institution. The study also revealed a significant relationship between the psychological safety perceptions of healthcare workers and organizational justice, including its sub-dimensions. Health managers and human resources professionals should develop strategies to support employees' psychological safety and improve their perceptions of justice.

A study on the influence of dominant sound sources on users’ emotional perception in a pediatric dentistry clinic

IntroductionSoundscape in dental clinics has varying degrees of impact on the emotions of healthcare workers and young patients. Emotions such as restlessness, anxiety, anger, and nervousness are commonly found among dental healthcare workers. Pediatric dental clinics are an important part of dental clinics, but there is a lack of research on the soundscape within pediatric dental clinics.MethodsThis study focuses on a typical pediatric dental clinic, using a combination of field questionnaires and objective measurements. It aims to determine the impact of dominant sound sources on the emotional perception (nervousness, restlessness, anger, fear, pain) and hostile emotional responses of users in the pediatric dental clinic.ResultsIn the soundscape of pediatric dental clinics for young pediatric patients, users experience negative emotional perceptions (nervousness, restlessness, anxiety, anger, fear, and pain) and emotional responses of hostility. The dominant sound sources can be divided into two categories: dental (dental drill, air-water syringe, and saliva ejector) and nondental (children crying). Under the influence of dental dominant sound sources, there was a significant negative correlation between the emotional perceptions of healthcare workers and their negative emotional perceptions (p < 0.05). Conversely, for young pediatric patients aged 0–11 years, a significant positive correlation was observed between their emotional perceptions and negative emotional perceptions. The mean perceived degrees of nervousness and fear in young pediatric patients were 1.82 and 1.71 times stronger, respectively, than those observed in healthcare workers. Under the influence of non-dental dominant sound sources, the average degree of emotional perception among healthcare workers was 0.71 higher than that of young pediatric patients, and anxiety perception was significantly enhanced (p < 0.05). The mean degree of nervousness perception was 1 point higher in healthcare workers compared to young pediatric patients, restlessness perception was 1.1 stronger, and there was a presence of mild pain perception. In terms of demographic/social factors, age, occupation, and years of work significantly affected the perceptions of fear and restlessness among healthcare workers, while age had a significant impact on the emotional reaction of hostility in young pediatric patients.DiscussionThe results of this study indicate that the soundscape is an important factor in creating a comfortable treatment environment in pediatric dental clinics. Healthcare workers and young pediatric patients are significantly affected by the dominant sound sources in the clinic, and these effects are closely related to demographic and social factors such as age, profession, and years of experience. This finding can provide more targeted methods and strategies for the design and creation of soundscapes in dental clinics.

Xpert HIV-1 qual point-of-care testing for HIV early infant diagnosis in Tanzania: experiences and perceptions of health care workers in a 2016 study

BackgroundHIV early infant diagnosis (HEID) at the centralized laboratory faces many challenges that impact the cascade of timely HEID. Point of Care (PoC) HEID has shown to reduce test turnaround times, allow for task shifting and has the potential to reduce infant mortality. We aimed at assessing the feasibility of nurse based PoC-HEID in five facilities of Mbeya region.MethodsWe analysed data from healthcare workers at five obstetric health facilities that participated in the BABY study which enrolled mothers living with HIV and their HIV exposed infants who were followed up until 6 weeks post-delivery. Nurses and laboratory personnel were trained and performed HEID procedures using the Xpert HIV-1 Qual PoC systems. Involved personnel were interviewed on feasibility, knowledge and competency of procedures and overall impression of the use of HIV-1 Qual PoC system in clinical settings.ResultsA total of 28 health care workers (HCWs) who participated in the study between 2014 and 2016 were interviewed, 23 being nurses, 1 clinical officer, 1 lab scientist and 3 lab technicians The median age was 39.5 years. Majority of the nurses (22/24) and all lab staff were confident using Gene Xpert PoC test after being trained. None of them rated Gene Xpert handling as too complicated despite minor challenges. Five HCWs (5/24) reported power cut as the most often occurring problem. As an overall impression, all interviewees agreed on PoC HEID to be used in clinical settings however, about half of them (11/24) indicated that the PoC-HEID procedures add a burden onto their routine workload.ConclusionOverall, health care workers in our study demonstrated very good perceptions and experiences of using PoC HEID. Efforts should be invested on quality training, targeted task distribution at the clinics, continual supportive supervision and power back up mechanisms to make the wide-scale adoption of nurse based PoC HEID testing a possibility.

Perceptions of Healthcare Workers on the Attributes of the Integrated Disease Surveillance and Response System in Zimbabwe.

To investigate healthcare workers' perceptions of the integrated disease surveillance and response (IDSR) strategy. A cross-sectional survey of healthcare workers (HCWs) was conducted from December 2021 to June 2022 to assess their perceptions of the IDSR system attributes. Of the 409 respondents, 12 (2.9%) reported no prior training on disease surveillance. The IDSR was deemed simple, acceptable, useful, and timely by most participants. There were sharp differences in perceptions of flexibility and simplicity between doctors and the other healthcare professionals. However, acceptability, timeliness, and usefulness were uniformly perceived. Healthcare workers with at least 11-years' experience perceived the usefulness of the IDSR system significantly higher than those with lesser years of experience. However, work experience did not have an impact on HCWs perceptions of the simplicity, timeliness, and flexibility of the IDSR system. Most healthcare workers have positive perceptions of the IDSR approach. However, there are reservations about how well the system can adapt to changing conditions and demands (flexibility) and how well it simplifies the implementation processes. These findings demonstrate the necessity of adopting cutting-edge strategies for capacity building as well as ongoing professional development of healthcare professionals responsible for the implementation of the IDSR strategy.

Constructing images of HCWs in Chinese government Weibo posts: a discourse-historical approach

This study examines the image construction of front-line healthcare workers (HCWs) in Chinese government Weibo (microblogs) during the COVID-19 pandemic. Specifically, we rely on a discourse-historical approach to analyze 1,510 posts collected from an influential government Weibo account, @healthchina (健康中国), during the first wave of the pandemic to investigate the diverse images of HCWs constructed, the discursive strategies employed, and the pragma-linguistic devices used by @healthchina. The data analyses find that Chinese HCWs are depicted as professional and competent in addressing the pandemic crisis, compassionate and caring to their patients, and responsible and devoted to public health. Two discursive strategies are found salient in HCW’s image construction—nomination and predication realized through the identity labels, attitude/judgment resources, metaphors and comparisons, pictures, and hashtags. We argue that Chinese government microbloggers intentionally constructed these images of the HCWs to elicit positive emotional responses, reinforce government trustworthiness, and foster social cohesion in the collective fight against the pandemic. This research underscores the strategic communication efforts aimed at shaping the perception of HCWs and their pivotal role in managing the pandemic.

Healthcare workers perceptions of patient safety culture in selected Ghanaian regional hospitals: a qualitative study

BackgroundPatient safety culture is an integral part of healthcare delivery both in Ghana and globally. Therefore, understanding how frontline health workers perceive patient safety culture and the factors that influence it is very important. This qualitative study examined the health workers’ perceptions of patient safety culture in selected regional hospitals in Ghana.ObjectiveThis study aimed to provide a voice concerning how frontline health workers perceive patient safety culture and explain the major barriers in ensuring it.MethodIn-depth semi-structured interviews were conducted with 42 health professionals in two regional government hospitals in Ghana from March to June 2022. Participants were purposively selected and included medical doctors, nurses, pharmacists, administrators, and clinical service staff members. The inclusion criteria were one or more years of clinical experience. Interviews were recorded and transcribed. Thematic analysis was used to identify themes.ResultThe health professionals interviewed were 38% male and 62% female, of whom 54% were nurses, 4% were midwives, 28% were medical doctors; lab technicians, pharmacists, and human resources workers represented 2% each; and 4% were critical health nurses. Among them, 64% held a diploma and 36% held a degree or above. This study identified four main areas: general knowledge of patient safety culture, guidelines and procedures, attitudes of frontline health workers, and upgrading patient safety culture.ConclusionsThis qualitative study presents a few areas for improvement in patient safety culture. Despite their positive attitudes and knowledge of patient safety, healthcare workers expressed concerns about the implementation of patient safety policies outlined by hospitals. Healthcare professionals perceived that curriculum training on patient safety during school education and the availability of dedicated officers for patient safety at their facilities may help improve patient safety.

Perception and Belief of Healthcare Workers regarding the COVID-19 Vaccine: A Cross-Sectional Study and Geographic Information System Mapping

The COVID-19 new deaths’ highest numbers in Southeast Asia were reported from Indonesia, with 8,784 new deaths. Healthcare workers (HCWs) have several roles in the COVID-19 vaccine implementation. This study aimed to assess COVID-19 vaccine perception and belief among HCWs and identify demographic mapping by using the geographical information system. This study used a quantitative method with cross-sectional design, wherein 112 registered HCWs in the Indonesian hospital and healthcare centre were shared a survey questionnaire using Google Forms® and then visualised it through geographic mapping. The perception of HCWs regarding the COVID-19 vaccine was considered good but in contrast to the belief. There was a significant relationship between age [ p value = .021; odds ratio (OR): 2.692; 95% confidence interval (CI): 1.229–5.896] and also HCWs’ workplace ( p value = .040; OR: 0.231; 95% CI: 0.0620–0.862) towards the belief of HCWs regarding the COVID-19 vaccine. Developing strategies to decrease HCWs and public hesitation and increase trust is vital for implementing vaccination programmes.

Perceptions of healthcare workers on men's sexual and reproductive health services utilization in Kwazulu-Natal.

Healthcare workers have crafted and implemented several health policies and programs to attract men, but men still struggle to access SRH services. This study explored healthcare workers' perceptions and views about the determinants of men's sexual and reproductive health service utilization. This qualitative study employed a purposive sampling technique to select healthcare workers in urology clinics and those managing men diagnosed with SRH conditions outside urology clinics. Data were analyzed thematically. HCWs highlighted men's lack of awareness due to inadequate community education and health campaigns, staff shortage, the unavailability of medicines and medical supplies, health system incapacity, personal factors, and cultural norms and beliefs as hindrances in using SRH services. Health policymakers and relevant stakeholders need to pay attention to the SRH needs of men. The ongoing awareness campaigns about the importance of SRH service utilization, including additional male nurses, can encourage men to engage more with such services.

COVID-19 epidemiology, health services utilisation and health care seeking behaviour during the first year of the COVID-19 pandemic in Mweso health zone, Democratic Republic of Congo.

Although the evidence about coronavirus disease 2019 (COVID-19) has increased exponentially since the beginning of the pandemic, less is known about the direct and indirect effects of the pandemic in humanitarian settings. In the Democratic Republic of the Congo (DRC), most studies occurred in Kinshasa and other cities. Limited research was conducted in remote conflict-affected settings. We investigated the COVID-19 epidemiology, health service utilisation, and health care-seeking behaviour during the first year of the pandemic (March 2020-March 2021) in the Mweso health zone, North Kivu, DRC. This mixed-methods study includes a descriptive epidemiological analysis of reported COVID-19 cases data extracted from the provincial line list, interrupted time series analysis of health service utilisation using routine health service data, qualitative perceptions of health care workers about how health services were affected, and community members' health care seeking behaviour from a representative household survey and focus group discussions. The COVID-19 epidemiology in North Kivu aligns with evidence reported globally, yet case fatality rates were high due to underreporting. Testing capacity was limited and initially mainly available in the province's capital. Health service utilisation showed different patterns - child measles vaccinations experienced a decrease at the beginning of the pandemic, while outpatient consultations, malaria, and pneumonia showed an increase over time. Such increases might have been driven by insecurity and population displacements rather than COVID-19. Community members continued seeking care during the first months of the COVID-19 pandemic and visited the same health facilities as before COVID-19. Financial constraints, not COVID-19, were the main barrier reported to accessing health care. The first year of the COVID-19 pandemic in the Mweso health zone was characterised by low testing capacity and an underestimation of reported COVID-19 infections. The increase in health care utilisation should be further explored to understand the role of factors unrelated to COVID-19, such as insecurity, population displacement, and poverty, which remain major challenges to successfully providing health services and improving the population's health. Measles vaccination coverage dropped, which exacerbated the ongoing measles outbreak. Improved decentralised testing capacity will be crucial for future epidemics and enhanced efforts to maintain child vaccination coverage.

Twitter Analysis of Health Care Workers' Sentiment and Discourse Regarding Post-COVID-19 Condition in Children and Young People: Mixed Methods Study.

The COVID-19 pandemic has had a significant global impact, with millions of cases and deaths. Research highlights the persistence of symptoms over time (post-COVID-19 condition), a situation of particular concern in children and young people with symptoms. Social media such as Twitter (subsequently rebranded as X) could provide valuable information on the impact of the post-COVID-19 condition on this demographic. With a social media analysis of the discourse surrounding the prevalence of post-COVID-19 condition in children and young people, we aimed to explore the perceptions of health care workers (HCWs) concerning post-COVID-19 condition in children and young people in the United Kingdom between January 2021 and January 2022. This will allow us to contribute to the emerging knowledge on post-COVID-19 condition and identify critical areas and future directions for researchers and policy makers. From a pragmatic paradigm, we used a mixed methods approach. Through discourse, keyword, sentiment, and image analyses, using Pulsar and InfraNodus, we analyzed the discourse about the experience of post-COVID-19 condition in children and young people in the United Kingdom shared on Twitter between January 1, 2021, and January 31, 2022, from a sample of HCWs with Twitter accounts whose biography identifies them as HCWs. We obtained 300,000 tweets, out of which (after filtering for relevant tweets) we performed an in-depth qualitative sample analysis of 2588 tweets. The HCWs were responsive to announcements issued by the authorities regarding the management of the COVID-19 pandemic in the United Kingdom. The most frequent sentiment expressed was negative. The main themes were uncertainty about the future, policies and regulations, managing and addressing the COVID-19 pandemic and post-COVID-19 condition in children and young people, vaccination, using Twitter to share scientific literature and management strategies, and clinical and personal experiences. The perceptions described on Twitter by HCWs concerning the presence of the post-COVID-19 condition in children and young people appear to be a relevant and timely issue and responsive to the declarations and guidelines issued by health authorities over time. We recommend further support and training strategies for health workers and school staff regarding the manifestations and treatment of children and young people with post-COVID-19 condition.

Perceptions of Medical Staff on COVID-19 Vaccination: A Qualitative Analysis

Background: The COVID-19 pandemic has caused almost unimaginable damage to the lives, health, and economies of many countries. Alongside health and behavioral control measures, vaccination has been considered the most successful method to control the COVID-19 epidemic. Although vaccination is an effective way to reduce and eliminate diseases, its effectiveness depends on the willingness of the population to receive the vaccine. The purpose of this study is to explore the perceptions of medical staff on COVID-19 vaccination through qualitative content analysis. Objectives: This study aims to explore the perceptions of medical staff on COVID-19 vaccination through qualitative content analysis. Methods: A qualitative study employing a content analysis approach was conducted at Khoy city hospitals in Iran. The researchers explored the perceptions of 16 medical staff members who were among the first group to receive the vaccine in 2021 - 2022. Health staff of various ages, genders, and professions including doctors, nurses, midwives, pharmacists, laboratory staff, and radiologists were included in the research. Sampling was purposeful, and data collection utilized face-to-face semi-structured individual interviews. Data analysis followed the method of “conventional qualitative content analysis.” Results: Data analysis revealed three main categories and seven sub-categories as follows: “Conflicting feelings” (confidence or doubt, hope or worry, complications and benefits), “continuing to fight against COVID-19” (responding to social/professional responsibility, encouraging people to accept the vaccine), and “getting rid of COVID-19” (return to normal life, reduction of mortality). Conclusions: The medical staff expressed a desire to receive the COVID-19 vaccine to continue fighting the disease and eliminate it, but they also had conflicting feelings about receiving it. The perceptions of healthcare workers about healthcare issues serve as a reliable source of knowledge for the public and play a crucial role in deciding whether to accept or reject critical health interventions. Therefore, health policymakers dealing with epidemic diseases should prioritize creating scientific and psychological support for acceptance among healthcare workers, who serve as a reference for the public.

Mapping the Consequences - An Exploratory Study on the Use of Body Mapping Technique to Assess Perceptions of Health-care Workers on the Effects of Uncontrolled Diabetes Mellitus and Hypertension.

Knowledge of the consequences of uncontrolled diabetes mellitus and hypertension on various body organs among health workers is necessary to educate patients. Body mapping is a tool used for exploring perceptions as a part of qualitative research. This study assesses the perceptions of health-care workers on the effects of uncontrolled diabetes mellitus and hypertension on the human body using the body mapping technique. All 19 staff members of an Urban Primary Health Center were asked to draw a human body and map the parts affected by uncontrolled diabetes mellitus and hypertension. The mean age of the participants was 35.42 ± 10.54 years, and median years of work experience were 4 (3, 7) years. Fourteen (74%) participants had mapped kidneys and 11 (58%) participants had mapped head/brain indicating stroke to indicate damage due to uncontrolled diabetes mellitus and hypertension. Only 7 (37%) and 4 (26%) participants perceived that feet and eyes could be affected.

Perspectives of healthcare workers on integrated management of childhood illness in Pakistan: A phenomenological approach.

In 2019, an estimated 5.2 million deaths were reported among children less than 5years of age. At primary healthcare level, healthcare workers (HCWs) mostly rely on history and clinical findings and less on inadequate diagnostic facilities. To enhance case management skills of HCWs, World Health Organization devised an integrated management of childhood illnesses (IMCI) strategy in 1995, modified to distance learning IMCI in 2014. A qualitative phenomenological study was conducted to explore perceptions of HCWs about standard and distance IMCI. Four focus group discussions were conducted with purposively selected 26 HCWs (IMCI trained) from 26 basic health units of Abbottabad district in Pakistan. Gadamer's philosophical hermeneutics were adopted during the inductive thematic analysis. Five themes that emerged are inexorable health seeking behaviors, IMCI being a comprehensive algorithm for consultation, a tedious protocol, scaling up protocol to specialists and private practitioners, and administrative insufficiency by the department of health. Improvement in case management skills of HCWs was reported as a result of IMCI trainings. It needs administrative support, regulations to control poly-pharmacy and provision of drugs without prescription, and a curb on political and bureaucratic interference.

Poor personal protective equipment practices were associated with heat-related symptoms among Asian healthcare workers: a large-scale multi-national questionnaire survey

BackgroundIt is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities.MethodsWe evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach’s alpha, assessed the questionnaire’s validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms.ResultsThe questionnaire was found to be reliable in assessing HCWs’ knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach’s alpha = 0.9), but not heat strain symptoms (Cronbach’s alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p < 0.001). Knowledge (path coefficient = 0.2, p < 0.001), and negative attitudes and practices (path coefficient = 0.2, p < 0.001) of HCWs towards heat stress and PPE usage adversely affected symptoms experienced.ConclusionsThe questionnaire was not reliable in assessing symptoms. HCWs should, nevertheless, still self-assess their symptoms for early detection of heat strain. To effectively attenuate heat strain, understanding HCWs’ attitudes and practices towards PPE usage should guide policymakers in implementing targeted heat management strategies.

Perceptions of interprofessional collaborative practice in South Africa: A systematic review.

Interprofessional education (IPE) and interprofessional collaborative practice (IPCP) were developed to address the health needs of communities through collaborative practice across healthcare disciplines. The impact of IPE on IPCP and clinical service delivery in South Africa is not evident, possibly because of the lack of IPCP experiences among healthcare professionals. International literature reports facilitators and barriers of IPCP implementation, but there was a need to filter the evidence to identify literature from the South African context regarding the perceptions of healthcare workers' perceived barriers and facilitators of IPCP. South African literature. A systematic review was conducted to synthesise evidence from articles published between January 2017 and December 2021. Only qualitative studies targeting health professionals in South Africa who had been exposed to IPCP were included. Consistent with Preferred Reporting Items for Systematic reviews and Meta-Analysis, a multi-database search yielded 424 articles, which were screened for relevance and appraised for quality using the Critical Appraisal Skills Programme (CASP) tool. A thematic synthesis of the findings was conducted by applying ethical principles. Synthesis of barriers and enablers for IPCP implementation in the South African context included key aspects of healthcare systems, management and team leadership. The integration of IPCP into clinical practice in South Africa is still limited as healthcare professionals operate in silos. Recommendations of this study include greater integration of services combined with competent management and visionary leadership, together with the incorporation of IPE into undergraduate professional training programmes.

Health Care Worker Perception on HIV Pre-Exposure Prophylaxis and Service Delivery among Health Care Workers in South-East Nigeria

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention among health care workers (HCWs) remains a key issue. Infection with the human immunodeficiency virus endangers public health and kills a large number of individuals, including medical staff. There is now a genuine danger of HIV transmission among HCWs during work exposure. This study aims to assess health care worker perception on HIV pre-exposure prophylaxis and service delivery among health care workers in South-East Nigeria. Descriptive cross sectional study design using multistage sampling techniques was used to select four hundred respondents. Data was analyzed using the SPSS software version 25.0. Mean scores were generated for the major outcome variables of knowledge, attitude and practice of immunization schedule. P value was assumed significant at values less than 0.05. The findings of this study shows that 218 (54.5%) were male and 182 (45.5%) were female, 312 (78.0%) have good knowledge , 109 (27.3%) had history of occupational exposure to HIV, 234 (58.5%) had high, 85 (21.3%) had moderate and 81 (20.3%) had low level of exposure to occupational HIV, socio demographic variable based on age, religion, tribe, marital status and tear of practice shows a significant association with perceived level of exposure to occupational HIV at (ꭓ2=45.511, p=0.000), (ꭓ2=67.189, p=0.000), (ꭓ2=692.874, p=0.000), (ꭓ2=35.331, p=0.000) and (ꭓ2=34.899, p=0.000) respectively as p&lt;0.05 and non-significant association with gender of the respondents at p&lt;0.05. The findings from this study shows that there is a high level of Pre-Exposure Prophylaxis among health care workers in the study area, larger proportion perceived level of exposure to occupational HIV and at significant risk of acquiring occupational infections, even though majority were satisfied with service delivery. Health authorities in the study area need to improve the training of HCWs and provision of infection prevention equipment.

Healthcare provider perspectives on emergency department-initiated buprenorphine/naloxone: a qualitative study

BackgroundTake-home buprenorphine/naloxone is an effective method of initiating opioid agonist therapy in the Emergency Department (ED) that requires ED healthcare worker buy-in for large-scale implementation. We aimed to investigate healthcare workers perceptions of ED take-home buprenorphine/naloxone, as well as barriers and facilitators from an ED healthcare worker perspective.MethodsIn the context of a take-home buprenorphine/naloxone feasibility study at a tertiary care teaching hospital we conducted a descriptive qualitative study. We conducted one-on-one in person or telephone interviews and focus groups with ED healthcare workers who cared for patients given take-home buprenorphine/naloxone in the feasibility study at Vancouver General Hospital from July 2019 to March 2020. We conducted 37 healthcare worker interviews from December 2019 to July 2020. We audio recorded interviews and focus groups and transcribed them verbatim. We completed interviews until we reached thematic saturation.Data analysisWe inductively coded a sample of transcripts to generate a provisional coding structure and to identify emerging themes, which were reviewed by our multidisciplinary team. We then used the final coding structure to analyze the transcripts. We present our findings descriptively.ResultsParticipants identified a number of context-specific facilitators and barriers to take-home buprenorphine/naloxone provision in the ED. Participants highlighted ED conditions having either facilitative or prohibitive effects: provision of buprenorphine/naloxone was feasible when ED volume was low and space was available but became less so as ED volume increased and space decreased. Similarly, participants noted that patient-related factors could have a facilitative or prohibitive effect, such as willingness to wait (willing to stay in the ED for study-related activities and buprenorphine/naloxone initiation activities), receptiveness to buprenorphine/naloxone, and comprehension of the instructions. As for staff-related factors, time was identified as a consistent barrier. Time included time available and time required to initiate buprenorphine/naloxone (including time building rapport). Healthcare worker familiarity with buprenorphine/naloxone was noted as either a facilitating factor or a barrier, and healthcare workers indicated that ongoing training would have been advantageous. Many healthcare workers identified that the ED is an important first point of contact for the target patient population.ConclusionIntegrating a buprenorphine/naloxone program into ED care requires organizational supports (e.g., for managing buprenorphine/naloxone within limitations of ED volume, space, and time), and ongoing education of healthcare workers to minimize identified barriers.

Problem and pro-social behaviour among adolescents living with HIV/AIDS and perception of healthcare workers on available medical and social support in Sokoto, northern Nigeria

Background: Adolescents living with HIV/AIDS (ALHIV) are likely to have behavioural, social, cognitive, and emotional problems. Early detection and treatment of these psychological issues in ALHIV is precarious to comprehensive HIV management. This study aimed to assess problem and pro-social behaviour among and to identify available health facility and social supports for ALHIV in Sokoto State, Nigeria. Methods: A cross sectional study with mixed methods of data collection was conducted among 236 adolescent- caregiver pairs. Key informant interviews were conducted among four health care workers. Quantitative data were analyzed using IBM SPSS version 23 while content analysis along thematic lines was done for qualitative data. Results: Mean age of adolescents was 14.6±2.2 years while mean age of caregivers was 37.9±7.2 years. Prevalence of pro-social behaviour among ALHIV was 6.4% (self- report) and 15.2% (caregiver report). Seventy-eight (33.1%) caregivers reported peer problems and 15 (6.4%) emotional problems among their ALHIV. Based on self-report, 160 (67.8%) ALHIV reported experiencing peer problems and 3 (1.8%) emotional problems. Eleven (4.7%) adolescents reported having low social support, 136 (57.6%) had moderate and 89 (37.7%) high social support. Viral suppression showed significant association with SDQ scores. Conclusions: The Sokoto State Ministry of Health and other organizations supporting HIV programs should ensure community enlightenment programs on HIV in order to reduce stigma associated with the disease.