Health Service Personnel Research Articles

HUBUNGAN PENGETAHUAN AKSEPTOR KB TENTANG IUD DENGAN KEIKUTSERTAAN MENGGUNAKAN IUD DI PMB BDN. NI WAYAN SUSIANTI, S.S.T.KEB

Contraception is a method or tool used with the aim of preventing pregnancy. The decrease in the number of IUD family planning participants over the years can be caused by the participants' lack of knowledge about the advantages of IUD contraception. Knowledge of contraceptive devices is a consideration in determining the contraceptive method used. The quality of family planning services is seen in terms of the availability of health service personnel tools, the high cost of IUD services, and the existence of barriers from husband support in the use of IUD contraceptive devices. The purpose of this study is to determine the Relationship of Family Planning Acceptors' Knowledge About IUD With Participation in Using IUD at PMB Bdn. Ni Wayan Susianti, S.S.T.Keb. This study uses a correlational analytic design with a cross-sectional approach. The sample selection in this study used purposive sampling technique. The sample for this study is 40 acceptors. Data were analyzed using Chi-square test analysis. The results of the analysis using the Chi-square test showed that from 40 respondents, a p-value of 0.001 was obtained. This result indicates that H0 is rejected and Ha is accepted, which means there is a significant relationship between the knowledge of family planning acceptors about IUD and participation in using IUD at PMB Bdn. Ni Wayan Susianti, S.S.T.Keb. Based on the results of this study, it is hoped that family planning acceptors will increase their knowledge about IUD with participation in using IUD.

Insights into decision‐maker's perceptions of good versus bad decisions in emergency services—A modified Delphi study

AbstractDecision‐making in emergency situations, such as those faced by fire, police, and health service personnel, presents unique challenges due to the high‐stakes and time‐pressured environment. Here we aim to better understand what emergency responders regard as constituting ‘good’ and ‘bad’ decisions in emergency situations. We administered a modified Delphi study, eliciting opinions from decision‐makers across all these sectors towards consensus around the key elements of good and bad decision‐making. Participants were first asked to define what makes a ‘good’ and a ‘bad’ decision, and subsequently to identify the top five most important elements of each. While consensus was not found, important insights were identified that can assist improve the standard of decision making at all levels of emergency response and management. We observed (i) a lack of a common understanding between participants of what a decision is, and how a decision differs from pre‐decision and postdecision components; (ii) responses varied according to whether a free text description or the identification of separate elements was requested; (iii) respondents valued ‘goodness’ across different and at times unrelated components a scaled measure of decision quality as opposed to a binary evaluation of ‘rightness’; and (iv) pre‐ and postdecision elements are considered more important than the decision itself when determining the quality of a decision. To address the issues highlighted by the study we recommend improvements in training, and improvements to organization doctrine related to decision making, risk tolerance, assessment of decision quality and development of intent‐based or principle‐based operational guidance. Ultimately, incident controllers from all services must remain cognizant that they will face considerable scrutiny if they cannot explain how they arrived at the decision they made.

Growing violence against medical professionals: A qualitative analysis of a worrying epidemic

Introduction. Increasing numbers of violent incidents against doctors have made headlines on a regular basis during the last few decades. Research suggests that doctors are disproportionately vulnerable to verbal abuse, threats, physical violence, and cyberbullying at work. As per the Indian Medical Association, verbal or physical abuse is experienced by 75% of doctors, and 43% of them consider it to be a significant cause of concern. Poor communication, overworked and understaffed medical staff, a lack of emergency care and management training, and inefficient grievance redressal procedures are probably contributing reasons. India responded by passing the Health Services Personnel and Clinical Establishments Bill, which is a noteworthy first step in resolving this matter. We must investigate different ways to promote peace, apply systemic adjustments in the provision of healthcare, and avert such unfavorable events in order to guarantee ongoing, excellent services for those who require them. The study set out to determine the likely reasons behind the rise in violence against physicians and to look into ways to make the situation better. Setting and design. Kasturba Medical College in Mangalore served as the study's location. A descriptive qualitative study with two steps is this one. Sorting of piles and free listing. Materials and methodology. Purposive sampling was employed in this investigation. Two interns and two tutors who were employed by Kasturba Medical College in Mangalore's community medicine department participated in one-on-one interviews for the study. The statistical analysis was conducted using Visual Anthropac 4.98.1 software. Results. A total of 28 causes and 19 solutions were found after free listing. A limit of 0.15 for Smith's salience score was set, and after that, 14 causes and 12 solutions were classified into groups of 3-6 and 3-5, respectively. A stronger triage system for emergency situations was the remedy with the highest salience value of 0.25, while undervaluing autonomy was the cause with the highest score of 0.25. Conclusions. In conclusion, one of the main issues we are currently facing is violence against doctors. Favoritism and discrimination among patients were identified as some of the main causes of violence against doctors by using the free listing and pile sorting method, which does not prioritize autonomy. Stricter laws against violence against doctors and an improved triage system for emergency cases were suggested as effective solutions for the aforementioned issue.

Analysis of the Needs and Development of Health Service Personnel at the Simalingkar Health Center in Medan City

The need and development of health service personnel as an integral part of health development is directed to meet the needs of the number and type of qualified health workers in providing all kinds of health service needs. This study aims to determine the needs of health workers both quantity and quality at the Simalingkar Health Center in Medan City. This research includes Descriptive Research with a qualitative approach, to find and obtain information about the analysis of energy needs at the Simalingkar Health Center in Medan City. The data and information obtained are then compared with the capabilities currently possessed with those expected for planning managers in the preparation of labor analysis of each work unit associated with the description and specifications of work at the Simalingkar Health Center in Medan City. The types of data used in this study are primary data and secondary data. Primary data are obtained through interviews and observations, while secondary data are obtained through tracing official records (documentation). The results showed that the preparation of health worker planning has been carried out so that the analysis of energy needs both in quantity and quality has been well planned. The number of health workers for the implementation of health services is quite sufficient at the Simalingkar Health Center in Medan City. Where health service personnel at Puskesmas have met the standards, or by the Minister of Health Regulation Number 75 of 2014. That way, the needs and development of health workers are well implemented.

Eating Patterns, Physical Activities with the Event of Obesity Based on Waist-Hip Circumstances Ratio

Obesity is a chronic health problem caused by various multifactorial factors, such as genetic factors, environmental factors, inappropriate eating behavior and low physical activity. The research aims to analyze the relationship between eating patterns and free time physical activity with the incidence of obesity based on the waist-hip circumference ratio in Jakarta Lantamal III Health Service personnel. The research is a quantitative study with a cross-sectional design. A total of 66 subjects who met the inclusion criteria and agreed to informed consent underwent anthropometric measurements and filled out questionnaires. Dietary pattern data uses the food frequency questionnaire (FFQ) form, leisure time physical activity data is taken using the Godin leisure time exercise questionnaire (GLTEQ). The data were analyzed using the Chi-Square test. 54,5% of research subjects were obese, 63,6% of subjects had a good diet, and 56,1% of subjects rarely consumed food sources of fiber. and subjects with light leisure time physical activity category, namely 42,4%. It was found that 83,8% of research subjects who rarely consumed fiber had obese nutritional status and 96,4% of research subjects who had light free time physical activity had obese nutritional status. The results of bivariate statistical analysis showed that there was a significant relationship between the frequency of consumption of food sources of fiber and activity. physical leisure time with the incidence of obesity (p-value<0,05). So, it can be concluded that low fiber consumption and reduced levels of physical activity can increase the incidence of obesity.

Implementation of telehealth primary health care services in a rural Aboriginal Community-Controlled Health Organisation during the COVID-19 pandemic: a mixed-methods study.

Globally, primary care organisations responded rapidly to COVID-19 physical distancing requirements through the adoption of telehealth to maintain the delivery of health care to communities. In Australia, temporary Medicare Benefits Schedule (MBS) telehealth items were introduced in March 2020 to enable the provision of telehealth services in the primary care setting. These changes included funding for two modes of telehealth delivery: videoconferencing and telephone consultations. As primary care organisations, Aboriginal Community Controlled Health Organisations (ACCHOs) rapidly adopted telehealth consultations to maintain the delivery of primary care services to Aboriginal and Torres Strait Islander clients. The aim of the present study was to evaluate the implementation (specifically the uptake, acceptability and requirements for delivery) of telehealth primary healthcare services for Aboriginal and/or Torres Strait Islander peoples by a rural ACCHO during COVID-19. A single-site convergent-parallel mixed-methods study was undertaken in the context of an ongoing research partnership established between a rural ACCHO and a university department of rural health. De-identified health service data from March 2020 to March 2021 was extracted, including MBS telehealth consultations and client demographics (eg age, gender and postcode). Variables were analysed using descriptive statistics to examine the uptake of telehealth by Aboriginal and Torres Strait Islander clients. A geographical analysis of postcode data was also undertaken. Semi-structured interviews were undertaken concurrently with a purposive sample of health service personnel (including health professionals) involved in the implementation or delivery of telehealth, and Aboriginal and/or Torres Strait Islander clients who had accessed telehealth, to explore the acceptability of telehealth and requirements for delivery. Thematic analysis using an inductive approach was undertaken. The analyses of quantitative and qualitative findings were merged to identify key concepts pertaining to the uptake, acceptability and requirements for telehealth delivery. During the first year of implementation, 435 telehealth primary healthcare consultations were delivered to Aboriginal and/or Torres Strait Islander clients. Seven health personnel and six Aboriginal and/or Torres Strait Islander clients participated in interviews. Merged findings from an analysis of quantitative and qualitative data were grouped under three concepts: uptake of telehealth consultations by Aboriginal and Torres Strait Islander clients, maintaining the delivery of ACCHO services during COVID-19, and implications for sustaining telehealth in an ACCHO. Findings identified that telehealth maintained the delivery of ACCHO services to Aboriginal and/or Torres Strait Islander clients across the lifespan during COVID-19, despite a preference for face-to-face consultations. A greater uptake of telephone consultations compared to videoconferencing was identified. Barriers to the utilisation of videoconferencing were largely technology related, highlighting the need for additional support for clients. Telehealth was a useful addition to face-to-face consultations when used in the appropriate context such as the administration of long-term medication prescriptions by a GP. Engaging the ACCHO sector in the policy discourse around telehealth is imperative for identifying requirements for ongoing implementation.

Direct and indirect barriers to hypothetical access to care among Canadian forces health services personnel

BackgroundThough research among Canadian Forces Health Services (CFHS) personnel is limited, the literature suggests formal healthcare is underused. Though much research has been conducted on particular barriers (e.g., stigma), examining a breadth of barriers could better inform behavioral interventions. Furthermore, work has yet to examine the indirect effects of barriers through their impact on intentions to access care.MethodsCFHS participants were randomly assigned to complete either a mental health (N = 503) or physical health (N = 530) version of the survey. The survey included questions on the perceived impact of barriers, health-related information (e.g., past access to care), intention to seek care, and two hypothetical scenarios (i.e., pneumonia and back injury or post-traumatic stress disorder and depression) as a proxy of access to care. Multiple regressions using Hayes PROCESS macro were conducted to assess the direct and indirect effects (through intentions) of the barriers on hypothetical access to care.ResultsResults show conflict with career goals barriers were indirectly linked to all health outcomes, and directly linked to mental health outcomes. Treatment preference barriers were directly and indirectly linked to care seeking only for mental health, while resource barriers were directly linked to care seeking only for physical health. Knowledge and ability to access care barriers were directly linked to care seeking for depression and pneumonia.ImplicationsInterventions to improve treatment-seeking should be developed only after the behavioural antecedents are understood, and should focus on combining evidence-based techniques to simultaneously target multiple aspects of the behaviour.

Construction and validation of cognitive frailty risk prediction model for elderly patients with multimorbidity in Chinese community based on non-traditional factors

Background and objectivesEarly identification of risk factors and timely intervention can reduce the occurrence of cognitive frailty in elderly patients with multimorbidity and improve their quality of life. To explore the risk factors, a risk prediction model is established to provide a reference for early screening and intervention of cognitive frailty in elderly patients with multimorbidity.MethodsNine communities were selected based on multi-stage stratified random sampling from May–June 2022. A self-designed questionnaire and three cognitive frailty rating tools [Frailty Phenotype (FP), Montreal Cognitive Assessment (MoCA), and Clinical Qualitative Rating (CDR)] were used to collect data for elderly patients with multimorbidity in the community. The nomogram prediction model for the risk of cognitive frailty was established using Stata15.0.ResultsA total of 1200 questionnaires were distributed in this survey, and 1182 valid questionnaires were collected, 26 non-traditional risk factors were included. According to the characteristics of community health services and patient access and the logistic regression results, 9 non-traditional risk factors were screened out. Among them, age OR = 4.499 (95%CI:3.26–6.208), marital status OR = 3.709 (95%CI:2.748–5.005), living alone OR = 4.008 (95%CI:2.873–5.005), and sleep quality OR = 3.71(95%CI:2.730–5.042). The AUC values for the modeling and validation sets in the model were 0. 9908 and 0.9897. Hosmer and Lemeshow test values for the modeling set were χ2 = 3.857, p = 0.870 and for the validation set were χ2 = 2.875, p = 0.942.ConclusionThe prediction model could help the community health service personnel and elderly patients with multimorbidity and their families in making early judgments and interventions on the risk of cognitive frailty.

Commentary: Memories of nursing in Singapore: an oral history approach.

Review: Comparing and contrasting unstructured interviews with newly qualified nurses and senior health service personnel

The influence of the quality of Tuberculosis services with adherence to taking Anti-tuberculosis drugs

Indonesia was the second world's highest TB case in 2021. Tuberculosis therapy that takes a long time can cause patients to drop out of treatment. Hospitals conduct quality evaluations regularly and improve the quality of health service personnel to realize excellent health services. This literature review aims to determine the effect of the quality of tuberculosis services on patient compliance with anti-tuberculosis drugs. This literature review was written using a systematic approach. The databases used were Google Scholar, Science Direct, Proquest, and Scopus. The total number of articles obtained was 8 out of 64 based on inclusion criteria. The things that affect the regularity of taking medication based on the eight journal articles above are as follows: 1) the assurance dimension is 50%, 2) the dimensions of empathy and reliability amounted to 37.5%, 3) the responsiveness dimension is 25%, 4) patient satisfaction, direct evidence and service quality amounted to 12.5%. Adherence to taking medication is influenced by: 1) the presence of supporters of taking medication, 2) difficulty taking the medication regularly, (3) perceived benefits of taking anti-tuberculosis drugs, and 4) self-perception related to healing. The dimensions of assurance, empathy, and reliability have the most influence on the regularity of taking anti-tuberculosis drugs.

Neurological complications of COVID-19 and SARS-CoV-2 vaccination: an update

The respiratory infectious disease COVID-19, which emerged in 2019, has affected the world population over a brief period. In 2020, the disease was declared a pandemic by the World Health Organization. Although most COVID-19 patients primarily develop respiratory symptoms, neurological symptoms have been observed. Neurological symptoms are usually mild and non-specific. However, some patients could experience life-threatening neurological symptoms. With the increase in the incidence of COVID-19, the disease spectrum of patients with central and peripheral nervous system involvement has expanded significantly compared to the previous period. Lack of awareness has caused delays in diagnosis and treatment; therefore, updating the disease spectrum of neurological complications of COVID-19 is necessary. After COVID-19 claimed millions of lives, researchers found that some vaccines may induce autoimmune inflammatory responses in the nervous system via molecular mimicry, leading to SARS-CoV-2 vaccine-related neurological deficits. These neurological complications are often ignored by clinicians, delaying diagnosis and treatment; it is essential to study cases of vaccine-associated neurological complications. Therefore, we summarize the neurological complications of COVID-19 and nervous system adverse reactions caused by SARS-CoV-2 vaccines to help clinicians and public health service personnel understand these rare complications. Avoiding delays in diagnosis and treatment would ensure the safety of COVID-19 patients and SARS-CoV-2 vaccine recipients.

Health-Care and Supportive Services in General Population Disaster Shelters.

The Communication (C), Maintaining Health (M), Independence (I), Services, Support and Self-Determination (S), and Transportation (T) is a framework (C-MIST) for identifying functional needs in an emergency response. A C-MIST documentation tool provides shelter staff with a list of potential client needs and actions to address them. This retrospective review describes the needs and actions indicated on completed C-MIST documentation tools (ie, records) within domestic general population shelters following Hurricane Florence in 2018. A convenience sample of 1209 records completed by shelter disaster health services personnel was provided by the American Red Cross. The records correspond to client stays in 19 shelters between September and October 2018. Data abstracted from hardcopy forms were de-identified and recorded in a database. Summary statistics were computed. High incidence needs included medical supplies for everyday care (including medications) not related to mobility (15.4%), medically or culturally needed diets (12.2%), durable medical equipment (9.7%), mental health care (8.8%), and transportation (8.4%). High incidence actions included replacement medication (9.3%), refer to Disaster Mental Health Services (6.4%), provide assistive mobility equipment (5.1%), provide diabetes management supplies (5.0%), provide alternative food and beverages (4.1%), and provide transportation (3.9%). The process for identifying health and functional support needs in shelters should be standardized through the use of the C-MIST framework.

Satisfaction of family physician team members in the context of contract system: A cross-sectional survey from Shandong Province, China.

Family physicians play a key role in responding to the growing demand for primary healthcare due to aging. The work attitude of family physician team members (FPTMs) impacts their work efficiency and quality. Knowing how satisfied they are with their jobs can help identify potential directions and entry points for incentives. The purpose of this study is to analyze the job satisfaction status and influencing factors of grassroots health service personnel after the implementation of the family physician contract system in China. The study conducted a cross-sectional survey with 570 FPTMs in three prefecture-level cities in the Shandong Province. Satisfaction was measured using 30 items across seven dimensions. Responses were recorded on a 5-point Likert scale. Descriptive statistical analysis was used to analyze the general information and satisfaction of FPTMs. Multiple linear regression analysis was used to analyze the factors influencing job satisfaction. The overall job satisfaction among FPTMs was not high. Among the seven dimensions, interpersonal relationships had the highest satisfaction (4.10 ± 0.78), while workload had the lowest satisfaction (3.08 ± 0.56). The satisfaction levels of the three sample regions were different, and the results were opposite to their regional economic development levels. The results of the multifactor analysis showed that gender, income level, educational background, working years, daily working hours, number of training sessions per year and the proportion of performance pay had significant impact on overall job satisfaction. The development of a family physician contract system has increased the workload of FPTMs. In addition to the implementation of the new policy, attention should be paid to the workload and working attitude of family physicians. The fundamental measures should focus on attracting more personnel to work at the grassroots level by accelerating education and training to solve the problem of insufficient health personnel at the grassroots level. Simultaneously, attention should be paid to the improvement of the medical staff's salary level and the need for self-promotion, such as training.

An Aboriginal Community-Controlled Health Organization model of service delivery: qualitative process evaluation of the Tulku wan Wininn mobile clinic

BackgroundMobile clinics have been implemented in diverse clinical and geographical settings to provide proximal health care for specific populations. Primary health care mobile clinics have been implemented widely for Indigenous populations, with a paucity of research evaluations around service delivery models internationally. To redress factors impeding service accessibility for Aboriginal and Torres Strait Islander Peoples, Budja Budja Aboriginal Cooperative (Aboriginal Community Controlled Health Organisation located in a small rural town in Victoria, Australia), developed and implemented the Tulku wan Wininn primary health mobile clinic.MethodsA qualitative process evaluation methodology was used to explore contextual factors mediating the implementation of the mobile clinic, including the acceptability of the service to health service personnel, external key informants, and Aboriginal and/or Torres Strait Islander clients. A synthesis of international ethical guidelines, (Consolidated Criteria for strengthening reporting of health research involving Indigenous peoples (CONSIDER statement), was prospectively applied to shape the study design and research process. Semi-structured interviews were conducted with participants. Data collection occurred from July 2019 to October 2021. Inductive thematic data analysis was undertaken concurrently with data collection.ResultsData was collected from 19 participants which included 12 health service personnel and key informants, and 7 Aboriginal clients. In total, data from 22 interviews were included as interviews with three clients were undertaken twice. Four themes were developed: considerations for early implementation, maintaining face-to-face services during COVID-19, acceptability as a model of service delivery, and maintaining the mobile clinic as a service delivery model.ConclusionEvidence supporting the acceptability of a primary health care mobile clinic for Aboriginal Peoples residing in rural Victoria is provided. Despite the experience of early implementation challenges and adaptations, the mobile clinic addressed known transport and cultural barriers to accessing primary health care services. In the context of COVID-19 lockdowns, the mobile clinic was valued for the provision of face-to-face care for Aboriginal clients. Key issues for maintaining the mobile clinic include health workforce and funding. Findings are of value to other organizations seeking to implement a primary health mobile clinic service delivery model to redress barriers to accessibility experienced by the communities they serve.

Identifying facilitators of early access to care among Canadian Forces Health Services personnel

LAY SUMMARY Despite the importance of the mental and physical well-being of Canadian Forces Health Services (CFHS) personnel, research suggests they may be under-accessing care. A lot of research has looked at what factors prevent individuals from accessing care (i.e., barriers), but almost none has examined what encourages individuals to access care (i.e., facilitators). In addition to examining which facilitators encourage CFHS personnel to access care, this study also examined whether facilitators directly impacted care-seeking behaviour, or whether they also indirectly influence behaviour by impacting general intentions to access care. Results showed that prioritizing one’s health directly and indirectly influenced care-seeking for both mental and physical health issues. Having the support of senior leadership influenced intention to seek care for mental health issues. Easy access to care influenced intention to seek care for physical health issues. Ensuring CFHS personnel prioritize their own health, have the support of senior leadership, and have easy access to care will help promote early access to care.

Do health professionals’ attitudes towards alcohol use matter for alcohol prevention efforts? Results from the WIRUS-OHS study

BackgroundUse of alcohol is a major public health issue, representing the 7th largest burden of disease in the world. Workplaces offer a unique arena for health initiatives addressing alcohol use, where occupational health services (OHS) personnel play an important role. However, we do not know if the extent of such initiatives may be influenced by personal drinking attitudes among OHS personnel. Thus, the aim of the study was to explore how drinking attitudes among OHS personnel were associated with their frequency of working with alcohol-related cases and with their views on alcohol prevention activities in the OHS.MethodsThe WIRUS project included a cross-sectional survey of attitudes and practices among OHS personnel (n = 325) employed by Norwegian OHS services (n = 69), who informed about sociodemographic and professional characteristics, drinking attitudes, frequency of cases with alcohol-related issues, and perceptions toward the role of the OHS in primary, secondary, and tertiary alcohol prevention activities. Measures of associations were examined with linear and logistic regression models.ResultsDrinking attitudes were unrelated to the frequency of working with alcohol-related cases. Physicians, psychologists, and nurses had higher frequency of working with alcohol-related cases, compared to those with other professional backgrounds (β = 0.46, p = 0.01). Drinking attitudes were also unrelated to attitudes towards primary/secondary/tertiary alcohol prevention activities in the OHS, while female OHS personnel were more positive towards increased primary alcohol prevention activities in the OHS (OR: 1.82, p < 0.05). Only marginal portions (1%-3%) of the variance in attitudes towards alcohol prevention activities in the OHS were accounted for by the models.ConclusionThis study did not find evidence of associations between OHS personnel’s drinking attitudes and their practices and attitudes towards alcohol prevention activities. The lack of association between OHS personnel’s attitudes towards alcohol use and their attitudes and practices relating to alcohol prevention in the workplace might point towards professionalism, as personal attitudes appear not to interfere with their priorities and professional mission. Given the small amount of outcome variance explained by the tested models, other variables should be used in future studies.

The effect of the covid-19 pandemic on the psychological status of 112 emergency health services personnel

The effect of the covid-19 pandemic on the psychological status of 112 emergency health services personnel

Indicator-based assessment of capacity development for disaster preparedness in the Indian context.

Capacity building and monitoring of response capacity are critical to disaster preparedness. Assessing disaster response capacity is a challenging task in India due to diverse geo-climatic conditions and exposure to different disasters. This paper addresses the absence of a methodological framework to measure multiple aspects of the disaster response capacity of districts in India through indicators. 26 indicators were identified under four factors namely; resources, communication and coordination, budget, and community engagement; anchored on a theoretical framework evolved through literature survey and key informant interviews. Each factor was modelled as a linear function of indicators based on data-sets maintained by district authorities. A Composite Index was constructed as a weighted aggregation of four factors using weightings elicited through Questionnaire Surveys among 151 expert respondents. Weightings were derived through an extension of Technique for Order Preference by Similarity to Ideal Solutions (TOPSIS) to balance the variability in perceptions of respondents. As disasters demand quick response, assessment of response capacity with a fewer number of indicators is desirable. Therefore, a reduced set of critical indicators sensitive to the Indian context were derived through model reduction applying probabilistic and statistical methods—{mathrm{l}}_{2} norm-based sensitivity analysis and coefficient of variation method. Critical indicators are: number of rescue and health service personnel, NGOs, Self-Help-Groups; efficacy of existing SOPs; literacy; and budget options. Robustness of the Composite Index was checked in terms of sensitivity to weightings and model reduction. The critical indicators and the Composite Index would sensitize decision-makers on disaster response capacities across districts.

The relative impact of barriers to care among military health services personnel: exploring differences using context specific scenarios.

BackgroundMilitary health care providers often under access both physical and mental health care, yet research has predominantly focused on barriers to mental health care. This study explored a comprehensive set of barriers using hypothetical scenarios to quantify barrier impact on access to both mental and physical health care.MethodsCanadian military health services personnel (N = 1033) completed one of two electronic surveys (assessing either physical health or other mental health barriers) that captured participant’s demographics, health, endorsement of barriers, intent to seek care, and whether the respondent would access care in different health scenarios (pneumonia, back injury, depression and post-traumatic stress disorder). Logistic regression was used to calculate odds of not accessing care (versus accessing care) for each of the four health scenarios.ResultsAll barrier factors independently predicted increased odds of not accessing care for all four scenarios. When entered into an adjusted model none of the barrier factors significantly predicted accessing care in the physical health scenarios. Staffing and workload resources and Treatment preferences (e.g., self-treat) were significant predictors of accessing care in the mental health scenarios. Weak general intentions to access care was the strongest predictors of not accessing care across all four scenarios.ConclusionsThe impact of barriers on hypothetical care-seeking behaviour differs depending on the context for which one is accessing care, with access to resources and preference to self-treat driving mental health care seeking. Intent appears to be the most impactful predictor of accessing care potentially mediating the effect of other barrier types on care seeking.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-022-07850-5.

The experience of stigma by service personnel during the COVID-19 pandemic in Sri Lanka

IntroductionStigma and discriminatory behaviours are common during pandemics. Stigma if not mitigated could result in varied negative psychological consequences in those who it is directed towards, as well as his/her associates. ObjectivesThe objective of this study was to assess the dynamics of stigma experienced by ten different categories of people, the places and persons who expressed stigmatising attitudes and behaviours, adherence to COVID-19 related health instructions by the general public, and the aspects of the pandemic that had the most psychological impact in the above-indicated ten categories of people. MethodologyWe conducted a secondary analysis of already available data collected by the Directorate of Mental Health and Health Promotion Bureau of the Ministry of Health to formulate a communication campaign to combat stigma and discrimination during the COVID- 19 pandemic. ResultsOf the 4022 participants, a majority (53.7%) were females, Sinhalese (86.2%) and 17.3% were in the 25-29 year age category. Personnel working in health, security and other essential services and their family members experienced stigma and discrimination from the wider society, neighbours or media. Participants quarantined either at quarantine centres or in their homes, and their family members, also experienced stigma and discrimination. A majority of the general public reported avoiding places where health, security and essential service personnel gathered. Further, a majority of participants reported adhering to the COVID-19 related health instructions. The aspect of the pandemic that had the most psychological impact was the fear of contracting the virus. ConclusionsResults indicated stigma and discrimination towards certain categories of people during the COVID-19 pandemic. It is essential that authorities take action to mitigate such instances, for instance by formulating media guidelines on reporting the pandemic – an action that was implemented subsequent to these study results.