Healthcare Attitudes Research Articles

Healthcare-seeking of medical students: the effect of socio-demographic factors, health behaviour and health status – a cross-sectional study in Hungary

BackgroundMedical students are more likely to have various physical and psychological issues, but less information is available about the healthcare-seeking behaviour for physical and mental health issues. The aim of this study is to determine the factors affecting medical students’ healthcare-seeking when visiting a general practitioner (GP) and/or psychologist.Methods688 medical students (326 International and 362 Hungarian,) participated in a cross-sectional study. The information was gathered using a self-administered online questionnaire and covered socio-demographic background, health behaviour, general and mental health status and healthcare-seeking. For analysing adjusted associations, multivariable logistic regression models were used.ResultsOverall, 56.8% of medical students visit the GP; and 17.2%, the psychologist. Hungarian medical students visited the GP with chronic diseases, International medical students were more likely to visit a GP when they encountered sexual activity and had chronic diseases. Moreover, there was a significant correlation between sex, alcohol consumption, and perceived stress in the total sample of psychologist visits. When Hungarian medical students were in their clinical years and had a poor self-rated mental health, they were more likely to visit a psychologist. Whereas female international medical students and those who had poor self-rated mental health were more likely to seek psychological help.ConclusionStudents visit a GP and/or psychologist is associated with a variety of factors, including socio-demographic background, health behaviours, and health issues. Medical schools should encourage help-seeking behaviours and early disclosure of medical students. Their ability to grasp healthcare attitudes and designing treatments will be important for both their academic success and future profession.

Complementing traditional care with digital therapeutics for chronic non-communicable disease management

Abstract We will examine the role of digital therapeutics in diabetes care, where we will discuss how Digital Therapeutics can supplement face-to-face consultations by facilitating data exchange between patients and healthcare professionals, improving disease monitoring, and promoting patient empowerment. In the context of mental health, we will present evidence supporting the effectiveness of computer-assisted cognitive behaviour therapy (CCBT) as a valuable adjunct to treatment as usual (TAU) in primary care settings. Throughout the presentation, we will highlight the importance of integrating digital therapeutics into existing healthcare systems and addressing barriers to their adoption, such as socio-demographic disparities and healthcare professional attitudes through tools such as regulatory frameworks and reimbursement pathways. By exploring the complementary role of digital therapeutics in chronic NCD management, we aim to encourage dialogue on the potential synergies between traditional care and digital interventions to improve patient outcomes and inform public health policy.

Torture survivors' experiences of receiving surgical treatment indicating re- traumatization.

Due to the invasive nature of surgical procedures and the involvement of medical personnel, torture survivors may experience re-traumatization during surgical treatment. This study aimed to explore torture survivors' experiences of re-traumatization during surgical treatment as well as the process by which trauma-related emotions and responses are evoked during surgical treatment for torture survivors. Eight men, aged 45 to 72, from four different countries, who have lived in Norway for 6-40 years, were recruited. We assessed torture and surgical care experiences through in-depth interviews, and the data were analyzed using thematic analysis, resulting in five themes: (1) Interactions with healthcare providers, (2) Reactions during treatment, (3) Triggers causing re-experiences, (4) Avoidance, and (5) Suggestions to healthcare providers. In this study, survivors reported challenges receiving surgical treatment, indicating re-traumatization and difficulty returning to daily life following treatment. Participants reported little collaboration in care-related decision-making processes, lack of recognition of torture by healthcare providers involved in surgical care and experiencing healthcare professionals' attitudes as a source of perplexity, frustration, and despair. Exacerbation of torture memories throughout treatment and re-experiencing of trauma symptoms aggravated these difficulties. Our findings suggest that surgical treatment can remind torture survivors of the traumatic aspects of torture, eliciting strong reactions and feelings like those experienced during torture.

COVID-19 Vaccine Hesitancy in Healthcare Workers and Attitude Changes During the Pandemic.

Many healthcare workers (HCWs) hesitated or refused to receive the COVID-19 vaccines during the pandemic. The attitudes of HCWs toward vaccines have an impact on society and patients. In this study, we aimed to investigate the reasons for vaccine hesitancy and refusal among HCWs during the COVID pandemic. We planned a two-step descriptive survey study. In the first step, we surveyed the unvaccinated HCWs in our hospital face-to-face after the first vaccination program. After eight months, we conducted another survey with the unvaccinated HCWs over the phone. We investigated the changes in their attitudes between the two surveys and the relationship of vaccine hesitation with their occupation and COVID-19 history. After the first vaccine program, 325 (21.2%) HCWs out of 1532 did not get vaccinated in our hospital. We found that there was a significant relationship between vaccine hesitancy and occupation. In our study, the group of "non-HCWs" had the highest vaccine hesitancy rate at the beginning. The most common reasons for vaccine hesitancy were breastfeeding and pregnancy (29.5%) and side effects, especially allergic reactions (18.0%). After eight months, in the second survey, vaccine hesitancy dropped to 5.6%. We found that 80.1% of the HCWs who stated they were planning to get vaccinated in the first survey were vaccinated, and 62.4% of those who were not planning it were vaccinated. In the second survey, 1.8% of HCWs were still planning the vaccination, but 3.8% of HCWs refused the COVID-19 vaccine. Not believing in the efficacy of the vaccine in the first survey was associated with vaccine refusal in the second survey (p=0.001). The overall rate of vaccine refusal was low among HCWs. Nevertheless, vaccine refusal among HCWs having more information about the vaccine and disease than the community may be related to cultural, psychological, and political reasons other than efficacy and safety. Future studies on the cultural, psychological, and political reasons for vaccine refusal will contribute to understanding vaccine refusal and increasing vaccine acceptance.

Pre-service healthcare professionals attitudes and self-efficacy towards individuals with intellectual disability in Ghana

BackgroundIntellectual disability (ID) involves impairment of general mental abilities, restricting the participation of individuals in conceptual, social and practical activities. Consequently, rehabilitation services are critical in efforts towards promoting the social and educational inclusion of persons with ID. However, the preparedness of health professionals in performing such a role depends on their perceptions of individuals with ID. Ajzen’s theory of planned behaviour was used as theoretical framework to understand the relationship between the perceived attitude and self-efficacy of healthcare students towards persons with ID.MethodA cross-sectional survey was conducted among healthcare students (N = 328) in a Ghanaian university. The Community Living Attitude Scale for ID(CLAS-ID) and General Self-efficacy (GSE) Scale were employed to assess their attitudes and self-efficacy towards people with ID respectively. The data were analysed using SPSS and AMOS and were subjected to a t-test, ANOVA, correlation and regression.ResultThe healthcare students were ambivalent about both self-efficacy and attitudes towards persons with ID, and there was correlation between attitudes and self-efficacy. Attitudes and self-efficacy also varied across the demographic characteristics of the respondents including age, having a relative with ID, level of study, religion, and programme of study.ConclusionThe study underscores the necessity for healthcare curriculum reform and provides corresponding recommendations. The study emphasizes the importance of enhancing healthcare students' understanding of ID, changing their attitudes, and bolstering their self-efficacy. This is crucial to foster positive attitudes, confidence in providing support to individuals with ID, and raising awareness within the broader community. To achieve this, health educators are encouraged to incorporate exposure to individuals with ID into healthcare students' training, along with more structured field experiences designed to increase their contact and interaction with individuals with ID. Such initiatives would enable students to better understand the uniqueness and requirements of individuals with ID.

Who chooses alternative sources of information about childhood vaccinations? A cross-sectional study.

Vaccine hesitancy can lead to problematic outcomes in terms of public health. A factor playing a fundamental role in this dynamic is the source of information considered by parents in the decision-making progress that leads to the acceptance or refusal of childhood vaccinations. This study aims to investigate the sources of information considered by the parents of children attending primary and secondary schools in two large Italian cities and to identify predictors that led to choosing alternative sources of information. An online questionnaire was administered to the parents of students attending elementary, middle, and high schools in Rome and Turin. Two validated tools were used: the Parent Attitudes about Childhood Vaccines Survey and the Vaccine Health Literacy of adults in Italian. Sources of information about vaccinations, trust toward the healthcare system, hesitancy and attitudes about COVID-19 vaccinations, were also investigated. A multivariable logistic regression model was built to identify predictors of the preferred sources of information on the topic. Totally, 2,301 answers to the survey were collected from June to October 2021. Of these, 1,127 came from parents in Rome (49%) and 1,174 from parents based in Turin (51%) with a mean age of 47.7 years (±6.4). The majority of the respondents were mothers (81%), married (73%), with two or more children (70.5%). The multivariable logistic regression model results showed that fathers were more inclined than mothers to use alternative sources of information (OR 1.48, 95% CI 1.29-2.00). Moreover, a higher level of vaccine hesitancy was a strong predictor for choosing alternative sources of information (OR 2.45, 95% CI 1.73-3.46). The HLVa-it scores show that parents with a lower Vaccine Literacy (VL) were more inclined to use alternative sources of information. Addressing health literacy issues and changing the official forms of communication could help improving vaccine acceptance. This study shows the importance of rebuilding a trusting relationship between patients and health care providers, which is fundamental in the fight against vaccine hesitancy.

Knowledge, Attitudes, and Practices of Adverse Drug Reaction Reporting Among Healthcare Professionals in Sri Lanka- A Cross Sectional Study.

Objectives: The objectives of this study were to describe the knowledge, attitudes and practices of Adverse Drug Reactions (ADR) reporting among healthcare professionals at Teaching Hospital Karapitiya (THK), a tertiary care hospital in Sri Lanka. Methodology: A descriptive cross-sectional study was conducted at THK. The healthcare professionals working in THK who were available during the study period were invited to the study. A self-administered pre-tested questionnaire was administered to the participants. Respondents were evaluated for their knowledge, attitudes and practices related to ADR reporting. The data were analyzed using SPSS statistical software. Results: Of the total 444 respondents, 31% were doctors and 69% were nurses. The majority of respondents, 90% (n = 400) were aware of the term ADR, while 64.8% (n = 288) could correctly define it. Among the respondents, 30.8% (n = 137) knew about the types of ADR and only 15.5% (n = 70) were able to mention a drug that is banned due to ADR correctly. Among the respondents, only 38.7% (n = 172) were aware of a formal process of reporting ADR and, only 35.3% (n = 157) stated that they had seen the ADR reporting form. Further, only 33.7% (n = 150) respondents have recognized ADR during their clinical practice and only a small proportion 18.2% (n = 81) have ever reported an ADR during their practice. Regarding attitudes toward ADR reporting, overall 84.1 (n = 373) had positive attitudes toward ADR reporting, while 13.54% (n = 60) of them stayed neutral and 2.25% (n = 10) had negative attitudes toward ADR reporting. Conclusions: Although the majority were aware of ADR , the knowledge and practices regarding spontaneous reporting of ADR are inadequate. However, most respondents have shown a positive attitude toward ADR reporting. A sincere and sustained effort should be made by concerned bodies to enhance the healthcare professionals' knowledge, attitudes, and practices regarding ADR reporting.

Health Care Provider Knowledge and Attitudes Regarding Adult Pneumococcal Conjugate Vaccine Recommendations - United States, September 28-October 10, 2022.

Despite the availability of effective vaccines against pneumococcal disease, pneumococcus is a common bacterial cause of pneumonia, causing approximately 100,000 hospitalizations among U.S. adults per year. In addition, approximately 30,000 invasive pneumococcal disease (IPD) cases and 3,000 IPD deaths occur among U.S. adults each year. Previous health care provider surveys identified gaps in provider knowledge about and understanding of the adult pneumococcal vaccine recommendations, and pneumococcal vaccine coverage remains suboptimal. To assess the feasibility and acceptability domains of the Advisory Committee on Immunization Practices (ACIP) Evidence to Recommendations (EtR) framework, a health care provider knowledge and attitudes survey was conducted during September 28-October 10, 2022, by the Healthcare and Public Perceptions of Immunizations Survey Collaborative before the October 2022 ACIP meeting. Among 751 provider respondents, two thirds agreed or strongly agreed with the policy option under consideration to expand the recommendations for the new 20-valent pneumococcal conjugate vaccine (PCV20) to adults who had only received the previously recommended 13-valent pneumococcal conjugate vaccine (PCV13). Gaps in providers' knowledge and perceived challenges to implementing recommendations were identified and were included in ACIP's EtR framework discussions in late October 2022 when ACIP updated the recommendations for PCV20 use in adults. Currently, use of PCV20 is recommended for certain adults who have previously received PCV13, in addition to those who have never received a pneumococcal conjugate vaccine. The survey findings indicate a need to increase provider awareness and implementation of pneumococcal vaccination recommendations and to provide tools to assist with patient-specific vaccination guidance. Resources available to address the challenges to implementing pneumococcal vaccination recommendations include the PneumoRecs VaxAdvisor mobile app and other CDC-developed tools, including summary documents and overviews of vaccination schedules and CDC's strategic framework to increase confidence in vaccines and reduce vaccine-preventable diseases, Vaccinate with Confidence.

Fertility Preservation in Children and Adolescents during Oncological Treatment-A Review of Healthcare System Factors and Attitudes of Patients and Their Caregivers.

Oncofertility is any therapeutic intervention to safeguard the fertility of cancer patients. Anti-cancer therapies (chemotherapy, radiation therapy, etc.) entail the risk of reproductive disorders through cytotoxic effects on gamete-building cells, especially those not yet fully developed. This literature review analyzes the available data on securing fertility in pediatric and adolescent populations to identify the methods used and describe aspects related to financing, ethics, and the perspective of patients and their parents. Topics related to oncofertility in this age group are relatively niche, with few peer-reviewed articles available and published studies mostly on adults. Compared to pubertal individuals, a limited number of fertility preservation methods are used for prepubertal patients. Funding for the procedures described varies from country to country, but only a few governments choose to reimburse them. Oncofertility of pediatric and adolescent patients raises many controversies related to the decision, parents' beliefs, having a partner, ethics, as well as the knowledge and experience of healthcare professionals. As the fertility of young cancer patients is at risk, healthcare professionals should make every effort to provide them with an opportunity to fulfill their future reproductive plans and to have a family and offspring. Systemic solutions should form the basis for the development of oncofertility in pediatric and adolescent populations.

Strategies For Safety: A Mixed Method Study of Communication, Teamwork and Health Professional Attitudes When Implementing Multidisciplinary Simulation in The Emergency Department

The Emergency Department (ED) team delivers care to critically unwell patients. Within this, there are a range of complexities and responsibilities identified. Technical skills can be taught in lectures and books; however, the newly evolving phenomenon of focusing on non-technical medical skills has advanced over time. Using non-technical skills, such as communication and human factors, can influence the team's functioning, which could potentially influence a positive outcome of a critical care event. This study explores whether multidisciplinary simulation training, focusing on non-technical skills, can improve participants’ communication and teamwork and if regular simulation practice can influence healthcare staff attitudes towards embedding a regular simulation program at a local site. A convergent mixed method approach was used to determine staff attitude towards a newly implemented simulation programin the hospital ED. Data was collected over six weeks. The quantitative component measured teamwork and communication with Guise’s validated and reliable tool, the Clinical Teamwork Scale (CTS). Further data using a developed evaluation survey provided participant feedback pre and post-simulation. Thirty-two participants, sixteen nurses and sixteen doctors, were surveyed. The results could suggest a trend of a positive outlook towards implementing a regular simulation practice. However, further analysis would be required. A common theme was participant confidence post-simulation practice and willingness to participate in future simulations. Baseline opinions from all participants were positive. The study has generated valuable insight towards staff attitudes toward MDT simulation in the ED setting. The evidence can further support the implementation of a regular simulation program.

Assessment of healthcare workers' knowledge and attitude on Ebola virus disease in Somalia: a multicenter nationwide survey

BackgroundIn September 2022, a new Ebola outbreak was reported in Uganda, East Africa, and 142 confirmed cases, including 19 Healthcare workers (HCWs) reported. Ebola is not endemic in Somalia, but the country is at a reasonable risk of the virus being introduced due to the direct connection with daily flights from Uganda without border health control and prevention activities. Therefore, evaluating HCWs' Knowledge and attitude is crucial since this is the first time being evaluated in Somalia. The study's objective is to evaluate the HCWs' Knowledge and attitude toward the Ebola virus disease in Somalia.MethodAn online self-administrated cross-sectional survey was conducted among HCWs (n = 1103) in all six federal member states of Somalia using a validated, reliable, well-structured questionnaire. Data we analyzed using descriptive statistics and Logistic regression were used to determine sociodemographic characteristics associated with poor Knowledge and negative attitude.ResultOver one-third (37.3%) of HCWs had poor Knowledge; the mean knowledge score was 7.97 SD ± 2.15. Almost 40.1% of the HCWs had a negative attitude; the mean attitude was 27.81 SD ± 8.06. Low-income HCWs (AOR = 2.06, 95%CI:1.01–4.19), Married HCWs (AOR = 1.39, 95%CI: 1.110–1.963), Midwives (AOR = 2.76, 95%CI: 1.74–4.39), Lab technicians (AOR = 2.43, 95%CI: 1.43–4.14), HCWs work in Jubaland state of Somalia (AOR = 3.69, 95%CI: 2.39–5.70), Galmudug state (AOR = 8.50, 95%CI: 4.59–15.77), Hirshabelle state (AOR = 3.18, 95%CI: 2.15–4.71) were more likely to have poor Knowledge compared to their counterparts. HCWs who work in Hirshabelle state (AOR = 5.44,95%CI: 3.58–8.27), Jubaland state (AOR = 8.47, 95%CI: 4.69–15.29), and Galmudug state (AOR = 4.43, 95%CI: 3.03–6.48) was more likely to have a negative attitude than those working in the Banadir region administration.ConclusionMost Somali healthcare workers showed good Knowledge and a positive attitude toward the Ebola virus. The implementation to enhance Knowledge and attitude must specifically focus on low-income HCWs, Midwives, Lab technicalities, and those who work in Hirshabelle, Jubaland, and Galmudug states of Somalia.

Why do consumers choose private over public health services? Reflective accounts of health providers in Vietnam

BackgroundIn Vietnam and many developing countries, private healthcare is increasingly being leveraged by governments to complement public services and increase health service access and utilisation. Extensive understanding of patterns of utilisation of private over public health services, and the rationale for such consumer decisions, is important to ensure and promote safe, affordable and patient-centred care in the two sectors. Few studies within the Southeast Asian Region have explored how private and public providers interact (via social networks, marketing, and direct contact) with consumers to affect their service choices. This study investigates providers’ views on social factors associated with the use of private over public health services in Vietnam.MethodA thematic analysis was undertaken of 30 semi-structured interviews with experienced health system stakeholders from the Vietnam national assembly, government ministries, private health associations, health economic association, as well as public and private hospitals and clinics.ResultsMultiple social factors were found to influence the choice of private over public services, including word-of-mouth, the patient-doctor relationship and relationships between healthcare providers, healthcare staff attitudes and behaviour, and marketing. While private providers maximise their use of these social factors, most public providers seem to ignore or show only limited interest in using marketing and other forms of social interaction to improve services to meet patients’ needs, especially those needs beyond strictly medical intervention. However, private providers faced their own particular challenges related to over-advertisement, over-servicing, excessive focus on patients’ demands rather than medical needs, as well as the significant technical requirements for quality and safety.ConclusionsThis study has important implications for policy and practice in Vietnam. First, public providers must embrace social interaction with consumers as an effective strategy to improve their service quality. Second, appropriate regulations of private providers are required to protect patients from unnecessary treatments, costs and potential harm. Finally, the insights from this study have direct relevance to many developing countries facing a similar challenge of appropriately managing the growth of the private health sector.

A realist synthesis of interprofessional patient safety activities and healthcare student attitudes towards patient safety

ABSTRACT Interprofessional education (IPE) has been used for instilling a positive safety culture within healthcare, yet what interventions work to change healthcare student attitudes and how improved patient safety outcomes are best achieved with this intervention, is unclear and challenging to evaluate. A realist synthesis was undertaken to ascertain how, why, and in what circumstances IPE activities result in a positive change to student attitudes to patient safety. Database searches of CINAHL, MEDLINE, Scopus, and Eric were undertaken in April 2022 to identify relevant studies. Synthesis with a realist framework of analysis, coupled with the development of a program theory was conducted to identify interactions among contexts, intervention, mechanisms, and outcomes (CIMO). Twenty-three articles eligible for inclusion articulated environments in which varied contexts, interventions, and mechanisms were activated to influence student attitudes to patient safety. Findings from this realist synthesis informs awareness into the methods of delivering and evaluating IPE activities and offers new perspectives for educators in planning and evaluating future IPE from a collaborative and positive safety culture perspective.

Assessing Knowledge, Attitudes, and Practices: Regarding Hepatitis B Infection and Vaccination Among Healthcare Professionals at AL-Salama Hospital, Ameria, Baghdad City: A Cross-Sectional Investigation Conducted in October-November 2022.

Hepatitis B Virus (HBV): A High-Risk Infection for Healthcare Workers (HCWs) , Healthcare workers (HCWs) are at an increased risk of contracting the highly dangerous hepatitis B virus (HBV) due to their frequent exposure to contaminated bodily fluids, particularly blood. Implementing precautionary measures such as personal safety protocols and vaccination can effectively prevent HBV infection. Objective: 1- Evaluation of Healthcare Professionals' Knowledge, Attitudes, and Practices (KAP) Regarding Hepatitis B Infection and Vaccination. 2- Evaluating Immunization Status of Healthcare Workers (HCWs) in Al-Salama-Ameria Hospital, Primary Care, and Specialist Dental Care Centers in Relation to Hepatitis B Virus (HBV). Materials and methods: In October and November 2022, a cross-sectional study was conducted at Al Salama Hospital (90 participants), primary care centers (44 participants), and specialist dental care centers (20 participants) in Ameria, Baghdad. A self-administered, structured questionnaire was used to collect information, including the knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) as well as their demographic details. The study data were analyzed using descriptive statistics, including frequencies, proportions, and percentages, with the assistance of Excel software. Verbal consent was obtained from each participant, and their identities were kept anonymous throughout the study. Results: Our research comprised a total of 154 healthcare workers (HCWs), consisting of 59 A medical facility comprised of 95 medical staff and 95 paramedical staff, possessing a collective wealth of knowledge. score among the participants was 68%, indicating a moderate level of knowledge. In terms of attitude, the overall score was 75%, indicating a positive attitude towards hepatitis B virus (HBV) infection and vaccination. However, the overall practice score was 58%, indicating a need for improvement in implementing preventive measures. Within the medical staff, a mere 15% had undergone HBV screening, while a significant 67% had successfully received the recommended three doses of vaccination. among the paramedical staff who had not been previously screened for HBV, only 37% had completed the three doses of vaccination. Conclusion: The findings of the study indicated that healthcare workers (HCWs) had a higher overall attitude score (75%) compared to their knowledge (68%) and practice (58%) scores. However, the rate of vaccination, particularly among paramedical staff, was low.

Barriers to optimal breastfeeding of medically complex children in the UK paediatric setting: a mixed methods survey of healthcare professionals.

Breastfeeding is indisputably significant for infants and children, as well as their mothers. However, when breastfed children are admitted to the paediatric ward, they may experience breastfeeding modification due to clinical challenges, lack of staff training and institutional barriers. Although previous research has identified multiple barriers to optimal feeding within the maternity, neonatal and community settings, we know less about the barriers that exist in paediatrics. Paediatric healthcare staff attitudes, training and awareness as well as ward culture are likely to have an impact on the experiences of families but are relatively unresearched in the paediatric setting, especially with regard to the multidisciplinary nature of clinical paediatric care. The aim of this study was to explore the attitudes, awareness and perceived barriers to effective breastfeeding support provision, as well as healthcare professional perception of barriers for families. This was a mixed methods study utilising a questionnaire which was completed by 409 healthcare professionals who identified as working within the paediatric setting. It included responses from paediatricians of all training grades, nurses, healthcare assistants and allied health professionals. Qualitative data from professionals were analysed to develop themes around professional and perceived parent barriers to optimal breastfeeding. This study explored the barriers experienced by staff, as well as professionals' perception of parent barriers. These included lack of knowledge of how to help, a default formula culture, the pressure of maintaining strict fluid balance and breastfeeding being a low priority in the face of critical illness. Of the paediatric departments represented by this sample of healthcare professionals, most had a relatively poor culture of supporting breastfeeding, with multiple institutional barriers identified. Most professionals felt that there was not enough support for breastfeeding families on an average shift, and a large proportion identified as being one of just a few breastfeeding advocates on their ward. In this relatively motivated and experienced sample of healthcare professionals, there were many identified barriers to optimal breastfeeding which could potentially be addressed by training that is carefully nuanced for the paediatric population. Ensuring that paediatric multidisciplinary healthcare professionals have sufficient skills and knowledge would address the identified challenge of poor awareness of breastfeeding and of how to overcome clinical lactation obstacles. Further improvements at policy level need to address the systemic lack of resourcing in paediatrics, as well as the lack of embedded breastfeeding-friendly organisational structures.

Beyond Access: Can a School Health Initiative Facilitate Healthcare Services Utilisation for School-Going Children?

Accessing quality healthcare services is critical to addressing the different health challenges confronting school-going children, especially those in low-resource communities. However, the evidence of access to services is utilisation and not the mere availability of such services. This study explored caregivers' descriptions of the factors influencing the access and utilisation of quality healthcare services for school-going children and their perceptions of the services provided through the integrated school health programme in South Africa. Qualitative interviews were conducted with 17 caregivers of school-going children in three low-resource communities of KwaZulu-Natal province. The data was analysed using thematic analysis, and the themes were clustered using components of the Aday and Andersen framework for access. Despite the efforts to expand the coverage and range of services provided through the Integrated School Health Programme (ISHP), we identified various factors that undermine the overall aim of the ISHP. Financial constraints, distance to health facilities, poor communication and information dissemination systems, low literacy levels, healthcare workers' negative attitudes, and long waiting periods at the referral sites constitute barriers to service utilisation. Specific attention should be paid to improving the communication system between the school-health team and the caregivers, providing support for transportation, improving the attitude of the clinic staff, and providing follow-up services for children referred for further screening and treatment.

Attitudes, beliefs, and knowledge regarding medical cannabis among healthcare students in the Republic of Cyprus: a cross-sectional descriptive correlational study.

Although international research-based literature from the last 2 decades seems to favor the use of medical cannabis (MC), there is a lack of evidence concerning healthcare students' education on MC in the Republic of Cyprus and across the world. Therefore, this study explores healthcare students' attitudes, beliefs, and knowledge regarding the use of MC. We paid special attention to differences across specific sociodemographic (gender, age, and religion status) and educational (level of study and study field) characteristics. A descriptive cross-sectional study was conducted between November 2019 and March 2020. All active undergraduate and postgraduate healthcare students (nurses, physiotherapists, speech therapists, pharmacists, and occupational therapists; N = 900) studying in public and private universities in the Republic of Cyprus were eligible to participate (final sample: N = 819, response rate = 91%). To collect data on the attitudes, beliefs and knowledge of the participants, we used the Medical Cannabis Questionnaire (MCQ). To analyze the data, we employed the Pearson's chi-square test for group differences, in addition to assessing the descriptive and inferential statistics. Approximately 82.2% believed that MC education should be integrated into the clinical practice requirements. Statistically significant differences were observed between genders in terms of beliefs/risk associated with the use of MC, with males being more likely to believe that there are significant mental-health benefits associated with using ΜC compared to females (84.9% vs. 76.2%, p<0.05). Females were more likely than males to believe that using MC poses serious physical (76.8% vs. 60.6%, p<0.001) and mental-health (77.9% vs. 66%, p<0.001) risks. Moreover, participants who received formal education about MC during their study/training were more prepared to answer patient/client questions about ΜC (p < 0.001). In addition, participants who received formal education had more frequently friends (p < 0.001) or family members who used MC (p < 0.005). This study provides useful information for curriculum development, educational changes, and policy decisions related to cannabis use for medical purposes in the Republic of Cyprus. The results showed that the majority of the healthcare students who participated in the study favored MC use. However, the participants reported a lack of knowledge and recommended additional evidence-based research and education to enhance their knowledge about MC use. Therefore, we recommend the implementation of formal education on MC among healthcare students in the Republic of Cyprus during their study and clinical training. Furthermore, it is important to include MC-related theoretical and clinical/laboratory courses during studies and clinical practice.

Assessment of health-care workers' attitudes, knowledge, and skills in the care of critically ill Muslim children in New York.

Pediatric health-care workers often care for families of minority religious backgrounds, but little is known about their perspective in providing culturally and spiritually appropriate care for Muslim patients. We aimed to (1) characterize the attitudes, knowledge, and skills of health-care workers in the care of critically ill Muslim children and (2) evaluate preferences for different educational interventions to improve care of critically ill Muslim children. We administered a single-center, cross-sectional, 33-question, electronic survey of interdisciplinary health-care workers in a large pediatric intensive care unit in New York City to characterize their attitudes, knowledge, and skills in caring for critically ill Muslim children. Of 413 health-care workers surveyed, there were 109 (26%) respondents. Participants responded correctly to 51.7 ± 22.2% (mean ± SD) and 69.2 ± 20.6% of background knowledge and clinical skills questions, respectively. Only 29.8% of participants perceived adequate institutional resources to provide culturally competent care to Muslim patients and their families. Participants identified end-of-life care (47.5%) and bioethical concerns (45%) as needed areas for additional institutional resources. When asked about support to aid in caring for Muslim patients, 43.4% of participants requested a team of Muslim health-care workers to provide guidance. Participants most often requested video-based training modules (32.5%) and written materials (30%) as potential educational interventions. We identify gaps in health-care worker knowledge and skills in the care of the critically ill Muslim child. We also describe possible areas for intervention to facilitate culturally and spiritually appropriate care delivery to Muslim children and families.

Religious Beliefs Shaping Health Care and Transforming Health Concepts: The Case of Shanghai.

This study examines the connection between health and religious beliefs in modern Chinese society and builds a model reimagining the conception of health. The study draws on interviews with 108 patients (52 were women and 56 were men) at Huashan Hospital (Shanghai City, China). The survey ran between May 10 and May 14, 2021. More than 50% of female and male respondents reported having religious beliefs. Most acknowledged the crucial role of faith and religious beliefs in overcoming treatment challenges and alleviating patient suffering. The role of faith and religious beliefs in physical/mental treatment and health maintenance received the highest average percent positive score among female respondents. According to the multipleregression results of demographic parameters (age, ethnicity, gender, education, and urban or rural residence), only gender had a statistically significant effect on the impact of religious beliefs on health care attitudes. The proposed model builds on the Confucian concept of Ren (humanity), which refers to a harmonious relationship between people within a family or society bound by specific rules. The results of this study can help expand awareness about religion and its role in healthcare as a means to support patients' spiritual and physical health.

Awareness, Attitudes, and Perceptions of Oral Healthcare among First Year Dental, Medical, and Nursing Students.

It has been reported that poor oral health can worsen general health conditions. Good collaboration between health professionals is important to provide proper oral healthcare. Thus, there is a need for oral healthcare interprofessional education (IPE). This study aimed to determine the baseline level of awareness, attitudes, and perceptions of oral healthcare among first-year students of dentistry, medicine, and nursing at Universitas Indonesia. A cross-sectional descriptive analytical study using a previously published questionnaire was conducted involving 442 students, consisting of dental students (DS), medical students (MS), and nursing students (NS) in Universitas Indonesia. Most students have shown good oral healthcare awareness, attitudes, and perception with no statistically significant difference between the groups (p < 0.05). The majority of the students did not perceive that (1) geriatric and nursing knowledge are required to practice oral care, (2) oral healthcare should be provided in cancer hospitals, and (3) oral healthcare can prevent cardiovascular disease and improve anorexia. This study showed that there were aspects of oral healthcare that should be improved in all student groups. Thus, oral healthcare IPE should be given to all students working in healthcare to develop knowledge and interprofessional collaboration in oral healthcare.