Confidence Of Healthcare Professionals Research Articles

Impact of shared decision-making in Taiwanese patients with atrial fibrillation eligible for novel oral anticoagulant therapy

Background/PurposeShared decision-making (SDM) promotes patient awareness about medical conditions and treatments, facilitating patient involvement in care decisions. This two-stage multicenter study evaluated impacts of SDM in Taiwanese adults with atrial fibrillation (AF) eligible for novel oral anticoagulant (NOAC) therapy. MethodsParticipants were NOAC-naïve (part I) or dabigatran-experienced (part II). During Stage I, part I participants (n = 124) completed a semi-structured survey (understanding evaluation sections only) before and after viewing SDM materials on stroke prevention for AF. Surveys collected data on anxiety about AF, confidence in healthcare professionals, usefulness of the SDM materials, and perception of different NOACs. During Stage II, part I participants after being prescribed NOACs, and part II participants completed another survey to compare impacts of SDM. ResultsDuring Stage I, dabigatran was the preferred NOAC after viewing the SDM materials among 90% of part I participants. During Stage II, both part I (n = 87) and part II participants (n = 104) completed another survey. Fewer part I participants were anxious about AF (p < 0.01), and more had confidence in healthcare professionals (p < 0.01) after viewing SDM materials than before. Most part I participants (≥90%) rated the SDM materials as “very helpful”. In Stage II, participants viewing SDM before initiating dabigatran had lower anxiety (part I, 43%; part II, 53%; p < 0.01) and a higher trust (part I, 92%; part II, 84%; p < 0.01). ConclusionIn conclusion, SDM reduced anxiety and improved trust in healthcare professionals among NOAC-naïve participants with AF.

The attitudes, knowledge and confidence of healthcare professionals about cannabis-based products

BackgroundUse of cannabis-based products is becoming more frequent, and it is important that healthcare professionals are informed and confident about them when making evidence-based decisions about their use. This study aimed to gain an international perspective on the attitudes, knowledge, and confidence of healthcare professionals about cannabis-based products.MethodsAn online questionnaire regarding these products was completed by 1580 healthcare professionals (neurologists, psychiatrists, general practitioners, pharmacists and nurses) from 16 countries across Asia, Europe, Oceania, South America, and the Middle East.ResultsRespondents expressed a high level of interest in cannabis-based products (median score 9 out of 10) and reported that they felt knowledgeable about them (median score 6 out of 7). They reported a high level of confidence when providing patients with information on cannabis-based products, returning median scores of 6 and 5 out of 7 for their legality and regulations, and their benefits and risks, respectively. Despite this, healthcare professionals sought further information on cannabis-based products across areas including legality, neurobiology, and scientific evidence. Finally, 59% (n = 930) of respondents considered robust clinical trial evidence as the most important factor to ensure patient safety in the context of these products. Few nominally significant differences emerged between healthcare professionals from different specialities or regions.ConclusionIn conclusion, this large survey of attitudes held by healthcare professionals towards cannabis-based products revealed a high level of interest and a demand for more information. Limitations of this study include potential sample bias and limited external validity.

Community Point of Care Testing in Diagnosing and Managing Chronic Kidney Disease.

Chronic kidney disease (CKD) poses a significant global health challenge with increasing prevalence and associated morbidity. Point-of-care testing (POCT) provides an opportunity to improve CKD management and outcomes through early detection and targeted interventions, particularly in underserved communities. This review evaluates the roles of POCT in CKD, focusing on utility (through screening programs, monitoring of kidney function, and assessing participants on renally excreted medications), accuracy, and acceptability. Screening programs employing POCT have demonstrated promising outcomes, with improved rates of CKD diagnosis in groups with disparate health outcomes, offering a vital avenue for early intervention in high-risk populations. These have been conducted in rural and urban community or pharmacy settings, highlighting convenience and accessibility as important facilitators for participants. In addition, POCT holds significant promise in the monitoring of CKD, particularly in groups requiring frequent testing, such as kidney transplant recipients and patients on renin-angiotensin-aldosterone inhibitors. The consideration of the variable analytical performance of different devices remains crucial in assessing the utility of a POCT intervention for CKD. While the convenience and improved accessibility of home self-testing versus healthcare professional management is important, it must be balanced with acceptable levels of accuracy and precision to maintain patient and clinical confidence. Despite challenges including variability in accuracy and the user-friendliness of devices, patient feedback has generally remained positive, with studies reporting increased patient satisfaction and engagement. However, challenges regarding wider uptake are limited by healthcare professional confidence (in test reliability), the potential for increased workload, and early prohibitive costs. In conclusion, POCT represents a growing and valuable tool in enhancing CKD care, particularly in resource-limited settings, but careful consideration of device selection and implementation strategies is essential to achieve desired outcomes.

Hybrid Framework Integrating Lexicon and Learning Methods for Enhancing Sentiment Analysis Based on Patients' Tweets on Medicines

- Sentiment analysis is the act of locating and categorizing the emotions conveyed in text data using text analysis tools. Previous studies have demonstrated the great potential for sentiment analysis of medicine reviews to provide useful data that will aid healthcare professionals and businesses in assessing the safety of pharmaceuticals after they have been sold. These details protect patients and strengthen their confidence in healthcare professionals. Existing frameworks for opinion investigation within the restorative field either take two types of methods one is lexicon methods and the other one is machine learning models. Learning-based approaches need annotated data, whereas lexicon-based approaches are domain-specific and have a smaller range of applications. To improve outcomes, this study employs a hybrid methodology that fusion machine and deep learning models with lexicon techniques. The reviews are annotated using all-purpose emotion lexicons like TextBlob and SenticNet. To extract meaningful features, we are using feature engineering methods TF and TF- IDF. Last but not least, classification tasks are carried out using learning models such as machine learning models and deep learning models for biomedical text. The execution of the prospective combined technique is appraised using performance metrics. According to experimental findings, combining lexicon- and learning-based techniques yields superior outcomes over using them alone. Additionally, TextBlob has demonstrated impressive results, providing an accuracy of 97% with LSTM-CNN and the Bio Bert model when used to a dataset of medication reviews, as well as 95% accuracy when used with TF and the logistic regression model. Additionally, TextBlob provides an accuracy of 94% when combined with TF and LSTM, and provides an accuracy of 97% when using with Bio Bert Model on a dataset including tweets.

Exploring young adults' fears related to healthcare and dental procedures.

Fear and anxiety related to dental and healthcare procedures are common among young adults and can negatively impact dental and healthcare consumership, resulting in poor health outcomes. This cross-sectional study aimed to examine young adults' experiences of fear related to dental and healthcare procedures and the potential relationships between the two forms of fear experiences and demographic factors. Young adults (252) were recruited from a large public university and completed a survey about their dental and healthcare fear/anxiety as well as their confidence in healthcare professionals. Descriptive and correlational analyses were completed to describe the experiences of young adults and the relationships between variables. Ten types of fear/anxiety were identified related to healthcare procedures, with the most common being needles and pain. Nine fears/anxieties were identified for dental visits, of which pain and sensory experiences other than pain were most common. Female participants were significantly more likely to report fear/anxiety related to dental procedures, and there was a statistically significant relationship between fear/anxiety related to healthcare procedures and that related to dental procedures. There was also a significant negative relationship found between confidence in healthcare providers and fear/anxiety related to healthcare procedures. Young adults experience fear/anxiety related to healthcare and dentist visits, and this fear/anxiety can impact their confidence in healthcare providers, such as primary physicians. The findings of the current study suggest primary care providers should be aware of potential fears/anxieties and offer patients appropriate supports.

Factors affecting overall care experience for people living with rare conditions in the UK: exploratory analysis of a quantitative patient experience survey.

Although individually rare, collectively, rare conditions are common and affect a large number of people and are often chronic, life threatening and affect multiple body systems; the majority of them have no effective treatment. The literature has identified many specific challenges for those living with rare conditions, however, we do not know which of these in combination are most likely to impact how someone rates their overall experience of care. The aim of this study is to do further exploratory analysis of the Genetic Alliance UK 2020 Rare Experience survey data to identify which variables are most strongly associated with respondents' overall care experience. There were strong associations between most of the selected survey variables and the overall rated experience of care variable. In the multiple linear regression only nine variables remained in the best fit model: 'Trust and confidence in hospital staff involved in ongoing care'; 'Satisfaction with information provided by healthcare professionals-following diagnosis'; 'The professionals providing care work as a team'; 'Feel care is coordinated effectively'; 'The timing and frequency of appointments are convenient for the patient/carer/family'; 'Whether or not there is a specific healthcare professional to ask questions of about the rare/undiagnosed condition'; 'Experience of searching for a diagnosis'; 'Knowledge of whether there is a specialist centre for the condition'; and 'Number of different clinics attend for the condition'. Our findings indicate the challenges that play the largest part in explaining the varied experiences with rare disease healthcare in the UK for our survey respondents. These challenges should be further investigated with a broader sample of people affected by rare conditions, ideally through the implementation of a comprehensive national rare condition patient registry. Our findings highlight an important potential gap in the Framework, 'trust and confidence in healthcare professionals'; further research is required to fully understand the foundations of trust and confidence.

Perception of Paternal Postpartum Depression among Healthcare Professionals: A Qualitative Study.

The pathway to parenthood constitutes a fundamental and transformative stage in every individual's life. While postpartum depression in mothers has been increasingly studied and acknowledged, paternal postpartum depression (PPD) has garnered only moderate research attention. This study aims to delve into the comprehension and knowledge of healthcare professionals who may encounter men suffering from postpartum depression. Within the framework of this qualitative research, we conducted six semi-structured interviews with various healthcare professionals. The data were subjected to interpretative phenomenological analysis, revealing the following themes: (1) the professionals' uncertainty in the face of paternal PPD; (2) the context and timing of healthcare professionals' involvement appeared unsuited for detecting paternal PPD; (3) the experiences of fathers were found not to be shared with healthcare professionals due to their inhibitions and avoidance reactions; (4) the social representation of the role of fathers influenced professionals in their considerations of this aspect. Strengthening the training and confidence of healthcare professionals in France would lead to an enhancement in the screening and management of paternal PPD. Additionally, the healthcare system should better organize postnatal support to enable caregivers to be more available during the peak of depression occurrence.

Access to healthcare services and confidence in healthcare professionals’ management of malaria: the views of Francophone sub-Saharan African Immigrants living in western Canada

BackgroundThere is a paucity of knowledge about the healthcare attitudes and practices of French-speaking immigrants originating from Sub-Saharan Africa (FISSA) living in minority settings. The purpose of this study was to characterize FISSA healthcare experiences and confidence in the malaria-related knowledge of health professionals in Edmonton.MethodsA structured survey was used to examine a cohort of 382 FISSA (48% female; 52% male) living in Edmonton. FISSA general healthcare attitudes, experiences and satisfaction with the Canadian healthcare system were studied. Healthcare Competency Perception (HCP) was characterized by using an index score. Statistical analyses were performed to evaluate the impact of healthcare experiences and other outcomes.ResultsIntriguingly, while only 42% of FISSA had a French-speaking family physician, 83% (197/238) of those who had received health care services in Alberta found that access to medical treatment was easy, and 77% (188/243) were satisfied with received care. Although 70% (171/243) of FISSA did not receive services in French, 82% (199/243) surprisingly reported having good levels of comprehension during their visits. Satisfaction with care was associated with having a family physician (p = 0.018) and having health insurance (p = 0.041). Nevertheless, confidence in the healthcare system’s ability to treat malaria effectively was significantly lower, with only 39% (148/382) receiving a positive score on the HCP index.ConclusionThis study provides an important insight into FISSA experience with and perception of the Alberta’s healthcare system.

Achieving mastery in inhaler technique: An evaluation of training provided to general practice healthcare professionals

Abstract Introduction A local scoping questionnaire on previous training and confidence demonstrating inhaler technique in general practice (GP) healthcare professionals (HCP), identified that despite frequent consultations with patients with respiratory disease, 43% reported being self-taught on inhalers. In addition, the proportion of HCPs who reported confidence for demonstrating inhaler technique was low, approximately 60% for pressurised metered dose inhalers (pMDI), and 35-50% for the dry powder inhalers (DPIs) Ellipta, Easyhaler, and NEXThaler. Aim To evaluate the impact of an expert-led face-to-face inhaler technique workshop on HCP confidence and skills. Methods GP HCPs at seven Primary Care Networks (PCN) within Leeds Integrated Care Board (ICB) were invited to attend a multidisciplinary pilot inhaler training session in September 2022, led by a Consultant Respiratory Pharmacist and three facilitators. Inhaler technique was assessed at baseline and after education on the theory and practical issues of inhaler technique for the four most prescribed devices locally (Ellipta, Easyhaler, pMDI, NEXThaler). Inhaler technique was assessed using a seven-step checklist and scored as Optimal (no errors), Satisfactory (no critical errors, but some minor errors) or Unsatisfactory (at least 1 critical error).1 Each facilitator was allocated one inhaler device type and assessed all attendees with that same device. Attendees were asked to complete a post-training evaluation questionnaire, which asked about understanding of inhaler technique and confidence in demonstrating it. Data were subjected to descriptive statistical analysis. This evaluation of educational provision did not require ethical approval. Results Data was available for 23 of the 24 participants who completed the full session. Inhaler technique improved across all four devices post-training. The proportion of HCPs with satisfactory or optimal inhaler technique improved by 87% for Ellipta (from 4% to 91%), 65% for Nexthaler (from 22% to 87%), 17% for pMDI (from 0% to 17%) and 65% for Easyhaler (from 0% to 65%). The most common critical error made using pMDI, even after training, was inhaling too fast, whilst the most common critical error for Ellipta, Easyhaler and Nexthaler devices was not tilting the chin up prior to inhalation. This improved after training. 22 attendees completed a post-training session evaluation form. An improvement in understanding of correct inhaler technique was reported by 89% of HCPs, and 100% agreed they felt more confident demonstrating inhaler technique to patients. Discussion/Conclusion Evaluation of our expert-led inhaler technique training showed that HCPs were more likely to feel confident and achieve mastery in inhaler technique using DPIs than pMDI. Despite pMDIs being the device HCPs felt most confident using prior to training, this was the device HCPs performed poorly in. Post-training, many attendees described that to use a pMDI they inhale slowly and steadily, but on demonstration continued to inhale quickly and deeply, highlighting the difficulty in changing ingrained incorrect practice. Whilst understanding on how to use pMDIs correctly probably improved, it is likely that more practice is required. Consideration should be given to regular repeat training sessions, and the setting of these (in person, remote or eLearning) should be assessed in wider rollout of this initiative.

Determining Clinical Practice Gaps for HCPs in Treating CLL Using CME-Based Surveys

Background: Targeted therapies have revolutionized the care of patients with chronic lymphocytic leukemia (CLL). In this context, new evidence continues to accumulate with the goal of optimizing the clinical use of these treatments as additional novel therapeutics continue to emerge. In this study, we sought to analyze current clinical practices of healthcare professionals (HCPs) regarding the care of patients with CLL, along with their awareness of the latest evidence on novel investigational therapies for these patients. Methods: Between March 2022 and June 2023, we conducted multiple live and online continuing medical education activities designed for experts to provide HCPs with evidence-based recommendations for the treatment of CLL. Baseline polling questions and surveys designed to assess key aspects of HCP knowledge, practice patterns, and confidence in this area were assessed across the activities. Results: Among 124 HCPs participating in educational activities between September 2022 and June 2023, 40% reported high confidence in their ability to plan optimal treatment strategies using BTK inhibitors for patients with CLL based on available evidence and guideline and expert recommendations. There was considerable discordance between HCP and expert treatment choices for various case scenarios in multiple educational activities; for example, for patient cases without del(17p)/ TP53-mutated/ IGHV-mutated CLL andbulky disease with diminished creatinine clearance, experts would recommend acalabrutinib with or without obinutuzumab for 77% of scenarios, while HCPs selected this treatment 35% of the time (Table). Among 57 HCPs who participated in educational programs from March 2022 to February 2023, 26% reported high confidence in their ability to recognize and manage AEs with BTK inhibitors in patients with CLL. Challenging AEs associated with the currently available BTK inhibitors also were self-identified by HCPs (Figure). One half of responding HCPs (52%) were able to identify characteristics that would qualify a patient for inpatient administration of the initial doses of venetoclax because of increased risk of tumor lysis syndrome (n = 48). Finally, among 213 HCPs participating in educational activities from September 2022 to June 2023, 43% were aware of recent data regarding the use of pirtobrutinib, an investigational noncovalent BTK inhibitor, for treating patients with CLL. Conclusion: Our data suggest that many HCPs are challenged to optimally incorporate contemporary treatment recommendations into the care of patients with CLL and struggle to maintain knowledge of investigational therapies that may affect the treatment landscape in the near future. Continuing educational activities designed to improve the knowledge, competence, and confidence of HCPs in the care of CLL would benefit patients with this disease. A more detailed data analysis of treatment trends and knowledge by geographic location and role on the care team will be presented.

Effectiveness of an educational intervention on first-year nursing students’ knowledge and confidence to perform basic life support: a quasi-experimental study

Background Knowing how to respond effectively to an acutely deteriorating patient is a National Safety and Quality Health Service Standard and a requirement for nurse registration with the Australian Health Practitioner Regulatory Authority. Literature has highlighted that a lack of knowledge, skills and confidence in healthcare professionals to perform basic life support may be a contributing factor to the high mortality and morbidity rates associated with cardiac arrest in the hospital setting. Aim To explore first-year nursing students’ knowledge and confidence to perform basic life support according to the Australian Resuscitation Council guidelines before and after watching an online video lecture. Method A quantitative quasi-experimental pre- and post-test design to measure changes, if any, in first-year nursing students’ knowledge and confidence to perform basic life support at an Australian university in 2021. Findings The collected data were analysed using Stata, a statistical software for data sciences. Participants’ mean knowledge score increased from 9.3 (SD: 2.5) in the pre-test to 13.9 (SD: 3) (p < 0.001) in the post-test (maximum possible score: 19). Participants’ mean confidence score increased from 17.0 (SD: 6.3) in the pre-test to 24.5 (SD: 4.4) (p < 0.001) in the post-test (maximum possible score: 30; p < 0.001). Discussion The most significant improvement in knowledge was observed in chest compression rate, breathing/ ventilation and checking patient response. The study found that the video lecture is an effective teaching method to increase students’ confidence to perform basic life support. Conclusion An online video-recorded lecture can increase undergraduate student nurses’ knowledge and confidence to perform basic life support. This is one educational strategy that universities can use to improve students’ knowledge and confidence to perform this essential skill for practice.

International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries

ABSTRACTBackgroundHealthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study’s purpose was to adapt and validate long- and short-form versions of the International Professionals’ Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs’ vaccine confidence and their associations with vaccination behaviors in European countries.Research design and methodsAfter the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions.Results2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors.ConclusionThis study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.

Addressing educational gaps through multidisciplinary team education in eosinophilic oesophagitis management

ABSTRACTOnce considered a rare disease, eosinophilic oesophagitis (EoE) is becoming increasingly prevalent, yet many healthcare professionals (HCPs) remain unfamiliar with the underlying pathophysiology and optimal management approaches. For this study, we developed a faculty-led, online, continuing medical education activity on EoE. The effectiveness of this activity was evaluated according to Moore’s framework, with changes in knowledge and competence (Moore’s Levels 3 and 4) assessed for a cohort of gastroenterologists, dietitians, allergists and immunologists (N = 300), using questionnaires completed before and after participation. Changes in HCP confidence in treating EoE were also reported and remaining educational gaps were identified. The activity was viewed by a global audience of 5,330 participants within 6 months, and significant improvements in knowledge and competence were reported following participation in the activity across all specialities, regions and experience (mean [standard deviation] score pre- versus post-activity: 4.32 [1.38] versus 5.46 [0.82]; p < 0.001). Confidence in treating EoE also increased from pre- to post-activity, with the proportion of participants reporting that they felt moderately or extremely confident increasing from 53% to 82%. Several educational unmet needs were identified, which can be used to inform the design of future educational activities in EoE

526-P: Increasing the Confidence of Health Care Professionals Treating Patients Living with Type 1 Diabetes through the Support-Pro Online Education Platform

Introduction: Support-Pro is a comprehensive online platform that was developed for healthcare professionals (HCP) and covers all technological, treatment and lifestyle needs for type 1 diabetes (T1D) management in short, practical modules. It was developed as studies have demonstrated that HCPs who work in healthcare not specific to T1D, find it difficult to keep up-to-date with new developments that could improve T1D care and management. However, specialized online resources, such as Support-Pro, could help rectify this problem. The objective of the study is to assess whether Support-Pro can increase HCPs confidence in treating and supporting people with T1D (PWT1D) and their satisfaction with the platform. Methods: Open-label, non-randomized, 3-month trial with 142 HCPs who had access to Support-Pro, and 66 who completed 3 months on the platform (NCT04859205). Results: On average, the 66 participants (years of practice: 14±10; 90% women; 71% Caucasian; 44% dietitians, 30% nurses, 23% pharmacists, 3% physician or resident physician) reported at 3 months, an average 10% improvement in their confidence (total score 58% to 68%; p&amp;lt;0.0001) and a median satisfaction score of 76%. HCPs most valued features that supported knowledge gain, such as downloadable PDF documents (72%) and case studies (44%). The platform was most used in first month of access (page views 1st month: 50 [5;135] vs. 3rd month: 0 [0;18]). Conclusions: HCPs who completed 3 months on Support-Pro platform reported increased confidence in treating PWT1D and high appreciation of learning content and modalities. This platform could improve the support and advice provided to PWT1D followed-up outside specialized clinics. Disclosure A.Katz: None. R.Rabasa-lhoret: Consultant; Dexcom, Inc., Abbott, Janssen Pharmaceuticals, Inc., Novo Nordisk Canada Inc., Sanofi, Lilly, Tandem Diabetes Care, Inc., Insulet Corporation. M.K.Talbo: None. A.Housni: None. L.Hill: None. A.Roy-fleming: None. S.Haag: Other Relationship; Omnipod. A.Brazeau: Other Relationship; Dexcom, Inc., Diabète québec, Ordre des diététistes nutritionnistes du Québec, Research Support; Canadian Institutes of Health Research, Fonds de recherche du Québec en Santé. Funding Strategy Patient-Oriented Research (JT1-157204); JDRF (4-SRA-2018-651-Q-R)

Nutrition Literacy: What Are Young Adults With Type-1 Diabetes Missing?

This study evaluated the nutrition literacy and perceived emotional burden of disease in young adults with type-1 diabetes. All participants are current or past members of the non-profit organization The Diabetes Link, formally known as the College Diabetes Network. The Diabetes Link is a 501(c)(3) nonprofit organization working to connect and support young adults with type-1 diabetes through the transitional periods of their lives, most commonly the transition from high school to college. Previous research shows that there is a significant uptick in glycated hemoglobin (HbA1c) levels in people with type-1 diabetes between the ages of 18 and 24, a period associated with many transitional events. While there are numerous hypothesized reasons why HbA1c levels spike during these ages, the lack of nutritional knowledge is frequently highlighted as a root cause of this increase. Participants were asked to complete a 40-question survey via Google Forms (Google LLC, Mountain View, California, United States) that contained questions pertaining to their treatment, dietary habits, confidence in healthcare professionals to provide nutrition advice, and overall feelings toward their diagnosis of type-1 diabetes. The survey also included four questions aimed at evaluating the participants' carbohydrate-counting skills to determine a basis of their nutritional knowledge. A binary logistic regression was performed using IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York, United States) to assess the influences of the burden and carbohydrate-counting knowledge on the participants' diabetes care, eating habits, and emotional outlook on nutrition. Data from this study show that the participants who scored high on the carbohydrate-counting quiz were 2.389 times more likely to avoid eating because of an out-of-range blood sugar level (p-value = 0.05), and the participants who reported higher levels of burden were 9.325 times more likely to avoid social gatherings because of food (p-value = 0.002). Conclusion: Results from this study demonstrate that the emotional burden associated with eating and not nutrition knowledge could contribute to the previously listed spike in HbA1c levels.

Examining molecular testing practices and targeted therapy use in advanced/metastatic non-small cell lung cancer (mNSCLC): A quality improvement initiative across ten community cancer centers.

e21191 Background: A growing number of targeted therapy approvals for mNSCLC have dramatically increased requirements for molecular testing. Identifying and addressing real-world challenges mNSCLC care teams face due to resulting workflow shifts is essential to optimize patient outcomes. Methods: In March–September 2022, 126 health care professionals (HCPs) who treat NSCLC at 10 US community oncology clinics completed surveys assessing practice patterns, challenges, and confidence related to biomarker testing and targeted therapy use. HCPs (N = 105) participated in interdisciplinary audit and feedback (AF) sessions to examine clinical evidence and develop clinic-specific action plans to address identified gaps. Results: Participants represented the interprofessional NSCLC care team: medical oncologists (32%), pathologists (1%), radiation oncologists (1%), pulmonologists (2%), PCP/other physicians (5%), advanced practice professionals (22%), nurses (19%), and other HCPs (e.g. patient navigator, practice manager; [19%]). At the time of the program there were 9 NCCN-recommended biomarkers for mNSCLC. Less than half of HCPs reported regular testing for 4 of these biomarkers (Table 1). The majority of HCPs were somewhat (52%) or very/extremely (23%) likely to start treatment prior to receiving molecular testing results. Top reported barriers to integrating molecular diagnostics into routine practice were biopsy tissue availability/quality (45%) and determining whether to begin treatment prior to receipt of molecular testing results (43%). Gap-oriented clinic action plans aimed to improve communication between oncologists, pulmonologists, and pathologists to increase quality and efficiency of testing. A targeted therapy toolkit was developed with a panel of oncology and pathology experts and distributed to participants to address gaps in knowledge of testing practices and guidelines. HCP confidence in biomarker testing increased from 72% to 92% following the intervention. More HCPs correctly answered knowledge (43% pre-AF vs 61% post-AF) and competence (29% pre-AF vs 54% post-AF) questions following participation in the AF sessions. Conclusions: While molecular testing is critical for mNSCLC care, HCPs report sub-optimal rates of conducting testing prior to treatment and incorporating results into treatment planning. Here, we highlight an unmet need for improved interdisciplinary communication and coordination in mNSCLC care teams and an educational intervention strategy that can be used to improve HCP biomarker and targeted therapy use in mNSCLC. [Table: see text]

The Effect of Health Professionals' Attitudes towards COVID-19 Vaccines on Hesitance Situations: The Mediator Role of Vaccine Confidence

Purpose of the research is to evaluate the attitudes, hesitancy and confidence of healthcare professionals towards COVID-19 vaccines during the second peak period of the COVID-19 epidemic in Turkey, and to determine the mediating role of vaccine confidence in the effect of their attitudes towards COVID-19 vaccines on hesitancy. A hospital-based cross-sectional research design was used in the study. The population of the research consisted of the health workers of three different training and research hospitals operating in Istanbul. Convenience sampling method was preferred in the study. The data were collected by the researchers themselves using the online survey technique. A total of 440 questionnaires were evaluated. The data were analyzed with SPSS and AMOS package programs. The findings of the study revealed that nearly two-thirds of the participants had a positive attitude towards potential COVID-19 vaccines, partially having higher confidence and less hesitation. In addition, the empirical result of the study revealed that positive attitudes towards potential COVID-19 vaccines reduce vaccine hesitancy. In addition, it has been found that vaccine trust has a significant indirect effect and partially mediates the relationship between attitude towards potential COVID-19 vaccines and hesitancy. This research revealed that positive attitudes towards potential COVID-19 vaccines reduce vaccine hesitations through high vaccine confidence. Thus, increased positive attitudes towards potential COVID-19 vaccines and increased vaccine confidence were significantly associated with decreased vaccine hesitancy.

Experience and opinions relating to pregnancy in patients with chronic intestinal failure: an international survey

IntroductionPregnancy in patients with chronic intestinal failure (CIF) is a relatively rare occurrence but is an important contemporary topic given both the increasing use of home parenteral nutrition (HPN) and...

Abstract P1-08-07: Educational Opportunities to Improve HER2 Testing and Use of Newer Therapies for HER2-Positive MBC Among Community Healthcare Professionals

Abstract Background: The management of HER2-positive (HER2+) metastatic breast cancer (MBC) has continued to evolve, with multiple FDA approvals of novel HER2-targeted agents since late 2019. Considering the growing HER2+ MBC treatment armamentarium and the emerging HER2-low MBC subtype, we undertook an analysis of the current implementation of guideline and expert recommendations for HER2 testing and treatment of HER2+ MBC with recently approved agents among oncology healthcare professionals (HCPs) participating in educational programs on these topics. Methods: Between January 2020 and April 2022, we conducted several expert-designed educational activities for HCPs focusing on recommended HER2 testing and treatment of HER2+ MBC. Polling questions on HCP knowledge, practice patterns, and confidence in the evaluation of HER2 status and the use of newer targeted therapies in the setting of HER2+ MBC were assessed across the activities and compared with expert recommendations. Results: Among 129 HCPs participating in 2 educational activities held from July 2020 to March 2021, 53% reported confidence to appropriately apply current HER2 testing guidelines to patient care. Similarly, among 407 HCPs who participated in 4 educational programs from May 2020 to January 2021, 24% reported confidence to incorporate recently approved drugs (including trastuzumab deruxtecan [T-DXd], neratinib, and tucatinib) into the care of patients with HER2+ MBC. The percentage of HCPs reporting confidence in the use of these new drugs remained low over this time period. Comparison of treatment recommendations for various HER2+ MBC case scenarios across 7 educational activities from January 2020 through April 2022 showed considerable discordance between experts and HCPs regarding the implementation of newly approved HER2-targeted regimens (Table 1). For patients with disease progression after 2 lines of therapy and no central nervous system (CNS) metastases, 27% to 57% of HCPs (n = 571) chose T-DXd in agreement with experts. For patients with disease progression after 2 lines of therapy with CNS metastases, 27% to 42% of HCPs (n = 597) chose a tucatinib-based regimen in agreement with experts. Treatment choice concurrence between HCPs and experts did not increase over the course of this study for either of these patient scenarios. Conclusions: These data suggest that some HCPs are challenged to optimally incorporate recommendations for HER2 testing and the implementation of novel HER2-targeted therapies in the care of patients with HER2+ MBC. Educational activities designed to improve the knowledge and confidence of HCPs would benefit patients with HER2+ MBC. A detailed analysis of trends over time and by role on the care team will be presented. Table 1. Expert and HCP Treatment Selections for Case Scenarios in HER2+ MBC. Citation Format: Ryan P. Topping, Rachael M. Andrie, Kristen Rosenthal, Timothy A. Quill. Educational Opportunities to Improve HER2 Testing and Use of Newer Therapies for HER2-Positive MBC Among Community Healthcare Professionals [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-08-07.

Motivational interview training improves self-efficacy of GP interns in vaccination consultations: A study using the Pro-VC-Be to measure vaccine confidence determinants

ABSTRACT Immunization-specific motivational interviewing (MI), a patient-centered communication style used to encourage internal motivation for attitudinal and behavioral change, can provide healthcare professionals (HCPs) with the skills and practice required to respond to patients’ doubts and concerns related to vaccines. We sought to assess the impact of an MI-training of General Practitioner (GP) interns on the psychosocial determinants of their vaccine confidence and behaviors. French GP interns participated in a virtual three-day MI-workshop in southeastern France. We used the validated Pro-VC-Be questionnaire – before and after the MI-workshop spanning over three months – to measure the evolution of these determinants. Scores before and after workshop trainings were compared in pairs. Participants’ scores for commitment to vaccination (+10.5 ± 20.5, P = .001), perceived self-efficacy (+36.0 ± 25.8, P < .0001), openness to patients (+18.7 ± 17.0, P < .0001), and trust in authorities (+9.5 ± 17.2, P = 0.01) significantly increased after the training sessions, but not the score for confidence in vaccines (+1.5 ± 11.9, P = .14). The effect sizes of the four score improvements were moderate to large, with self-efficacy and openness to patients having the largest effect sizes (P = .83 and 0.78, respectively). This study provides evidence that certain determinants of overall vaccine confidence in HCPs, reflected respectively in the openness to patients and self-efficacy scores of the Pro-VC-Be, improve after immunization MI-training workshops. Incorporating immunization-specific MI-training in the curriculum for HCPs could improve several necessary skills to improve HCP-patient relationships and be useful for vaccination and other healthcare services.