Professional Health Care Workers Research Articles

P080 Supporting shared decision-making about osteoporosis medicines: Combining multiple methods to develop the prototype iFraP intervention

Abstract Background/Aims Shared decision-making (SDM) is a joint process in which a person and healthcare professional work together to reach decisions about care. The iFraP (Improving uptake of Fracture Prevention drug treatments) intervention comprises computerised decision aid (DA), Fracture Liaison Service (FLS) clinician training package, and information resources to support SDM about osteoporosis medicines. This abstract details our multi-method approach to develop this intervention. Methods Intervention development was underpinned by the Medical Research Council guidelines for development of complex interventions. Four studies guided intervention prototype development, including (1) an evidence synthesis of existing osteoporosis DAs to examine quality and effectiveness; (2) a review of patient information about osteoporosis to evaluate quality and optimal language for talking about osteoporosis; (3) a Delphi consensus survey with patients, carers, and health professionals to gain consensus on intervention content, informed by an evidence review of relevant clinical guidelines and behavioural theories; (4) and focus groups and interviews with patients recently attending FLS, FLS clinicians and general practitioners (GPs) to explore current FLS practice, and barriers and facilitators to change. Expert stakeholders and public contributors informed each sub-study. Results Studies one and two informed design of the iFraP computerised DA. Evidence reviews of existing osteoporosis DAs and patient information found that they did not meet patient needs and identified poor readability, variable quality, and unbalanced and confusing content. Public contributors preferred DAs which were individualised, and together with expert stakeholders, supported the development of understandable explanations of osteoporosis and osteoporosis medicines to include in iFraP resources. Study three identified essential components of the FLS consultation which directly informed DA content. Study four identified the need for complementary iFraP information resources, training, and potential barriers to iFraP DA use. Patients expressed that they did not feel adequately prepared for their FLS consultation, leading to the development of an enhanced leaflet to accompany their FLS appointment letter. Patients, FLS clinicians, and GPs all expressed the need for a patient-friendly individualised summary of the FLS consultation, to facilitate consistent information across services and reinforce FLS messaging. This finding informed development of the iFraP Bone Health Record, an individualised, easy-read PDF print-out of the iFraP DA. FLS clinicians identified training needs relating to communicating risk, involving patients in decisions and clinical decision-making. Barriers to use included concerns that the DA would increase consultation duration, and that SDM may undermine their goal to facilitate medicine adherence. Identified barriers to use and training needs informed the content and delivery of the interactive eLearning and role play session, with consideration of theoretically-informed behaviour change techniques. Conclusion The iFraP complex intervention development work demonstrates the use of multiple methods to develop an evidence-based and theoretically-driven intervention in-preparation for testing. Disclosure L. Bullock: None. J. Fleming: None. E.M. Clark: None. S. Leyland: None. S. Thomas: Grants/research support; ST owns Prescribing Decision Support Ltd that developed the iFraP decision aid. C. Gidlow: None. T.W. O'Neill: Grants/research support; TON is supported by the NIHR Manchester Biomedical Research Centre. C.P. Iglesias-Urrutia: None. A. Hawarden: Grants/research support; AH is funded by a Versus Arthritis Clinical Research Fellowship (reference 22726). F. Manning: None. J. Protheroe: None. J. Lefroy: None. S. Ryan: None. R. Horne: None. C.D. Mallen: Grants/research support; CM is funded by the NIHR Applied Research Collaboration West Midlands and the NIHR School for Primary Care Research. C. Jinks: Grants/research support; CJ is part funded by NIHR Applied Research Collaboration (ARC) West Midlands. Z. Paskins: Consultancies; ZP has received consultancy fees from UCB Pharma. Grants/research support; ZP is funded by the National Institute for Health Research (NIHR) [Clinician Scientist Award (CS-2018-18-ST2-010)/NIHR Academy].

'We had conversations we wouldn't have had otherwise'-Exploring home-dwelling people with dementia and family members' experiences of deliberating on ethical issues in a literature-based intervention.

To explore home-dwelling people with dementia and family members' perceptions of the feasibility and acceptability of an intervention using dementia-related literature excerpts to facilitate conversations on ethical issues related to living with dementia. Ethical issues in dementia care emerge throughout the illness. In the early stages, they may involve decisions about disclosing the illness to the family, shifting roles and responsibilities, and considerations of transitioning to a nursing home. Addressing ethical issues and providing adequate support to home-dwelling people with dementia and their families are often lacking. An exploratory-descriptive qualitative study. We conducted eight interviews with 14 home-dwelling persons with dementia and their family caregivers. Six were dyadic interviews, and two were individual interviews with family caregivers. We analysed the interview data using template analysis. We adhered to the COREQ checklist in reporting this study. Using excerpts from dementia-related literature was a feasible and acceptable way of initiating discussions on ethical issues among home-dwelling persons with dementia and family caregivers. However, engaging the families of newly diagnosed individuals was challenging due to emotional distress. The intervention provided peer support, including identifying with others and sharing experiences. Moreover, participating couples found intimacy and relational attunement through shared reflections. Based on the findings, it appears that the participants in this study felt that using excerpts from dementia-related literature to deliberate on ethical issues was feasible and acceptable. Deliberating on ethical issues with peers and family caregivers offers valuable social support and opportunities for strengthening relationships. This study makes an important contribution by providing valuable insights into how ethical issues related to living with dementia can be addressed using related literature and suggests how the intervention can be integrated into existing care initiatives for home-dwelling people with dementia and their families. We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. A healthcare professional working as a so-called dementia coordinator (a title used in the Danish context) was involved in the conduct of this study by being responsible for the recruitment of home-dwelling people with dementia and their family members. Moreover, she had joint responsibility for facilitating the intervention along with the first author.

Contribution of a bonded scholarship scheme to staffing rural health facilities

Background. Local and international research has identified rural origin as an important reason why healthcare professionals (HCPs) work in rural areas, and in South Africa (SA) considerable effort has gone into recruiting and training rural-origin students. However, there is little information in the SA literature on where graduates supported by these initiatives work, and whether they contribute to the rural workforce long term. Objective. To determine the number of years that rural-origin Umthombo Youth Development Foundation (UYDF)-supported graduates of different disciplines worked at rural public healthcare facilities (PHCFs).Methods. A retrospective descriptive study reviewed work record data of 405 UYDF graduates, to calculate the number of years they worked at a rural PHCF. Data were analysed descriptively and presented in tables with totals and percentages. Results. Ninety percent (363/405) of UYDF-supported graduates returned to work at a rural PHCF. High percentages of social workers (85%), optometrists (80%), speech therapists, nurses (72%) and dental therapists (70%) worked for ≥5 years at a rural PHCF, while only 13% of audiologists, 14% of doctors, 29% of pharmacists, and 28% of dentists and occupational therapists worked at a rural PHCF for ≥5 years. Ten percent (42/405) of graduates did not work at a rural PHCF at all. A total of 110/124 (89%) of doctors supported by UYDF had worked at a rural PHCF, with 32% (40/124) working at a rural PHCF for ≥3 years. Overall, 54% of UYDF-supported graduates (219/405) worked for ≥3 years at a rural PHCF, and 38.5% (157/405) worked for ≥5 years at rural PHCFs. The majority of UYDF graduates had contributed towards long-term staffing of rural PHCFs. Lack of professional development opportunities at rural PHCFs as well as the reduced number of funded posts at rural PHCFs reduced the effectiveness of the UYDF initiative. Conclusion. The UYDF Scholarship Scheme has shown that investment in rural students through a bonded scholarship can contribute to staffing rural PHCFs, as >90% of graduates worked at rural PHCFs, and for some disciplines >70% of graduates worked for ≥5 years at a rural PHCF. Allied HCPs worked on average for longer periods at rural PHCFs than doctors.

Assessment of anxiety and depression among professional healthcare workers during the COVID-19 pandemic – observational cross-sectional study

Aim: Evaluate the prevalence of depression among professional healthcare workers (PHCW) during the COVID-19 pandemic. Methods: A cross-sectional study was conducted during the fourth wave of COVID-19 infection in Iraq. A semi-structured questionnaire in English was used to obtain information about the study variables. Results: The study included 314 participants, with a mean age of 34.3 years, slightly higher male to female sex (55.1 to 44.9%), doctors represent (26.1%), pharmacist represent (26.4%) while 36.9% includes other PHCW (nurse, laboratory technician, doctor assistance, and paramedics). There was a high prevalence of depression in the current study (98.4%). There was no significant association between total HADS with sex, specialty, and duration of working in COVID-19 isolation wards. Meanwhile, age above 50 years appears to be associated with higher HADS scores compared to younger PHCW. Conclusion: Healthcare practitioners faced a heightened susceptibility to experiencing depression throughout the COVID-19 pandemic.

Using Detective Skills: Getting to the Bottom of Dual Antiplatelet Therapy.

Consultant pharmacists have always been effective at identifying patients at high risk for bleeding. Their training qualifies them to do more than just identify. Early in the author's career, he was trained to look for dual antiplatelet therapy (DAPT) and recommend monitoring for signs and symptoms of bleeding in those identified. He used this method for several months before a nurse called him out and asked, "Why do you send us recommendations to monitor for bleeding?" She explained that this was a routine part of nursing assessments, regardless of the presence of DAPT. That's when he realized that the recommendation was like telling a pharmacist not to crush an extended-release formulation of a medication. It was duplicating the work of other health care professionals, undervaluing their expertise, and counterproductive to a team-based approach.

Shortage of Plastic Surgeons in Lebanon: Impact of the 2019 Economic Crisis.

Lebanon's ongoing economic crisis since 2019 has seen an unprecedented migration of professional healthcare workers. This article analyzes the adequacy of registered plastic surgeons in Lebanon in 2023. A list of registered plastic surgeons was obtained from the Lebanese Order of Physicians. Registered plastic surgeons were contacted via email or phone and were asked to fill in a survey questionnaire addressing their work status. Additionally, the number of plastic surgeon graduates, between 2018 and 2022, was obtained from Lebanese medical schools. Of the 162 plastic surgeons registered with the Lebanese Order of Physicians in 2023, 158 responded to the survey (97.5%). The work settings of the active plastic surgeons fell into three categories: working in Lebanon full time, splitting work between Lebanon and abroad, and exclusively working abroad. The ratio of plastic surgeons practicing full time in Lebanon is 1.11 per 100,000 inhabitants, which is significantly below the recommended ratio of 2.01. Twenty eight percent of the plastic surgeons working in Lebanon are aged between 65 and 75 years. Meanwhile, an average of only three graduates (2018-2022) enter the workforce annually after completing training in plastic and reconstructive surgery residency. Among the various subspecialties within plastic and reconstructive surgery, aesthetic surgery was the most commonly practiced by those surveyed. There is a relative shortage of plastic surgeons in Lebanon that is compounded by a significant focus on aesthetic procedures. Implementation of strategies is needed to bridge this gap and meet the needs of the underserved people of Lebanon.

Item development for a patient‐reported measure of compassionate healthcare in action

AbstractBackgroundCompassionate care is a fundamental component of healthcare today; yet, many measures of compassionate care are subjective in focus and lack clarity around what compassionate care looks like in practice. Measures mostly relate to physical healthcare settings, neglecting mental healthcare. They also lack significant involvement of people with lived experience (PLE) of healthcare delivery in their development. This study aimed to begin the process of developing a new patient‐reported measure, one that captures the observable actions of compassionate care delivery or ‘compassionate healthcare in action’ by any healthcare professional working in any care setting. The study involves PLE of healthcare delivery, both patients and staff, throughout.MethodsA multistage mixed‐methods scale development process was followed. First, items were derived inductively from reflexive thematic analysis of patient and clinician interviews about what compassionate care meant to them (n = 8), with additional items derived deductively from a literature review of existing measures. Next, a panel of patient, clinician and researcher experts in compassionate care was recruited (Round 1: n = 33, Round 2: n = 29), who refined these items in a two‐round modified online Delphi process.ResultsConsensus was reached on 21 items of compassionate care in action relating to six facets: understanding, communication, attention, action, emotional sensitivity and connection. These items will form the basis for further scale development.ConclusionsThis item development work has laid the foundation of a potential new tool to systematically measure what compassionate healthcare in action looks like to patients. Further research is underway to produce a valid and reliable version of this proposed new measure. We have outlined these initial stages in detail in the hope of encouraging greater transparency and replicability in measure development, as well as emphasising the value of involving PLE throughout the process.Patient or Public ContributionThis study involved PLE of both physical and mental healthcare (as staff, patients and service users) throughout the development of the new measure, including initial project conceptualisation and participation in item generation and refinement stages.

Effects of Sleep-Deprived Lifestyle on Cognitive Abilities of Healthcare Professionals Working in Shifts

Effects of Sleep-Deprived Lifestyle on Cognitive Abilities of Healthcare Professionals Working in Shifts

When routine becomes stressful: A qualitative study into resuscitation team members’ perception of stress and performance

ABSTRACT Interprofessional teamwork is of high importance during stressful situations such as CPR. Stress can potentially influence team performance. This study explores the perception of stress and its stressors during performance under pressure, to be able to further adjust or develop training. Healthcare professionals, who are part of the resuscitation team in a large Dutch university medical center, discussed their experiences in homogeneous focus groups. Nine focus groups and one individual interview were conducted and analyzed thematically, in order to deepen our understanding of their experiences. Thematic analysis resulted in two scenarios, routine and stress and an analysis of accompanying team processes. Routine refers to a setting perceived as straightforward. Stress develops in the presence of a combination of stressors such as a lack of clarity in roles and a lack of knowledge on fellow team members. Participants reported that stress affects the team, specifically through an altering of communication, a decrease in situational awareness, and formation of subgroups. This may lead to a further increase in stress, and potentially result in a vicious cycle. Team processes in a stressful situation like CPR can be disrupted by different stressors, and might affect the team and their performance. Improved knowledge about the stressors and their effects might be used to design a training environment representative for the performance setting healthcare professionals work in. Further research on the impact of representative training with team-level stressors and the development of a “team brain” might be worthwhile.

The Impact of the Covid-19 Pandemic on the Mental Health of Healthcare Professionals and Paramedical Staff Working in Peshawar, KP

Background: COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Therefore, it is extremely important to identify the healthcare workers who are at increased risk of psychological stress.Objectives: To determine mental health issues due to COVID-19 among health care workers during the pandemic. To determine the factors behind mental health issues among healthcare workers during COVID-19Material and Methods: A cross-sectional study, carried out at two major tertiary hospitals in Peshawar Khyber teaching hospital (KTH) and Hayatabad Medical Complex (HMC). The participants included house officers, trainees, consultants and nurses. Data was collected through questionnaires. Survey tools such as Patient Health questionnaire -9 (PHQ-9) scale for depression and Generalized anxiety disorder (GAD-7) scale for anxiety were used. Chi -square test was applied to find association between mental health issues and COVID-19.Results: About 230 HCWs participated having equal number of males and females. Most of the participants were in age group 25-30 and were composed of trainee medical officers. We found that 61.2% of the participants screened positive for depression while 52.6% of the participants screened positive for anxiety and it was due to dissatisfaction towards facilities provided by their respective hospitals. Conclusion: Anxiety and depression were prevalent among the health care workers especially younger and un married individuals during COVID -19. To foster supportive work environment effective strategies are needed.Keywords: Anxiety, Covid -19, Depression, Pandemic

Bereavement and Critical Incidents Involving Healthcare Professionals in Italy During COVID-19: The Importance of the Spiritual Dimension

This exploratory research investigated the work of healthcare professionals during the COVID-19 pandemic, highlighting the major critical aspects, including healthcare providers’ needs as well as personal, professional, and social changes brought about by the pandemic upon both living and dying. In general, for many healthcare providers, the changes imposed by COVID-19 together with their inadequate training led to an excessive emotional load that caused high levels of stress and, consequently, the risk of burnout. In the present study, we wanted to investigate the impact of the COVID-19 pandemic on healthcare professionals and to explore if and how spirituality influenced their experience. We adopted a qualitative methodological design based on interpretative phenomenological analysis. The respondents were 15 healthcare professionals (12 general practitioners, 1 physician, and 2 nurses). This research was carried out in Italy during the first lockdown, that is, between March and September 2020. Following the analysis of participants’ experiences, four main themes were created: (1) critical issues in healthcare, critical incidents, and changes in the attitudes and habits of general practitioners during the pandemic; (2) emotional experiences and primary needs during the emergency; (3) dying during the pandemic and new psychological symptoms in noninfected patients; and (4) resilience and the role of spirituality. Since healthcare professionals, and general practitioners more specifically, were extensively exposed to the dying process and to changes in the end-of-life scenario, the support offered by palliative care is desirable, in terms of both the special skills that palliative physicians can provide and the presence of psychologists as well as through death education.

Hazardous, harmful, and dependent alcohol use in healthcare professionals: a systematic review and meta-analysis.

Healthcare professionals work in high-pressured and demanding environments, which has been linked to the use of alcohol as a coping strategy. This international review aimed (i) to determine the pooled prevalence of hazardous, harmful, dependent, and frequent binge drinking in healthcare professionals, and (ii) to explore factors associated with variation in these outcomes. Scopus, MEDLINE, and PsycINFO were searched from 2003 to 17th November 2022, for studies reporting a prevalence estimate for any outcome among healthcare professionals. Random-effects meta-analyses determined pooled prevalence estimates. Sub-group analyses were conducted, stratifying the meta-analyses by pandemic period vs pre-pandemic period. Meta-regressions explored factors that were associated with variation in the outcomes. PROSPERO (CRD42020173119). After screening 9,108 records, 64 studies were identified as eligible. The pooled prevalence was 19.98% [95% Confidence Intervals [CI]: 16.05-24.23%] for hazardous alcohol use (K = 52), 3.17% [95% CI: 0.95-6.58%] for harmful drinking (K = 8), 14.59% [95% CI: 7.16-25.05%] for dependent drinking (K = 7), and 17.71% [95% CI: 8.34-29.63%] for frequent binge drinking (K = 11). The prevalence of hazardous drinking was greater during the pandemic (28.19%) compared with pre-pandemic estimates (17.95%), though this was not statistically significant (p = 0.049). Studies including all hospital staff (32.04%) showed higher prevalence estimates for hazardous drinking compared with studies of doctors (16.78%) and nurses (27.02%). Approximately one fifth of healthcare professionals drink to hazardous levels, with higher prevalence estimates observed during the COVID-19 pandemic. It may be that healthcare professionals used alcohol to cope with the additional trauma and stressors. Further research is needed to investigate whether this is sustained in the post-pandemic period.

What is bad news in fertility care? A qualitative analysis of staff and patients' accounts of bad and challenging news in fertility care.

What do fertility staff and patients think is bad news in fertility care? Staff and patients agree bad news is any news that makes patients less likely to achieve parenthood spontaneously or access and do successful treatment, but their appraisals of how bad the news is are differently influenced by specific news features and the context of its delivery. Bad news is common in fertility care, but staff feel unprepared to share it and four in 10 patients react to it with unanticipated emotional or physical reactions. Research has paid much attention to how bad news should be shared, but considerably less to what news is perceived as bad, despite the fact this may dictate elements of its delivery. Two cross-sectional, online, mixed-method surveys (active 7 January-16 July 2022) were distributed to fertility staff and patients across the UK and Europe. Staff inclusion criteria were being a healthcare professional working in fertility care and having experience of sharing bad news at least once a month. Patients' inclusion criteria were being adults and having had a conversation in which staff shared or explained bad news concerning their fertility care within the last 2 months. Surveys were created in English using Qualtrics, reviewed by patients and healthcare professionals, and distributed via social media, Prolific, fertility organizations, and scientific societies. Patients were asked, regarding the last time bad news were shared with them, 'What was the bad news?' and 'What other news would you consider bad news in fertility care?'. Staff were asked to 'List the three most challenging topics of bad news you share with your patients'. Staff and patient data were separately thematically analysed to produce basic codes, organized into sub-themes and themes. Themes emerging from patients' and staff data were compared and synthesized into meta themes. Three hundred thirty-four staff accessed the survey, 286 consented, and 217 completed (65% completion rate). Three hundred forty-four patients accessed the survey, 304 consented, and 222 completed (64% completion rate). Eighty-five percent of participants were women, 62% resided in Europe, and 59% were in private care. Average staff age was 45.2 (SD = 12.0), 44% were embryologists or lab technicians, 40% were clinicians (doctors, consultants, or physicians), and 8% nurses or midwifes. Average patient age was 32.2 (SD = 6.4) and 54% had children. Staff answers originated 100 codes, 19 sub-themes and six themes. Patients' answers produced 196 codes, 34 sub-themes, and 7 themes. Staff and patient themes were integrated into three meta-themes reflecting main topics of bad news. These were Diagnosis and negative treatment events and outcomes, Inability to do (more) treatment, and Care and patient factors disrupting communication. Staff and patients agreed that some news features (uncertain, disruptive, definitive) made news more challenging but disagreed in relation to other features (e.g. unexpected/expected). Patient factors made bad news more challenging to staff (e.g. difficult emotions) and care factors made bad news more challenging to patients (e.g. disorganized care). Participants were self-selected, and most were women from private European clinics. Questions differed for staff and patients, focused on subjective perceptions of news, and did not measure news impact. The badness of fertility news is not only a product of the extent to which the news compromises parenthood goals but also of its features (timing, nature, number) and the context in which the news is delivered. Guidance on sharing bad news in fertility care needs to go beyond easing the process for patients to also consider staff experiences. Guidance may need to be tailored to news features and context. Cardiff University funded the research. S.G., J.B., O'.H., and A.D. report funding from the Higher Education Funding Council for Wales and the European Society for Human Reproduction and Embryology (ESHRE) to develop fertiShare: a sharing bad news eLearning course for fertility care. fertiShare will be distributed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence (CC BY-NC-SA 4.0). No other conflicts are reported in relation to this work. N/A.

Professional prehospital clinicians’ experiences of ethical challenges associated with the collaboration with organised voluntary first responders: a qualitative study

BackgroundVolunteer First Responders are used worldwide. In the Region of Southern Denmark, two types of programs have been established. One of these programs consists of voluntary responders without any requirements of education or training who are summoned to prehospital cardiac arrests. The other type of program is established primarily in the rural areas of the region and consists of volunteers with some mandatory education in first aid. These volunteers are summoned to all urgent cases along with the ambulances. Cooperation between professional healthcare workers and nonprofessionals summoned through official channels may be challenging. This study aimed to explore prehospital clinicians’ experiences of ethical challenges in cooperation with volunteer first responders.MethodsWe conducted 16 semi-structured interviews at four different ambulance stations in the Region of Southern Denmark. Five emergency physicians and 11 emergency medical technicians/paramedics were interviewed. The interviews were transcribed, and the data were analysed using systematic text condensation.ResultsThe study's 16 interviews resulted in the identification of some specific categories that challenged the cooperation between the two parties. We identified three main categories: 1. Beneficence, the act of doing good, 2. The risk of harming patients’ autonomy 3. Non-maleficence, which is the obligation not to inflict harm on others.ConclusionThis study provides an in-depth insight into the ethical challenges between prehospital clinicians and voluntary first responders from the perspective of the prehospital clinicians. Both programs are considered to have value but only when treating patients with cardiac arrest. Our study highlights potential areas of improvement in the two Danish voluntary programs in their current form.

Beliefs, attitudes and feelings about work among healthcare workers and teachers during the fifth wave of COVID-19.

To compare the beliefs, attitudes and feelings about work of healthcare professionals (HCPs) and teachers living in the Canary Islands (Spain) during the COVID-19 pandemic. The study had two parts. In Part 1, the Delphi technique was used to adapt a questionnaire. Part 2 was a cross-sectional, comparative study, performed from August 31st to October 25th, 2021 using the questionnaire online distributed to samples of HCPs and teachers. The questionnaire had three dimensions each separated into three sections (i.e., beliefs [coping ability, prevention and organisation]; attitudes [risks, commitments, and obligations]; feelings about work [burnout, support and work satisfaction]). In total 1423 questionnaires were available for analysis, 640 from teaching staff and 783 from HCPs. Significant differences were found in eight of the nine sections. HCPs had a more positive attitude towards work compared with teachers, but had more negative beliefs and feelings about work. In addition, by comparison with teachers, HCPs were more committed to their work, more predisposed to take risks and fulfill their obligations, even though our sample of teachers felt more supported and satisfied at work. Our results show that the pandemic caused a greater negative impact on job satisfaction of HCPs compared with teachers because they felt less supported by their superiors, which had a greater impact on their psychological health.

Determinants of Burnout Among Healthcare Professionals Working in the Labour Room of a Tertiary Care Hospital in South Punjab, Pakistan

Objective: To find out the frequency and determinants of burnout among healthcare workers and staff working in a labour room of a Gynaecology unit of a tertiary care hospital in South Punjab, Pakistan. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Shaikh Zayed Hospital, Rahim Yar Khan, Pakistan, from Mar to May 2022. Methodology: A total of 93 healthcare workers, including doctors and nurses from the labour room of the study centre, were included. Possible causes of burnout were noted. The 16-item instrument OLBI was utilized. Results: Of the 93 study participants, 35(37.6%) were post-graduate residents. High exhaustion was reported by 61(65.6%) study participants, while high disengagement was noted in 44(47.3%). Burnout was reported by 38(40.9%) study participants. Age (p=0.006), marital status as married (p=0.004), designation as post-graduate resident (p<0.001), patient expectations unfulfilled (p<0.001), litigation anxiety (p<0.001), lack of control of processes (p=0.017), role conflict (p=0.001) and communication gap among workers (p<0.001) were found to have a significant association with burnout. Conclusion: The frequency of burnout among healthcare professionals and nurses working in the labour room of a tertiary care hospital in a developing country was high. Age, marital status as married, post-graduate residents, patients' expectations unfulfilled, litigation anxiety, lack of control of processes, role conflict and communication gap among workers were found to have a significant association with burnout.

DEVELOPMENT DIRECTIONS OF PROFESSIONAL NURSING EDUCATION

Background: With the signing of the Bologna Convention by the Republic of Serbia, higher schools were reformed into higher vocational schools for a period of three years. The paper analyzes the education programs of professional healthcare workers and their importance for the business of modern healthcare institutions. Method: A survey was conducted that included the gender, age, and educational structure of the respondents, the number of children and household members they live with, the length of service and the type of employment relationship of the respondents, and the attitudes and opinions of health workers. Results: The results of a survey conducted among students of specialized studies at the High School of Professional Studies in Belgrade are shown in tables. The importance of higher education for healthcare workers for the successful operation of healthcare institutions was confirmed. Discussion: The authors dealt with this problem in the course of their work as professors, and their observations, which they presented at expert meetings, were cited in the literature. Conclusion: Based on the results of the work, the conclusions were reached that knowledge from the management of the work organization helps in acquiring managerial positions in the institution and that the acquired skills and abilities encourage the staff in carrying out the social mission. Health workers have shown that they want to improve their profession and support changes and additions to the school's program contents in accordance with the progress of medicine.

Swiss cohort of healthcare professionals & informal caregivers (SCOHPICA): baseline survey's results

Abstract Background Worldwide, health systems face workforce problems such as personnel shortages, low job satisfaction and burnout. In Switzerland, data is insufficient to address this health system crisis. Hence, the Swiss COhort of Healthcare Professionals and Informal Caregivers (SCOHPICA) aims to study healthcare professionals (HCPs) and informal caregivers’ experiences, well-being, and career/personal trajectories. Results of the baseline survey on HCPs (completed in January 2023) are reported. Methods SCOHPICA is an open prospective cohort. Any HCP working with patients in any healthcare setting in Switzerland was eligible. The data was collected with a self-reported electronic questionnaire. Outcome variables are intents to stay in the job/profession/health sector and well-being; we also explored organizational, psychosocial, psychological and occupational factors, as well as sociodemographic and socioprofessional variables. Results The baseline sample included 1707 HCPs, with 32% registered nurses, 12% physicians and 9% physiotherapists among others. In the next few months, 20% of HCPs “not really/not at all intended to stay in their job”, 13% “in their profession” and 11% “in the health sector”; “not intending to stay in the profession” was highest among healthcare assistants (HCAs), nurses and pharmacists. Well-being was also low for these HCPs. Across other factors, pharmacists, physicians, and nurses showed worse scores than other HCPs, especially for workload and work-life balance. HCAs, pharmacists, and nurses reported more burnout and worse self-rated health. Conclusions Results revealed that some categories of HCPs had a lower intent to stay in their profession, and worse working conditions and experiences, such as nurses and pharmacists, compared to other HCPs. Future data collections, findings and data dissemination through a data repository will support decision-makers and public health policies with first-hand evidence. Key messages • SCOHPICA is the first cohort study to examine the working conditions, intents to leave/stay in the profession, well-being and trajectories of all types of healthcare professional across Switzerland. • At baseline, 13% of healthcare professionals did not intend to stay in their profession; pharmacists and nurses reported worse working conditions and experiences than other healthcare professionals.

Moral injury in a global health emergency: a validation study of the Italian version of the Moral Injury Events Scale adjusted to the healthcare setting

ABSTRACT Background: When exposed to events that transgress one’s moral beliefs, a plethora of negative consequences may follow, which are captured by the concept of moral injury (MI). Despite its relevance to experiences of healthcare workers during a global health emergency, there is lack of validated MI instruments adapted to the healthcare setting. Objective: The present study aims to provide a validation of the Italian version of the Moral Injury Events Scale (MIES) adjusted to the healthcare setting by assessing its factor structure, internal consistency and construct validity. Methods: A sample of 794 healthcare workers (46% nurses, 51% female) engaged in hospital facilities during the COVID-19 pandemic in Italy completed measures of MI, PTSD, anxiety, depression, burnout, meaning in life and positive affect. Results: Using an exploratory structural equation modelling (ESEM) we assessed the scale factor structure for the entire sample and separately for nurse professional and female healthcare worker groups. Findings support a three-factor solution: Factor 1 ‘perceived transgressions by others’; Factor 2 ‘perceived transgressions by self’; and Factor 3 ‘perceived betrayals by others’. Findings also indicate some level of convergence with measures of PTSD, anxiety, depression and burnout. Conclusion: Results suggest that the MIES may be useful in capturing unique experiences of moral injury amongst healthcare workers engaged in a global health emergency. The low range correlations with measures of psychological distress might potentially indicate that MI, which captures cognitive value judgements rather than manifest symptomatology, may uniquely explain a certain amount of variance. Implications for the development of new empirically derived and theoretical guided tools are discussed, highlighting the need for future research to examine the role of individualising and social binding moral principles in gaining a more nuanced understanding of moral injury experiences amongst healthcare professionals across different socio-cultural settings.

Burnout Syndrome and Associated Factors Among Health Care Professionals Working in Dessie Comprehensive Specialized Hospital, Dessie, Ethiopia

Burnout is a mental, emotional, and physical exhaustion that affects many healthcare workers. However, there is a lack of information in Ethiopia. Therefore, this study aimed to assess the prevalence of burnout syndrome and identify the associated risk factors among healthcare professionals in Dessie Comprehensive Specialized Hospital, Ethiopia. A cross-sectional study was conducted on randomly selected 251 health workers at Dessie Comprehensive Specialized Hospital. The Maslach Burnout Inventory-Human Service Survey was used to assess burnout (MBIHSS). A multivariable logistic regression analysis was used to explore the potential determinants of burnout syndrome among the participants. A total of 251 healthcare professionals were included in this study making a response rate of 99.2%. The prevalence of burnout syndrome among healthcare professionals was 15.1% (95% CI [10.8, 19.9]). Being male (AOR = 3.22:95% CI [1.17, 8.87]), lack of interest in their profession (AOR = 2.66, 95% CI [1.84, 6.02]), experiencing physical violence (AOR = 3.52, 95% CI [1.32, 9.36]), unsatisfied with their job (AOR = 4.17, 95% CI [1.46, 11.90]) were variables found to be significantly associated with burnout syndrome. Burnout is a major problem among working in Dessie Comprehensive Specialized Hospital healthcare professionals. Being male, having no interest in their job, having physical violence, and not being satisfied with their job contributed to burnout syndrome. Interventions to increase interest in there in their job, improve physician-patient relationships, provide safer workplace environments, and increase job satisfaction may be promising strategies to reduce burnout syndrome.