Attitudes Of Health Care Providers Research Articles

The approach of society regarding the violence against healthcare providers

Objective: The aim of this study is to investigate the society’s approach to violence and to offer solutions to prevent violence in health. Method: This study was conducted in Kahramanmaraş province in February and March 2020. The questionnaire of 50 questions was applied to 1306 people face-to-face. Results: 53.8% of our participants were female. Among the people who had an argument with healthcare providers, 53.0% of them were male. 40.2% of the people who had an argument were aged 25-40. 78.1% have a high school or less education. 86.6% of the ones who considered violence as a tool of demanding justice had high school. Only 19.2% of the people who consider violence as demanding justice had information about code white. 82.9% of the people who state that the most significant reason for the violence is the attitude of healthcare providers had a high school or lower level of education. Participants were asked about the reasons for violence, and 44.0% of them answered that it was the presence of angry and aggressive people. Conclusion: Violence in the health sector has many complicated and intertwined aspects. Its solution is for the people in charge to do their part.

Male involvement in birth preparedness through health Facility community dialogue in kajiado county- Kenya

Birth preparedness enables families to prepare for pregnancy thus increasing the uptake of antenatal care, skilled birthing, and postnatal care, enhancing readiness to handle pregnancy complications and first delays experienced in seeking obstetric care. Male partners influence maternal health outcomes due to their financial power and cultural endowment. Health facility community dialogue through maternity open days provides a platform for pregnant mothers, and their families/ community to interact with health care providers, visit maternity units, demystify birthing practices, and mitigate any fears/misconceptions/ myths about the birthing process thus empowering them on their reproductive health rights. Kenya has limited data on male involvement in birth preparedness through health facility community dialogue/maternity open days. The study objectives were to explore health system factors and nomadic cultural community factors that influence male involvement in birth preparedness through health facility community dialogue. Data was collected through structured guided interviews for focused group discussions on eighteen participants and two community health volunteers as key information informants. Health system factors that influence birth preparedness were; infrastructure: space, confidentiality, privacy, adequacy of beds/beddings, cleanliness, hot beverage/showers after birth, waiting time, and health care provider attitude. Nomadic cultural community factors were value-belief. The study showed the above factors hindered male involvement in birth preparedness.The county government of Kajiado to come up with health facility community dialogue forums on birth preparedness through open maternity days by having an annual budget.

Attitude and ethical behaviors of healthcare providers as antidotes of health service consumer satisfaction in Mgbuoshimini Primary Health Centre, Port Harcourt, Nigeria

Health service consumers' satisfaction with the services they receive has been a challenge over the past decade, and this has been attributed to many factors that diverse scholars have investigated using different variables. In this study, the attitude and ethical behaviours of healthcare providers as antidotes to health service consumers' satisfaction in the Primary Health Centre at Mgbuoshimini, Port Harcourt, Nigeria, were investigated. A cross-sectional descriptive research design was used to select participants from pregnant women, nursing others, couples for family planning, and sick patients. The data were analysed using descriptive statistical tools. The results of the grand total response values were 400 (100%) and strongly agree had 190 (47.5%), agree had 160 (40%), 390 (100%) and strongly agree had 260 (66.7%), agree had 100 (25.6%), and strongly disagree had 13 (3.3%). The overall results were strongly agreed (66.7%) and agreed (25.6%); these connote that the attitudes and ethical behaviours of the healthcare providers towards healthcare service consumers in the primary healthcare facility were poor and that healthcare providers do not execute good ethical behaviour towards health service consumers in the facility, leading to low levels of health resource consumption, low patronage image promotion, and consumers' loss of confidence in the service provider. Therefore, the government should put mechanisms in place to ensure a positive attitude and favourable ethical behaviour among healthcare providers, and individual healthcare providers should also acquire soft skills to improve their attitude and ethical behaviour.

"I will never wish this pain to even my worst enemy": Lived experiences of pain associated with manual vacuum aspiration during post-abortion care in Kenya.

In Kenya, where abortion is legally restricted, most abortions are induced using unsafe procedures, and lead to complications treated in public health facilities. The introduction of Manual Vacuum Aspiration (MVA) to treat incomplete abortion has improved the management of abortion complications. However, this technology comes with pain whose management has been a challenge. This paper explores the lived experiences of pain (management) during MVA to document the contributing factors. We used an ethnographic approach to explore girls and healthcare providers' experiences in offering and accessing post-abortion care in Kilifi County, Kenya. The data collection approach included participant observation and informal conversations in public health facilities and neighboring communities, as well as in-depth interviews with 21 girls and young women treated for abortion complication and 12 healthcare providers. Our findings show that almost all patients described the MVA as the most painful procedure they have ever experienced. The unbearable pain was explained by various factors, including the lack of preparedness of health facilities to offer PAC services (i.e. lack of pain medicine, lack of training, inadequate knowledge and grasp of pain medication guidelines, and malfunctioning MVA kits). Moreover, the attitudes of healthcare providers and facilities management toward the MVA device limited the supply and replacement of MVA kits. Moreover, the scarcity of pain medicines also gave some providers the opportunity to abuse patients guided by their values, whereby they would deny patients pain medication as a form of "punishment" if they were suspected of inducing their abortion, especially adolescent girls. The study findings suggest the need for clearer guidelines on pain medication, value clarification and attitude transformation training for providers, systematizing the use of medical uterine evacuation using medical abortion drug and strengthening the supply chain of pain medication and MVA kits to reduce the pain and improve the quality of post-abortion care.

Knowledge, attitude, and practice (KAP) of antimicrobial prescription and its resistance among health care providers in the COVID-19 era: A cross sectional study.

Antimicrobial resistance (AMR) is considered as a global health and development threat. During COVID-19 pandemic, there has been an increase in antimicrobial resistance. Health care providers (HCPs) play the main role in facing antibiotic resistance because they have the authority to prescribe antibiotics during clinical practice as well as in promoting patients' compliance with therapies and avoid self-medication. So, this study will serve as an important source of information in context with Covid19 pandemic in Egypt. The data was collected using a validated standardized self-administered online questionnaire compromised of four sections: socio-demographic data of the HCPs, the general knowledge on antibiotics and AMR, the HCP attitude towards antibiotic prescription and AMR and the practice in applying the appropriate antibiotic prescription. Most of HCPs (93.7%) recorded good knowledge level about antibiotic prescription and antimicrobial resistance with mean score of knowledge13.21 ± 1.83. About 79% of HCPs recorded a positive attitude towards proper antibiotic prescription with mean score of attitudes 63.02 ± 7.68. Fifty four percent of HCPs demonstrated a good level of practice with mean score of practice 9.75 ± 2.17. In conclusion, HCPs in our study have a good level of knowledge and attitude about antibiotics. However lower level of proper practice towards the problem of AMR in COVID19 era was noticed. Implementation of effective policies and guidelines is crucial to evaluate the antimicrobial use especially in the COVID-19 era to reduce the unintended consequences of the misuse of antibiotics and its impact on AMR.

Barriers Faced by Women with Physical Disabilities for Reproductive Health Care Services Utilization

Women with physical disabilities are often marginalized from mainstream healthcare services, and their reproductive health needs are not often met. The study aimed to explore the barriers faced by women with physical disabilities in reproductive health care utilization. This descriptive cross-sectional study was conducted between January to December 2021 among 83 conveniently selected women with physical disabilities of the reproductive age group (18-49 years). Data were obtained through face-to-face interviews from the participants using a pre-tested, semi-structured, interviewer-administered questionnaire. Among participants, the mean age was 29.3 years. All individuals reported that they experienced some sort of barrier to reproductive healthcare utilization. The Majority (50.6%) of the participants reported that disease was the cause of their disability. Traditional hurdles prevented 57% of participants from accessing reproductive healthcare, whereas 32.5% lacked familial support. Most (78.3%) of them said that accessing healthcare was expensive. More than half of the participants seeking reproductive healthcare found no wheelchair ramp or transfer aid. No service provider educated 69.9% of participants about reproductive healthcare services and rights. When asked about healthcare hurdles, individuals reported fear of poor care (75.9%), negative healthcare provider attitudes (68.7%), and communication issues with providers (67.5%). Some barriers to accessing reproductive health care services include high expenses, lack of family support, poor physical accessibility, lack of information, fear of poor care, negative attitudes of providers, and communication difficulties. Improving access to reproductive healthcare for women with physical disabilities requires addressing barriers and implementing necessary interventions.

Communication of patients’ and family members’ ethical concerns to their healthcare providers

BackgroundLittle is known about communication between patients, families, and healthcare providers regarding ethical concerns that patients and families experience in the course of illness and medical care. To address this gap in the literature, we surveyed patients and family members to learn about their ethical concerns and the extent to which they discussed them with their healthcare providers.MethodsWe surveyed adult, English-speaking patients and family members receiving inpatient care in five hospitals in the Washington DC-Baltimore metropolitan area from July 2017 to March 2020. Descriptive statistics were used to determine the frequency, comfortableness, and helpfulness of discussions regarding ethical concerns experienced when sick or receiving medical care. Univariable and multivariable stepwise logistic regression models were used to identify associations between healthcare provider and respondent characteristics and attitudes and (1) the likelihood of speaking to a healthcare provider about their ethical concern and (2) their level of comfort during these discussions.ResultsOf 468 respondents who experienced ethical issues, 299 (64%) reported discussing the situation with a member of their healthcare team; 74% (197/265) of respondents who had such a discussion found the discussion comfortable, and 77% (176/230) of respondents found the discussion helpful. To make discussions more comfortable and helpful, respondents proposed suggestions in open-ended responses involving (1) content and quality of communication; (2) positive healthcare provider qualities such as empathy, open-mindedness, knowledge, honesty, and trustworthiness; and (3) other contextual factors including having adequate time and available resources.ConclusionsPatients and families often have ethical concerns that they discuss with clinicians, and they want clinicians to be routinely receptive and attentive to such discussions.

Investigation of Awareness of Students On Child Neglect and Abuse and Their Attitudes Towards Reporting Child Neglect and Abuse

Purpose: This study aims to investigate the awareness of nursing department students about child neglect and abuse and their attitudes about reporting cases of child neglect and abuse.
 Material and Methods: The study population consisted of 464 students studying at the Department of Nursing of the Faculty of Health Sciences of a university. No sampling was performed in the study, and 331 students who agreed to participate in the research were included in the study. The data were collected using the Personal Information Form, The Diagnosis Scale of The Risks and Symptoms of Child Abuse and Neglect and the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale. The research data were collected by the researchers by face-to-face interview method between March-April 2022.In the analysis of the data, percentage distributions, averages, the t-test, one-way analysis of variance, and correlation analysis were used. 
 Results: The Diagnosis Scale of the Risks and Symptoms of Child Abuse and Neglect score average of the students participating in the study was 3.66±0.41, and their score average on the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale was 67.14±7.47. A significant difference was found between the students' gender, year in school, the status of having received a course/lesson/training on neglect and abuse, and their average scores on The Diagnosis Scale of The Risks and Symptoms of Child Abuse and Neglect and the Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale. It was found that there was a positive and significant relationship between students' knowledge levels on child abuse and neglect and their attitudes towards reporting child abuse.
 Conclusion: Professionals working in the field of health have an important role in the prevention, detection and treatment of abuse and neglect cases. For this reason, education of professionals, society, families and children working on this issue is at the forefront of the actions that need to be aware of to identify and report neglect and abuse.

Exploring Factors Influencing Paternal Engagement in Prenatal Health Services within Hoima East Division, Hoima City: A Comprehensive Assessment

Socioeconomic, cultural, and gender dynamics continue to impede women's autonomy in healthcare decision-making. Men often wield control over financial resources, time allocation, and access to medical services, creating disparities in women's health choices. This study investigated male engagement in antenatal care among residents of Hoima East Division, Hoima City in Western Uganda. Employing a cross-sectional survey design and quantitative methods, data was meticulously coded, cleaned, and analyzed using Microsoft Excel Version 13 and STATA 14.0. The study encompassed 534 participants, with a predominant age range of 21-30 years (59.4%) and a majority being married (82.2%). Most participants had completed secondary education (53.8%), identified as Catholic (41.1%), and had 3-4 children (50.1%). Results indicated that 263 individuals (69.8%) exhibited low levels of male involvement in antenatal care, while 114 (30.2%) demonstrated high levels of engagement. Notably, 54.6% displayed inadequate knowledge, contrasting with the 45.4% who exhibited a strong grasp of antenatal care. The analysis revealed significant associations between male involvement and various factors including age, marital status, educational attainment, employment status, decision-making capacity, monthly income, perception of healthcare providers' attitudes, privacy provisions at antenatal clinics, and waiting times. Despite these findings, the level of male involvement and understanding of antenatal care remained suboptimal. In summary, this research highlights the multifaceted interplay of factors influencing male involvement in antenatal care. Factors such as age, marital status, education, employment, decision-making capacity, income, healthcare provider attitudes, and clinic conditions emerged as pivotal determinants. Addressing these variables can potentially enhance male participation and knowledge regarding antenatal care, ultimately empowering women in making informed health decisions. Keywords: Antenatal care and associated factors, Attitude of health care providers, Health facilities, Maternity care, Male partners.

Knowledge, attitude, and proficiency of healthcare providers in cardiopulmonary resuscitation in a public primary healthcare setting in Qatar.

Early and effective cardiopulmonary resuscitation (CPR) increases both survival rate and post-cardiac arrest quality of life. This study aims to assess the current knowledge and ability of physicians and nurses in health centers (HCs) operated by the Primary Health Care Corporation (PHCC) in Doha, Qatar, to perform CPR. This study consists of two parts. The first part is a descriptive cross-sectional survey using an online form targeting physicians and nurses working in all HCs to assess their CPR knowledge and attitude. The second part is a direct observation of CPR drills to evaluate the skills and competencies of code blue team members in a convenient sample of 14 HCs. A multivariate model was employed to test the independent effect of explanatory variables on the total knowledge score. A total of 569 physicians and nurses responded to the survey. Only one-half (48.7%) formally received training on basic life support within the last year. Furthermore, 62.7% have tried to revive a dying person with no pulse. All the participants recognize the importance of knowing how to revive a dying adult or child as part of their job. The study showed that being a nurse was the most important predictor of a higher knowledge score in both components. Attending more resuscitation courses (3-6 courses in the last 3 years) ranked second in importance, and a longer experience in clinical practice (5-10 and >10 years) ranked third in predictive power. In addition, the direct observation of CPR drill performance revealed a satisfactory outcome. The level of CPR knowledge and skills practice among healthcare providers in PHCC is deemed satisfactory as most providers reported having performed CPR in the past. Considering that PHCC is the first step to people's healthcare in Qatar, clinical staff should be certified and assessed regularly to ensure retention of resuscitation knowledge and skills.

Integrated person- and people-centred primary care for diabetes in low- and middle-income countries: The nurses' perspective on patient needs.

The aim of this study was to identify what nurses working in primary care settings perceive as necessary to support the life needs of people with type 2 diabetes. Articulate these needs with the needs expressed by people with diabetes in a previous study. Finally, illustrate the potential of the used method. A highly structured qualitative group method for brainstorming and idea sharing was used to generate a participant-owned concept map that can support and evaluate practice change. Data were collected between April and May 2022 in two public primary healthcare centres in Sacaba, Bolivia, with 33 professional nurses, technical nurses, nurse trainees and one physician. The concept mapping process by Trochim was used to generate, share and structure ideas, maximizing equality of input. The nurses identified 73 unique needs that were structured in 11 conceptual clusters related to four different stakeholders or domains: organization of care and health policy, strengthening knowledge, skills and attitudes of healthcare providers, empower people living with diabetes and their family, and community-level health promotion and diabetes education. The needs and domains identified by nurses and people with type 2 diabetes are very similar and inform a multisectoral and transdisciplinary action plan to jointly monitor and evaluate progress towards people-centred care for people with diabetes. This study demonstrates nurses' important contribution to analysing and designing people-centred care in their community. They identify and act upon social determinants of health related to schools, safety and legislation. Besides global relevance, results inform the municipal health plan and an ongoing research project on cardiometabolic health. Data from prior patient consultations were included in the study design, and study results inform the municipal health plan.

Factors affecting treatment adherence among leprosy patients: Perceptions of healthcare providers

BackgroundTreatment adherence is a vital aspect in the management of chronic diseases like leprosy; however, most studies on treatment adherence focus on patients. This study aims to examine the perceptions of healthcare providers on factors that can promote or prevent patients from adhering to treatment. MethodsWe conducted three focus group discussions (FGDs) with healthcare providers who have at least one year experience in managing leprosy in three large leprosy case-holding hospitals in Metro Manila, Philippines. We audio-recorded, transcribed, translated the FGD proceedings, and analyzed the transcripts thematically to identify patient-intrinsic and patient-extrinsic enablers and barriers to treatment adherence of leprosy patients. ResultsPatient-intrinsic motivators to complete treatment include innate desire to be cured, fear of infecting family and friends, fear of disability, good knowledge about the disease, need for medical clearance to be considered fit to work, and experiencing leprosy reactions. Patient-extrinsic motivators to complete treatment include free treatment, immediate and sufficient counselling, flexibility in treatment, follow-up and motivation of healthcare workers, and presence of Hansen’s Club and support groups. Patient-intrinsic barriers to good treatment adherence include distance between residence and hospital, financial and opportunity costs, adverse drug reactions, misconceptions about being cured, disabilities and presence of leprosy reactions, stubbornness and/or laziness, and undergoing clinical depression. Patient-extrinsic barriers to good treatment adherence include poor availability of MDT, transfer to other leprosy treatment facilities without informing current facility, and stigma. ConclusionHealthcare providers perceive that patient-intrinsic and patient-extrinsic factors influence the treatment adherence of leprosy patients through different mechanisms. We highlight the role of healthcare provider attitudes, stigma, and support groups in promoting treatment adherence.

Medical student attitudes and perceptions of psychedelic-assisted therapies.

Although certain psychedelic agents may soon gain federal approval for use in treating specific psychiatric conditions, the utilization of such therapies in clinical practice will depend largely on the attitudes of healthcare providers. Therefore, this study assesses the current attitudes, knowledge, exposure, and acceptance of psychedelics and psychedelic-assisted therapies amongst medical students. In fall semester of 2022, surveys were emailed to 580 medical students attending medical institutions in the state of Nevada in the United States. Utilizing knowledge and attitude items from previously published studies, the survey collected demographic data and assessed student attitudes with five-point Likert-scale variables. Data was analyzed using summary statistics and Kruskal-Wallis tests for differences in mean survey scores (i.e., attitudes towards psychedelics) based on demographic factors. 132 medical students participated in the survey (22.7% response rate). Medical students demonstrated overall positive attitudes towards psychedelics, lack of knowledge regarding psychedelics, and uncertainty towards neurocognitive risks of psychedelics. Overall, 78.6% of students agreed that psychedelics have therapeutic potential, while 95.2% agreed that psychedelics deserves further research in assessing this potential. Additionally, there was no statistically significant effect of demographic variables, including age, sex, and level of training, on attitudes. Although students are overall curious and optimistic about psychedelics, they demonstrate a lack of knowledge regarding recent research efforts. As the field of psychiatry prepares to implement psychedelics and psychedelic-assisted therapies, education and awareness of such agents should be initiated early on in medical clinical training.

(050) Vulvodynia Viewed From a Disease Prevention Framework: Insights From Patient Perspectives

Abstract Introduction Persons with vulvodynia (a chronic vulvar pain condition) suffer many barriers to diagnosis and treatment, several of which may be exacerbated by the sociocultural and geographical context in which they live. Objectives We drew on the experiences of patients with vulvodynia who were living in small urban and rural communities to learn what they perceived as the major barriers to diagnosis and treatment as well as to probe for possible solutions. Methods For this qualitative case study, we conducted 3 focus groups with a total of 10 participants, drawn from patients seen at our academic tertiary referral center, with a goal of understanding their lived experience with vulvodynia. The patient dialogue was coded into themes and temporally grouped to illustrate struggles and victories in diagnosis and treatment. Results Participants confirmed that healthcare provider knowledge and attitudes as well as system challenges (specialist and allied healthcare provider availability) are major barriers to timely diagnosis. Of novel interest are other factors that exacerbate distress and delay diagnosis such as patients’ inadequate knowledge of sexual functioning and sociocultural messages regarding “normal” sexual activity. Our work suggests that a disease prevention framework that includes comprehensive sexual education before or at the onset of sexual activity may be of benefit in reducing the burden of vulvodynia when added to strategies to increase healthcare provider knowledge and improve access to effective treatments. Conclusions While healthcare provider knowledge and attitudes are often at the forefront of barriers to diagnosis, our study suggests that to minimize patient distress and expedite diagnosis, resources must also be directed to promoting comprehensive sexual health education. Disclosure No.

HPV vaccine knowledge, attitudes, and practices among New York State medical providers, dentists, and pharmacists

ABSTRACT Healthcare provider vaccine knowledge and attitudes influence delivery of a strong vaccine recommendation. We aim to describe HPV vaccine knowledge, attitudes, and recommendation or discussion practices (KAP) among New York State medical providers, dentists, and pharmacists. A survey to assess providers’ KAP was distributed electronically to NYS members of medical organizations. Descriptive and inferential statistical methods were used to characterize provider KAP. Responses from 1637 surveys were included, from 864 (53%) medical providers, 737 (45%) dentists, and 36 (2%) pharmacists. 59% (509/864) of medical providers responded that they recommend HPV vaccine to patients, with 390/509 (77%) strongly recommending vaccine at 11–12 years. Medical providers were more likely to report recommending HPV vaccine for children ages 11–12 years if they strongly agreed that HPV vaccine prevents cancer 326/391 (83%) vs 64/117 (55%) and responded that HPV vaccination does not increase the risk of unprotected sex (386/494 (78%) vs 4/15 (25%)) (p < .05). Less than 1/3 of dentists reported discussing HPV vaccine with 11–26-year-old females (230/737, 31%) and males (205/737, 28%) at least “sometimes.” Dentists were more likely to answer that they routinely discuss HPV vaccine with children ages 11–12 years if they responded that HPV vaccination does not increase sexual activity (70/73 (96%) vs 528/662 (80%), p < .001). Few pharmacists reported discussing HPV vaccine with 11–26-year-old females (6/36 (17%)) and males (5/36 (14%)) at least “sometimes.” Gaps in HPV vaccine knowledge among providers still exist and may influence vaccine attitudes and recommendation or discussion practices.

Stigma and discrimination against people living with HIV by health care providers in Egypt

ObjectiveHIV/AIDS has been recently increasingly observed in developing countries including Egypt. This study aimed to explore stigma and discrimination attitudes of health care providers (HCPs) in Egypt, as elimination of stigma in healthcare settings is a priority to improve case detection and management.MethodsA Google form questionnaire using the validated Arabic version of Health Care Provider HIV/AIDS Stigma Scale (HPASS) was sent to physicians and nurses of Ministry of health (MOH) hospitals and University hospitals in 10 randomly selected Governorates in Egypt. Data was collected from July to August, 2022 from 1577 physicians and 787 nurses. Bivariate and multivariable linear regression analyses were used to identify the predictors of the stigmatizing attitude of HCPs towards People living with HIV (PLHIV).ResultsThe majority of HCPs had worries about contracting HIV infection from their patients (75.8% of physicians and 77% of nurses). They believed that protective measures are not good enough to protect them from getting infected (73.9% of physicians and 74.7% of nurses). About half of the participants had worries about the safety of performing blood investigations to PLHIV (54% of physicians and 59.9% of nurses). Less than half of HCPs believed they have the right to refuse providing care to patients to protect themselves (44.6% of physicians and 50.1% of nurses). Only 10.5% of physicians and 11.9% of nurses have previously refused to provide health care to PLHIV. There was a significantly higher mean score of prejudice and stereotype among nurses compared to physicians (prejudice; 27.34 ± 7.88 vs 26.17 ± 7.5, stereotype; 18.54 ± 4.61 vs 16.43 ± 5.21, for nurses and physicians, respectively). Less years of physicians’ experience (B = -0.10, p < 0.01) and rural residence (B = 1.48, p < 0.05) were significantly associated with higher prejudice score while having lower qualification (B = -1.47, p < 0.001) was significantly associated with higher stereotype score.ConclusionStandards of practice should be developed to adjust the services and prepare HCPs to provide medical care free from stigma and discrimination against PLHIV. Improving knowledge of HCPs regarding the methods of transmission of HIV, the use of infection control measures and the emotional factors shaping lives of PLHIV should be targeted through updated training programs. More concern should be directed to young providers in the training programs.

Positive attitudes toward adoption of a multi-component intervention strategy aimed at improving HIV outcomes among adolescents and young people in Nampula, Mozambique: perspectives of HIV care providers

BackgroundService providers' attitudes toward interventions are essential for adopting and implementing novel interventions into healthcare settings, but evidence of evaluations in the HIV context is still limited. This study is part of the CombinADO cluster randomized trial (ClinicalTrials.gov NCT04930367), which is investigating the effectiveness of a multi-component intervention package (CombinADO strategy) aimed at improving HIV outcomes among adolescents and young adults living with HIV (AYAHIV) in Mozambique. In this paper we present findings on key stakeholder attitudes toward adopting study interventions into local health services.MethodsBetween September and December 2021, we conducted a cross-sectional survey with a purposive sample of 59 key stakeholders providing and overseeing HIV care among AYAHIV in 12 health facilities participating in the CombinADO trial, who completed a 9-item scale on attitudes towards adopting the trial intervention packages in health facilities. Data were collected in the pre-implementation phase of the study and included individual stakeholder and facility-level characteristics. We used generalized linear regression to examine the associations of stakeholder attitude scores with stakeholder and facility-level characteristics.ResultsOverall, service-providing stakeholders within this setting reported positive attitudes regarding adopting intervention packages across study clinic sites; the overall mean total attitude score was 35.0 ([SD] = 2.59, Range = [30–41]). The study package assessed (control or intervention condition) and the number of healthcare workers delivering ART care in participating clinics were the only significant explanatory variables to predict higher attitude scores among stakeholders (β = 1.57, 95% CI = 0.34–2.80, p = 0.01 and β = 1.57, 95% CI = 0.06–3.08, p = 0.04 respectively).ConclusionsThis study found positive attitudes toward adopting the multi-component CombinADO study interventions among HIV care providers for AYAHIV in Nampula, Mozambique. Our findings suggest that adequate training and human resource availability may be important in promoting the adoption of novel multi-component interventions in healthcare services by influencing healthcare provider attitudes.

Sexual and Reproductive Health Care for Irregular Migrant Women: A Meta-Synthesis of Qualitative Data.

Migratory movements are a political, social, and public health issue on a global scale. Access to sexual and reproductive health services for irregular migrant women (IMW) is a public health issue. The aim of this study is to identify qualitative evidence of IMW's experiences of sexual and reproductive health care in emergency and primary care settings. The methods employed involve conducting a meta-synthesis of qualitative studies. Synthesis includes assembling and categorising findings based on similarity in meaning. The search was conducted between January 2010 and June 2022 using PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. Out of the initial pool of 142 articles identified, only 9 fulfilled the predetermined criteria and were subsequently included in the review. Four main themes were established: (1) the need to focus emergency care on sexual and reproductive health; (2) unsatisfactory clinical experiences; (3) forced reproduction; and (4) alternating between formal and informal healthcare services. The attitudes of IMW towards sexual and reproductive health are influenced by culture, educational level, fear, barriers, and the attitude of healthcare providers. Healthcare institutions need to be aware of the IMW's experiences to understand the specific difficulties they face. IMW calls for socially and culturally sensitive health care, cultural mediators, improved communication, and safe environments that ensure confidentiality.

Exploring the unmet needs of Mexican women living with metastatic breast cancer: A patient survey.

e24223 Background: Breast cancer is the most prevalent form of cancer among women worldwide and the top cause of cancer-related fatalities. In Mexico, delayed diagnosis and referral contribute to a significant proportion of breast cancer patients being diagnosed with metastatic breast cancer (mBC) or experiencing distant recurrences. Patients with mBC face unique needs and concerns for their illness, which are frequently not attended to or covered. Gaining insight into their diagnostic experiences is crucial for enhancing the standard of care. The aim of this study is to explore the unmet needs of Mexican women living with mBC. Methods: An anonymous and voluntary survey was distributed to women diagnosed with mBC. The instrument employed was drawn from the European "Being There" study and underwent translation into Spanish in accordance with the current best practices for the translation and cultural adaptation of health measurement tools. The survey addressed various subjects including patient’s personal experiences concerning diagnosis and treatment, attitudes of healthcare providers toward cancer services, information available to patients, and patients' views on enhancing future care. Results: A total of 29 responses were received from women ranging in age from 26 - 74 years. Despite generally positive feedback on the care received (42% as excellent/very good, 55% as good/acceptable, and only 3% as bad), these women identified areas for improvement. Regarding their personal experience receiving information about their diagnosis and treatment, 86% reported receiving medical attention that helped them cope with their illness and 80% reported being convinced that the medical team was highly qualified and coordinated. However, only 55% of physicians and 44% of nursing staff displayed interest in the patients' goals and wishes after they received their diagnosis. Regarding the attitudes of healthcare providers in cancer services, 62% of the women believed that they should be more empathetic, 65% would like to see the same doctor/nurse/specialist on every visit, and 69% indicated that they would like them to show more interest in the challenges they face on a day-to-day basis. Table 1 summarizes the information that these women would like to receive about their treatment. Conclusions: In conclusion, this study provides insight into the experiences and unmet needs of women living with mBC in Mexico. While the care received by the women was generally positive, the study highlights the need for improvement in certain areas to address their unmet needs. The findings can be used to enhance the standard of care for women with mBC. [Table: see text]

Ressentis des professionnels de santé sur la sexualité des patients hospitalisés en psychiatrie : une étude qualitative

ObjectivesQuestions concerning the sexuality of patients in psychiatric hospitals have come to light, particularly since the introduction of mixed gender patients in these institutions in the 1960s. Although the concerns about mixed gender are less topical, there are questions about the approach used toward sexuality in psychiatric hospitals. Today, even in a desire to protect patients, it is no longer acceptable to prohibit sexual relations on the wards in general, without considering the patient's clinical condition. A global study of the sexuality of patients in psychiatric hospitals is necessary. Initially, our study will focus on the attitudes of caregivers about the sexuality of patients. The main objective of this article is to present a thematic analysis of the discourse of health care professionals interviewed about the sexuality of adult patients hospitalized in psychiatry wards, focusing particularly on their feelings. The secondary objectives are to understand the problems encountered in daily practice by health professionals and to identify possible areas for improvement. MethodsThe study was carried out in three centers, and a total of 18 caregivers were included. The criteria for participation were to be a health professional who cared for or had treated adult patients on psychiatric wards. For this study, we favored qualitative research because it focuses on the subject's discourse, which will allow us to concentrate on the feelings of the caregivers interviewed. ResultsFirst of all, the theme of persistent taboos that we initially encountered must be qualified. In fact, although sexuality is often discussed only if the health care team is confronted with it in the department, it appears that it is increasingly possible to discuss it. Second, we noted the prevalence of the themes of vulnerability and consent in the discourse of health professionals. These themes are directly linked to those of difficulty and anxiety, which were also highlighted during the data analysis. This suggests that it is difficult for health care providers to assess whether a patient has consented to engage in sexual activity, especially for those hospitalized under duress. Sexual violence is a major concern for caregivers. How best can they protect vulnerable patients while respecting their privacy and rights? Furthermore, we found a certain heterogeneity in the way care was provided. There are differences within the same institution, but also within the same department, depending on the caregivers. The study also allowed us to identify variations in the way patients are treated and the way they feel, depending on their gender, with men often being considered as predators and women as victims. Among the subjects interviewed, there was an unanimous desire to have access to training concerning the sexuality of patients. Finally, the subject of sexuality raises other issues such as the rights of hospitalized patients and restrictions of freedom imposed during hospitalization and also the position of the health care team with respect to a patient's intimacy and communication between the medical and paramedical teams. Many aspects of this issue where there is a need for improvement must be studied, particularly training, which seems essential to enable caregivers to feel more comfortable and to offer better quality care to patients. The training on dealing with sexuality is inseparable from the training on the rights of hospitalized patients. Other areas for improvement have been identified, such as the implementation of workshops on sexuality in the wards or the development of multidisciplinary protocols in the event of a reported sexual assault or significant doubt on the part of the health care team regarding possible violence where the victim is not able to call the health care team or notify the competent authorities. ConclusionIn this qualitative approach to the sexuality of patients hospitalized in psychiatry, we have seen that the attitudes of health care providers concerning sexuality have evolved considerably because of new legislation and a change in the way society views this issue. Nevertheless, professionals seem to have difficulty in assessing the capacity to consent to sexual intercourse in patients who present a significant degree of vulnerability due to the psychological disorders they may be suffering from. In addition, we feel it is important to emphasize the need for training in the promotion of sexual and emotional health, the prevention of sexual violence and the management of sexual violence. Also, the establishment of multi-professional discussion forums on the issue of sexuality in patients with psychiatric disorders should be supported. Finally, we believe that this study should be supplemented by a qualitative analysis of the discourse of patients hospitalized in psychiatric institutions to better understand the areas of care that should be developed in the future, from the perspective of a global approach to the person suffering from mental disorders.