Role Of Health Care Providers Research Articles

The association between cannabis and codeine use: a nationally representative cross-sectional study in Canada

BackgroundDue to the growing use of cannabis for the purposes of pain relief, evidence is needed on the impact of cannabis use on concurrent analgesic use. Therefore, our objective was to evaluate the association between the use of cannabis and codeine.MethodsWe conducted a cross-sectional study using data from the nationally representative Canadian Tobacco, Alcohol and Drugs Survey (2017). The primary explanatory variable was self-reported use of cannabis within the past year. The outcome was the use of codeine-containing product(s) within the past year. We used multivariable binomial logistic regression models.ResultsOur study sample comprised 15,459 respondents including 3338 individuals who reported cannabis use within the past year of whom 955 (36.2%) used it for medical purposes. Among individuals who reported cannabis use, the majority were male (N = 1833, 62.2%). Self-reported use of cannabis was associated with codeine use (adjusted odds ratio [aOR] 1.89, 95% CI 1.36 to 2.62). Additionally, when limited to cannabis users only, we found people who used cannabis for medical purposes to be three times more likely to also report codeine use (adjusted odds ratio [aOR] 2.96, 95% CI 1.72 to 5.09).DiscussionThe use of cannabis was associated with increased odds of codeine use, especially among individuals who used it for medical purposes. Our findings suggest a potential role for healthcare providers to be aware of or monitor patients’ use of cannabis, as the long-term adverse events associated with concurrent cannabis and opioid use remain unknown.

Between Healthcare Practitioners and Clergy: Evangelicals and COVID-19 Vaccine Hesitancy.

Evangelical Christians are among the most hesitant to get the COVID-19 vaccine. This study examined the extent to which COVID-19 vaccination uptake among Evangelicals is explained by demographic characteristics, Health Belief Model constructs, and faith-based support factors. Survey research firm Qualtrics recruited 531 U.S. adults and conducted a survey to explore predictors of COVID-19 vaccine uptake among people who self-identified as Evangelicals in September 2021. A logistic regression showed that those reporting high perceived benefits of the COVID-19 vaccine were more likely to be vaccinated, while those reporting high perceived barriers were less likely to be vaccinated. Those whose healthcare provider asked them about the vaccine were more likely to be vaccinated than those whose healthcare provider did not ask. Finally, while those who reported information seeking from religious leaders were less likely to be vaccinated, those who reported more faith-based support for vaccination were more likely to be vaccinated. In addition to beliefs about benefits and barriers to vaccination, the role of healthcare providers and clergy were important factors influencing vaccination status. Intervention efforts that capitalize on partnerships between health providers and clergy in supportive congregations may be able to reach undecided Evangelicals.

Defining the role of pharmacists in addressing the social determinants of health.

As one of the overreaching goals of Healthy People 2030, addressing the social determinants of health (SDOH) to reduce health disparities is a nationwide concern, with objectives informed by interdisciplinary teams of experts. However, there remains much discussion regarding the roles of healthcare providers in addressing SDOH. While current guidance suggests that all members of the healthcare team must be empowered to address SDOH, current guidance explicitly references physicians, nurses, social workers and staff, and do not specifically include pharmacists. While pharmacists are taught about the impact of SDOH in pharmacy curricula, actionable strategies for pharmacists to address SDOH in practice have not been clearly outlined. Pharmacists have multifaceted interactions with patients and may be influential in meeting individual patient needs, identifying social risk factors, and addressing upstream causes of health disparities. This paper proposes a framework for the role of pharmacists in addressing the SDOH through strategies at the patient, practice, and community levels. The concepts presented in this paper are meant to serve as a launch point for discussion and to promote the inclusion of pharmacists in the conversations around sustainable efforts to achieve health equity. This framework is not intended to limit the scope of pharmacists in addressing SDOH - on the contrary, it is our hope that this outline may be used to expand the education of future healthcare professionals regarding their role in addressing the social determinants of health.

INCIDENCE AND MANAGEMENT OF AGGRESSION BY HEALTH CARE PROVIDERS IN FEDERAL NEURO-PSYCHIATRIC HOSPITAL, CALABAR

Aggressive management is one of the cardinal roles of psychiatric mental healthcare providers. This study aimed at reporting incidence and management of patients’ aggressive behaviors within January to December, 2021 in Federal Neuro-Psychiatric Hospital, Calabar. An ecto-facto research design was used to conduct the study. Five research questions were formulated to guide the study. The population of study was Healthcare providers which involved Nurses, Doctors, Social workers, Health Assistants and Emergency Prepared Unit of the facility. Purposive sampling technique was used to study the 461 mental healthcare providers with observational techniques. A standard AIS tool was used as instrument to illicit how aggressive incidents were observed and managed. Obtained data were analyzed with descriptive statistics using frequencies, percentages, tables, charts and graphs. Findings revealed that Ward 1 had the highest incidents of aggression followed by Wards 3 & 4; that the highest aggression incidence occurs in the morning followed by night shifts; that Nurses use their verbal and physical intervention most in managing incidents; that the most triggering factor of aggression is patients’ poor mental state and effective management results in prevention of aggressive incidence to other patients, protection of the young, weak and aged patients from harm, prevention of patients’ escape and protection of hospital properties from destruction among others. This study implies that nurses who are closest to the patient deliver verbal and physical interventions most times before the arrival of the doctor on call. It was therefore recommended among other things that more male psychiatric nurses should be employed and psychiatric nurses should be placed on special allowances like call duty allowance, hazard allowance and others to motivate them do their work.

Attitudes and Practice of Health Care Providers Toward Cancer Screening: A Cross-sectional Multicenter Study, Saudi Arabia

BackgroundScreening is a cancer prevention measure for groups who are asymptomatic, and diagnosis is a medical test for groups who are symptomatic. The occupational privilege of health care providers (HCPs) is expected to play a positive role in cancer screening practices. Therefore, this study aimed to assess perceptions and personal attitudes of HCPs regarding their decision to screen for cancer in the Eastern Province of Saudi Arabia.DesignA cross-sectional multicenter survey study was conducted. A well-designed and validated questionnaire was distributed to the HCPs at three tertiary hospitals in the Eastern Province of Saudi Arabia.ResultsOut of 900 health care providers who received the questionnaire, 372 completed it. Two-thirds, 247 (66.4%) of them were nurses and the rest were physicians and the mean age was 34.1 ± 7.1 years. Regardless of gender, profession, or age, the overall rate of belief in the importance of regular cancer screening was high; 91.4%. The number of participants who did not screen for colonoscopy was significantly higher than those who screened. The number of females in the age group of between 45 and 54 years who screened with mammography was significantly higher than non-screened. In a similar way, male HCPs above 54 years who got themselves screened for Prostate-Specific Antigen (PSA) were significantly higher than those who did not.ConclusionsFindings of the current research and existing evidence specifically for the Saudi community indicated a need to raise awareness, emphasizing the role of HCPs in motivating themselves, their families, and their patients to implement various cancer screening programs.

Effect of Video Counseling about Prevention of Anemia on Adolescent Girls Behavior in Supporting the First 1000 Days of Life

BACKGROUND: Lack of knowledge, attitudes, and behavior awareness to prevent anemia among adolescent girls in supporting 1000 HPK has resulted in high anemia incidence in Indonesia. Multimedia counseling is a method of learning that involves audio, visual, and discussion to make it more interesting and easy to understand. AIM: This study analyzed the effect of multimedia counseling about prevention of anemia on adolescent girls behavior to prevent anemia. MATERIALS AND METHODS: This study used pre-test–post-test with control group design, with a quasi-experimental design using the case–control method. The study population was 259, the samples were 90 respondents who were assigned to two groups, namely, 45 people in anemia group and 45 in non-anemia group. The samples were selected by simple random sampling. Respondents were given multimedia counseling about anemia prevention, behavioral questionnaire and food frequency questionnaire (FFQ). Capillary blood test was conducted using Quik-Check, an the respondents were followed up every week and evaluated for 5 weeks. Results were tested using t-test and linear regression. RESULTS: Multimedia counseling had an effect on knowledge (t = 3.097; CI = 95%; 2.229–10.215; p = 0.003), attitude (t = 9.56; CI = 95%; 10.055–15.331; p = 0.001), behavior (t = −2.22; CI = 95%; −4.628–−0.260; p = 0.029), FFQ (t = −2.18; CI = 95%; −4.883 – −0.227; p = 0.032), and BMI (t = −10.40; CI = 95%; −5.094 - −3.460; p = 0.001) among adolescent girls in preventing anemia with R-Square of 0.952 (95%). CONCLUSION: There was an effect of multimedia counseling on the increase in knowledge, attitudes, and behavior in preventing adolescent anemia. Provision of ongoing multimedia counseling and monitoring of female careers in preventing adolescent anemia needs to be improved. Therefore, the role of health-care providers for monitoring and evaluation is very necessary.

Health Promotion Behaviors of Pregnant Couples in the COVID-19 Pandemic: Actor-Partner Interdependence Model.

Pregnancy during the pandemic may be a stressful life event. This cross-sectional study aimed to identify the actor and partner effects of the fear of COVID-19, depression, posttraumatic growth, and marital adjustment on the health promotion behaviors of pregnant couples during the COVID-19 pandemic in Korea. Data were collected from 123 pregnant couples using a structured questionnaire. The data were analyzed using the Actor-Partner Interdependence Model (APIM). The actor effects of the fear of COVID-19, depression, and posttraumatic growth on the health promotion behaviors of pregnant women and their spouses were significant. Furthermore, both actor and partner effects of husbands’ marital adjustment on health promotion behaviors were significant. When carrying out nursing intervention for the health promotion of pregnant couples, programs aimed at reducing depression and improving posttraumatic growth in pregnant couples should be included. In addition, improving marital adjustment will positively affect the health promotion behaviors of pregnant couples. The findings highlight the important role of healthcare providers in assessing depressive symptoms and fear of COVID-19 in pregnant couples and providing support to promote health behaviors as part of prenatal care.

The Role of Healthcare Providers in Promoting Human Papillomavirus Vaccines among Men Who Have Sex with Men: A Scoping Review.

Background: The uptake of human papillomavirus vaccines (HPVV) among men who have sex with men (MSM) remains unsatisfactory. Healthcare providers play a crucial role in improving HPVV acceptability and uptake among MSM. This scoping review aims to provide an overview of (1) the perceived role of healthcare providers by MSM, and (2) the knowledge, beliefs and practices of healthcare providers themselves in promoting HPVV uptake. Methods: A literature search was performed with PubMed and Scopus databases using a specific search string. The relevant original research articles on this topic were identified, and the major findings were charted and discussed. Results: The literature search identified 18 studies on the perceived role of healthcare providers by MSM, and 6 studies on the knowledge, beliefs and practices of healthcare providers in promoting HPVV uptake among MSM. Recommendations by healthcare providers and disclosure of sexual orientation were important positive predictors of higher HPVV acceptability and uptake. Sexual healthcare providers were more confident in delivering HPVV to MSM clients compared to primary practitioners. Conclusion: Recommendation from, and disclosure of sexual orientation to healthcare providers are important in promoting HPVV uptake among MSM. The competency of healthcare providers in delivering HPVV to MSM can be improved by having clearer guidelines, education campaigns and better incentives.

Ethnobotanical study of medicinal plants traditionally used in Gokwe South District, Zimbabwe

Traditional medicines play an important role in health care provision in developing countries as primary therapies and/or as complementary medicines. The aim of this study was to document medicinal plants used in Gokwe South District in Zimbabwe. Forty six participants from 12 wards were interviewed between October 2020 and April 2021 using a semi-structured questionnaire. Ethnobotanical data including local names of the plants, plant parts used, medicinal uses, methods of preparation and administration were documented. The ethnomedicinal data were analysed using different quantitative indices including informant consensus factor (ICF), fidelity level (FL), relative frequency of citation (RFC) and use value (UV). One hundred and twenty seven plant species from 49 families were documented for treating and managing 23 medical categories. Gastro-intestinal disorders (60 citations), respiratory infections (47 citations), reproductive system and health (33 citations) and sexually transmitted infections (21 citations) were commonly treated with medicinal plants within the study area. Nineteen species were recorded for the first time as sources of traditional medicines with no prior record of being used as medicinal plants for any specific disease or ailment in the country. Trees (58.0%) were the main sources of traditional medicines, followed by shrubs (27.0%), herbs and climbers (10.0% and 5.0%, respectively). The most frequently used plant parts were roots (48.8%), followed by bark (37.8%) and leaves (34.6%). The variety of plants that are used to treat and manage human diseases and ailments in the study area emphasizes the importance that medicinal plants play in primary health care system of the rural people in Gokwe South District. Some of the plants used in the study area were characterized by high frequency of citation and use values, and species such as Xeroderris stuhlmannii (Taub.) Mendonça & E.P.Sousa and Zanthoxylum chalybeum Engl., if adequately explored could be instrumental in the discovery and development of health promoting, pharmaceutical products and drugs.

Pregnant Women's Perception and Attitude Towards Mode of Delivery in Erbil City- A Qualitative Study

Background and objective: The childbirth experience has always been represented as a significant event in women’s lives. With the rising rates of cesarean sections in the Kurdi-stan region and lack of evidence, this study was conducted to explore women’s perceptions and attitudes towards a mode of delivery. Method: An exploratory qualitative design with indepth interviews was used to collect data from 18 pregnant women. All in-depth interviews were tape-recorded, transcribed, and subsequently analyzed. Inductive content analysis methods were used to establish the meaning units, subthemes, and main themes. Result: From the analysis of depth-interview data of 18 pregnant women, 48 meaning units were obtained. These meaning units were collected into four themes and nine sub-themes. These themes were identified as perceived advantages and disadvantages of a mode of delivery, knowledge deficit, weak healthcare provider's role, and fear related to vaginal delivery. Conclusion: Results showed that women’s decision-making on the mode of delivery depended on their family and friends’ opinions. Health care providers had few roles in providing the necessary information about the advantages and disadvantages of delivery modes, childbirth, and decreasing their fear of vaginal delivery.

The burden of nicotine-dependent smokers in China: The role of primary healthcare providers

The burden of nicotine-dependent smokers in China: The role of primary healthcare providers

COVID-19 boosters and building trust among UK minority ethnic communities

COVID-19 boosters and building trust among UK minority ethnic communities

The Perceived Role of Healthcare Providers and Systems in the Development of Secondary Health Conditions among Adults with Spinal Cord Injury

Individuals with spinal cord injury (SCI), with high healthcare utilization rates and costs, require special attention and tailored care protocols to meet their healthcare needs. This qualitative study collected narrative information from adults with SCI and their family members and/or caregivers to examine the perceived role of healthcare providers and systems in the development and treatment of secondary health conditions (SHCs). After personal information was collected, individuals participated in focus groups which were recorded and transcribed; transcripts were then reviewed, cleaned, and uploaded to NVivo10 software to facilitate the analysis. An initial stage of coding was conducted which identified potential categories and themes; afterwards, the perceived role of healthcare providers in the development and management of secondary health conditions (SHC) was prioritized and transcripts were re-coded. Two overlapping themes emerged: (1) Iatrogenic and nosocomial factors; and (2) Relationships with healthcare providers. Iatrogenic and nosocomial factors had three subthemes: (1) Misdiagnosis; (2) Perceived mistreatment or mistakes made during treatment; and (3) Unintended consequences of medical treatment; while three subthemes were identified for Relationships with healthcare providers: (1) Respect; (2) Knowledge and experience; and (3) Patient Expertise. To improve safety, reduce healthcare costs, and facilitate more favorable perceived outcomes for individuals with SCI, healthcare providers, organizations and systems need to implement principles of high reliability organizations to improve outcomes through the treatment and prevention of SHC.

Interprofessional collaboration among first responder students in a simulated disaster exercise.

Interprofessional disaster simulation exercises provide an opportunity for first responder students to learn about disaster response and recovery, to practice their roles and to learn to collaborate with other first responders. With the move to virtual education during the COVID-19 pandemic, a table-top disaster exercise is an alternative format to inperson exercises. To date, most disaster simulation exercises for students have focused on the roles of healthcare providers. As first responders play a critical role in disaster management, there is a need for interprofessional exercises that include students in first responder programs. A table-top disaster simulation exercise was held with students from the police (n = 94) and firefighter (n = 30) programs at a large community college in Toronto, Canada, in February 2021. It was held virtually using the Zoom® platform, with college faculty as well as professionals from community partner sites. An evaluation survey that had open- and closed-ended items was administered to students following the event. Thirty-eight percent of the students participated in the survey, and the majority rated the event highly useful and reported that the exercise demonstrated the importance of interprofessional collaboration. Students' responses to the open-ended survey items yielded two themes: understanding roles and performing under duress. This evaluation demonstrates the value of using a simulated disaster exercise to teach first responder students about their role in disaster response and recovery, and the importance of interprofessional collaboration.

Effects of decision aids on breast reconstruction: A systematic review and meta-analysis of randomised controlled trials.

To systematically evaluate the effects of decision aids for women facing breast reconstruction decision on decision conflict, decision regret, knowledge, satisfaction, anxiety and depression. Breast reconstruction decision is not good or bad and should be guided by clinical evidence and patient preferences. Decision aids can increase the patient's decision-making enthusiasm and ability, improve the quality of decision and promote shared decision-making between patients and medical staff. Systematic review and meta-analysis. Eight databases were conducted from the establishment of the database until October 2021. The PRISMA checklist was selected for analysis in this paper. The meta-analysis was conducted in Review Manager 5.3. The quality of the studies was assessed using the Cochrane risk-of-bias tool. The result is decision conflict, decision regret, knowledge and other secondary outcomes. Sensitivity analysis and subgroup analysis were also conducted. A total of twelve randomised controlled trials (RCTs) were included in the systematic review and meta-analysis. Meta-analysis revealed that decision aids could significantly reduce decision conflict and decision regret, improve knowledge, satisfaction and depression and had no influence on anxiety. The results of the systematic review and meta-analysis reviewed the positive effect of decision aids on the decision-making of women facing postmastectomy breast reconstruction. In the future, more well-designed RCTs are needed to confirm the effects of decision aids on the decision-making of breast reconstruction and nurses should be encouraged to take part in the development of decision aids in accordance with strict standards and apply them to breast cancer patients considering postmastectomy breast reconstruction. Our study provides evidence for the effectiveness of decision aids on breast reconstruction and points to the important role of healthcare providers in the use of decision aids and in facilitating shared decision-making.

Systematic identification and replication of factors associated with human papillomavirus vaccine initiation among adolescents in the United States using an environment-wide association study approach

ObjectiveHuman papillomavirus (HPV) vaccination coverage is low among adolescents in the USA. Identification of factors associated with HPV vaccine initiation (receipt of ≥1 dose) is critical for improving uptake. Our...

The Weakness of Will: The Role of Free Will in Treatment Adherence.

Chronic disease prevention and management requires a lifelong commitment and adherence to lifestyle modifications, monitoring of symptoms, medication use, and other forms of therapy. Treatment adherence is a crucial and complex concept in patient care provision, and it requires the voluntary active involvement of patients for the best possible outcome. Multiple factors, which may or may not be under the patient’s control, can influence treatment adherence. However, adherence or non-adherence to a certain treatment is predominantly influenced by one’s sense of agency, values, beliefs, attitudes, and willpower. It is evident that mental states appear to influence patients’ decision-making, and the best treatment outcome occurs when a patient identifies their goals, needs, and desires and exercises their decision-making and free will during the course of receiving care. The role of healthcare providers is critical in promoting treatment adherence, thereby enhancing patient outcomes. Thus, this paper highlights the importance of promoting a sense of agency and integrating patients’ values, beliefs, attitudes, and intentions during the provision of healthcare. It is indispensable to recognize the individual’s ability and initiative to control and manage their illness in the face of challenging socioeconomic and cultural reality. On logical grounds, it is not enough to appreciate the value of free will and mental states, it is also essential to empower and cultivate an individual patient’s willpower to make a well-informed, free decision based on their mental state for the most optimal treatment outcomes.

Pharmacovigilance: Monitoring and Reporting Adverse Drug Reactions

Pharmacovigilance plays a pivotal role in ensuring the safety and efficacy of pharmaceutical products throughout their lifecycle. Monitoring and reporting adverse drug reactions (ADRs) are fundamental components of pharmacovigilance, aimed at identifying and minimizing risks associated with medication use. This paper provides an overview of the pharmacovigilance process, emphasizing the importance of robust ADR monitoring and reporting systems. It explores the various methods employed in pharmacovigilance, including spontaneous reporting, literature review, observational studies, and signal detection techniques. Additionally, the paper discusses the challenges and opportunities in ADR monitoring, such as underreporting, signal refinement, and the emergence of new data sources like social media and electronic health records. Strategies to enhance ADR reporting, including education and training initiatives for healthcare professionals and patients, as well as the utilization of advanced technology and data analytics, are also examined. Furthermore, the role of regulatory agencies, pharmaceutical companies, healthcare providers, and consumers in promoting pharmacovigilance efforts is highlighted.

The value and contribution of intellectual disability nurses/nurses caring for people with intellectual disability in intellectual disability settings: A scoping review.

People with intellectual disability experience poorer health and healthcare access issues. As a leading role in healthcare provision for people with intellectual disability nurses are key to supporting person-centred care and health outcomes. However, little is known about specialist intellectual disability nursing and their contribution to care provision for people with intellectual disability. A systematic scoping review. Searches of seven academic databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO, Embase, Scopus and Web of Science were conducted to identify relevant literature. Literature addressing intellectual disability nursing or nursing care for people with intellectual disability in intellectual disability centres/units/care homes were reviewed and reported as per PRISMA-ScR checklist and PRISMA flow diagram. The published literature (n=68) is extensive and describes the value and contribution of intellectual disability nursing across all domains of professional practice and supports a biopsychosocial-educational approach to addressing the physical, mental and social needs of clients with intellectual disability across the care continuum of health management, health promotion and health education. Despite the importance of the review question and the large volume of publication evidence detailing wide-ranging professional nursing roles and responsibilities, there remains limited literature on the assessment and intervention strategies employed by intellectual disability nurses that highlight their specialist knowledge and skill. Future research should focus on making the role of the nurse more visible and presenting their unique contributions to client care, service delivery, policy and ultimately to the art and science of nursing.

Starting the conversation on gene therapy for phenylketonuria: Current perspectives of patients, caregivers, and advocates

Phenylketonuria (PKU) is a rare genetic condition caused by inborn error(s) in the gene for the enzyme phenylalanine hydroxylase. Resulting loss of phenylalanine (Phe) metabolism requires strict dietary therapy and/or medication to prevent toxic accumulation of Phe. Novel investigational therapies, including gene therapies that aim to address underlying causes of PKU, are now entering clinical trials. However, perceptions of this technology in the PKU community have not been assessed. We conducted a qualitative survey recruiting adult patients, caregivers, and patient advocates from the US and 3 EU countries to assess the impact of living with PKU and the perceptions of gene therapy. Telephone interviews were conducted for up to 60 min following a standardized discussion guide. Interviewers classified each participant by their level of knowledge regarding gene therapy as either: low (little or no prior awareness); moderate (awareness of gene therapy as a concept in PKU); or high (working knowledge of gene therapy, e.g., vectors). In total, 33 participants were recruited (patients, n = 24; caregivers, n = 5; advocates, n = 4). The patient sample was well balanced among age groups, sex, and US/EU geographies. The participants' experiences and burden of living with PKU were largely negative, characterized by frustrations with current management consistent with prior reports. Most participants (n = 18/33) were identified as displaying moderate gene-therapy knowledge, 10/33 as displaying high knowledge, and 5/33 as displaying low knowledge. Both positive and negative perceptions were observed; positive perceptions were often linked to “hope” that gene therapy may represent a cure, whereas negative perceptions were linked to the “uncertainty” of outcomes. High knowledge of gene therapy appeared to trend with negative perceptions; 7/10 participants from this group reported high levels of concern over gene therapy. In contrast, participants who displayed low knowledge reported low (n = 3/5) or moderate (n = 2/5) concern, with predominantly positive perceptions. These data highlight the need for education around the theoretical risk:benefit profile of gene therapy. Despite current unknowns around gene therapy, our study demonstrates the important role of healthcare providers as educators who can use available data to provide balanced information to patients and caregivers.