Health Professionals In Hospitals Research Articles

Adverse Drug Reactions Reporting among Health Professionals in Government Hospitals in Katsina State, Nigeria

Medicines have the potential to cause Adverse Drug Reactions (ADRs) and therefore the need for health professionals to detect and spontaneously report to the National Agency for Food and Drug Administration and Control (NAFDAC) for further actions to ensure patients and public safety. The study was conducted to ascertain the proportion and reporting procedures of ADRs reported by health professionals in the Government Hospitals in Katsina State, Nigeria. This was a cross-sectional survey of 392 health professionals randomly selected from the 19 secondary hospitals in Katsina state. Data were collected through a self-administered structured questionnaire from 18th January to 19th February 2021 with a 98.7% and 1.3% response rate. Data were analyzed using STATA software Version 15.0. Descriptive statistics were used to describe the background characteristics of respondents, and the outcome, such as the proportion of ADR reported summarized in percentages, frequencies, and charts. There was only a 28.3% ADRs reporting rate, and 25.1% of health professionals who saw an ADRs case reported it by completing the ADRs form. The level of knowledge on ADRs reporting procedures was 58.3% among respondents. The main systemic challenge with ADRs reporting was the lack of access to the reporting form for ADRs. Therefore, there is a need to improve access to the reporting form in all the hospitals. Keywords: Adverse Drug Reaction Reporting, Government Hospitals, Health Professionals, Katsina state, Nigeria, Reporting Rate.

Factors associated with knowledge towards postoperative nausea and vomiting management among health professionals in referral Hospitals of Northwest Ethiopia. A multi-center cross-sectional study

BackgroundKnowledge of health care professionals on postoperative nausea and vomiting (PONV) and antiemetic prescription trends affects patient's outcome after surgery and anesthesia and also patient and family satisfaction. Hence, knowing the knowledge status of health professionals towards PONV management is vital for the optimal care of surgical patients. Therefore, the study aimed to assess the knowledge and factors associated with PONV management among health professionals in referral hospitals of Northwest Ethiopia. MethodsAn institutional based cross-sectional study was conducted on 407 health care professionals from March 1 to 30, 2019. A Simple random sampling technique was used to select the study participants. Both bivariable and multivariable logistic regression analysis were used to identify factors associated with the knowledge level of health professionals on PONV management. In the multivariable analysis, variables with a p-value <0.05 were considered statistically significant. ResultsIn this study, about 52.8% (95% CI: 47.9, 57.2) of the participants had good knowledge of PONV management. Being male (AOR = 1.95; 95% CI: 1.20, 3.17), Physician (AOR = 5.36; 95% CI: 2.20, 13.5), Anesthetist (AOR = 3.88; 95% CI: 1.66, 9.08), and taking training on PONV management (AOR = 5.32; 95%CI: 1.58, 17.89) were positively associated with good knowledgeable of health professionals about PONV management. Conclusionand recommendation: More than half of health care professionals who are working in the perioperative sites of the referral hospitals had good knowledge about the PONV management. Being male, Physician, Anesthetist and taking in-service training on PONV management were significantly affecting the knowledge level of health professionals on PONV management. Thus, providing regular in-service training on PONV management, especially for physician and anesthetist is highly recommended.

Encountering Parents Who Are Hesitant or Reluctant to Vaccinate Their Children: A Meta-Ethnography.

(1) Background: Health professionals play an important role in addressing parents who are hesitant or reluctant to immunise their children. Despite the importance of this topic, gaps remain in the literature about these experiences. This meta-ethnography aimed to synthesise the available body of qualitative work about the care experiences of community and hospital health professionals in encounters with parents hesitant or reluctant to vaccinate their children. The aim is to provide key information for the creation of strategies that address vaccine hesitancy or refusal and ensure public trust in vaccination programs, which are required in a pandemic context such as the current one. (2) Methods: Noblit and Hare’s interpretive meta-ethnography of 12 studies was followed. A line of argument synthesis based on a metaphor was developed. (3) Results: The metaphor “The stone that refuses to be sculpted”, accompanied by three themes, symbolises the care experiences of health professionals in their encounters with parents that hesitate or refuse to vaccinate their children. (4) Conclusions: The creation of clearer communication strategies, the establishment of a therapeutic alliance, health literacy and the empowerment of parents are recommended. The incorporation of health professionals in decision making and the strengthening of multidisciplinary teams interacting with such parents are also included.

A Research Paper on Study of Performance of Online Appointment System with Respect to Traditional System from Patient’s Perspective

Planning appointments has become a daunting task especially for health professionals in hospitals and clinics. Failure of appointment appointments can also result in dispersed appointments, increased number of shows, general patient dissatisfaction and financial losses for health organizations. Many day-to-day medical centers now use a combination of telephone-based planning and computer-based appointments but there is still a technical and human error gap. This online facility can add power to any hospital or clinic website. Reduces the hard work associated with managing a medical environment. More time to commit to patient care, better patient compliance and financial efficiency are other rewards. The integration of covid time, technology and rapid population growth has been strongly driven to introduce patient planning online. In this used project, you sometimes experience minor problems where you need to consult a doctor about your health problems or nearby and follow their meetings. The Online Doctor System will provide one authorized direct communication between the doctors of your choice if necessary for your minor problems. Using the web Online Healthcare System, patients will be able to complete online forms in seconds before entering the virtual office room. It will also allow you to upload your lab results such as x-ray copies, medical history etc which your doctors may refer you for.

Clinical Ethics from the Islamic Perspective : A qualitative study exploring the views of Jordanian doctors.

Like other Arab countries, Jordan must find ways of responding to the rapid processes of change affecting many aspects of social life. This is particularly urgent in healthcare, where social and technical change is often manifested in tensions about ethical decision-making in the clinic. To explore the attitudes, beliefs and concerns relating to ethical decision-making among health professionals in Jordanian hospitals, a qualitative study was conducted involving face-to-face interviews with medical personnel in four hospitals in Amman, the capital of Jordan. Data were analysed thematically in relation to a pre-existing set of ethical categories. Interviews were conducted with thirty-eight doctors covering most medical specialities. Five major themes emerged from the interviews: ethical awareness, ethical issues, the impact of religion on ethical decision-making, practical and theoretical resources for ethical decision-making, and challenges. While uncertainty was expressed about some aspects of Western approaches to ethics, participants strongly supported adoption of a range of Western bioethical principles, including cultural and ethical diversity, along with adherence to Islamic religious norms. A range of serious ethical challenges facing the Jordanian health system were identified, covering social, legal, managerial, and technical issues. Ethical decision-making in Jordan is complex, having to accommodate the needs of patients, the opinions of doctors and their families, the views of religious authorities, managerial considerations, and both local norms and international standards. Health professionals struggle with three sets of tensions that emerge out of the struggle between traditional, community-embedded forms of social organization and the demands generated by globalization and the influence of Western culture: the tensions between tradition and modernity, conservatism and pragmatism, and religion and secularism. Doctors in Jordan prefer approaches to ethical decision-making that realize a balance between the extremes, although the exact nature of where that balance should lie remains uncertain.

Parto e perinatalidade: O papel do psicólogo hospitalar nesse contexto

Atendimentos psicológicos realizados no contexto dos hospitais, clínicas e centros de saúde devem abranger os três pilares existentes no âmbito hospitalar, quais sejam, pacientes, familiares e profissionais da saúde. O psicólogo especialista na modalidade hospitalar pode atuar em diversas frentes, incluindo o atendimento individual e em grupos psicoterapêuticos, atendimentos em ambulatórios e unidades de terapia intensiva (UTIs), enfermarias, pronto-atendimentos, avaliações diagnósticas, psicodiagnósticos e consultorias. Muito embora identifiquem-se diversos estudos que dissertam sobre a psicologia hospitalar, sobretudo no que tange à atuação junto ao doente, pouco se fala sobre essa frente no contexto do parto e da perinatalidade. Dito isto, este artigo tem por objetivo dissertar sobre o papel do psicólogo nesse contexto. Justifica-se por ser um estudo relevante, com pouca literatura sobre o tema, que busca trabalhar a importância do psicólogo não somente no tratamento de doentes, mas também na promoção de saúde das parturientes. Trata-se de um estudo qualitativo, com levantamento bibliográfico feito em bases de dados online. Os achados sugerem que apesar do psicólogo estar inserido no contexto hospitalar, sua inserção nos centros obstétricos ainda não é plenamente efetiva. Conclui-se, desta forma, que ainda há um longo caminho na construção de práticas psicológicas de apoio às famílias e, em especial às parturientes, antes, durante e após o parto, bem como, um espaço dentro do ambiente obstétrico/hospitalar para o profissional da psicologia. Outrossim, salienta-se a importância de pesquisas e estudos dedicados ao tema, que corroborem para a construção de protocolos relacionados ao atendimento psicológico no contexto obstétrico hospitalar.

The hospital telemedicine TELEMED database: Providing information on evidence-based telemedicine services to hospital managers and healthcare professionals

Background Increased use of telemedicine in the healthcare system is a political goal in Denmark. Although the number of hospital patients using interventions such as the video consultation has increased in recent years only a small proportion of the outpatient and inpatient visits involve telemedicine. The TELEMED database (https://telemedicine.cimt.dk/) has been launched at the Center for Innovative Medical Technology in Denmark to ensure that hospital managers and healthcare professionals have access to information about telemedicine services and their effectiveness. This article describes the development and the content of the TELEMED database. Methods A structured literature search was made in the PubMed Database for randomised controlled trials or observational studies with a control group that investigated the effect of telemedicine interventions for hospital patients. Data were extracted from each article on the clinical effectiveness, patient perceptions, economic effects and implementation challenges. As the database should only provide inspiration to healthcare professionals regarding possibilities for use of telemedicine, the risk of bias in the studies was not assessed. Results The literature search resulted in 2825 hits. Based on full text assessment, 331 articles were included for data extraction and assessment. These articles present telemedicine services used in 22 different medical specialities. Forty-eight percent of the studies found a positive, statistically significant clinical effect, while 47% showed no statistically significant difference. In 48% of the studies, patients’ experiences were examined and of these 68% found positive patient experiences. Fifty-four percent of the articles included information on the economic effects and, of these, 51% found reduction in healthcare utilization. In the majority of studies between two and four types of implementation challenges were found. Conclusions and recommendations: The TELEMED database provides an easily accessible overview of existing evidence-based telemedicine services for use by hospital managers and health professionals, who whish to to implement telemedicine. The database is freely available and expected to be continuously improved and broadened over time.

Compliance towards infection prevention measures among health professionals in public hospitals, southeast Ethiopia: a cross-sectional study with implications of COVID-19 prevention

IntroductionThe new coronavirus disease 2019 is an emerging respiratory disease caused by the highly contagious novel coronavirus which has currently overwhelmed the world. Realizing a comprehensive set of infection prevention measures is a key to minimize the spread of this virus and its impacts in all healthcare settings. Therefore, this study was aimed to assess the compliance towards COVID-19 preventive measures and associated factors among health professionals in selected public hospitals, southeast Ethiopia.MethodsA descriptive hospital-based cross-sectional study was conducted among 660 health professionals in public hospitals of southeast Ethiopia from October 1 to 31, 2020. A multistage sampling technique was used to select the study participants. Data were collected by interview using structured and pretested questionnaires. Ordinary logistic regression modeling was used to estimate the crude and adjusted odds ratio. To declare the statistical significance of factors associated with the outcome variable, P-value < 0.05 and 95% confidence interval were used.ResultsA total of 654 health professionals were involved in the study; of whom, 313 participants were nurses. The overall good compliance and knowledge of health professionals regarding COVID-19 preventive measures were 21.6 and 25.5%, respectively. Working in the general hospital (AOR = 0.55; 95% CI 0.38, 0.79), service year (AOR = 2.10; 95% CI 1.35, 3.21), knowledge (AOR = 1.80; 95% CI 1.14, 2.89), and water availability (AOR = 3.26; 95% CI 2.25, 4.72) were some of the factors found to have a statistically significant association to compliance of health professionals regarding COVID-19 preventive measures.ConclusionIn this study, nearly one fifth of health professionals had good compliance towards COVID-19 prevention practices. Thus, a consistent supply of COVID-19 prevention materials, facilities, and improving the knowledge of health professionals through on and off-job training are crucial.

Where have all the appendicectomies gone?

The COVID-19 pandemic stimulated a national lockdown in the UK. The public were advised to avoid unnecessary hospital attendances and health professionals were advised to avoid aerosol-generating procedures wherever possible. The authors hypothesised that these measures would result in a reduction in the number of patients presenting to hospital with acute appendicitis and alter treatment choices. A multicentred, prospective observational study was undertaken during April 2020 to identify adults treated for acute appendicitis. Searches of operative and radiological records were performed to identify patients treated during April 2018 and April 2019 for comparison. A total of 190 patients were treated for acute appendicitis pre-lockdown compared with 64 patients treated during lockdown. Patients treated during the pandemic were more likely to have a higher American Society of Anesthesiology (ASA) score (p = 0.049) and to have delayed their presentation to hospital (2 versus 3 days, p = 0.03). During the lockdown, the use of computed tomography (CT) increased from 36.3% to 85.9% (p < 0.001), the use of an antibiotic-only approach increased from 6.2% to 40.6% (p < 0.001) and the rate of laparoscopic appendicectomy reduced from 85.3% to 17.2% (p < 0.001). The negative appendicectomy rate decreased from 21.7% to 7.1% during lockdown (p < 0.001). The COVID-19 lockdown was associated with a decreased incidence of acute appendicitis and a significant shift in the management approach. The increased use of CT allows the identification of simple appendicitis for conservative treatment and decreases the negative appendicectomy rate.

Factors associated with work-private life conflict and leadership qualities among line managers of health professionals in Swiss acute and rehabilitation hospitals \u2013 a cross-sectional study

BackgroundThe workforce shortage of health professionals is a matter of global concern. Among possible causative factors in this shortage are the incompatibility of health professionals’ work with their private life, which may lead to increased stress and burnout symptoms, job dissatisfaction and a higher intention to leave the profession prematurely. Also, poor leadership qualities among direct line managers (e.g. clinic directors, leading physicians, ward managers, team leaders) have been associated with health professionals’ job dissatisfaction and intention to leave in previous studies. This study therefore aimed to identify key factors associated with health professionals’ work-private life conflicts and their managers’ leadership quality.MethodsThe study is based on a cross-sectional survey in 26 Swiss acute and rehabilitation hospitals, consisting of 3398 health professionals from various disciplines. For data analysis, multilevel models (with hospitals as the second level variable) were performed for ‘work-private life conflict’ and ‘quality of leadership’, considering significant main effects (using AIC) and significant interactions (using BIC) of potential explanatory variables.ResultsThe main findings reveal that the compatibility of health professionals’ work and private life is associated with how much they can influence shift planning (possibility of exchanging shifts, B = -2.87, p < 0.01), the extent to which their individual preferences are considered (e.g. working on one specific shift only, B = 6.31, p < 0.01), number of work shifts per weekend (B = 1.38, p < 0.01) and working hours per week (B = 0.13, p < 0.01). In addition, the factors high quantitative demands (B = 0.25, p < 0.01), being required to hide their emotions (B = 0.16, p < 0.01) and poor social community support at work (B = -0.12, p < 0.01) were related to severe work-private life conflicts among health professionals. Regarding managerial leadership, health professionals perceived the leadership qualities of their direct line manager as being better if they received more social support (B = 0.61, p < 0.01) and rewards (B = 0.41, p < 0.01) at work.ConclusionsThe results show key components of improving the compatibility of work and private life for health professionals as well as managerial leadership qualities, and may help leaders working in acute or rehabilitation hospitals to develop appropriate interventions.

Evaluation of the use and effectiveness of telemedicine among the health professionals during the COVID 19 lockdown period: A cross sectional study

Background: Telemedicine has been documented as a viable option in attending to patient's need where distance is a critical factor. The Federal Government of Nigeria on March 27, 2020, imposed a total lockdown in Lagos state in order to curb the spread of the coronavirus disease 2019 (COVID-19) pandemic. The restriction in movement prevented many patients from attending their regular clinics and physical consultations. The aim of this study was to evaluate the use and effectiveness of telemedicine among the hospital health professionals during the lockdown period. Methods: This was an online cross-sectional study among doctors at a tertiary health facility in Lagos. Ethical approval was obtained from the institutional ethical committee. A list of the telephone and WhatsApp contacts of doctors were obtained from the hospital directory; the SurveyMonkey tool was used as an online web-based structured questionnaire for data collection. The information obtained was analyzed to find means and averages. Results: A total of 104 doctors completed the survey. The proportion of participants who used telemedicine was 93.3%, with the most commonly used telemedicine option being phone call (27.1%) and WhatsApp video call (27.1%). The main management provided during this period was counseling (56.6%). Seventy-nine percent of the participants were satisfied with the result of the management provided through telemedicine options, but the major concern was that of ethical issues (36.2%). Majority (44.2%) of the respondents agree that telemedicine was effective during the COVID-19 lockdown period. There was no association found between gender, age, designation, and perceived effectiveness of telemedicine by respondents in this study (P = 0.88, 0.4, and 0.07, respectively). Conclusion: Telemedicine was found to be a useful tool for effective patient's management during the lockdown period although there exist ethical concerns. The formulation of policies guiding its use will ensure the security of information and patient's confidentiality.

Antiemetic Prophylaxis Practice and its Associated Factors Among Health Professionals in Referral Hospitals of North West Ethiopia: Multicenter Cross-Sectional Study.

Background:The practice of antiemetic prophylaxis within the prevention and management of postoperative nausea and vomiting is important for optimal care of surgical patients. The poor practice of antiemetic prophylaxis on postoperative nausea and vomiting prevention come up with complications, reduce patient satisfaction, and increase overall costs. This study aims to assess practice and associated factors of antiemetic prophylaxis among health professionals in referral hospitals of Northwest Ethiopia.Method and materials:Institutional based cross-sectional study was conducted on 407 health professionals from February 27 to March 30, 2019, in referral Hospitals of Northwest Ethiopia. A stratified random sampling technique was used to select the study participants. A structured questionnaire was used to collect data. Bivariable and multivariable logistic regression was used to identify factors associated with the antiemetic prophylaxis practice level of health professionals on postoperative nausea and vomiting prevention and management. The p-values of < 0.05 were considered statistically significant.Results:In this study 153 (37.6%) of health professionals were practicing antiemetic prophylaxis. The multivariable logistic regression analysis showed that anesthetists were (AOR: 8.11; 95% CI: 3.27, 20.08) and physicians (AOR: 4.78; 95% CI: 2.46, 9.30) were more likely to give anti-emetic prophylaxis as compared with midwives. Learning in academic classes (AOR: 3.83; 95% CI: 1.46, 10.09), took training (AOR: 6.97; 95% CI: 2.208, 22.021), professionals who said that there are enough anti-emetic drugs available (AOR: 3.10; 95% CI: 1.67, 5.77), professionals, who respond that patients can afford to buy antiemetic’s (AOR: 3.56; 95% CI: 1.23, 10.32) were more likely to give anti-emetic prophylaxis as compared to their counterparts.Conclusions:Less than fifty percent (37.6%) of health Professionals practice antiemetic prophylaxis. Type of Profession, learning, training, availability, and cost of antiemetic drugs were factors significantly affecting the practice of antiemetic prophylaxis.Highlights:Less than fifty percent of health Professionals practice antiemetic prophylaxis.The availability, drugs affects the practice of antiemetic prophylaxis.The cost of anti-emetics affects the practice of antiemetic prophylaxis.

Challenges of Team Management according to Hospital Health Professionals

Challenges of Team Management according to Hospital Health Professionals

Identifying practical approaches to the normalisation of interprofessional collaboration in rural hospitals: A qualitative study among health professionals

ABSTRACT This qualitative study explores the ideas and experiences of interprofessional collaboration (IPC) among health professionals in rural public hospitals and to propagate its normalization into practice by identifying existing or suggested solutions. The literature focuses largely on the barriers and facilitators to IPC in metropolitan areas and there is room to identify more practical responses for implementing solutions. Semi-structured interviews were conducted with 13 healthcare professionals (October 2018-March 2019). Interviews were audio-recorded, transcribed and underwent thematic analysis to identify themes derived from the dataset. Using the lens of the Normalization Process Theory (NPT) allowed for amalgamation of participant ideas and identification of solutions to implement IPC in practice. Participants’ definitions of IPC and Interprofessional Teamwork were incongruous with the current literature, however when provided with formal definitions, participants agreed that they both participated and observed IPC with varying degrees of success. Factors influencing this success included good working relationships and positive workplace cultures, having an understanding of each professions’ roles and needs and the hierarchy of professions in conjunction with attitudes of senior healthcare professionals. Solutions to improved IPC and its normalization included induction processes and informal introductions, formalized interprofessional interactions, interprofessional education and positive leadership, such as the ‘assertive followership model’. Analyzed in the framework of the normalization process theory, this research shows that IPC is increasingly becoming a coherent, integrated aspect of the healthcare system but there is room for improvement, and cognitive participation in IPC varies across healthcare professionsals. In order to facilitate the normalization process, program and policy makers, hospital administrations and professional associations could consider formalized interprofessional team interactions, formalizing IPC through simple introductions, interprofessional education and positive leadership. Future research could explore through the NPT specific areas of care that benefit from IPC implementation such as community aged-care.

Acute Stress Disorder Among Frontline Health Professionals During the COVID-19 Outbreak: A Structural Equation Modeling Investigation.

The outbreak of COVID-19 that commenced in December 2019 in Wuhan, China, has caused extensive public health concerns and posed substantial challenges to health professionals, especially for those in the center of the epidemic. The current study aimed to assess the prevalence, related factors, and mechanism of acute stress disorder (ASD) among health professionals in Wuhan during this critical period. The study used a cross-sectional design. Self-administered questionnaires were distributed to the frontline health professionals in Wuhan hospitals from January 28 to February 1, 2020. Mental health-related measurements included ASD, depression, anxiety, conflict experiences, hostility, and psychosomatic symptoms. Structural equation modeling was used to analyze the factors associated with ASD among health professionals. A total of 332 frontline health professionals were included in the analysis (mean [standard deviation] age = 32.21 [8.77] years; 78.0% women). ASD was a prominent mental health problem in the health professionals surveyed, with a prevalence of 38.3%. Anxiety (24.7%) and depression (20.2%) were also common. Structural equation modeling analyses revealed that emotional distress (i.e., anxiety and depressive symptoms) fully mediated the association between conflicts with ASD (the standardized indirect coefficient β = 0.47, p = .016). The most common reported symptom was chest pain (51.2%). ASD was significantly associated with psychosomatic symptoms. The majority (67.8%) reported being easily annoyed or irritated, and ASD was associated with hostility. During the COVID-19 outbreak, a substantial number of health professionals in Wuhan suffered from ASD. Furthermore, ASD was found to be associated with psychosomatic symptoms as well as the hostility. The poor mental health of health professionals has detrimental impacts both on the well-being of staff in health care systems and may adversely affect the quality of patient care. We call for interventions that aim to relieve the psychological and occupational stress. Considering that most of our participants were young, female frontline health professionals, the results may not be generalized to more heterogenous samples.

Characteristics and predictors of burnout among healthcare professionals: a cross-sectional study in two tertiary hospitals

BackgroundThe pattern and impact of burnout among the medical staff are not yet well defined. However, the consequences of burnout are not limited to the healthcare providers but also may...

Patient-level and system-level barriers associated with treatment delays for ST elevation myocardial infarction in China

ObjectiveThis study aims to understand the current ST elevated myocardial infarction (STEMI) treatment process in Guangdong Province and explore patient-level and system-level barriers associated with delay in STEMI treatment, so...

Occupational Contamination with Cyclophosphamide in Manipulators

Abstract Introduction Cyclophosphamide is a cytotoxic widely used in the treatment of various cancers. It has been observed, for many years, that those responsible for its handling and administration are exposed and levels of contamination have been detected in biological samples collected from these professionals, in surfaces and in the air. Objectives To review the literature on occupational contamination by cyclophosphamide. Methodology The following inclusion criteria were selected: articles published until the present year, articles in English, scientific papers on cyclophosphamide contamination in hospital health professionals, scientific articles on contamination detection methods and articles on the effects that can outcome from cyclophosphamide contamination. Results The cyclophosphamide levels have been decreasing with the implementation of preparation and cleaning guidelines as well as with the emergence of new techniques of manipulation and technological innovations. However, the dermal route remains the main route of contamination and those responsible for cytotoxic manipulation are not the only ones exposed. It was verified that hospital professionals, who in their profession would not be in contact with cyclophosphamide, also presented levels of contamination in the collected urine samples. Conclusion It is necessary to continue to alert hospital professionals to the importance of always complying with the handling and cleaning protocols, since one of the main causes of contamination is precisely the performance of incorrect procedures during both tasks. This is a topic that should be further studied in order to minimize the exposure and consequently the associated risks.

Acceptance for Social Health Insurance among Health Professionals in Government Hospitals, Mekelle City, North Ethiopia

Background. Ethiopia is one of the countries with high out-of-pocket payments leading to catastrophic health expenditure. The government of Ethiopia introduced social health insurance (SHI) scheme with the overall objective of achieving universal health care access. Studying health professionals’ acceptance to pay for social health insurance is crucial for the successful implementation of the scheme. Therefore, this study aimed to assess the acceptance of social health insurance and its associated factors among health professionals in government hospitals, Mekelle city, North Ethiopia. Methods. An institution-based cross-sectional study design was used. The study participants were selected using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 20. Bivariable and multivariable logistic regression models at a 5% level of significance, and odds ratios with 95% CI level were used to determine the association between the health professionals’ acceptance of health insurance and explanatory variables. Results. The study revealed that 62.5% of the respondents were willing to participate in the SHI scheme in which 74.9% were willing to pay 3% or more of their monthly salary. Health professionals’ acceptance for SHI significantly associated with monthly salary (AOR = 9.49; 95% CI: 2.51, 35.86), awareness about SHI (AOR = 3.89; 95% CI: 1.05, 14.28), history of difficulty in covering medical bills (AOR = 6.2; 95% CI: 2.42, 15.87), attitudes towards social health insurance (AOR = 7.57; 95% CI: 3.14, 18.21), and perceived quality of health care services if SHI implemented (AOR = 2.89; 95% CI: 1.18, 7.07). Conclusion. The study indicated that there were still a high proportion of health professionals who were not willing to pay for SHI. Therefore, strengthening awareness creation, creating awareness about SHI, promoting the scheme using the different channels of communication to bring about favorable attitude, and providing health care services with required standard quality could help to increase the acceptance of SHI by health professionals.

Perceptions and predictors of organizational justice among healthcare professionals in academic hospitals in South-Eastern Nigeria

BackgroundResearch on organizational justice in hospitals in African countries are limited despite being important for workforce performance and hospital operational efficiency. This paper investigated perceptions and predictors of organizational justice among health professionals in academic hospitals in South-east Nigeria.MethodsThe study was conducted in two teaching hospitals in Enugu State, South-east Nigeria using mixed-methods design. Randomly sampled 360 health professionals (doctors = 105, nurses = 200 and allied health professionals, AHPs = 55) completed an organizational justice scale. Additionally, semi-structured, in-depth interview with purposively selected 18 health professionals were conducted. Univariate and bivariate statistics and multivariable linear regression were used to analyze quantitative data. Statistical significance was set at alpha 0.05 level. Qualitative data were analyzed thematically using NVivo 11 software.ResultsThe findings revealed moderate to high perception of different dimensions of organizational justice. Doctors showed the highest perception, whereas AHPs had the least perception. Among doctors, age and education predicted distributive justice (adjusted R2 = 22%); hospital ownership and education predicted procedural justice (adjusted R2 = 17%); and hospital ownership predicted interactional justice (adjusted R2 = 42%). Among nurses, age, gender and marital status predicted distributive justice (adjusted R2 = 41%); hospital ownership, age and gender predicted procedural justice (adjusted R2 = 28%); and hospital ownership, age, marital status and tenure predicted interactional justice (R2 = 35%). Among AHPs, marital status predicted distributive justice (adjusted R2 = 5%), while hospital ownership and tenure predicted interactional justice (adjusted R2 = 15%). Qualitative findings indicate that nurses and AHPs perceive as unfair, differences in pay, access to hospital resources, training, work schedule, participation in decision-making and enforcement of policies between doctors and other health professionals due to medical dominance. Overall, supervisors have a culture of limited information sharing with, and disrespectful treatment of, their junior colleagues.ConclusionPerceptions of organizational justice range from moderate to high and predictors vary among different healthcare professionals. Addressing specific socio-demographic factors that significantly influenced perceptions of organizational justice among different categories of health professionals and departure from physician-centered culture would improve perceptions of organizational justice among health professionals in Nigeria and similar settings.