Improve Healthcare Professionals Research Articles

Evaluating the effects of simulation training on stroke thrombolysis: a systematic review and meta-analysis

BackgroundIschaemic strokes are medical emergencies, and reperfusion treatment, most commonly intravenous thrombolysis, is time-critical. Thrombolysis administration relies on well-organised pathways of care with highly skilled and efficient clinicians. Simulation training is a widespread teaching modality, but results from studies on the impact of this intervention have yet to be synthesised. This systematic review and meta-analysis aimed to synthesise the evidence and provide a recommendation regarding the effects of simulation training for healthcare professionals on door-to-needle time in the emergency thrombolysis of patients with ischaemic stroke.MethodsSeven electronic databases were systematically searched (last updated 12th July 2023) for eligible full-text articles and conference abstracts. Results were screened for relevance by two independent reviewers. The primary outcome was door-to-needle time for recombinant tissue plasminogen activator administration in emergency patients with ischaemic stroke. The secondary outcomes were learner-centred, improvements in knowledge and communication, self-perceived usefulness of training, and feeling ‘safe’ in thrombolysis-related decision-making. Data were extracted, risk of study bias assessed, and analysis was performed using RevMan™ software (Web version 5.6.0, The Cochrane Collaboration). The quality of the evidence was assessed using the Medical Education Research Study Quality Instrument.ResultsEleven studies were included in the meta-analysis and nineteen in the qualitative synthesis (n = 20,189 total patients). There were statistically significant effects of simulation training in reducing door-to-needle time; mean difference of 15 min [95% confidence intervals (CI) 8 to 21 min]; in improving healthcare professionals’ acute stroke care knowledge; risk ratio (RR) 0.42 (95% CI 0.30 to 0.60); and in feeling ‘safe’ in thrombolysis-related decision-making; RR 0.46 (95% CI 0.36 to 0.59). Furthermore, simulation training improved healthcare professionals' communication and was self-perceived as useful training.ConclusionThis meta-analysis showed that simulation training improves door-to-needle times for the delivery of thrombolysis in ischaemic stroke. However, results should be interpreted with caution due to the heterogeneity of the included studies.

Occupational Health Hazard Experiences of Doctors and Nurses at a Tertiary Hospital in Bangladesh

Objective: This study aimed to explore the workplace safety experiences of health workers (doctors and nurses) at a tertiary hospital in Bangladesh. Materials and Methods: This was a descriptive cross-sectional study among conveniently selected 305 registered physicians and nurses working in the designated tertiary hospital. After obtaining the written informed consent, data was collected using face-to-face interviews with a pre-tested, semistructured, interviewer-administered questionnaire from December 2021 to January 2022. Frequency and proportion described the variables. Result: The mean age of the participants was 28.8 years. Female individuals constituted the majority, accounting for 69.2% of the total. Approximately 69.8% of individuals reported experiencing occupational health hazards. Psychological hazards were the most frequently reported (56.1%), followed by workplace-acquired health hazards (15.7%) and physical hazards (13.8%) among all participants. While 79.0% of the participants were aware of workplace health and safety, only 7.9% received safety training, and only 7.5% reported any occupational hazard to the hospital management. Conclusion: Healthcare personnel adjust to several professional hazards in a complicated series of events, as the study shows. The complexity of the healthcare environment poses considerable psychological and health hazards. Although there is good preparedness and procedure awareness, the analysis shows some crucial resources and training still need to be improved. Therefore, some strategic actions are needed to improve healthcare professionals’ safety and well-being in the modern healthcare environment through crucial resources and training.

Medical Doctors Approaches and Understanding of Health Literacy: A Systematic Literature Review.

A physician's role is critical in fostering patient health literacy (HL) and influencing various aspects, including patient-physician communication and treatment effectiveness. The purpose of this systematic literature review is to analyze physicians' perspectives, comprehension, and management of HL. The focus of this review is on physicians' views, opinions, experiences, and strategies related to HL. We conducted comprehensive searches across seven databases, including PubMed, Scopus, ProQuest, Science Direct, Web of Science, The Cochrane Library, and Google Scholar. Original research articles published between January 1, 2009, and July 31, 2020, were considered for inclusion. This literature review incorporates qualitative studies and mixed-methods studies, with a focus on extracting qualitative data. Among the 22 articles included in our review, we employed the method of inductive thematic analysis for data analysis. A detailed description of the review methodology can be found in a previously published protocol available through PROSPERO (CRD42020212599). The themes that emerged from the thematic analysis include: (a) physicians' perception and management of HL; and (b) barriers. The results of the systematic review reveal that healthcare professionals exhibit varying perceptions of patients' HL levels and ascribe different meanings to it. However, none of them employ a specific measuring tool. While there appears to be no uniform approach to managing patients with low HL, some prioritize certain communication strategies, such as repetition, simplified language, and providing written instructions, among others. Most physicians cited multiple barriers that impede the development of patients' HL, including dysfunctions within the healthcare system, staff shortages, managing a large number of patients, limited time, work-related stress, cultural and socio-economic barriers, medical jargon, and language barriers. Considering the pivotal role of physicians in fostering patient HL, it is crucial to enhance medical education in addressing and managing HL, both within academic curricula and through continuing education seminars. Furthermore, there is a pressing need to improve healthcare professionals' working conditions, ensuring that each physician can allocate the necessary time to each patient based on their individual needs, without being hindered by stress-inducing work environments.

Development of an educational program for healthcare professionals who provide appearance care for patients with cancer: Feasibility study of an e-learning program.

This study aimed to evaluate the feasibility and utility of an e-learning training program to improve healthcare professionals' knowledge about providing appearance care to patients with cancer. Healthcare professionals who provide appearance support were invited to participate voluntarily and complete a survey before and after the program. Participation request letters were distributed to 133 individuals, including 75 from four facilities invited via professional connections, and agreed to participate in the study and 58 participated in the National Cancer Center's appearance care training and indicated an interest in participating in the study. The 100 participants (75.2%) included 96 females, with an average age of 40.5 years. The participants reported high levels of satisfaction with the program, where more than 90% responded "satisfied" or "somewhat satisfied" and eager to use the content they learned in the program when they returned to their workplaces. However, the participants identified several barriers to applying their newly acquired knowledge including lack of knowledge (about 80%). Participant knowledge scores about appearance support were significantly higher after program participation. The survey results indicated the high feasibility of the e-learning program through improved knowledge about appearance care and high satisfaction with the program. The program needs further improvements for its practical utility.

Health care professionals most relevant phrases used in a digital medical translation tool in 24-7 communication with minority speaking heart surgery patients during hospitalization

Abstract Background/Introduction Health care professionals’ communications with hospitalized minority speaking heart patients are even in 2023 still frequently limited to non-verbal language, notes from informal caregivers and "google translate" in situations where interpreters are not available. Health care based digital solutions aiding translation may help improve health care professionals’ assessment, information about and treatment of minority speaking patients, and there is an urgent need for innovative research into this area. Purpose To describe the most relevant phrases used by health care professionals’ in a digital, medical translation tool for 24-7 communication with minority speaking heart surgery patients during hospitalization. Methods A digital medical translation tool was customized using the internationally recognized ABCDE (Airway, Breathing, Circulation, Disability, Exposure) systematic approach to assess and treat, in addition with the pre-operative surgical safety checklist employed as a framework. Health care professionals’ use of phrases in the digital tool when communicating with the minority speaking heart surgery patient’s during their clinical hospital pathway (Figure 1) were then counted, categorized, and finally linked to health care professionals’ actions. Results Fifty-five health care professionals (i.e. registered nurses, intensive care nurses, operating room nurses, anaesthesia nurses and physiotherapists) were during 60 shifts with 24-7 follow-up of five minority speaking heart surgery patients using a total of 410 phrases from the digital medical translation tool. The phrases were categorized and counted into the ten most common categories (Figure 2): 1. Pain (e. g. are you in pain?), 2. Nutrition (e. g. are you hungry?), 3. Respiration (e.g. breathe in), 4. Mobilisation (e.g. you have to get up and stand), 5. Psychological support (e.g. the surgery went well), 6. Safe surgery (e.g. do you have any teeth that are loose?), 7. Medications (e.g. pain relievers), 8. Communication (e.g. just answer "yes" or "no"), 9. Examination (e.g. you are going to have an x-ray examination), 10. Circulation (e.g. do you feel dizzy?). Health care professionals’ actions (i.e. assessment, information and reassurance, and instructions) were categorized and related to these phrases. Conclusions A health care based digital medical translation tool can aid in communication with minority speaking patients in situations when interpreters are not available. This study shows how health care professionals’ use of such a translation tool when communicating with minority speaking heart surgery patients during hospitalization can employ phrases and categories 24-7 to improve patients’ healthcare.Fig.1 Clinical pathwayFig.2 HCP communication

Temporal Reinforcement of Naloxone Training Results in Significant Retention of Anti-bias and Overdose-Response Knowledge.

The opioid epidemic is an increasingly severe problem affecting public health and leading to significant economic burdens on healthcare systems. Overdose reversal training and de-stigmatization efforts are common strategies used to combat this epidemic.Nevertheless, healthcare professionals report a lack of confidence in administering naloxone and high stigmatization levels towardpeople with opioid use disorder (OUD).While one-time educational training reduces stigma and improves naloxone administration confidence, we previously demonstrated that knowledge retention at a three-month follow-up is reduced amonga cohort of medical students. This study aimed to improve the effectiveness of opioid overdose awareness and reversal training (OOART) with a three-month follow-up abbreviated OOART (aOOART) booster video. Voluntary OOART was offered to first-year medical students (M1) at the Drexel University College of Medicine in 2022.At this training, 82 students completed a pre-training survey to establish a baseline knowledge and attitude towardpeople with OUD and their familiarity with the steps to reverse an opioid overdose. Following the hour-long training, 64 of 82 (79%) participants completed the post-training survey to measure the immediate retention of training information. After 2.5 months, students were randomly selected to receive a 6.5-minute aOOART booster video or serve as an unboosted control. Students in the booster and non-booster cohorts then completed a three-month follow-up survey. Students who received the aOOART booster had significantly increased opioid reversal knowledge scores compared to non-boosted control students at the three-month follow-up.The aOOART booster resulted in a retention of the lowered stigma, and participants expressed a higher willingness to respond to an opioid overdose compared to participants who did not receive the booster video at the three-month follow-up. This study shows that an aOOART booster method improves knowledge retention following initial OOART.Further, the aOOART booster video served to maintain participants' reduced stigma towardpeople with OUD and maintained participants' willingness to respond to an opioid overdose.These results support the incorporation of an abbreviated, periodic OOART reinforcement video into opioid overdose response training nationwide. We believe this "booster video" approach is a novel and effective method to improve healthcare professionals' and medical student preparedness to render appropriate care to people with OUD.

Characteristics and Predictors of Apparent Treatment Resistant Hypertension in Real-World Populations Using Electronic Health Record-Based Data.

Apparent treatment-resistant hypertension (aTRH) is defined as uncontrolled blood pressure (BP) despite using ≥3 antihypertensive classes or controlled BP while using ≥4 antihypertensive classes. Patients with aTRH have a higher risk for adverse cardiovascular outcomes compared to patients with controlled hypertension (HTN). Although there have been prior reports on the prevalence, characteristics, and predictors of aTRH, these have been broadly derived from smaller datasets, randomized controlled trials, or closed healthcare systems. We extracted patients with HTN defined by ICD 9 and 10 codes during 1/1/2015-12/31/2018, from two large electronic health record databases: the OneFlorida Data Trust (n=223,384) and Research Action for Health Network (REACHnet) (n=175,229). We applied our previously validated aTRH and stable controlled HTN computable phenotype algorithms and performed univariate and multivariate analyses to identify the prevalence, characteristics, and predictors of aTRH in these populations. The prevalence of aTRH among patients with HTN in OneFlorida (16.7%) and REACHnet (11.3%) was similar to prior reports. Both populations had a significantly higher proportion of Black patients with aTRH compared to those with stable controlled HTN. aTRH in both populations shared similar significant predictors, including Black race, diabetes, heart failure, chronic kidney disease, cardiomegaly, and higher body mass index. In both populations, aTRH was significantly associated with similar comorbidities, when compared with stable controlled HTN. In two large, diverse real-world populations, we observed similar comorbidities and predictors of aTRH as prior studies. In the future, these results may be used to improve healthcare professionals' understanding of aTRH predictors and associated comorbidities.

A survey on Iranian midwives' knowledge about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding.

The COVID-19 pandemic has impacted the care that maternal and newborn health professionals, especially midwives, provide. If they know how to care for COVID-19 patients during pregnancy, delivery, and postpartum, they can manage these cases better. The study aimed to identify the knowledge of Iranian midwives about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding. The study aimed to identify the knowledge of Iranian midwives about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding. This cross‑sectional study was conducted on 438 Iranian midwives from March to April 2021. Personal data and knowledge of them were gathered using an electronic web-based questionnaire. The statistical analysis was performed using the SPSS software version 18. The mean age of participants was 31.8 ± 2.3. The mean knowledge score of midwives was 11.2 ± 2.8, which was moderate. 91.55% of Midwives were more knowledgeable about COVID-19 infection symptoms in pregnant women. 34.93% and 31.05% of midwives had correct knowledge about vaccination against COVID-19 during pregnancy and breastfeeding, respectively. Results showed no statistically significant relationship between personal characteristics and knowledge of them (p > 0.05). Midwives' knowledge about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding was moderate. Continuing educational programs are needed by the Ministry of Health and Medical Education to design and implement for improving healthcare professionals' knowledge about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding.

Capability, Opportunity, and Motivation Model for Behavior Change in People With Asthma: Protocol for a Cross-Sectional Study.

Asthma is a common lung condition that cannot be cured, but it can usually be effectively managed using available treatments. Despite this, it is widely acknowledged that 70% of patients do not adhere to their asthma treatment. Personalizing treatment by providing the most appropriate interventions based on the patient's psychological or behavioral needs produces successful behavior change. However, health care providers have limited available resources to deliver a patient-centered approach for their psychological or behavioral needs, resulting in a current one-size-fits-all strategy due to the nonfeasible nature of existing surveys. The solution would be to provide health care professionals with a clinically feasible questionnaire that identifies the patient's personal psychological and behavioral factors related to adherence. We aim to apply the capability, opportunity, and motivation model of behavior change (COM-B) questionnaire to detect a patient's perceived psychological and behavioral barriers to adherence. Additionally, we aim to explore the key psychological and behavioral barriers indicated by the COM-B questionnaire and adherence to treatment in patients with confirmed asthma with heterogeneous severity. Exploratory objectives will include a focus on the associations between the COM-B questionnaire responses and asthma phenotype, including clinical, biological, psychosocial, and behavioral components. In a single visit, participants visiting Portsmouth Hospital's asthma clinic with a diagnosis of asthma will be asked to complete a 20-minute questionnaire on an iPad about their psychological and behavioral barriers following the theoretical domains framework and capability, opportunity, and motivation model. Participants' data are routinely collected, including demographics, asthma characteristics, asthma control, asthma quality of life, and medication regime, which will be recorded on an electronic data capture form. The study is already underway, and it is anticipated that the results will be available by early 2023. The COM-B asthma study will investigate an easily accessible theory-based tool (a questionnaire) for identifying psychological and behavioral barriers in patients with asthma who are not adhering to their treatment. This will provide useful information on the behavioral barriers to asthma adherence and whether or not a questionnaire can be used to identify these needs. The highlighted barriers will improve health care professionals' knowledge of this important subject, and participants will benefit from the study by removing their barriers. Overall, this will enable health care professionals to use effective individualized interventions to support improved medication adherence while also recognizing and meeting the psychological needs of patients with asthma. ClinicalTrials.gov NCT05643924; https://clinicaltrials.gov/ct2/show/NCT05643924. DERR1-10.2196/44710.

The association between workload, alcohol use, and alcohol misuse among psychiatrists in China.

Survey alcohol use and workload among Chinese psychiatrists and explore their associations. We conducted an online questionnaire among psychiatrists working in large psychiatric institutions across the country. We collected data including demographic factors, alcohol use, and workload. Alcohol use was assessed using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), and workload-related questions included working hours, night shifts, and caseloads. In total, 3,549 psychiatrists completed the survey. Nearly half (47.6%) reported alcohol use, and the percentage of alcohol use in males (74.1%) was significantly higher than in females. 8.1% exceeded the AUDIT-C cutoff scores for probable alcohol misuse (19.6%in males and 2.6%in females). AUDIT-C scores were significantly correlated with working hours per week (p = 0.017) and the number of outpatient visits per week (p = 0.006). Regressional analysis showed that alcohol use was significantly associated with the following factors: longer working hours (Working more than 44 h/week, OR = 1.315), having an administrative position (OR = 1.352), being male (OR = 6.856), being single (OR = 1.601), being divorced or widowed (OR = 1.888), smoking (OR = 2.219), working in the West (OR = 1.511) or the Northeast (OR = 2.440). Regressional analysis showed that alcohol misuse was significantly associated with the following factors: fewer night shifts (Three to four night shifts/month, OR = 1.460; No more than 2 night shifts/month, OR = 1.864), being male (OR = 4.007), working in the Northeast (OR = 1.683), smoking (OR = 2.219), frequent insomnia (OR = 1.678). Nearly half of the psychiatrists in China reported alcohol use and 8.1% had probable AUD. Alcohol consumption is significantly associated with several workload-related factors, such as long working hours, heavy caseload, and administrative duties. Alcohol misuse was inversely associated with the number of night shifts per month. While the direction of causality is unclear, our findings may help identify vulnerable professional groups and develop more targeted interventions to improve healthcare professionals' well-being.

The Effects of an Educational Intervention on Exercise Advice Behaviors of Thai Oncology Nurses

ObjectiveTo evaluate an educational intervention based on the Theory of Planned Behavior to increase oncology nurses’ exercise advice behaviors. MethodsA single-group, quasi-experimental repeated measures design study was used with 124 oncology nurses in a Thai cancer institute. The educational intervention included preeducation self-directed activities for 1 hour, a 2-hour group education session, and posteducation outreach contact 1 week later. The outcome measures, including the Theory of Planned Behavior constructs, exercise knowledge, and self-reported exercise prescription behaviors, were collected at three time points: Time 1 (2 weeks preintervention), Time 2 (immediately preintervention), and Time 3 (2 weeks after the intervention). ConclusionResults indicated a statistically significant increase in scores after the intervention for all outcomes, including the Theory of Planned Behavior constructs (overall P value <.001), exercise knowledge (β = 2.99, P < .001), and exercise prescription behaviors: asking (odds ratio [OR] = 12.98, P < .001), assessing (OR = 6.20, P < .001), referring (OR = 4.10, P < .001), and writing exercise advice (OR = 11.52, P < .001). Additionally, verbal counseling behavior was performed by all participants, and therefore, the odds for verbal counseling were not reported. Structural equation modeling analysis demonstrated that attitudes and perceived behavioral control explained 41% of the variance in exercise advice intention. Perceived behavioral control and intention also explained 20% of the variance in self-reported exercise advice behaviors. Implications for Nursing PracticeAttitudinal and perceived behavioral control constructs should be a focus of attention to improve health care professionals’ exercise advice behaviors. More focused research is required to examine whether patients engage in and follow the exercise advice provided by oncology nurses.

Moral distress and positive experiences of ICU staff during the COVID-19 pandemic: lessons learned

BackgroundThe COVID-19 pandemic causes moral challenges and moral distress for healthcare professionals and, due to an increased work load, reduces time and opportunities for clinical ethics support services. Nevertheless, healthcare professionals could also identify essential elements to maintain or change in the future, as moral distress and moral challenges can indicate opportunities to strengthen moral resilience of healthcare professionals and organisations.This study describes 1) the experienced moral distress, challenges and ethical climate concerning end-of-life care of Intensive Care Unit staff during the first wave of the COVID-19 pandemic and 2) their positive experiences and lessons learned, which function as directions for future forms of ethics support.MethodsA cross-sectional survey combining quantitative and qualitative elements was sent to all healthcare professionals who worked at the Intensive Care Unit of the Amsterdam UMC - Location AMC during the first wave of the COVID-19 pandemic. The survey consisted of 36 items about moral distress (concerning quality of care and emotional stress), team cooperation, ethical climate and (ways of dealing with) end-of-life decisions, and two open questions about positive experiences and suggestions for work improvement.ResultsAll 178 respondents (response rate: 25–32%) showed signs of moral distress, and experienced moral dilemmas in end-of-life decisions, whereas they experienced a relatively positive ethical climate. Nurses scored significantly higher than physicians on most items. Positive experiences were mostly related to ‘team cooperation’, ‘team solidarity’ and ‘work ethic’. Lessons learned were mostly related to ‘quality of care’ and ‘professional qualities’.ConclusionsDespite the crisis, positive experiences related to ethical climate, team members and overall work ethic were reported by Intensive Care Unit staff and quality and organisation of care lessons were learned. Ethics support services can be tailored to reflect on morally challenging situations, restore moral resilience, create space for self-care and strengthen team spirit. This can improve healthcare professionals’ dealing of inherent moral challenges and moral distress in order to strengthen both individual and organisational moral resilience.Trial registrationThe trial was registered on The Netherlands Trial Register, number NL9177.

Enhancing nurses' anti-phishing knowledge, attitude, and practices through an educational intervention and serious game

Introduction: E-learning opportunities can improve healthcare professionals’ digital competencies. More precisely, the anti-phising training may support nurses when encountering malicious content on Internet. This paper presents the impact of an educational intervention enhanced by a serious game on the nurses’ Knowledge, Attitudes and Practices (KAP) regarding Internet usage. Materials and Methods: this study was based on a double pre test design and is the second part of a PhD thesis based on a project that assess the Infosec practices of nurses who work in seven hospitals in the first and second Healthcare Region in Greece. Nurses who were interested in participating in this second phase of the project were given a link to access the material and the questionnaire. The convenience sample was divided into four sub groups out of which only one group was exposed to the anti phising training. All participants completed the HAIS Q tool and KAP was estimated in PSPP 1.6.2. Descriptive statistics and one-way ANOVA were performed. Tuckey post hoc analysis was conducted to determine differences among groups. Results: the sample of 124 nurses was utilized. Participants that took part in the educational intervention performed better in Knowledge and Practices items. Their total awareness was rated higher than that of their peers who were not exposed to the intervention. There was no significant difference in Attitude towards Internet usage. Conclusions: a multimodal educational intervention was delivered and positively affected nurses' Knowledge, Practices, and general Awareness on Internet usage. Nevertheless, the researchers highlight that the present version of the educational intervention was a pilot study and further research could be conducted.

Healthcare professionals' knowledge, attitude and its associated factors toward electronic personal health record system in a resource-limited setting: A cross-sectional study.

Electronic personal health record (e-PHR) system enables individuals to access their health information and manage it themselves. It helps patient engagement management of health information that is accessed and shared with their healthcare providers using the platform. This improves individual healthcare through the exchange of health information between patients and healthcare providers. However, less is known about e-PHRs among healthcare professionals. Therefore, this study aimed to assess Health professionals' Knowledge and attitude and its associated factors toward e-PHR at the teaching hospital in northwest Ethiopia. An institution-based cross-sectional study design was used to determine healthcare professionals' knowledge and attitude and their associated factors toward e-PHR systems in teaching hospitals of Amhara regional state, Ethiopia, from 20 July to 20 August 2022. Pretested structured self-administered questionnaires were used to collect the data. Descriptive statistic was computed based on sociodemographic and other variables presented in the form of table graphs and texts. Bivariable and multivariable logistic analyses were performed with an adjusted odds ratio (AOR) and 95% CI to identify predictor variables. Of the total study participants, 57% were males and nearly half of the respondents had a bachelor's degree. Out of 402 participants, ~65.7% [61-70%] and 55.5% [50-60%] had good knowledge and favorable attitude toward e-PHR systems, respectively. Having a social media account 4.3 [AOR = 4.3, 95% CI (2.3-7.9)], having a smartphone 4.4 [AOR = 4.4, 95% CI (2.2-8.6)], digital literacy 8.8 [(AOR = 8.8, 95% CI (4.6-15.9)], being male 2.7 [AOR = 2.7, 95% CI (1.4-5.0)], and perceived usefulness 4.5 [(AOR = 4.5, 95% CI (2.5-8.5)] were positively associated with knowledge toward e-PHR systems. Similarly, having a personal computer 1.9 [AOR = 1.9, 95% CI (1.1-3.5)], computer training 3.9 [AOR = 3.9, 95% CI (1.8-8.3)], computer skill 19.8 [AOR = 19.8, 95% CI (10.7-36.9)], and Internet access 6.0 [AOR = 6.0, 95% CI (3.0-12.0)] were predictors for attitude toward e-PHR systems. The findings from the study showed that healthcare professionals have good knowledge and a favorable attitude toward e-PHRs. Providing comprehensive basic computer training to improve healthcare professionals' expectation on the usefulness of e-PHR systems has a paramount contribution to the advancement of their knowledge and attitude toward successfully implementing e-PHRs.

Proceedings of the International Scientific Conference “Cancer, Work &amp; Employment”

This paper is an overview of the International Scientific Conference on “Cancer, Work &amp; Employment” that was held in Paris on November 21 and 22, 2022, and organized by the French National Cancer Institute (INCa). The conference was structured around four keynote presentations and two roundtables, with renowned international speakers. The focus of this conference was to discuss the challenges of return or access to work and job retention when facing cancer, from interdisciplinary perspectives (e.g., psychology, sociology, economics). Speakers analyzed return-to-work (RTW) determinants for cancer patients, with a particular focus on specific forms of cancer, working conditions (e.g., self-employment, adaptations at work when returning), and the influence of differences in social welfare systems. Current interventions to support RTW were analyzed, from the patient’s point of view and in terms of improving healthcare professionals’ practices. Prospects for future research in the field were also discussed (e.g., focus on underrepresented populations, considering the influence of longer treatments, incorporating changes in career paths). Finally, the broad spectrum of disciplines and the diversity in involved countries offered a rare opportunity to exchange ideas and helped initiate collaboration between participants.

Vaginal Douching: A Neglected Health Risk Behavior among Women and Sexually Active Adolescent Girls in Tanzania?

In this paper I present the public heath importance of vaginal douching or vaginal cleaning risk behavior among women and sexually active adolescent girls in Tanzania. I argue, vaginal douching control exclusion from sexually transmitted infections, human immunodeficiency virus and cervical cancer diagnosis, treatment and control guidelines explains, in part, why health professionals (physician, obstetricians and gynecologists) rarely advise their clients on this risk behavior. Similarly, this exclusion explains why there are limited research and (public) health interventions aiming at combating vaginal douching hazards among douching women and sexually active adolescent girls in this country. I recommend the Ministry of Health and (health) development partners to initiate, encourage and support health (medical and public health) research to generate comprehensive and informative multidisciplinary data on vaginal douching behaviors and practices and their impact to douching women’s and sexually active adolescent girls’ health and wellbeing. The goal is to generate data that would facilitate improving healthcare professionals’ ability to diagnose, treat, control, and prevent vaginal douching-related health problems and illnesses among douching women, sexually active adolescent girls and the populace in Tanzania.

Scoping review of intergenerational learning methods for developing digital competence and their outcomes

Due to the rapid digitalization of healthcare, it is important to strengthen professionals’ digital competence, particularly to support older professionals to stay in work until retirement age. People of different ages have different digital competencies. Younger generations are ‘digital natives’ who have learned to use digital devices fluently from a young age, while older generations have had to learn to use them in adulthood. The increasing number of new technologies causes in some cases stress, especially for more older healthcare workers. Intergenerational learning methods for developing digital competence may offer a way to narrow digital competence gaps in healthcare. The aim of this scoping review was to identify current evidence regarding intergenerational learning methods for developing digital competence, and their outcomes. The results can be used to help develop methods for intergenerational digital competence development and improve healthcare professionals’ digital competence. A scoping review was conducted across four databases (Scopus, CINAHL, Web of Science, ProQuest) without time limits. The search produced 2905 references, of which 23 studies are included in the review. Thematic analysis was used to analyze these studies’ results. The results showed that a key method for intergenerational digital competence development is reverse mentoring, where a less experienced person serves as a mentor to a more experienced one. Intergenerational digital competence development methods can be done one-on-one or in groups, in classes or on digital platforms. The outcomes of these methods illustrated that they promote mutual learning, increase the digital competence of older adults and the work life skills of young mentors, and narrow the gap between generations. Using such methods, it is possible to make better use of each generation’s expertise. Intergenerational learning could suggest ways of narrowing the digital gap and enhancing intergenerational communication. Healthcare could benefit from implementing intergenerational learning methods for developing digital competence, increasing the digital competence of healthcare professionals, and narrowing the gap between generations.

Fall rates by specialties and risk factors for falls in acute hospital: A retrospective study.

Falls are common adverse events in acute care hospitals, and about 25-50% of fallers suffer injuries. In acute care, fall rates range from 0.4-9 falls per 1000 patient days, varying among unit types, patient characteristics, and diseases. Several risk factors have been identified, including recent falls, age, reduced mobility, cognitive ability and polypharmacy. Several countries have become an aging society in which an increasing number of older patients need acute care. Therefore, the prevention of falls has become one of the most important aspects of patient safety. This retrospective study aimed to explore adults' inpatient falls in a Finnish university hospital with several specialties. The objectives were to draw an overall picture of fall rates in Finnish acute care, and to model risk factors for falls including secondary diagnoses. The study was conducted in a large university hospital in Finland. The data consisted of patients' electronic health records from 2014-2016 and included a total of 114,951 adult patients. Univariable and multivariable binary logistic regression model analysis was used to identify risk factors for falls and multiple imputation was used to missing data. The study reporting followed the STROBE guidelines. A total of 841 falls were recorded, totalling 1.5 falls per 1000 patient days, and the rate of falls with injury was 0.4 per 1000 patient days. The regression model included the following risk factors: increasing old age, prolonged hospital stays, specialty of neurology, mode of arrival (emergency care and hospital transfer), no operation during hospital stays and secondary diagnoses such as dementia, pneumonia and alcohol abuse. In acute care, falls occur most in patients with neurological diagnoses and least in surgical patients. Risk factors for falls include increasing age, emergency arrival, hospital transfer and prolonged hospital stay. Educational interventions to improve healthcare professionals' competence and preventive interventions to avoid inpatient falls need to be prioritized in medical specialties with high fall rates.

Understanding Healthcare Professionals’ Knowledge on Perinatal Depression among Women in a Tertiary Hospital in Ghana: A Qualitative Study

Health conditions affecting women in the perinatal period still account for a major contribution to disease burden in Sub-Saharan Africa, yet there is a dearth of empirical research to understanding health professionals' perspective on their experiences and how they care for perinatal women in depression. We used a qualitative exploratory descriptive approach through a face- to face-interview to explore the knowledge of 11 health professionals of Komfo Anokye Teaching Hospital, Kumasi- Ghana. Interviews were taped recorded and transcribed verbatim. The study adopted Haase's modification of Colaizzi's method for the analysis. Four main themes emerged: ineffective communication (Referral lapses among care providers, long waiting time, lack of confidentiality), workload (Inefficient staff to meet perinatal women's need, no screening tools and time constraints), Reaction to patients symptoms (Identifying patient's symptoms, assessment through patient's centeredness and Education and counselling). Our results emerged that time constraints, stigmatization and lack of awareness delayed the care and management of perinatal depression among healthcare professionals in the hospital setting. There is the need to improve healthcare professionals' knowledge on perinatal depression and it is imperative for the hospital administrators to invest in continuous training and professional development for healthcare professionals.

Using virtual reality to educate healthcare professionals on patients’ experience of delirium

Delirium is an acute onset confusion that has fluctuating consciousness symptoms such as hallucinations, mood changes and distractibility. It is experienced by around 2 in 10 patients within the hospital [1]. Amongst these patients, 96% are older adults and their outcomes are consistently worse due to the delirium alone, including increased mortality rates [2]. It can also be extremely frightening and distressing. Hence, the attitudes and knowledge of healthcare professionals surrounding delirium is an important topic to address in order to aid prevention as well as manage delirium. Despite training, delirium is under reported and generally poorly managed. Studies have found that the use of virtual reality in medical education has improved empathy, depth of knowledge, and self-awareness [3]. Using a 360° camera and virtual reality headsets, an in-patient scenario was created whereby the effects of delirium such as hallucinations and disorientation were depicted. The aim of the project was to establish whether virtual reality can be used to improve healthcare professionals understanding and awareness of patients’ experience of delirium. The virtual reality video and the interviews can be found on YouTube. Eight people were recorded using the VR and five of them were interviewed afterwards. The interviews were conducted using an unstructured approach in which the topics of how the virtual reality tool changed their perception of dementia, what they learnt from the tool, and whether they thought the tool was useful, were discussed. Thematic analysis was carried out retrospectively. The thematic analysis of the qualitative data highlighted four key themes amongst the healthcare professionals’ responses. These themes were education, insight, empathy, and future practice. The most common theme was insight, with comments such as ‘having the virtual reality, it breaks that barrier between you and them,’ ‘you realise how just isolated that person is,’ and how the virtual reality made them feel like they are ‘in the room,’ emphasising this theme. The outcome has been to prove concept and highlight the usefulness of virtual reality as a method of educating healthcare professionals. We have been emboldened by the feedback received. We are looking to incorporate the VR film as part of a broader simulation-based training. The training is already being adopted by local clinical teams and our local university partners. 1. Combined NHS (National Health Service). Delirium Training Video (Virtual Reality). 2022. 2. Royal College of Nursing. Delirium | Older people | Royal College of Nursing. The Royal College of Nursing. 2013. 3. Dyer E, Swartzlander BJ, Gugliucci MR. Using virtual reality in medical education to teach empathy. Journal of the Medical Library Association. 2018;106(4):498–500.