Influence Health Professionals Research Articles

Barriers and facilitators to health professionals' engagement in quality improvement initiatives: a mixed-methods systematic review.

Quality improvement (QI) initiatives in healthcare are crucial for enhancing service quality and healthcare outcomes. The success of these initiatives depends on the active engagement of healthcare professionals, which can be influenced by several factors within the healthcare system. This systematic review synthesized the factors influencing healthcare professionals' engagement in QI projects, focusing on identifying both barriers and facilitators. A mixed methods systematic review (MMSR) was conducted using the JBI methodology for MMSR. Databases such as MEDLINE, CINAHL, Scopus, and Embase were searched for studies that explored barriers and facilitators to QI engagement of health professionals in the clinical setting. Methodological quality was assessed using the Mixed-Methods Appraisal Tool (MMAT). The extracted data were synthesized using the JBI convergent integrated approach to MMSR. Eighteen studies (seven qualitative, nine quantitative, and two mixed-methods) published between 2007 and 2023 were included in the review. The analysis revealed barriers and facilitators to engagement in QI initiatives at different levels of the health system. At the QI program level, the engagement of health professionals to QI was influenced by the approach to QI, evidence underpinning the QI initiative, QI knowledge and training, and access to QI specialists. At the health professional level, barriers and facilitators were related to their organizational role, motivation, perceptions about QI, and collaborations with individuals and groups. At the organizational level, factors related to culture and climate, leadership, available resources (including human resource and workload, infrastructure, and incentives), and institutional priorities influenced health professionals' participation in QI. This review highlights the complex interplay of organizational, individual, and QI program level factors that influence the engagement of healthcare professionals in QI. Overcoming these complex barriers and leveraging facilitators is crucial for enhancing participation in QI efforts. The findings underscore the need for a multi-level strategy that focuses on creating a conducive organizational culture, providing robust leadership, and ensuring adequate resources and training for healthcare professionals. Such strategies hold the potential to enhance the effectiveness and sustainability of QI initiatives in healthcare settings.

Health professionals' technology readiness on the acceptance of teleradiology in the Amhara regional state public hospitals, northwest Ethiopia: Using technology readiness acceptance model (TRAM).

Considering individual differences caused by personality differences is crucial for end users' technology acceptance. However, previous studies overlooked the influence of users' technology readiness on technology acceptance. This study, therefore, aimed to evaluate the influence of technology readiness on teleradiology acceptance in the Amhara Regional State Public Hospitals using a technology readiness acceptance model. An institutional-based cross-sectional mixed study design was conducted in September 2021 among 547 health professionals working at sixteen public hospitals in the Amhara region of northwest Ethiopia. Eight key informants were interviewed to explore organizational-related factors. Face-to-face and Google Meet approaches were used to collect the data. We applied structural equation modeling to investigate the influence of technology readiness on health professionals' teleradiology acceptance using Analysis of Moment Structures Version 23 software. Of the total participants, 70.2% and 85.7% were ready and intended to use teleradiology, respectively. According to technology readiness measuring constructs, optimism and innovativeness positively influenced health professionals' technology acceptance. Perceived ease of use and perceived usefulness showed a statistically positive significant effect on health professionals' intention to use teleradiology. In addition, a statistically significant mediation effect was observed between technology readiness measuring constructs and behavioral intention to use. Furthermore, a shortage of budget, inadequate infrastructure, and users' lack of adequate skills were reported as critical organizational challenges. We found a higher proportion of readiness and intention to use teleradiology among health professionals. Personality difference measuring constructs and organizational factors played considerable influence on teleradiology acceptance. Therefore, before the actual implementation of teleradiology, ensuring the system's user-friendliness, improving infrastructure, allocating an adequate budget, and availing of capacity-building opportunities are recommended.

Views and experiences of long-acting reversible contraception among ethnic minorities in high-income countries: a systematic review of qualitative studies

BackgroundEthnic minorities in high-income countries have higher rates of unintended pregnancies but are less likely to use highly efficacious long-acting reversible contraception (LARC). The reasons for this are unclear.AimTo understand...

Influence of health workers’ fear of death on attitudes to end-of-life care: A multicentre survey-based hospital study with Bayesian analysis

We conducted a study to assess whether personal fear of death may influence health professionals’ attitudes to the care of dying patients. We found that higher levels of anxiety about the death and dying of others were associated with discomfort starting discussions about end-of-life care, and that the belief that provision of all treatment options should be prioritised over patient discomfort. Whether self-reported attitudes to death and dying of patients affect clinical outcomes needs study. Trials are needed to determine what specific training could reduce fear of death in healthcare professionals and change attitudes to the death and dying of patients.

Sustainability, spread, and scale in trials using audit and feedback: a theory-informed, secondary analysis of a systematic review

BackgroundAudit and feedback (A&F) is a widely used implementation strategy to influence health professionals’ behavior that is often tested in implementation trials. This study examines how A&F trials describe sustainability, spread, and scale.MethodsThis is a theory-informed, descriptive, secondary analysis of an update of the Cochrane systematic review of A&F trials, including all trials published since 2011. Keyword searches related to sustainability, spread, and scale were conducted. Trials with at least one keyword, and those identified from a forward citation search, were extracted to examine how they described sustainability, spread, and scale. Results were qualitatively analyzed using the Integrated Sustainability Framework (ISF) and the Framework for Going to Full Scale (FGFS).ResultsFrom the larger review, n = 161 studies met eligibility criteria. Seventy-eight percent (n = 126) of trials included at least one keyword on sustainability, and 49% (n = 62) of those studies (39% overall) frequently mentioned sustainability based on inclusion of relevant text in multiple sections of the paper. For spread/scale, 62% (n = 100) of trials included at least one relevant keyword and 51% (n = 51) of those studies (31% overall) frequently mentioned spread/scale. A total of n = 38 studies from the forward citation search were included in the qualitative analysis. Although many studies mentioned the need to consider sustainability, there was limited detail on how this was planned, implemented, or assessed. The most frequent sustainability period duration was 12 months. Qualitative results mapped to the ISF, but not all determinants were represented. Strong alignment was found with the FGFS for phases of scale-up and support systems (infrastructure), but not for adoption mechanisms. New spread/scale themes included (1) aligning affordability and scalability; (2) balancing fidelity and scalability; and (3) balancing effect size and scalability.ConclusionA&F trials should plan for sustainability, spread, and scale so that if the trial is effective, the benefits can continue. A deeper empirical understanding of the factors impacting A&F sustainability is needed. Scalability planning should go beyond cost and infrastructure to consider other adoption mechanisms, such as leadership, policy, and communication, that may support further scalability.Trial registrationRegistered with Prospero in May 2022. CRD42022332606.

Factors influencing health professionals' use of high-flow nasal cannula therapy for infants with bronchiolitis - A qualitative study.

To explore the factors influencing the use of high-flow nasal cannula (HFNC) therapy for infants with bronchiolitis. Qualitative approach using semi-structured interviews. The semi-structured interviews (face-to-face or virtual) were conducted between September 2020 and February 2021. Deductive content analysis was used to map key influencing factors for use of HFNC therapy to the Theoretical Domains Framework (TDF). Nineteen interviews were undertaken before reaching thematic saturation (7 nurses, 12 doctors) in emergency departments and paediatric wards from four purposively selected hospitals in Australia and New Zealand. Influencing factors were mapped to eight domains in the TDF with 21 themes identified. Main findings included: (1) Health professionals' expectations of HFNC therapy on patient deterioration, work of breathing and oxygenation; (2) Staff emotions relating to concern and anxiety about deterioration and "need to do something"; (3) Social influences from other health professionals and parents and (4) Environmental factors relating to logistics of care and patient transfer considerations. These factors, combined with the ready availability of HFNC equipment and health professionals having the required skills to administer the therapy, contributed to its initiation. Individual/personal and contextual/environmental factors contribute to the use of HFNC therapy for infants with bronchiolitis. It is evident these influences contribute substantially to increased use, despite evidence-based guidelines recommending a more nuanced approach to this therapy. These findings will inform a targeted implementation intervention to promote evidence-based use of HFNC therapy in infants with bronchiolitis.

O.28.1 - Factors that influence health professionals team communication in emergencies.: Presenter(s): Sharon Bourke, Federation University, Australia

O.28.1 - Factors that influence health professionals team communication in emergencies.: Presenter(s): Sharon Bourke, Federation University, Australia

Pattern and perception of wellbeing, quality of work life and quality of care of health professionals in Southwest Nigeria

BackgroundPersonal wellbeing (PW) including quality of life and work life is a very complex concept that influences health professionals’ commitment and productivity. Improving PW may result in positive outcomes and good quality of care. Therefore, this study aimed to assess the pattern and perception of wellbeing, quality of work life (QoWL) and quality of care (QoC) of health professionals (HPs) in southwest Nigeria. MethodsThe study was a convergent parallel mixed method design comprising a cross-sectional survey (1580 conveniently selected participants) and a focus group interview (40 purposively selected participants). Participants’ PW, quality of life (QoL), QoWL, and QoC were assessed using the PW Index Scale, 5-item World Health Organization Well-Being Index, QoWL questionnaire, and Clinician QoC scale, respectively. The pattern of wellbeing, QoWL and quality of care of HPs were evaluated using t-test and ANOVA tests. Binary regression analysis was used to assess factors that could classify participants as having good or poor wellbeing, QoWL, and quality of care of HPs. The qualitative findings were thematically analyzed following two independent transcriptions. An inductive approach to naming themes was used. Codes were assigned to the data and common codes were grouped into categories, leading to themes and subthemes.ResultsOf 1600 administered questionnaires, 1580 were returned, giving a 98.75% response rate. Only 45.3%, 43.9%, 39.8% and 38.4% of HP reported good PW, QoL, QoC and QoWL, respectively; while 54.7%, 56.1%, 60.2% and 61.6% were poor. There were significant gender differences in PW and QoC in favor of females. With an increase in age and years of practice, there was a significant increase in PW, QoWL and QoC. As the work volume increased, there was significant decrease in QoWL. Participants with master's or Ph.D. degrees reported improved QoWL while those with diploma reported better QoC. PWI and QoC were significantly different along the type of appointment, with those who held part-time appointments having the least values. The regression models showed that participant’s characteristics such as age, gender, designation, and work volume significantly classified health professionals who had good or poor QoC, QoWL, PW and QoL. The focus group interview revealed four themes and 16 sub-themes. The four themes were the definitions of QoC, QoWL, and PW, and dimensions of QoC.ConclusionMore than half of health professionals reported poor quality of work life, quality of life and personal wellbeing which were influenced by personal and work-related factors. All these may have influenced the poor quality of care reported, despite the finding of a good knowledge of what quality of care entails.

Exploring health professionals’ perceptions of how their own diet influences their self-efficacy in providing nutrition care

Objective Supporting health professionals’ dietary behaviours is important to their own health and may influence the quality of care they provide. Understanding health professionals’ perceptions on the experiences which have shaped their views on nutrition is important to inform interventions. Design A cross-sectional qualitative design utilised in depth interviews via telephone or videoconference. Health professionals with direct interaction with patients were recruited through the media channels of Australian national health professional associations. A semi-structured interview guide was used. Interview data analysis was conducted using thematic analysis. Twenty-two health professionals participated in the study including dietitians. Results Three themes emerged from the data: (1) Life experiences influence health professionals’ feelings of self-efficacy in providing nutrition care. (2) Learning through observation and role modelling occurred continually and shaped health professionals’ attitudes and beliefs on nutrition care. (3) Social interactions influenced self-efficacy through social persuasion and social pressure. The social environment played a role in both facilitating and/or hindering adoption of a dietary behaviour in their own lives. Conclusions Health professionals perceive their personal dietary experiences strongly influence their self-efficacy to provide nutrition care. Strategies which enable health professionals to improve their diets could lead to improvements in nutrition care. Creating socially supportive environments in the workplace warrant investigation to support health professionals to eat well and provide nutrition care to patients.

Moral distress, emotional impact and coping in intensive care unit staff during the outbreak of COVID-19

BackgroundFrom the beginning, the COVID-19 pandemic increased ICU workloads and created exceptionally difficult ethical dilemmas. ICU staff around the world have been subject to high levels of moral stress, potentially leading to mental health problems. There is only limited evidence on moral distress levels and coping styles among Spanish ICU staff, and how they influenced health professionals’ mental health during the pandemic. ObjectivesTo assess moral distress, related mental health problems (anxiety and depression), and coping styles among ICU staff during the first wave of the COVID-19 pandemic in Spain. DesignCross-sectional. Settings and participantsThe study setting consisted of intensive care unit and areas converted into intensive care units in public and private hospitals. A total of 434 permanent and temporary intensive care staff (reassigned due to the pandemic from other departments to units) answered an online questionnaire between March and June 2020. MethodsSociodemographic and job variables, moral distress, anxiety, depression, and coping mechanisms were anonymously evaluated through a self-reported questionnaire. Descriptive and correlation analyses were conducted and multivariate linear regression models were developed to explore the predictive ability of moral distress and coping on anxiety and depression. ResultsMoral distress during the pandemic is determined by situations related to the patient and family, the intensive care unit, and resource management of the organisations themselves. intensive care unit staff already reached moderate levels of moral distress, anxiety, and depression during the first wave of the pandemic. Temporary staff (redeployed from other units) obtained higher scores in these variables (p = 0.04, p = 0.038, and p = 0.009, respectively) than permanent staff, as well as in greater intention to leave their current position (p = 0.03). This intention was also stronger in health staff working in areas converted into intensive care units (45.2%) than in normal intensive care units (40.2%) (p = 0.02). Moral distress, coupled with primarily avoidance-oriented coping styles, explains 37% (AdR2) of the variance in anxiety and 38% (AdR2) of the variance in depression. ConclusionsOur study reveals that the emotional well-being of intensive care unit staff was already at risk during the first wave of the pandemic. The moral distress they experienced was related to anxiety and depression issues, as well as the desire to leave the profession, and should be addressed, not only in permanent staff, but also in temporary staff, redeployed to these units as reinforcement workers.

Effect of barrier related factors on perceived usefulness and ease of use of social media applications in the Australian healthcare sector

Despite the growing popularity of social media internationally, an extant review of the literature revealed a low rate of social media usage among healthcare professionals. While cynicism amongst healthcare professionals might be a reason, there might be other factors that could explain healthcare professionals’ reluctance to use social media in their practices. This research investigated potential barriers that affected healthcare professionals’ behavioural intention to use social media. A cross-sectional survey was randomly administered to 824 healthcare professionals working in Australian healthcare organisations. At the end of data collection, 219 usable responses were collected. Analysis of data via structural equation model (SEM) found that perceived trust, privacy threats, professional boundary, facilitating conditions and self-efficacy significantly influence the notion of perceived usefulness and ease of use. In addition, information quality directly influences health professionals’ perceived ease of utilising social media technology. The result also indicated that gender moderates the relationship between barrier-related factors and perceived usefulness and ease of use. This study’s findings have important implications for healthcare providers and policymakers regarding medical professionals’ perceptions of the potential challenges in using social media as well as developing strategies to counter misinformation against the backdrop of COVID-19.

What Influences Health Professionals' Recommendations for Non-Scheduled Childhood Vaccinations? A Qualitative Study of Health Professionals' Perspectives in Three Provinces of China.

Recommendations by health professionals are important for vaccines that are not included in national schedules. This study explored health professionals’ perspectives on recommending non-scheduled (user-fee) childhood vaccinations in China, identifying key influences on professionals’ interactions with caregivers. We conducted individual semi-structured interviews with 20 health professionals from three provinces in China and analyzed data thematically using deductive and inductive coding. Health professionals from all three provinces were uncomfortable about being perceived to encourage parents to accept vaccines that incurred a fee. They provided information about non-scheduled vaccines but emphasized parental autonomy in decision-making. Rural parents were less aware of unscheduled vaccines and health professionals were more likely to encourage parents living in more affluent areas to consider these vaccines; varicella vaccine was preferred by parents as a way of preventing school absence. Economic incentives for unscheduled vaccines were given to staff at most study sites, although the amount given varied widely. These variations meant that staff receiving lower incentives were not motivated to promote non-scheduled vaccines if their workload was high; on the contrary, those receiving higher incentives were more likely to promote these vaccines. Health professionals need more guidance on how to recommend unscheduled vaccines in an informative, positive and appropriate manner. It is evident that parents’ awareness of these vaccines, and their economic circumstances, influence vaccinators recommendation practice. Economic incentives prompted health professionals to recommend non-scheduled vaccines; however, the application of such staff incentives varied widely in China. To adopt appropriate economic incentives, professional organizations should develop protocols for the use of incentives that account for their influence on recommendation practices. Suitable recommendation policy needs to balance basic salaries with performance-based incentives, consider overall workload, and include monitoring and evaluation of economic incentives.

Intention to Use Wiki-Based Knowledge Tools: Survey of Quebec Emergency Health Professionals.

BackgroundClinical decision support systems are information technologies that assist clinicians in making better decisions. Their adoption has been limited because their content is difficult to adapt to local contexts and slow to adapt to emerging evidence. Collaborative writing applications such as wikis have the potential to increase access to existing and emerging evidence-based knowledge at the point of care, standardize emergency clinical decision making, and quickly adapt this knowledge to local contexts. However, little is known about the factors influencing health professionals’ use of wiki-based knowledge tools.ObjectiveThis study aims to measure emergency physicians’ (EPs) and other acute care health professionals’ (ACHPs) intentions to use wiki-based knowledge tools in trauma care and identify determinants of this intention that can be used in future theory-based interventions for promoting the use of wiki-based knowledge tools in trauma care.MethodsIn total, 266 EPs and 907 ACHPs (nurses, respiratory therapists, and pharmacists) from 12 Quebec trauma centers were asked to answer a survey based on the theory of planned behavior (TPB). The TPB constructs were measured using a 7-point Likert scale. Descriptive statistics and Pearson correlations between the TPB constructs and intention were calculated. Multiple linear regression analysis was conducted to identify the salient beliefs.ResultsAmong the eligible participants, 57.1% (152/266) of EPs and 31.9% (290/907) of ACHPs completed the questionnaire. For EPs, we found that attitude, perceived behavioral control (PBC), and subjective norm (SN) were significant determinants of the intention to use wiki-based knowledge tools and explained 62% of its variance. None of the sociodemographic variables were related to EPs’ intentions to use wiki-based knowledge tools. The regression model identified two normative beliefs ("approval by physicians" and "approval by patients") and two behavioral beliefs ("refreshes my memory" and "reduces errors"). For ACHPs, attitude, PBC, SN, and two sociodemographic variables (profession and the previous personal use of a wiki) were significantly related to the intention to use wiki-based knowledge tools and explained 60% of the variance in behavioral intention. The final regression model for ACHPs included two normative beliefs ("approval by the hospital trauma team" and "people less comfortable with information technology"), one control belief ("time constraints"), and one behavioral belief ("access to evidence").ConclusionsThe intentions of EPs and ACHPs to use wiki-based knowledge tools to promote best practices in trauma care can be predicted in part by attitude, SN, and PBC. We also identified salient beliefs that future theory-based interventions should promote for the use of wiki-based knowledge tools in trauma care. These interventions will address the barriers to using wiki-based knowledge tools, find ways to ensure the quality of their content, foster contributions, and support the exploration of wiki-based knowledge tools as potential effective knowledge translation tools in trauma care.

Decision making in the end-of-life care of patients who are terminally ill with cancer \u2013 a qualitative descriptive study with a phenomenological approach from the experience of healthcare workers

BackgroundIn Colombia, recent legislation regarding end-of-life decisions includes palliative sedation, advance directives and euthanasia. We analysed which aspects influence health professionals´ decisions regarding end-of-life medical decisions and care for cancer patients.MethodsQualitative descriptive–exploratory study based on phenomenology using semi-structured interviews. We interviewed 28 oncologists, palliative care specialists, general practitioners and nurses from three major Colombian institutions, all involved in end-of-life care of cancer patients: Hospital Universitario San Ignacio and Instituto Nacional de Cancerología in Bogotá and Hospital Universitario San José in Popayan.ResultsWhen making decisions regarding end-of-life care, professionals consider: 1. Patient’s clinical condition, cultural and social context, in particular treating indigenous patients requires special skills. 2. Professional skills and expertise: training in palliative care and experience in discussing end-of-life options and fear of legal consequences. Physicians indicate that many patients deny their imminent death which hampers shared decision-making and conversations. They mention frequent ambiguity regarding who initiates conversations regarding end-of-life decisions with patients and who finally takes decisions. Patients rarely initiate such conversations and the professionals normally do not ask patients directly for their preferences. Fear of confrontation with family members and lawsuits leads healthcare workers to carry out interventions such as initiating artificial feeding techniques and cardiopulmonary resuscitation, even in the absence of expected benefits. The opinions regarding the acceptability of palliative sedation, euthanasia and use of medications to accelerate death without the patients´ explicit request vary greatly. 3. Conditions of the insurance system: limitations exist in the offer of oncology and palliative care services for important proportions of the Colombian population. Colombians have access to opioid medications, barriers to their application are largely in delivery by the health system, the requirement of trained personnel for intravenous administration and ambulatory and home care plans which in Colombia are rare.ConclusionsTo improve end-of-life decision making, Colombian healthcare workers and patients need to openly discuss wishes, needs and care options and prepare caregivers. Promotion of palliative care education and development of palliative care centres and home care plans is necessary to facilitate access to end-of-life care. Patients and caregivers’ perspectives are needed to complement physicians’ perceptions and practices.

Health professional's willingness to advocate for strengthening global commitments to the Paris climate agreement: Findings from a multi-nation survey.

Health professionals have the potential to address the health threats posed by climate change in many ways. This study sought to understand the factors that influence health professionals' willingness to engage in climate advocacy. We hypothesized and tested a model with six antecedent factors predicting willingness to engage in advocacy for strengthening global commitments to the Paris Agreement. Using survey data from members of health professional associations in 12 nations (n=3,977), we tested the hypothesized relationships with structural equation modeling. All of the hypothesized relationships were confirmed. Specifically, higher rates of perceived expert consensus about human-caused climate change predicted greater climate change belief certainty and belief in human causation. In turn, all three of these factors, including higher levels of perceived health harms from climate change, positively predicted affective involvement with the issue. Affective involvement positively predicted the feeling that health professionals have a responsibility to deal with climate change. Lastly, this sense that climate advocacy is a responsibility of health professionals strongly predicted willingness to advocate. As a unique study of predictors of health professionals' willingness to advocate for climate change, our findings provide unique insight into how an influential set of trusted voices might be activated to address what is arguably the world's most pressing public health threat. Limitations of the study and suggestions for future research are presented, and implications for message development are discussed.

Exercise Promotion: Reviewing the Importance of Health Professionals’ Interpersonal Behaviors on Exercisers’ Basic Psychological Needs

Previous studies have investigated the impact of exercisers' perceptions of health professionals' interpersonal behaviors on exercisers' exercise adherence. From these studies, there is increased interest in developing and evaluating programs to improve health professionals' communication skills and interpersonal behavior. In this narrative review, we provide examples of self-determination theory and newer modifications to it, discuss the empirical conditions that foster optimal exerciser motivation, consider the antecedent factors influencing health professionals' behaviors, and offer practical suggestions to health professionals seeking to promote regular exercise practice. Since exercisers perceive and differentiate health professionals' need-supportive, need-thwarting, and need-passive behaviors, health professionals who can critically and consciously distinguish these different types of behavior are more likely to foster supportive climates and suppress the use of need-thwarting and need-indifferent behaviors. The interpersonal interaction between health professionals and exercisers strongly influences how exercisers will regulate their behavior toward persistent exercise.

An Empirical Study of Intrinsic Determinants Influencing Telemedicine Services Adoption by Healthcare Professionals

<p style="text-align: justify;"><strong>Background:</strong> Telemedicine services have been confronted with several determinants that hinders their successful implementations. Identifying such determinants for acceptance and use of telemedicine services is a growing concern for healthcare professionals as people nowadays perpetually live their lives through telemedicine services. This current study seeks to investigate the internal determinants that influence health professionals’ intention to utilize telemedicine services in Ghana.</p> <p style="text-align: justify;"><strong>Method:</strong> An integrated theory was derived by combining healthcare technology acceptance theories to examine this quandary. Purposive and convenience sampling methods were used in the selection of healthcare professionals from different medical fields whilst using questionnaires for the data collection in four government health institutions. Structural equation modeling (SEM) approach was utilized in the data analysis.</p> <p style="text-align: justify;"><strong>Results:</strong> Selected constructs: perceived usefulness, management strategies, health institution's financial sustainability, perceived ease of use, and communication channels had significant influence on health professionals’ behavioral intention to use telemedicine services. Surprisingly, user characteristics of healthcare professionals was not significant as divulge by the results of the integrated theory.</p> <p style="text-align: justify;"><strong>Conclusion:</strong> Findings portray that healthcare professionals were pragmatic when making choices for technology applications and were interested in using telemedicine services. Effective utilization of telemedicine services will aid as a strategy to eradicate hardships in healthcare services delivery in Ghana. The study contributes to empirical knowledge by identifying the vital internal predictive factors affecting telemedicine services among healthcare professionals.</p>

What Makes Some Diseases More Typical than Others? A Survey on the Impact of Disease Characteristics and Professional Background on Disease Typicality.

Health professionals tend to perceive some diseases as more typical than others. If disease typicalities have implications for health professionals or health policy makers’ handling of different diseases, then it is of great social, epistemic, and ethical interest. Accordingly, it is important to find out what makes health professionals rank diseases as more or less typical. This study investigates the impact of various factors on how typical various diseases are perceived to be by health professionals. In particular, we study the influence of broad disease categories, such as somatic versus psychological/behavioral conditions, and a wide range of more specific disease characteristics, as well as the health professional’s own background. We find that professional background strongly impacted disease typicality. All professionals (MD, RN, physiotherapists and psychologists) considered somatic conditions to be more typical than psychological/behavioral. As expected, psychologists also found psychological/behavioral conditions to be more typical than did other groups. Professions of respondents could be well predicted from their individual typicality judgments, with the exception of physiotherapists and nurses who had very similar judgment profiles. We also demonstrate how various disease characteristics impact typicality for the different professionals. Typicality showed moderate to strong positive correlations with condition severity and mortality, and only non-severe conditions were rated as atypical. Hence, studying how different disease characteristics and occupational background influences health professionals’ perception of disease typicality is the first and important step toward a more general study of how typicality influences disease handling.

Health professionals\u2019 experiences of providing care for women survivors of sexual violence in psychiatric inpatient units

BackgroundSurvivors of sexual violence, who are predominantly women, commonly access mental health services. Psychiatric inpatient units in Australia are predominately mixed gender and may further retraumatise these women. Sexual violence is under-recognised by mental health professionals and there is a lack of adequate policy or direction for mental health service services. To date, only a small amount of research has focused on health professionals’ experiences of providing trauma-informed care to women in psychiatric settings, with most studies focused on specific practices or interventions. Qualitative data is particularly lacking on this topic. This is a critical gap in the knowledge given that health professionals are key to detecting and addressing victimisation. The aim of this study was to gain an in-depth understanding of healthcare professionals’ experiences and perceptions in providing care to women who are survivors of sexual violence in psychiatric inpatient units.MethodsThis qualitative study utilised semi-structured interviews with 40 health professionals recruited from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic analysis.ResultsThree main typologies were developed to describe participants’ experiences of the care provided to women; 1) Dismissing and denying; 2) Acknowledging but unprepared; 3) Empathising but despairing.DiscussionGender, professional training, adherence to the biomedical model, and level of experience influenced health professionals’ experiences.ConclusionsHealth professionals in this study held varying attitudes towards female consumers and responses to sexual violence. Our findings suggest the need to address individual staff perception and promote trauma-informed and gender-sensitive care across all disciplines, genders, and levels of experience.

Can Organizational Leaders Sustain Compassionate, Patient-Centered Care and Mitigate Burnout?

Organizational leaders are recognizing the urgent need to mitigate clinician burnout. They face difficult choices, knowing that burnout threatens the quality and safety of care and the sustainability of their organizations. Creating cultures and system improvements that support the workforce and diminish burnout are vital leadership skills. The motivation to heal draws many health professionals to their chosen work. Further, research suggests that compassion creates a sense of personal reward and professional satisfaction. Although many organizations stress compassion in mission and vision statements, their strategies to enhance well-being largely ignore compassion as a source of joy and connection to purpose.Passage of the HITECH (Health Information Technology for Economic and Clinical Health) Act in 2009 and the Affordable Care Act in 2010 ushered in a new era in healthcare. Little is known about how changes in the healthcare delivery system related to these legislative milestones have influenced health professionals' capacity to offer compassionate care. Further, advances such as artificial intelligence and virtual care modalities brought more attention to the elements that form the clinician-patient relationship.This study analyzed the views of U.S. healthcare providers on the status of compassionate healthcare compared with 2010. Postulating that compassion is inversely correlated with burnout, we studied this relationship and contributing factors. Our review of evidence-based initiatives suggests that leaders must define the organizational conditions and implement processes that support professionals' innate compassion and contribute to their well-being rather than address burnout later through remedial strategies.