Health Professionals Research Articles

Blood pressure abnormality detection and Interpretation utilizing Explainable Artificial Intelligence

ObjectiveHypertension is a pressing medical dysfunction that increases the risks of many fatal diseases. Early detection of hypertension can be crucial to lead a healthy life. Machine learning (ML) can be useful for the early prediction of a patient's likelihood of having a blood pressure abnormality and preventing it. Explainable artificial intelligence (XAI) is a state-of-the-art ML toolset that helps us understand and explain the prediction of an ML model. This research aims to build an automatic blood pressure anomaly detection system with maximum accuracy using the fewest features and learn why a model arrived at a particular result using XAI. MethodsThis research utilized the "Blood Pressure Data for Disease Prediction" dataset from Kaggle. Data were collected from medical reports of random participants in 2019 based on the presence of blood pressure abnormality, chronic kidney disease, and adrenal and thyroid disorders. We have used several ML algorithms (extreme gradient boosting (XGBoost), random forest (RF), support vector machine (SVM), decision tree (DT), and Logistic regression (LR)) to predict blood pressure abnormality based on patient's data. Principal component analysis (PCA) and recursive feature elimination (RFE) algorithms are used as feature optimizers. The receiver operating characteristic (ROC) curve analysis and accuracy were the key outcome metrics. Through the experiment, we have also calculated various performance measurement techniques like precision, recall, specificity, F1 score, and kappa to pin down the model with the best performance. Moreover, we have implemented several XAI methods namely permutation feature importance (PFI), partial dependence plots (PDP), Shapley additive explanations (SHAP), and local interpretable model-agnostic explanations (LIME) for additional exploration of our best model. ResultsThe combination of RFE and XGBoost provides the most significant results. The results of the study show that the algorithm has an AUC of 0.95, indicating good discriminatory power in detecting abnormal BP. The accuracy, precision, recall, specificity, F1-score, and kappa gained are 91.50%, 88.64%, 92.65%, 92.27%, 90.83%, and 0.8 respectively. According to the results of the XAI experiment, the genetic pedigree coefficient and hemoglobin level in a patient contribute the most to blood pressure abnormality prediction. Adrenal and thyroid diseases, as well as chronic kidney illness, have an impact on the projections. Existing research backs up this conclusion. ConclusionWhile comparing to previous works on this dataset, the results of our research are superior and the use of XAI shed new light on our model's prediction. This study would provide new insight into blood pressure detection in the medical profession.

Perceptions, attitudes and beliefs on antenatal exercises among primiparous pregnant women: a qualitative study in Sri Lanka

BackgroundEven if promoting antenatal exercises is an evolving concept worldwide, there is a scarcity of qualitative exploratory studies which directly focus on pregnant mothers’ views about exercises. So, this study...

How often are patients recording their healthcare consultations in Australia and why? An online survey

PurposeRecording important healthcare consultations can benefit patients. Technological developments enable recordings by patients and health professionals, as well as real-time ‘listening’ by AI scribes. Not enough is known about whether and why patients record their consultations. ObjectiveTo investigate people's experiences and preferences regarding consultation recording in Australia. MethodsA 21-item online survey available for all Australians aged 18+ was distributed via social media and professional networks in 2022. Items explored recording behaviour (past and planned), and reasons for recording and sharing. Quantitative data were analysed descriptively; qualitative content analysis was used to analyse open-text items. ResultsA total of 486 responses were received, of which 236 responses were analysed. Of these, 26 % had openly recorded a healthcare consultation, and 15 % had recorded covertly. The majority (71 %) of participants would consider recording a visit and would like their clinic to allow this (56 %). Participants strongly opposed the idea of sharing a recording on social media (84 %). Open-text responses indicated participants valued the health professional's consent, and protecting their own privacy by not oversharing recordings. ConclusionRecording of consultations in Australia is common, usually to enhance patients' knowledge, understanding, and participation in their care. Patients value the possibility of recording, especially when they are experiencing vulnerability. Recording can help people navigate the impacts of disability and barriers to information access. Privacy and fairness remain paramount. InnovationThis is the first survey of recording practices in Australia and is highly-relevant given recent technological developments. The findings indicate that changes in policy, law and technologies themselves are needed, to clarify parties' rights and responsibilities and to ensure the benefits of consultation recording are realised.

“Us versus Them”: is the voice of the community heard when planning communication screening programmes for preschoolers?

ObjectivesCommunity consultation is necessary to ensure the uptake and use of community-based screening intervention to detect early childhood disabilities, as its absence can result in poor service acceptance and usage. To document stakeholders' perspectives regarding planning a community-based communication disorder (an impairment in the ability to receive, send, process and comprehend concepts or verbal, non-verbal and graphic symbol systems) screening programmes for pre-schoolers. Study designThis qualitative research design used purposive and random sampling to recruit 46 participants from eThekwini Municipality, South Africa. These stakeholders consisted of caregivers/parents of children who underwent screening for communication disorders, People who are Deaf, their parents, early childhood development practitioners, health professionals and government officials involved with children with disabilities. All participants were adults aged between 19 and 79 years, with an average age of 39.7 years. MethodsData was collected through focus group discussions and individual interviews, which were thematically analysed. ResultsThe four emergent themes were screening approaches, methods, location and personnel. Service users expected greater access to screening and reliable tests to identify problems by trained personnel at sites within the community. Service providers preferred a targeted approach to screening with parental input. Task shifting and sharing were seen as a solution to address staff shortages and provide services at health facilities, as resource constraints made it challenging to provide outreach services. ConclusionStakeholder engagement revealed diverging views between service users and providers, with implications for programme provision and uptake. There is a need for ongoing, inclusive discussion to ensure consensus during the planning stage, in order to render services that address issues of equity and accessibility for people with disabilities in marginalised communities.

What about us?: a call to include oral health professions within interprofessional education for collaborative practice

ABSTRACT Interprofessional collaboration (IPC) among the health professions is recognised as a vital component of efficient health systems and comprehensive healthcare teams. Interprofessional education for collaborative practice (IPECP) is foundational for health professional students to gain an understanding of professional roles, responsibilities, and the value of other professions to patient care. Oral health professionals are highly skilled and knowledgeable experts who recognise the oral-systemic health link. However, they have been largely excluded from, and underutilised within primary healthcare settings and interprofessional teams. Given that oral health is a key indicator of overall health and wellbeing, there is a need mobilise oral health professionals within primary healthcare practice. Yet, advancements for IPECP in oral health education face significant barriers which impede the integration of the oral health professions within interprofessional teams. Collaborative approaches across health programmes to devise intentional, authentic, and transformative strategies for IPECP are needed to bridge gaps in patient care and to dismantle problematic perceptions of ‘oral health’ as distinct from overall health and wellbeing in contemporary healthcare practice.

Building Resilience in Medical Students: "Strengthening You to Strengthen Them".

Medical students, like many health professional students, are at risk for burnout and other negative well-being outcomes. Research suggests that building resilience may help to mitigate these risks. A multi-disciplinary team developed, delivered, and evaluated a training on building resilience for medical students entitled, "Resilience for Health Providers - Strengthening You to Strengthen Them." The training program provided parallel learning intended to teach medical students how to apply protective factors to both themselves and their patients. The research team proposed that training medical students to understand mechanisms that support resilience such as motivation and self-efficacy may increase the development of resilience as part of their medical training. Through parallel learning, students can also learn how to apply these mechanisms to their patients. The evaluation of the training's effectiveness consisted of pre- and post-tests. Medical students' resilience was measured using the Connor-Davidson Resilience Scale (CD-RISC-10), a tested and validated scale. Findings indicated that post-test scores increased in each domain from pre-test. Participants reported enhanced skill building for both their own resilience and that of patients after the training. Results from the CD-RISC-10 scale showed that the medical students rated slightly lower than the mean identified by the CD-RISC-10 creators. The results from this initial study to strengthen health professionals' self-reported resilience showed that the training improved medical students' self-reported resilience and their confidence in assisting houseless participants to improve their understanding of building their own self-resilience.

Incretin-Based Therapies and Lifestyle Interventions: The Evolving Role of Registered Dietitian Nutritionists in Obesity Care

The emergence of incretin-based therapies, specifically glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide (GIP), as a new class of obesity medications, is dramatically changing obesity care. Use of these medications, known categorically as anti-obesity medications, as part of comprehensive obesity management is associated with significantly greater weight loss and health benefits than found with earlier generation obesity medications. The outcomes reported from medication trials were often achieved in conjunction with lifestyle counseling sessions by a registered dietitian nutritionist (RDN) or other qualified health care professional. Research demonstrates that evidence-based obesity care should incorporate lifestyle interventions. Counseling by a RDN, paired with incretin-based therapies, can play a critical role in supporting adherence to the medication regimen, preventing and managing side effects, adequate nutrient intake, and establishment of lifestyle behaviors for long-term weight and health management. To date, minimal research has been reported on the impact of incretin-based therapies on food and nutrient intake. Until that research is conducted, RDNs and other health professionals can apply knowledge and experience from clients who have undergone other intensive treatments. This article provides considerations for lifestyle interventions, with a focus on medical nutrition therapy (MNT) provided by RDNs, for adults prescribed incretin-based therapies. RDNs have the education and training to provide MNT for people with overweight or obesity, as well as lifestyle counseling on physical activity, stress management, sleep hygiene, goal setting, and other behaviors associated with positive health outcomes. RDNs have a critical role in the integration of incretin-based therapies into obesity management.

Quality of life and spiritual needs of patients diagnosed with cancer in a tertiary hospital in southwestern Nigeria

ObjectiveIn Africa, cancer is considered a death sentence. Its impact can be debilitating for the patient and those who care for them. This study therefore assessed the spiritual needs and Quality of life of Cancer patients in a tertiary hospital in Nigeria. MethodsThis study utilized a cross-sectional descriptive design. We systematically recruited 302 cancer patients who visited the cancer registry and outpatient departments. A standardized and validated Spiritual needs questionnaire (SpNQ) and WHO Quality of Life (WHOQL) were used to collect data. Data was analyzed with SPSS version 23 with a significance level set at p < 0.05. ResultsThe preponderance cancer among respondents was breast cancer 146 (48.4%) followed by prostate cancer 41 (13.6%). Most of the respondents admitted having “strong” spiritual needs. Categorization of the spiritual need score was below average in 20% of the respondents which indicated those with low spiritual needs and the majority 241 (79.8%) of the patients had high spiritual needs. Most respondents had poor quality of life in all four domains. The spiritual care needs of respondents were significantly associated with the quality of life of the respondents particularly in the psychological domain (p = 0.040) and social domain (p = 0.005). ConclusionThis study revealed high spiritual needs and poor quality of life among cancer patients. Healthcare practitioners should provide for the spiritual needs of cancer patients to enhance their quality of life.

Effectiveness of EHR systems on decision support in primary healthcare: a technology acceptance model 3 perspective.

This study aims to evaluate healthcare practitioners' perceptions of electronic health record (EHR) systems and their effectiveness in supporting clinical decision-making in Tanzanian Primary Healthcare (PHC) facilities. A mixed-methods approach was employed, combining quantitative data from structured questionnaires and qualitative insights from open-ended responses. The study was conducted in the Dodoma region of Tanzania, focusing on a diverse representation of PHC facilities, including district hospitals, health centres and dispensaries. Data were analysed using multiple linear regression for quantitative data, and thematic analysis was applied to qualitative responses. The results revealed that while EHR systems are widely used in Tanzanian PHC facilities, their impact on clinical decision-making remains limited. Only a moderate portion of practitioners perceived EHR systems as effective in decision support, and frequent system use was negatively correlated with user satisfaction. Challenges such as inadequate training and support, system crashes, slow performance and poor usability and integration into clinical workflows were significant barriers to effectively utilising EHR systems. This study contributes to the limited literature on EHR system implementation in low-resource settings, specifically Tanzania, by focusing on decision-support features within EHR systems. The findings offer valuable insights for healthcare policymakers, system designers and practitioners to optimise EHR implementation and improve healthcare outcomes in resource-constrained environments.

Global Research Trends on Factors Affecting Patient Satisfaction Levels in Hospital Inpatient Wards: A Bibliometric Analysis

ABSTRACT Research on patient satisfaction in hospital inpatient rooms is one of the main focuses in efforts to improve the quality of health services. Understanding the factors that influence patient satisfaction is crucial for policy makers and healthcare practitioners. Although various studies have been conducted, the global map of this research trend is still not clearly depicted. This study aims to fill this gap by conducting a bibliometric analysis of the literature related to patient satisfaction in hospitals, using a visualization approach to provide deeper insights into the dynamics of research in this area. The method used involved data collection of scholarly articles from 2014 to 2024 using Google Scholar's Publish or Perish application. A total of 50 articles were selected based on relevance to keywords such as Patient Satisfaction, Inpatient Room, Satisfaction Factors, Hospital, and Health Services. This data was then analyzed using VOSviewer to visualize the relationship between various elements in the literature through network visualization, overlay visualization, and density visualization. This approach mapped research trends, identified key clusters, and showed collaboration patterns and dominant topics. The results show that service quality and patient satisfaction are the main focus in the literature. Research clusters showed significant attention to basic aspects of healthcare such as hospital care and facilities, while demographic aspects and specific determinants were less explored. Citation analysis showed that articles providing comprehensive reviews or practical models received more attention. In addition, the density visualization revealed the dominance of quality of care aspects, but also showed the potential for further research on topics such as technological innovation and the impact of health policy. The conclusions of this study show that although much research has been conducted, there are still significant research gaps that can be further explored. This study maps global trends in patient satisfaction studies, and provides guidance for researchers to focus on less explored areas, thereby contributing to the improvement of healthcare quality in hospitals. Keywords: Patient Satisfaction, Service Quality, Hospital, Bibliometric Analysis.

Deciphering the Therapeutic Applications of Nanomedicine in Ovarian Cancer Therapy: An Overview.

The majority of deadly cancers that afflict the female reproductive system occur in the ovary. Around 1,40,000 women worldwide die from ovarian cancer each year, making it the sixth most common cancer-associated deceases among females in the United States. Modern, cutting-edge treatments like chemotherapy and surgery frequently produce full remissions, but the recurrence rate is still very high. When this crippling condition is diagnosed, there are frequently few therapeutic choices available because of how quietly it manifests. Healthcare practitioners must have a fundamental grasp of the warning signs and symptoms of ovarian cancer, as well as the imaging techniques and treatment choices available, to give the patient the best care possible. The discipline of medical nanotechnology has gained a lot of momentum in recent years in resolving issues and enhancing the detection and treatment of different illnesses, including cancer. This article gives a brief summary of types, risk factors and approaches to ovarian cancer treatment. We subsequently discussed the pathophysiology of ovarian cancer with the risk factors. This review also emphasizes the various signalling pathways involved in ovarian cancer. Our comprehensive integration of recent findings in fundamental research in the nano arena reveals the strong interest in these nanomedicines in ovarian cancer treatment. However, these nanomedicines still require more research, as indicated by the comparatively small number of clinical trials ongoing. This article will provide a reference for ovarian cancer treatment.

Using Music to Teach Health Professions Students to Listen Closely and Promote Peace.

Promoting peace with patients requires clinicians to be skilled in helping patients feel safe, respected, and heard. Close listening is a teachable skill set that enables clinicians to focus sensory attention on a patient and to cultivate space for reflection before speaking. While communication skills are taught in health professions education, close listening is rarely formally emphasized as an equally important skill. This article draws on musical arts education methods to suggest strategies for teaching close listening that can be applied to peace promotion in patient care.

The Differential Diagnosis of Leg Ulcers.

Chronic wounds on the leg (below the knee) are called leg ulcers. They have many causes, and thus patients with leg ulcers are treated by many different kinds of medical specialist. Appproximately 80% of sufferers have chronic venous insufficiency (CVI) and/or peripheral arterial occlusive disease (PAOD). Knowledge of the relevant differential diagnoses is important for appropriate treatment, particularly for patients with atypical findings or an intractable course. This article is based on publications retrieved by a selective search in PubMed, including current guidelines and expert recommendations. The diagnostic evaluation of a leg ulcer can be structured according to the ABCDE rule. This involves individualized, targeted history-taking (anamnesis); bacteriological testing; clinical examination; ancillary testing, particularly for perfusion (defective vascular system); and extras, such as biopsies. Specifically, we present in this article the main aspects of the complex diagnostic evaluation of venous leg ulcers, arterial leg ulcers, vasculitis, vasculopathy, calciphylaxis, pyoderma gangrenosum, necrobiosis lipoidica, ecthyma, and squamous cell carcinoma. There remain many unsolved problems, including interactions between the various areas of clinical treatment and the relative paucity of relevant high-quality research. A timely differential-diagnostic evaluation for the many diseases that can cause leg ulcers, which require treatment from representatives of many different medical specialties and health professions, is a prerequisite for their effective individualized treatment.

The perception and understanding of the terminology used to describe malnutrition from the perspective of patients and health workers: A meta-synthesis of qualitative studies

The perception and understanding of the terminology used to describe malnutrition from the perspective of patients and health workers: A meta-synthesis of qualitative studies

Infection Prevention and Control Response and Escalation Framework – evaluation and application beyond a pandemic

BackgroundThe COVID-19 pandemic brought rapid and frequent changes to Infection Prevention and Control (IPAC) recommendations making it difficult for clinicians to stay informed of the most recent requirements and guidelines. The COVID-19 IPAC Response and Escalation Framework (IPAC Framework) was developed to provide scalable IPAC guidance during the pandemic to healthcare in New South Wales, Australia. The use of such frameworks during or outside of a pandemic has rarely been reported and evaluated here. MethodsUsing a thematic analysis approach, a qualitative study using an online, cross-sectional survey comprising 27 questions was sent to 248 key stakeholders. Participants were health workers with broad clinical and system representation with responsibilities for risk assessment, communicating, implementing and/or monitoring the IPAC Framework. ResultsThe IPAC Framework provided a useful IPAC tool for the management of COVID-19 as perceived by 93% of respondents. The overwhelming majority (91%) reported the Framework provided enough information on IPAC strategies needed for COVID-19 that were aligned with transmission risk. Resources supporting the IPAC Framework were reported by most respondents (84%) as being widely accepted as the authoritative guidance. ConclusionAn IPAC response and escalation framework is perceived as highly useful by clinicians and administrators to manage IPAC requirements in health care during a pandemic. The IPAC Framework can be applied more generally to support ongoing IPAC requirements.

Do Health Workers Believe that Personal Recovery is Possible? An Evaluation of the Recovery Attitudes Questionnaire

Do Health Workers Believe that Personal Recovery is Possible? An Evaluation of the Recovery Attitudes Questionnaire

Integrating community health workers into HIV care clinics: a qualitative study with health system leaders and clinicians in the Southern United States

BackgroundCommunity health workers (CHWs) can support patient engagement in care for a variety of health conditions, including HIV. This paper reports on the experiences of HIV clinics and health departments that integrated CHWs into their health systems as part of a capacity-building initiative to address HIV-related disparities in the United States.MethodsSemi-structured interviews were conducted with key informants (n = 14) in two Ryan White HIV/AIDS program jurisdictions: Mississippi (jurisdiction covers the entire state) and the city of New Orleans, Louisiana. This work was part of a larger evaluation of an initiative that used a Learning Collaborative model to facilitate the implementation of evidence-informed interventions to address HIV care continuum gaps in four jurisdictions. The two jurisdictions that focused on integrating CHWs into HIV care clinics and support service agencies were selected for this sub-analysis. Interview participants included HIV clinic leaders and staff, health department leaders, and other Learning Collaborative leaders. Interview transcripts were coded and analyzed for themes related to the acceptability, feasibility, and perceived impact of CHW integration.ResultsOverall, participants expressed interest in having support from CHWs at HIV clinics and service agencies to assist with patient retention and engagement efforts. However, there were challenges integrating CHWs into existing systems (e.g., gaining access to electronic health records, changing policies to conduct home visits, and clarifying roles and scope of work). Negotiating contracts and accessing funding for CHW positions presented major challenges that often contributed to turnover and conflicts around scope of practice. When health departments leveraged existing funding streams to support CHW positions, the clinics and agencies where the CHWs worked had limited flexibility over the hiring process.ConclusionsOur findings reinforce the value and acceptability of CHWs as part of the workforce in HIV clinical and support service settings; however, integrating CHWs into clinics and service agencies required effort. Training the CHWs was not sufficient; other staff and clinicians had to understand the role of CHWs to facilitate their integration into health systems. Resources are needed to support organizations in incorporating CHWs effectively, and long-term, flexible sources of funding are necessary for these positions.

Theoretically informed codesign of a tailored intervention to support pressure ulcer prevention behaviours by older people living in their own homes in the UK and their lay carers: an intervention codesign study (C-PrUP)

ObjectiveTo codesign a theoretically underpinned, healthcare practitioner-mediated, tailored intervention to support housebound older patients and their lay carers to adopt pressure ulcer prevention behaviours.DesignTheoretical domains framework informed codesign.SettingOne geographical area...

Supporting the care to breast cancer patients with unique needs: Evidence from online community members’ responses

BackgroundBreast cancer is the most common cancer diagnosed in women globally. Online cancer communities (OCCs) provide platforms for breast cancer patients to connect, share experiences, and support each other. These communities facilitate discussions on a range of health- and non-health-related topics. However, posts discussing unique topics may receive varying levels of attention and support. This study aims to devise a method for identifying and supporting such posts, enhancing community response and support strategies. MethodsWe propose a Uniqueness Score Extraction Framework to compute health- and non-health-related uniqueness scores for online community posts. The framework utilizes deep learning-based natural language processing models to identify the topics discussed in OCCs and calculates the health- and non-health-related uniqueness scores of a post based on the uniqueness of the topics identified by the BERTopic model. We further employ econometric models to assess how the uniqueness scores of posts affect community members’ responses to those posts. ResultsOur study reveals that posts with a higher concentration of unique health-related topics in OCCs elicit quicker, more frequent, but shorter responses. Conversely, posts containing more unique non-health-related topics in the entire post prompt faster and longer responses, unless these topics become overly dominant, in which case the number of replies decreases, and response times are prolonged. ConclusionOur research develops a framework to identify posts with high uniqueness scores in OCCs, and sheds light on community member responses to these discussions. The findings indicate that while members are supportive, particularly regarding health-related topics, the post-content’s nature and focus greatly affect their engagement. These discoveries could enhance our understanding of community dynamics in OCCs, offering valuable implications for researchers, OCC facilitators, and medical professionals in supporting patients within online platforms.

Students Exploring Health Disparities in Undergraduate Kinesiology Course

ABSTRACT Kinesiology courses that implement health disparities (HD) topics into the undergraduate curriculum engage students in critical and conscious thinking about health outcomes and strategies as they prepare for careers as future health and medical professionals. Health disparities are disproportionate differences in health based on race, gender, socioeconomic status, sexuality, and environmental factors that are preventable for providing opportunities to achieve optimal health. Implementing HD topics into undergraduate courses increases knowledge and awareness and inspires long-term interest in health equity work. This ethnographic case study assessed how 142 undergraduate Kinesiology majors navigated HD topics with critical consciousness as a guiding framework. Three themes emerged from student exploration: eye-opening experiences, lived experiences, and learning experiences. Upper-level students reported an increase in HD (75%–95%) awareness of the meaning of the term and the communities impacted. The lack of prior engagement (29%) with HD ignited tensions around learning experiences. Students who engage in HD topics earlier in their academic programs increase their knowledge and strategies for integrating HD into future learning and practices.