Patient Attitudes Research Articles

The effects of nursing students' patient safety management knowledge, attitude, and confidence in performance on standard precaution performance

The effects of nursing students' patient safety management knowledge, attitude, and confidence in performance on standard precaution performance

Determinants of Health Care Dissatisfaction among a US Population-based Cohort of Women with Polycystic Ovary Syndrome.

The 2018 International Evidence Based Guidelines (IEBG) for PCOS were created, in part, in response to poor patient satisfaction on international surveys. Patient satisfaction in the US, before and after these guidelines has not yet been characterized. To evaluate care patterns and patient attitudes among women with PCOS in the US before and after IEBG. Cross-sectional. A population-based community sample of women in the US. Women with PCOS confirmed by a care provider. None. Standardized questionnaires on care patterns and satisfaction in care. 1056 respondents, aged 23±6 years at diagnosis were included. 69.2% had to wait >1 year and 72.9% saw >1 provider prior to receiving a diagnosis. <45% strongly agreed or agreed with statements regarding trusting their doctor. <27% were very or somewhat satisfied with care across all questions. In multivariable analyses, composite outcome of trusting your physician was associated with insurance type (uninsured vs private) (OR (95% CI), 0.5 (0.3-0.9), p=0.020)), race (Hispanic vs Caucasian) (0.6 (0.5-0.9), p=0.007), (Black vs Caucasian) (1.6 (1.0-2.4), p=0.045) and timing of diagnosis (within 5 years vs >5 years) (1.3 (1.0-1.7), p=0.038). Care satisfaction was associated with insurance type (public vs private) (0.6 (0.4-0.9), p=0.010), (uninsured vs private) (0.5 (0.3-0.9), p=0.021), and timing of diagnosis (within 5 years vs >5 years) (1.4 (1.1-1.9), p=0.010). Satisfaction and trust in care is overall poor among patients with PCOS in the US. Higher scores among those diagnosed within the past 5 years, compared to those with a more remote diagnosis, may indicate an improving trend in care.

Patient perceptions of digital and therapist-led CBT for insomnia: A qualitative study

ABSTRACT Objectives Technology has the potential to increase access to evidence-based insomnia treatment. Patient preferences/perceptions of automated digital cognitive behavior therapy for insomnia (CBTI) and telehealth-delivered CBTI remain largely unexplored among middle-aged and older adults. Using a qualitative approach, the current study describes patients' reasons for participating in the clinical trial, preferences for digital CBTI (dCBTI) versus therapist-led CBTI, patient attitudes toward dCBTI, and patient attitudes toward telehealth-delivered therapist-led CBTI. Method Middle-aged and older adults (N = 80) completed a semi-structured interview before CBTI exposure. Qualitative responses were coded, and themes were inductively extracted. Results Most (62.5%) of the participants expressed a preference for therapist-led CBTI to dCBTI. Convenience was the most commonly reported advantage of dCBTI (n = 55) and telehealth-delivered CBTI (n = 65). Decreasing transit time and pandemic-related health concerns were identified as advantages to dCBTI and telehealth-delivered CBTI. Lack of human connection and limited personalization were perceived as disadvantages of dCBTI. Only three participants reported technological barriers to dCBTI and telehealth-delivered CBTI. Conclusion Findings suggest that, despite an overall preference for therapist-led treatment, most middle-aged and older adults are open to dCBTI. As both dCBTI and telehealth-delivered CBTI are perceived as convenient, these modalities offer the potential to increase access to insomnia care.

What do patients want from a digital device that supports heart failure self-management?

ObjectiveTo assess patients’ needs and the factors determining their acceptance of an e-Health intervention. MethodsPurposive sample of patients with heart failure, attending an outpatient consultation were invited to complete a questionnaire designed to assess their needs and acceptance of an e-Health intervention. Data analysis was performed using Chi-square tests with post-hoc corrections. ResultsResponse rate was 61 % (n = 101), with most patients (>70 %) indicating they could see themselves using an e-Health intervention to manage their heart failure. Participants with a healthy lifestyle (i.e., non-smoker and consumed alcohol < once/week) were more likely to have a positive attitude towards technology (p adj.=0.013). Those willing to use an e-Health intervention were convinced of its advantages by other patients with heart failure (p adj.=0.013). Advanced age, education level, employment or marital status did not influence patient attitudes toward health technology. Conclusions & practice implicationsResults indicate patients have a positive attitude towards the use of e-Health interventions to enable their self-management of heart failure. These findings will inform further development and delivery strategies of e-Health interventions.

Knowledge, attitude, and practice of embryo transfer among women who underwent in vitro fertilization-embryo transfer.

The infertile patient's knowledge, attitude, and practice (KAP) toward embryo transfer may affect treatment outcomes and the mental health of women who underwent in vitro fertilization-embryo transfer (IVF-ET). This study aimed to investigate the KAP of embryo transfer among women who underwent IVF-ET. This cross-sectional study was conducted on women who underwent IVF-ET at our Hospital between May 2023 and November 2023, using a self-designed questionnaire. A total of 614 valid questionnaires were finally included. The mean KAP scores were 19.46 ± 5.06 (possible range: 0 28), 39.41 ± 5.20 (possible range: 12-60), and 48.02 ± 6.75 (possible range: 0-60), respectively. The structural equation model demonstrated that knowledge has a direct effect on attitude (β = 0.27, p < 0.001) and attitude has a direct effect on practice (β = 0.55, p < 0.001) and anxiety (β = 0.59, p < 0.001). Moreover, multivariable linear regression analysis showed that anxiety score [coefficient = 0.09, 95% confidence interval (CI): 0.03-0.16, p = 0.003], BMI (coefficient = 0.09, 95%CI: 0.03-0.16, p = 0.003), education (coefficient = 5.65-6.17, 95%CI: 1.09-10.7, p < 0.05), monthly per capita income (coefficient = 1.20-1.96, 95% CI: 0.21-3.07, p = 0.05), reasons for IVF (coefficient = -1.33-1.19, 95% CI: -2.49-0.09, p < 0.05), and more than 5years of infertility (coefficient = -1.12, 95% CI: -2.11-0.13, p = 0.026) were independently associated with sufficient knowledge. Knowledge (coefficient = 0.19, 95% CI: 0.12-0.26, p < 0.001), anxiety (coefficient = 0.39, 95% CI: 0.34-0.45, p < 0.001), monthly per capita household income >10,000 (coefficient = 1.52, 95% CI: 0.61-2.43, p < 0.001), and three or more cycles of embryo transfer (coefficient = -2.69, 95% CI: -3.94-1.43, p < 0.001) were independently associated with active attitude. Furthermore, attitude (coefficient = 0.21, 95% CI: 0.11-0.30, p < 0.001) and anxiety (coefficient = 0.57, 95% CI: 0.49-0.65, p < 0.001) were independently associated with proactive practice. Women who underwent IVF-ET had inadequate knowledge and negative attitudes but proactive practice toward embryo transfer, which were affected by anxiety, income, and reasons for IVF. It is necessary to strengthen the continuous improvement of patient education to improve the management of embryo transfer.

Utilization of Telemedicine to Supervise Medical Students in the Post-Acute/Long-Term Care Setting

ObjectivesTelemedicine has become a widely accepted alternative to face-to-face patient encounters. Although there have been several peer-reviewed journal articles on incorporating telemedicine into the medical school curriculum, particularly during the COVID-19 pandemic, assessments of the effectiveness of remote supervision of medical students have not been reported. This prospective cohort study of student subjects using observational survey data evaluated the efficacy of telemedicine as an educational resource by comparing learning outcomes between osteopathic medical students receiving direct (physically present) supervision with a group who received remote (telemedicine) supervision by clinical faculty within a post-acute/long-term care (PA/LTC) setting. Learning outcomes in the domains of patient rapport, attitudes, knowledge, and behavior were measured using standardized survey instruments. DesignProspective cohort study of student subjects using observational survey data. Setting and ParticipantsA total of 167 fourth-year osteopathic medical students at a teaching nursing home (TNH). MethodsA total of 167 fourth-year osteopathic medical students (OMS-4s) were randomly assigned face-to-face PA/LTC patient encounters at the TNH. The encounters were follow-up visits to residents of the TNH that were supervised by faculty geriatricians. Half were accompanied by the physician and the other half were supervised by the physician through telemedicine. Evaluation using validated survey instruments measured patient rapport, verbal communication, and physical examination skills as well as attitudes, knowledge, and behaviors of the student/subjects. ResultsA nonparametric statistical analysis of 4 dependent variables measuring patient rapport, attitudes, knowledge and behavior showed no significant difference between the 2 teaching modalities. Conclusions and ImplicationsThe results of this prospective cohort study indicate that telemedicine supervision is comparable (noninferior) to direct supervision of medical student trainees in a PA/LTC setting.

Knowledge, attitude, and practice of non-emergency surgical patients toward anesthesia

This study aimed to investigate the knowledge, attitude, and practice (KAP) of non-emergency surgical patients toward anesthesia. This cross-sectional study was conducted between May and October 2023 at Zibo Central Hospital among non-emergency surgical patients. A total of 429 valid questionnaires were enrolled (mean age: 42.81 ± 13.17 years old; 227 (52.91%) females). The mean KAP scores were 7.79 ± 3.95 (possible range: 0–18), 32.35 ± 2.80 (possible range: 8–40), and 18.14 ± 3.96 (possible range: 6–24), respectively. Multivariate logistic regression analysis showed that knowledge (OR = 1.095, 95% CI 1.036–1.158, P = 0.001) and previous poor anesthesia experience (OR = 0.081, 95% CI 0.017–0.386, P = 0.002) were independently associated with practice. Non-emergency surgical patients had inadequate knowledge, positive attitude, and proactive practice towards anesthesia. It is crucial for healthcare professionals to implement targeted educational interventions to inform patients about the anesthesia process, potential risks, and benefits.

Changes in Technical Equipment and Patient Perspectives Navigating Towards Enhanced Digitalization in Breast Cancer Across Pre-COVID-19 and Early COVID-19 Eras

IntroductionThe potential benefits of eHealth support in enhancing patient care, satisfaction, and cancer outcomes are well-established; however, its integration into routine care has been gradual. The emergence of the COVID-19 pandemic in 2020 dramatically affected cancer patients, imposing multifaceted challenges that impede traditional doctor-patient interactions. Consequently, there has been a surge in the adoption of eHealth for supporting oncological therapies. This study investigates the fundamental prerequisites for transitioning to a more digitally oriented routine care, focusing on the availability of appropriate technical equipment and the cultivation of a positive mindset towards eHealth among breast cancer patients. Patients and MethodsIn 2013, 2016, and 2020, breast cancer patients participated in surveys utilizing a comprehensive paper questionnaire encompassing 29 inquiries about their health status, technical equipment, and attitudes toward digital therapy support. ResultsA total of 959 patients participated in the interviews. Comparative analyses between the 2013, 2016, and 2020 surveys revealed a widespread increase in internet access and device ownership across various age groups. By 2020, 3 quarters of patients were utilizing the internet for health-related topics. Notably, there has been a considerable improvement in patients' personal attitudes towards eHealth and their expectations for future digital therapy support. DiscussionOver the seven years spanned by the surveys, there has been a substantial positive shift in the attitudes of breast cancer patients towards eHealth, accompanied by a marked improvement in their technical equipment. This study reveals that the essential prerequisites for digital therapy support now appear to be prevalent among breast cancer patients.

Knowledge, Attitude, and Practice Toward Varicocele in Patients with Varicoceles: A Cross-Sectional Study in Chinese Patients.

To explore patients' knowledge, attitude, and practice (KAP) toward varicocele in China and the relationship between treatment selection and KAP. This cross-sectional study enrolled varicocele patients at the Third Affiliated Hospital of Soochow University (September to October 2023). Structural equation modeling (SEM) was used to explore the relationship between clinical factors and KAP. A score >mean score for each dimension was defined as adequate knowledge, positive attitude, and proactive practice. The patients were grouped according to varicocelectomy vs no surgery. Univariable and multivariable logistic regression analyses were used to identify the factors independently associated with KAP. A structural equation modeling (SEM) analysis was performed to examine how the KAP dimensions influenced each other. Among 502 patients, 44.02%, 35.86%, and 20.12% were ≤30, 31-40, and >40 years old, respectively. Those who underwent varicocelectomy (n=407) had significantly higher knowledge (20 (15-22) vs 0 (0-6), P<0.001), attitude (26 (24-26) vs 14 (10-18), P<0.001), and practice (20 (17-24) vs 8 (6-16), P<0.001) than those who did not. A higher proportion of patients with varicocelectomy were <40 years old, more educated, had higher income, and were unmarried compared with those without surgery (all P<0.001). High school or higher education level and varicocelectomy (irrespective of type) were independently associated with adequate knowledge (all P<0.001). Knowledge, college/bachelor's degree education, and varicocelectomy type (irrespective of type) were associated with positive attitudes (all P<0.05). In the SEM, knowledge directly influenced attitude, knowledge directly influenced practice, and attitude directly influenced practice (all P<0.001). Having knowledge of the subject may direct varicocele patients to varicocelectomy. Chinese patients who underwent varicocelectomy exhibit appropriate KAP regarding varicocele, while non-surgery patients have poorer KAP. These results suggest that patients who did not undergo surgery should nevertheless be properly informed about their disease.

Patients' Perspectives and Attitudes About the Relationship Between Fixed Orthodontic Treatment and Oral Hygiene.

The aim of this study was to evaluate patients' attitudes and perspectives on the relationship between fixed orthodontic treatment and oral hygiene. The study included 175 patients undergoing fixed orthodontic treatment. Data was collected through questionnaires that included patient demographics, oral hygiene behaviours, perspectives on white spot lesions (WSL) and periodontal problems, and attitudes towards orthodontic treatment. The chi-square test was used to analyse the relationship between categorical data. The significance level was set at p<0.05. The mean age of the patients (109 males, 66 females) was 17.8±6.4 years. Most of the patients who received orthodontic treatment brushed their teeth twice a day. Traditional and orthodontic toothbrushes were preferred over electric ones. The most common oral hygiene tools were toothbrushes and interdental brushes. A total of 151 patients (86.28%) indicated that their primary source of oral hygiene guidance was the orthodontist.A total of 113 patients (64.57%) had no knowledge of dental plaque, while 117 patients (66.85%) had no knowledge of WSL.While 80 patients (84%) with knowledge about periodontal problems believed that the primary cause of periodontal problems was inadequate oral hygiene, 43 patients (74.85%) with knowledge about WSL attributed the main cause of WSL to the use of braces.Negative attitudes towards orthodontic treatment and oral hygiene were more prevalent among adolescents (p<0.05), with no difference in gender or treatment duration. Patients who received information about WSL and periodontal problems exhibited a more positive attitude towards treatment and oral hygiene (p<0.05). This study highlights the limited patient awareness of plaque and WSL during fixed orthodontic treatment. Physician guidance has a significant impact on patient attitudes, and specific educational programmes are required in orthodontic treatment.

INTERACTIONAL QUALITY AS AN ANTECEDENT OF PATIENT ATTITUDES: EVIDENCE FROM AN ARMY HOSPITAL IN THE FEDERAL TERRITORY OF KUALA LUMPUR

Background and Purpose: The quality of interactions between service providers (employees) and patients in the course of providing everyday services may have a major impact on patient attitudes, according to a thorough evaluation of several recent quality management studies released in the 21st century. The relationship has been extensively studied in public and private healthcare organizations, but little is known about the role of interactional quality as a key antecedent in army hospitals. The purpose of this study is to investigate the connection between patient attitudes and interactional quality. Methodology: The study adopted a cross-sectional research design, with 212 self-administered questionnaires collected from patients in an army hospital in the Federal Territory of Kuala Lumpur, Malaysia, using a purposive sampling technique. The SmartPLS was used to evaluate the measurement model and to test the structural model. Findings: According to the findings of structural equation modelling, interactional quality attributes, namely responsiveness, assurance, and empathy were significant predictors of patient attitudes such as satisfaction and loyalty. Contributions: To sustain and improve the service performance of the organisational sample, this study offers crucial advice, that is quality of interaction between employees and patients is built according to responsiveness, assurance, and empathy. The competence of employees to practice this interaction in delivering daily services can enhance patients’ satisfaction and loyalty. Practitioners may utilize to comprehend various perspectives on interactional quality. These recommendations can also be used to improve patient relationship management programmes. Keywords: Interactional quality, patient satisfaction, patient loyalty, army hospital. Cite as: Ismail, A., Mokhtar, A. Jamil, A. H., Ibrahim, N. S., Rino, Hussin, T., &amp; Tajuddin, A. (2024). Interactional quality as an antecedent of patient attitudes: Evidence from an army hospital in the Federal Teritory of Kuala Lumpur. Journal of Nusantara Studies 9(2), 80-105. http://dx.doi.org/10.24200/jonus.vol9iss2pp80-105

The impact of the importance of the life priority "Health" in the formation of the patient's attitude to the organization of medical care provided on an outpatient settings

AIM: to analyze the influence of the structure of the life priority “health” in shaping the patient’s attitude towards the organization of medical care provided in an outpatient setting. MATERIALS AND METHODS OF RESEARCH: Primary data were obtained through an anonymous survey of 486 patients of medical organizations in Moscow. In total, the author’s questionnaire offered eight priority options: “Family”, “Work”, “Education”, “Career”, “Health”, “Material goods”, “Spiritual values”, “Faith (religion)”. When answering, the respondent arranged the proposed priorities in hierarchical order according to the degree of decreasing importance in relation to himself personally. As a division into comparison groups, the concept of standard structure was used, that is, the correspondence of the individual structure of life priorities to the collective structure. The main group (147 people) included patients who considered the life priority “Health” to be very significant. Patients included in the control group (112 people) placed the life priority “Health” in the fourth and subsequent places in the hierarchy, that is, they considered it less important compared to other priorities. 228 patients ranked the life priority “Health” in third place (the majority) and they were excluded from further consideration. RESULTS AND DISCUSSION: The overall assessment of the activities of a medical organization providing medical care in an outpatient setting does not depend on the place in the hierarchy of life priorities of the “Health” value, however, with an average frequency of visits, which is the most common characteristic of the need for outpatient medical care, the value of the assessment of the quality of the organization of the activities of a medical organization is higher in the control group of patients, that is, with a low importance of the life priority “Health”. CONCLUSION: Despite the higher integral ratings given by patients with a low importance of the life priority “Health”, and a lower proportion of those who did not express any complaints about the organization of the clinic’s activities, they expressed more complaints about certain aspects of the organization of the work of the medical organization and its mode of operation.

Compliance and Attitudes towards the Gluten-Free Diet in Celiac Patients in Italy: What Has Changed after a Decade?

This study aims were (i) to describe Italian celiac patients who agreed to participate in the latest web survey and their attitudes toward the GF diet (compliance, perceived limitations, and worries) and (ii) to compare the answers given by the 2011 and 2022 responders. The self-administered questionnaire was distributed through the Italian Coeliac Association channels (link on social media, websites, and newsletters) to all of the celiac patients willing to participate in 2011 and 2022 (2427 and 3529 responders who answered the same questions, respectively). Descriptive analyses and the Pearson's chi-squared test were performed. The responders were 1 to 84 years old and mainly female. The prevalence of adherent patients in 2022 was 91%, with the highest value (94%) in children (≤10 years old) and adolescents (15-17 years old). Overall, young adults were the most worried group. About a decade after the first survey, we observed a decreasing prevalence of transgression events (-5%) and (at least) occasional temptation (-17%), a decreasing prevalence of health-related and general worries, but an increasing prevalence of social life withdrawal. In conclusion, it is important to periodically monitor celiac patients' compliance and attitudes towards the gluten-free diet. As also highlighted in international guidelines, a reorganization of the diagnosis/follow-up visits, including an expert dietary consultation, is needed.

Identifying Strategies to Improve Shared Decision Making for Pregnant Patients' Decisions about Prenatal Genetic Screens and Diagnostic Tests.

Prenatal genetic screens and diagnostic tests are vital components of prenatal care. The first prenatal visit is a critical time in the decision-making process when patients decide whether to use these tests in addition to address a series of other essential prenatal care aspects. We conducted this study to examine the role of a shared decision-making (SDM) instrument to support these discussions. We conducted a cluster randomized controlled trial of patients allocated to an SDM tool or usual care at their first prenatal visit. Participants completed a baseline survey to measure decision-making needs and preferences. Direct observation was conducted and analyzed using the OPTION scale to measure SDM during prenatal genetic testing discussions. Levels of SDM were similar across groups (P = 0.081). The highest levels of SDM were observed during screening test discussions (NEST 2.4 ± 0.9 v. control 2.6 ± 1.0). Lowest levels were observed in discussions about patients' preference for risk versus diagnostic information (NEST 1.0 ± 1.1 v. control 1.2 ± 1.3). Study findings demonstrate the need for targeted patient-focused and provider-focused efforts to improve SDM to enhance patients' informed decision making about these options. Importantly, patients' baseline knowledge and attitudes need to be considered given that patients with less knowledge may need more carefully crafted communication. Choices about whether, when, and how to use prenatal genetic tests are highly preference-based decisions, with patients' baseline attitudes about these options as a major driver in health care discussions.The decision-making process is also shaped by patient preferences regarding a shared or informed decision-making process for medical decisions that are highly personal and have significant ramifications for obstetric outcomes.There is a need to develop targeted efforts to improve decision making and enhance patients' ability to make informed decisions about prenatal genetic tests in early pregnancy.

Pharmacist-Led Deprescribing of Opioids and Benzodiazepines in Older Adults: Examining Implementation and Perceptions.

Background: This study examines the implementation and perceptions of a pharmacist consultant deprescribing program aimed at reducing the risk of falls in older adults using opioids and benzodiazepines. Methods: This qualitative study conducted interviews with healthcare providers. The interviews were conducted from August to December 2021 and analyzed using inductive coding techniques. Results: Five participants, predominantly female MDs or PA-Cs from rural clinics, were interviewed. The participants adopted a pharmacist-led deprescribing program due to their heightened awareness of the opioid crisis, dedication to patient safety, and a desire for opioid deprescribing education. Initially, concerns included patient resistance and provider-driven barriers. However, over time, patient attitudes shifted toward greater openness to the program. The providers emphasized several critical needs for the success of the program: guaranteed access to pharmacists, tailored patient education, resources specific to providers, and financial support, including telehealth options. These factors were deemed essential to overcoming initial barriers and ensuring effective implementation. Conclusion: Integrating pharmacists into primary care settings shows promise for deprescribing opioids and benzodiazepines in older adults. Future research should explore telehealth options for patient-pharmacist consultations and expand the application of these findings to other healthcare settings. The study highlights the importance of awareness, patient education, access to resources (pharmacists), and provider support in addressing deprescribing among older adults.

Family Experience Caring for the Elderly with Diabetes Mellitus Using Sister Calista Roy's Adaptation Process Approach

Introduction: Families who care for the elderly who suffer from diabetes mellitus experience problems in the adaptation process to prevent recurrence and it is difficult to provide an understanding of the condition of the disease to the elderly. The purpose of the study was to describe in detail the experience of families caring for the elderly with diabetes mellitus using a sister calista roy adaptation process approach. Methods: This study uses a qualitative method with a phenomenological study approach. The population of this study were all families living at home with the elderly who suffer from diabetes mellitus in Keling Village, Kepung District with a total sample of 6 participants using purposive sampling technique. The data collection method used in-depth interview techniques. Data analysis technique using Interpretative Phenomenological Analysis. Results: The analysis of this study resulted in the theme of the process of family adaptation to care for the elderly with diabetes mellitus, including: 1) Family stimulation by understanding the condition of the disease and obligations in caring for the patient; 2) Family coping mechanisms by having a patient and calm attitude, and providing effective communication; 3) Family self-regulation by exercising self-control and caring attitude; 4) Family behavior by providing consultation on health services, meeting needs and managing stress. Conclusions: The process of family adaptation in caring for the elderly with diabetes mellitus by reflecting on the behavior of the adjustment process with various kinds of coping that is done to produce an adaptive or maladaptive behavior.

“They really trust us!”: medical interpreter’s roles and experiences in an integrated primary care clinic

ABSTRACT This study describes medical interpreters’ experiences with behavioral health (BH) services in a primary care clinic. Focus group data with medical interpreters representing multiple languages was analyzed using hybrid inductive-deductive thematic analysis. Themes related to interpreter roles were: (1) case management, (2) patient-interpreter relationship, and (3) patient-provider liaison. Themes related to barriers and facilitators to interpreter-mediated BH care were: (1) cultural factors, (2) patient-provider interactions, (3) BH-specific considerations, and (4) clinic factors. Results illustrate ways that interpreters directly (e.g. interpreter-mediated services) and indirectly (e.g. relationship building) support care. The interpreter-patient relationship reportedly helped improve patient attitudes and buy-in for BH.

Exploration of Socio-Cultural Aspects of Cancer Patients Who Refuse Chemotherapy: Literature Review

Background: Cancer is a multifaceted disease characterized by the uncontrolled growth and spread of abnormal cells. Socio-cultural background plays an important role in many aspects of cancer patients' lives, including beliefs, behaviors, perceptions, emotions, and attitudes towards illness and pain. Objective: The aim of this study was to explore the socio-cultural aspects of cancer patients who refuse chemotherapy. Methods: The research method used was a systematic review by identifying journal articles published online consisting of English language from 2019-2024. Articles were retrieved using PubMed, ScieceDirect, and JSTOR search engine tools. Results: There were 5 journals based on the inclusion criteria. Conclusion: The results showed that socio-cultural aspects have a complex influence on cancer patients' decision to refuse chemotherapy.

Disposition of health-care workers toward hospital patients during the COVID-19 pandemic in Nigeria

During the second wave of the COVID-19 pandemic, the World Health Organization declared health-care workers &amp;ldquo;the last line of defense against the COVID-19 pandemic.&amp;rdquo; Against this backdrop, this study investigated the state, responses, and attitudes of health-care workers toward hospital patients during the pandemic in Nigeria, alongside the attitudes of patients and the responsibilities of Nigerian social workers in ensuring adequate patient care. Employing a descriptive research design, the study sampled 17 respondents from Enugu State and utilized a qualitative research approach with an in-depth interview guide for data collection. The findings revealed that Nigerian healthcare workers exhibited a negative attitude toward hospital patients during the pandemic. Factors contributing to this negative attitude include fear of contracting the virus due to inadequate personal protective equipment, lack of incentives, insufficient hazard allowances, and inadequate hospital facilities. The death rate of patients with complications unrelated to COVID-19 was high because patients avoided hospital care even when critically ill due to fear of contracting the virus. Consequently, there was an increase in self-medication and reliance on alternative medicine among patients. Social workers played a significant role by advocating for improved hospital care and welfare for patients. They engaged in dialogue with hospital management to secure better attention and treatment for patients and advocated for adequate welfare provision for health-care workers. Social workers undertook educational initiatives to raise awareness among patients about the dangers of alternative medicine, self-medication, and the imperativeness of complying with the stipulated COVID-19 preventive protocol. In conclusion, this study recommends policy reforms aimed at enhancing budgetary allocations to the health-care sector and institutionalizing the social work profession in Nigeria through constitutional provisions.

Retention efficacy and patient experience with customized clear retainer and wrap-around circumferential retainer among non-extraction orthodontic patients: A 12-month follow-up cohort study.

The aim of this study was to evaluate retention efficacy by assessing retention stability and patient perspectives according to type of circumferential retainer: the wrap-around circumferential retainer (WCR) and customized clear retainer (CCR). This cohort follow-up study involved 52 patients aged 18-62 who underwent fixed-appliance orthodontic treatment without extractions or orthognathic surgery. Following screening consenting participants were divided into WCR and CCR groups. All participants before follow-up received fixed retainers for the upper and lower anteriors and respective removable retainers within 2 weeks post-debond. Intraoral scans and lateral cephalograms were taken immediately after debonding (T0) and again 12 months later. Dentoalveolar changes in several measurements were compared to evaluate retention efficacy. Surveys were conducted at 1 month (T1) and 12 months (T2) post-debonding to assess changes in patient experiences. Outcome assessments were blinded. Paired T-tests and independent T-tests were used for intragroup and intergroup comparisons of dentoalveolar measurements, respectively. Survey responses were analysed using the Pearson Chi-Square test. The final assessment included 32 participants. Model analysis revealed no significant differences between the groups, except for maxillary intermolar width (p = .033). In the WCR group, the cephalometric analysis indicated a significant increase in the incisor mandibular plane angle (p = .002) and a decrease in the interincisal angle (p = .014), while changes in the CCR group were statistically non-significant. Patient attitude evaluation showed similar trends for wear time and overall satisfaction. However, a higher percentage of respondents in the WCR group reported irritation when wearing the retainers (p = .037) at T1 and discomfort related to speech (p = .038) at T2. CCR showed better retention efficacy in terms of lower incisor inclination. Patients experienced relatively less irritation and speech discomfort with CCRs.