Perceptions Of Healthcare Providers Research Articles

Supporting Underserved Communities for Health Care: US Immigrants’ Experiences with Social Support

Background Social support is associated with improved clinical outcomes but is understudied among US immigrants. We examined two types of social support, perceived health provider support and community support, and characterized perceptions of social support among US immigrants compared with nonimmigrants. Methods We conducted cross-sectional data analysis on self-reported data from Health Information National Trends Survey 5, Cycle 2. Population-level estimates were obtained using jack-knife replicate weights. Results Immigrant status was not associated with perceived health care provider support or community support. However, compared with nonimmigrants, US immigrants were more likely to report rarely (adjusted odds ratio [aOR]=3.07) or never (aOR=3.18) having access to emotional support. Conclusions Further research that incorporates nuanced factors (eg, time since arrival) that may influence social support in diverse US immigrant groups is needed to determine the impact of social support on health outcomes in an underserved and often overlooked population.

Glucose management in critically ill adults: A qualitative study from the experiences of health care providers

Aims and objectiveTo explain the components and elements of glucose management in critically ill adult patients from the healthcare providers’ experiences. BackgroundCritically ill adults are highly susceptible to stress-induced hyperglycaemia due to glucose metabolic disorders. Healthcare workers play a key role in the glycaemic management of critically ill patients. However, there is a lack of qualitative studies on the content and elements of glycaemic management and healthcare workers' perceptions about glycaemic management in China. DesignQualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. MethodsIndividual semi-structured interviews were conducted from January to April 2022. Fifteen physicians and nurses were recruited from ten hospitals in mainland China. Data were analysed using inductive thematic analysis. ResultsGlucose management in critically ill adult patients from their experiences included two parts: the inner ring (practice behaviours) and the external space (methods and drivers). The practice behaviours of glucose management include five elements, while the methods and drivers of glucose management focus on three elements. The content covered under each element was identified. ConclusionThis study developed a glycaemic management model for critically ill adult patients, clarified its elements based on the perceptions of healthcare providers and elaborated on the methods and drivers covered under each element to provide a reference for physicians and nurses to develop a comprehensive glycaemic management guideline for critically ill adult patients. Relevance to clinical practiceOur study proposed a glucose management practice model for critically ill adult patients, and the elements and components included in this model can provide a reference for physicians and nurses when performing glucose management in critically ill patients.

Healthcare provider perceptions and reported practices regarding opioid prescription for patients with chronic cancer pain.

Data indicates that clinicians might be under-prescribing opioids for patients with chronic cancer pain, and this could impact adequate pain management. Few studies have sought to understand healthcare provider (HCP) perceptions and practices regarding the prescription of opioids for chronic cancer pain. We assessed HCP perceptions and practices regarding opioid prescription for patients with chronic cancer pain since the onset of the COVID-19 pandemic. An anonymous cross-sectional survey was conducted among 186 HCPs who attended an opioid educational event in April 2021 and 2022. Sixty-one out of 143 (44%) opioid prescribers reported reluctance to prescribe opioids for chronic cancer pain. In a multivariate logistic model, younger participants (log OR - 0.04, 95% CI - 0.085, - 0.004; p = 0.033) and pain medicine clinicians (log OR - 1.89, CI - 3.931, - 0.286; p = 0.034) were less reluctant, whereas providers who worry about non-medical opioid use were more reluctant to prescribe opioids (log OR 1.58 95% CI 0.77-2.43; p < 0.001). Fifty-three out of 143 (37%) prescribers had experienced increased challenges regarding opioid dispensing at pharmacies, and 84/179 (47%) of all respondents reported similar experience by their patients. Fifty-four out of 178(30%) were aware of opioid-related harmful incidents to patients or their families, including incidents attributed to opioid misuse by a household or family member. A considerable number of opioid prescribers were reluctant to prescribe opioids for patients with chronic cancer pain. Many reported challenges regarding dispensing of opioids at the pharmacies. These may be unintended consequences of policies to address the opioid crisis. Future measures should focus on addressing regulatory barriers without undermining the gains already made to combat the opioid crisis.

Using Emr In A Corporate Hospital: Healthcare Providers Perspective From Bangladesh

Background: An Electronic Medical Record (EMR) is an essential tool for delivering high-quality healthcare in a hospital. In recent years, hospitals have increased their investment in EMRs to improve the level of integrated management of information. The purpose of this study was to explore the perspectives of using EMR among healthcare providers (HCPs) in a corporate hospital in Bangladesh.&#x0D; Methods: This cross-sectional study was conducted among 153 HCPs (doctors, nurses, lab technicians, drug dispensers, billing managers, and administrative personnel) who have access to EMR and working in a selected corporate hospital of Dhaka city. The study period was January to December 2019. HCPs were selected by convenience sampling technique. Data were collected by face-to-face interview using semi structured questionnaire. Data analysis was done by IBM SPSS software. Ethical issues were maintained strictly.&#x0D; Result: Study revealed that 59.5% HCPs were in the age group of 18-29 years with the mean age being 29.26 (±7.58) years. Only 32.7% HCPs had previous experience of using this type of software before working in the current hospital and 62.7% got technical training on EMR within the current hospital. The majority (81.7%) of the HCPs found that the technical training was effective for using the EMR software. The difficulty of using EMR was significantly associated with the age (p&lt;0.001), gender (p&lt;0.001), professional status (p&lt;0.001) and highest level of education (p&lt;0.001) of the HCPs. HCPs ability to overcome job related challenges was significantly associated with the professional status of them (p&lt;0.001). HCPs perception regarding effectiveness of EMR was found significantly associated with their place of technical training (p=0.004) and duration of the training (p=0.012).&#x0D; Conclusion: EMR can be a helpful tool for the health service providers to provider health services at the corporate hospitals. Digital literacy need to be increased among the HCPs to ensure effective use of EMRs. Regular maintenance and upgrades of the technology infrastructure are necessary for advanced record-keeping and quality service.&#x0D; JOPSOM 2021; 41(2):12-19

Telerehabilitation in Colombia: A Country Report and Qualitative Analysis During the Covid-19 Pandemic - Perceptions of Healthcare Providers and Patients.

Given Colombia's status as a middle-income country with healthcare challenges, leveraging telemedicine could significantly benefit hard-to-reach regions, under-resourced and underserved communities. This study provides a comprehensive overview of the country's telerehabilitation landscape, exploring the clinicians' and patients' perspectives during the COVID-19 pandemic through systematic review and qualitative analysis. Sixteen therapists and three patients were identified via snowball sampling. The literature review was scarce and scattered across various topics in the country; some studies delved into specific aspects like legislative frameworks and patient outcomes from different medical specialties. The qualitative analysis demonstrates that despite the learning curve, telerehabilitation strengthens therapeutic support, enhances patient autonomy, fosters a positive patient-provider relationship, achieves treatment goals, promotes family involvement, reduces time and costs, and ensures continuity of therapy services. This study identified research gaps, challenges, and opportunities in telerehabilitation in a Latin American country. Adopting telemedicine technologies in low- and middle-income countries could significantly enhance their healthcare systems.

Perceptions of healthcare providers on artificial intelligence integration into dermatology clinical practice; a crosssectional study in the Kingdom of Saudi Arabia

Objective: The study aimed to understand the perceptions of healthcare providers in the dermatology field in Saudi Arabia about using artificial intelligence (AI) and to know their attitudes, and expectations toward AI applications in the dermatology field. Methods: A quantitative cross-sectional design was used, and the participants were selected through convenience sampling from different areas of Saudi Arabia randomly. A self-administered online questionnaire was used to conduct the study. Results: Dermatologists in Saudi Arabia showed a positive attitude toward AI in dermatology. In general, gender and nationality did not affect their attitudes about AI (p-value&amp;gt; 0.05). It was worthy that the majority of participants (75.5%) were already aware of AI, indicating a certain level of familiarity within the healthcare community. Furthermore, a significant percentage of participants (72.9%) believed that AI technology could potentially reduce errors in clinical practice and decrease the differences in judgments between medical professionals. Conclusion: A positive attitude was shown by Saudi Arabian healthcare providers toward using AI in dermatology. Additionally, dermatologists were aware of the potential of AI in detecting skin diseases by using histopathological and dermoscopy imaging.

Why are pregnant women physically inactive? A qualitative study on the beliefs and perceptions about physical activity during pregnancy.

This study aimed to describe the beliefs and perceptions of pregnant women and healthcare providers about physical activity during pregnancy. Using a qualitative approach, 30 pregnant women and the 14 healthcare providers caring for them were interviewed in the second trimester of pregnancy. We included women who maintained, decreased, or stopped physical activity since becoming pregnant. They were divided into low (≤ 8 years) and high schooling (> 8 years). Semi-structured, in-depth interviews were conducted and guided by three key questions: (1) When does physical activity during pregnancy start to be considered a wrong behavior?; (2) What are the main barriers (biological or others) to physical activity?; and (3) Do the actions of healthcare providers and people close to pregnant women reinforce barriers? Interviews were audio recorded, transcribed, and analyzed based on recurring themes. All women changed their physical activity behavior (decreased or stopped) when they discovered their pregnancy. Fear of miscarriage, contractions, bleeding, and of causing malformations in the baby were the most reported reasons for decreasing or stopping physical activity. Participants also lacked access to consistent information and healthcare providers' support on the benefits of physical activity. Despite the current international recommendations to regular physical activity during pregnancy, uncertainty regarding its benefits remains. Interventions to promote physical activity during this period should include the training of healthcare providers so they can advise and discard ideas contrary to mother-child health benefits.

Factors influencing the implementation of integrated screening for HIV, syphilis, and hepatitis B for pregnant women in Nepal: A qualitative study.

In Nepal, national guidelines recommend free HIV and syphilis screening for pregnant women at their first antenatal visit, using an opt-out approach. However, screening uptake is low and the guidelines do not include hepatitis B screening. It is essential to understand the factors influencing the implementation of integrated screening for HIV, syphilis, and hepatitis B, as recommended by WHO, to improve uptake and prevent vertical transmission. This study explored the knowledge, attitudes, and perceptions of pregnant women, their families, healthcare providers and policymakers on integrated prenatal screening. We conducted 12 in-depth interviews with pregnant women, 10 with their husbands and 4 with mothers-in-law in Kapilvastu and Kathmandu. In addition, we interviewed 7 health workers and 4 decision-makers. These interviews were sufficient to reach saturation. Data were analysed using a thematic content analysis. A combination of the social-ecological model and the WHO building blocks provided a theoretical framework for interpreting data. The analysis showed that antenatal screening in Nepal involved many stakeholders and was influenced by various factors. Implementation issues were found in the building blocks service delivery, health workforce and medical products. Husbands and in-laws play an important role in the acceptance of screening by pregnant women, especially in rural areas. High levels of stigma and discrimination against people with sexually transmitted diseases were reported, and knowledge of hepatitis B and syphilis was low. Access and uptake of screening could be improved through rapid testing, by strengthening the health system and by integrating hepatitis B screening through an opt-out approach like that for HIV and syphilis. Effective community involvement through awareness campaigns and investment in lower-level health facilities is essential to improve screening rates. This study provides information for decision-makers about challenges in implementing integrated screening to guide the design of targeted interventions to reduce vertical transmission.

Perceptions of primary healthcare providers for screening and management of mental health disorders in India: a qualitative study.

Individuals experiencing mental health disorders encounter numerous challenges while accessing mental healthcare services. Despite the inclusion of mental health in the primary healthcare system, screening and managing mental health disorders remain significantly overlooked. Therefore, there is a need to understand the perceptions of healthcare providers in primary care settings, identify the challenges faced, and gather suggestions for effective mental healthcare delivery. The present qualitative study was conducted in 13 primary healthcare facilities in the Jodhpur district of Rajasthan, India, from 2023 to 2024 among 25 primary healthcare providers. Semi-structured interview guides were developed for each category of primary healthcare provider, including Medical Officers, Community Health Officers, and General Nurse Midwives, Auxiliary Nurse Midwives and in-depth interviews were recorded, transcribed, and thematically analyzed using codes and sub-codes. Results are summarized under the themes: (i) Navigating Mental Healthcare in Primary Healthcare Facilities, (ii) Challenges and Barriers in Mental Healthcare Delivery, (iii) Recommendation for Enhancing Mental Healthcare Services, and (iv) Approaches for Comprehensive Capacity Building Training and Module and further findings of each theme are presented under various sub-themes. The findings suggest that despite a perceived competence in providing mental health services, there were substantial levels of negative attitudes towards mental health disorders among participants and provide insights for policymakers and healthcare professionals to develop targeted interventions and improve mental healthcare delivery at primary care facilities.

Improving shared decision-making around antimicrobial-prescribing during the end-of-life period: a qualitative study of Veterans, their support caregivers and their providers

Abstract Objective: Antimicrobials are frequently used for palliation during end-of-life care, but adverse effects, such as antimicrobial resistance, are a concern. Shared decision-making is beneficial in end-of-life care conversations to help align antimicrobial-prescribing with patient preferences. However, there is limited data regarding optimal incorporation of antimicrobial-prescribing discussions into shared decision-making conversations. We explored healthcare provider, patient, and support caregiver (eg, family member/friend) perceptions of barriers and facilitators to discussing antimicrobial-prescribing during the end-of-life period. Design: Qualitative study. Participants: Healthcare providers; palliative care/hospice care patients/caregivers. Methods: We conducted semi-structured interviews on shared attitudes/beliefs about antimicrobial-prescribing during end-of-life patient care at one acute-care and one long-term-care facility. Interviews were analyzed for thematic content. Results: Fifteen providers and 13 patients/caregivers completed interviews. Providers recognized the potential benefit of leveraging shared decision-making to guide antimicrobial-prescribing decisions. Barriers included limited face-to-face time with the patient and uncertainty of end-of-life prognosis. Patients/caregivers cited trust, comprehension, and feeling heard as important characteristics which act as facilitators in fostering effective shared decision-making around antimicrobial use. Communication in which providers ensure patients are involved in shared decision-making discussions could be increased to ensure patients and their providers develop a mutually agreeable care plan. Conclusions: Shared decision-making is a practice that can guide antimicrobial-prescribing decisions during end-of-life care, thus potentially minimizing antimicrobial-related adverse effects. Our findings highlight opportunities for increased shared decision-making around antimicrobial use during end-of-life care. Interventions designed to address the identified barriers to shared decision-making have the potential to improve antimicrobial-prescribing practices at end-of-life.

Perspectives in Managing Kidney Disease and Atherosclerotic Cardiovascular Disease.

Chronic kidney disease (CKD) and atherosclerotic cardiovascular disease (ASCVD) share a complex and dependent link with each other and other cardiometabolic conditions. Currently, there is insufficient data regarding patient and provider perceptions about this important clinical overlap. This study sought to evaluate healthcare provider (HCP) and patient attitudes and perceptions about CKD and ASCVD, including risk, diagnosis, and management of both conditions. Cross-sectional surveys of 58 nephrologists and 74 cardiologists who treat patients with CKD and ASCVD and 195 patients who self-reported having CKD and ASCVD were conducted in the USA between May and June 2021. Most nephrologists agreed that the presence of cardiometabolic comorbidities increased patients' risk of developing CKD; 86% agreed that type 2 diabetes increased the risk, and 67% agreed that ASCVD increased the risk. However, only 52% of the nephrologists reported they typically discuss the risk of developing CKD with patients prior to diagnosing them. Slightly more than one-third of patients (35%) reported their HCP discussed other conditions' impact on the development of CKD; of all HCPs surveyed, nephrologists were the least likely to discuss CKD risk with their patients. Most nephrologists (83%) also reported they recommended lifestyle modification to patients; however, only about half of patients (53%) reported they were currently using a lifestyle change to treat CKD and/or ASCVD. Although CKD and ASCVD are known to have a bidirectional relationship, HCPs in our study did not report routinely educating patients about the risk of developing one or both conditions. As HCPs with perhaps the deepest understanding of the interplay between CKD and cardiorenal comorbidities, nephrologists are well positioned to help patients understand the link between cardiovascular and renal health, help identify strategies to limit risk, and appropriately treat the conditions.

To Explore the Perception of Healthcare Providers Towards the Role of AI in Improving Healthcare Outcomes

To Explore the Perception of Healthcare Providers Towards the Role of AI in Improving Healthcare Outcomes

Stakeholder Perception of the Implementation of Genetic Risk Testing for Twelve Multifactorial Diseases.

Genome-wide association studies have been employed to develop numerous risk prediction models using polygenic risk scores (PRSs) for multifactorial diseases. However, healthcare providers lack confidence in their understanding of PRS risk stratification for multifactorial diseases, which underscores the need to assess the readiness of PRSs for clinical use. To address this issue, we surveyed the perceptions of healthcare providers as stakeholders in the clinical implementation of genetic-based risk prediction for multifactorial diseases. We conducted a web-based study on the need for risk prediction based on genetic information and the appropriate timing of testing for 12 multifactorial diseases. Responses were obtained from 506 stakeholders. Positive perceptions of genetic risk testing were found for adult-onset chronic diseases. As per participant opinion, testing for adult-onset diseases should be performed after the age of 20 years, whereas testing for psychiatric and allergic disorders that manifest during childhood should be performed from birth to 19 years of age. The stakeholders recognized the need for genetic risk testing for diseases that develop in adulthood, believing that the appropriate testing time is after maturity. This study contributes to the discussion on the clinical implementation of the PRS for genetic risk prediction of multifactorial diseases.

A qualitative study of the comfort care experience from the perceptions of health care providers providing care for terminally ill infants in neonatal intensive care unit at the end of life

PurposeThe purpose of this study was to describe the comfort care experiences of health care providers at the NICU at end of life. Designand Method: The study used a qualitative phenomenological approach, to collect data from 20 health care providers (nurses and physicians) who were selected purposively from the NICUs settings in three Jordanian hospitals utilizing semi-structured interviews. The data was recorded and analyzed thematically. ResultsFour distinct themes captured the comfort care experiences of health care providers: (1) Reality vs. Hope, (2) Beliefs and Emotions, (3) Provision of Comfort Care, (4) Passion of Attachment. ConclusionThe finding of the study indicated that the experience of the health care providers was very stressful and challenging. There was a lack of prior education on comfort care and a lack of comfort care policies to provide quality comfort care. This study supports need for adjustments in staffing to meet the complex needs of terminally ill infants at the NICU.

Patients’ perspectives and the perceptions of healthcare providers in the treatment of early rectal cancer; a qualitative study

BackgroundShared decision-making has become of increased importance in choosing the most suitable treatment strategy for early rectal cancer, however, clinical decision-making is still primarily based on physicians’ perspectives. Balancing quality of life and oncological outcomes is difficult, and guidance on patients’ involvement in this subject in early rectal cancer is limited. Therefore, this study aimed to explore preferences and priorities of patients as well as physicians’ perspectives in treatment for early rectal cancer.MethodsIn this qualitative study, semi-structured interviews were performed with early rectal cancer patients (n = 10) and healthcare providers (n = 10). Participants were asked which factors influenced their preferences and how important these factors were. Thematic analyses were performed. In addition, participants were asked to rank the discussed factors according to importance to gain additional insights.ResultsPatients addressed the following relevant factors: the risk of an ostomy, risk of poor bowel function and treatment related complications. Healthcare providers emphasized oncological outcomes as tumour recurrence, risk of an ostomy and poor bowel function. Patients perceived absolute risks of adverse outcome to be lower than healthcare providers and were quite willing undergo organ preservation to achieve a better prospect of quality of life.ConclusionPatients’ preferences in treatment of early rectal cancer vary between patients and frequently differ from assumptions of preferences by healthcare providers. To optimize future shared decision-making, healthcare providers should be aware of these differences and should invite patients to explore and address their priorities more explicitly during consultation. Factors deemed important by both physicians and patients should be expressed during consultation to decide on a tailored treatment strategy.

Healthcare Professionals' Perception Regarding Patient Rights and Safety in Najran, Saudi Arabia.

Patient safety and rights are the most crucial aspects of healthcare quality. In Saudi Arabia, there is a paucity of evidence concerning the perspectives of healthcare providers on the rights and safety of patients. Hence, this study aimed to assess the perceptions of healthcare providers toward patients' rights and safety in Najran, Saudi Arabia. A cross-sectional study was undertaken in Najran, Saudi Arabia, from December 2022 to October 2023, utilizing an online survey. This study included 307 healthcare providers who responded to the questionnaire via Google web link (Google LLC, Mountain View, California, United States). The present research comprised 307 healthcare personnel, of whom 65.8% were male and possessed a variety of academic backgrounds. The participants exhibited a high level of support for patients' rights, as evidenced by their agreement with 88.4-90% of questions on a variety of dimensions; this demonstrated their dedication to providing patient-centered care. Concerning medical errors, a significant proportion of respondents (74.9-86.1%) exhibited comprehensive comprehension and a readiness to disclose such incidents. Diverse viewpoints surfaced regarding the attribution of errors, the necessity of reporting, and the accountability for disclosure. The interdependence of patient rights and attitudes towards patient safety was highlighted by substantial positive correlations. The viewpoints of healthcare professionals regarding medical errors and patients' liberties were discussed in this study. Advocacy for patients' rights is indicative of a commitment to patient-centered care that prioritizes autonomy and transparency. Although most participants demonstrated a willingness to report medical errors and possess a solid comprehension of their causes, divergent views emerged regarding attribution and disclosure. The interrelation between patient rights and attitudes toward patient safety was supported by positive correlations. The significance of continuous education in healthcare to promote a safety culture and enhance patient-centric practices is underscored by these results.Future research is needed to investigate the effects of culturally tailored interventions on the attitudes and practices of healthcare providers in Najran with regard to patient rights and safety.

Experience and perceptions of healthcare providers on clinical management and care of near-miss infants: a qualitative content analysis

IntroductionNeonatal Near Miss (NNM) refers to neonates with severe complications who almost died but survived immediately after birth. In Ethiopia, the prevalence of NNM has been assessed using a validated Neonatal Near-Miss Assessment Scale. However, understanding the experiences and perceptions of healthcare providers in the clinical management and care of NNM infants remains unexplored. The aim was to investigate the determinants contributing to the survival of neonatal near-miss babies and to identify any barriers encountered, as reported by the experiences of healthcare providers in public hospitals of Amhara Regional State, northwest Ethiopia.MethodsSemi structured interviews were used to collect data from 25 midwives, nurses, and pediatricians with at least six months of prior experience in one of the labor wards or neonatal intensive care units at one of the four public health hospitals in the Amhara Regional state of northwest Ethiopia included in a large intervention study assessing a NNM scale. Purposeful sampling was used, selecting participants based on their experiences related to the aim of this study. The participants had a varying level of education and years of experience to care for NNM infants. The average age of the healthcare providers was 31 years, with 7 years of work experience. The transcripts of the interviews with the healthcare providers were analyzed using qualitative content analysis.ResultsThe experience and perceptions of healthcare providers was described in the main category “A sense of hopelessness when caring for the baby” capturing a broader emotional and professional aspect, while the subcategories “Unclear responsibilities discharging one’s mission”, “Provision of kangaroo mother care” and “Quick action required at birth” are more specific and practical. Healthcare providers perceived a sense of hopelessness when caring for the NNM infant, particularly providing Kangaroo Mother Care (KMC) and quick actions when required at birth to save the life of the infant.ConclusionUnclear responsibilities and a sense of hopelessness could have acted as barriers, hindering the ability of healthcare providers to fulfill their mission of taking swift actions and providing KMC to NNM infants, thus impacting their ability to save the lives of these infants. Healthcare providers’ and parents’ attitudes must be changed towards hope rather than hopelessness when caring for NNM infants.

Focus on post-exertional malaise when approaching ME/CFS in specialist healthcare improves satisfaction and reduces deterioration.

Post-exertional malaise (PEM) is considered a hallmark characteristic of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This may also apply to subgroups of patients with long COVID-induced ME/CFS. However, it is uncertain to what extent PEM is acknowledged in routine specialist healthcare for ME/CFS patients, and how this affects patient outcomes. This study aims to evaluate to what extent ME/CFS patients experienced focus on PEM in specialist healthcare practice and its significance for outcome and care quality. Data from two online cross-sectional surveys covering specialist healthcare services for ME/CFS patients at rehabilitation institutes in Norway and two regional hospitals, respectively, were analyzed. Evaluations of 788 rehabilitation stays, 86 hospital consultations, and 89 hospital interventions were included. Logistic regression models and Mann-Whitney U-tests were used to quantify the impact of addressing PEM on health and functioning, care satisfaction, or benefit. Spearman's rank correlation and Cronbach's alpha of focus on PEM with the respondents' perception of healthcare providers' knowledge, symptom acknowledgment, and suitability of intervention were assessed as measures for care quality and their internal consistency, respectively. PEM was addressed in 48% of the rehabilitation stays, 43% of the consultations, and 65% of the hospital interventions. Failure to address PEM roughly doubled the risk of health deterioration, following rehabilitation (OR = 0.39, 95% CI 0.29-0.52; 40.1% vs. 63.2% P = <0.001) and hospital intervention (OR = 0.34, 95% CI 0.13-0.89; 22.4% vs. 45.2%, p = 0.026). The focus on PEM (PEM-focus) during the clinical contact was associated with significantly higher scores on patients' rated care satisfaction and benefit of both consultation and intervention. Furthermore, addressing PEM was (inter)related to positive views about healthcare providers' level of knowledge of ME/CFS, their acknowledgment of symptoms, obtained knowledge, and the perceived suitability of intervention (Cronbach's alpha ≥0.80). PEM is still frequently not acknowledged in specialist healthcare practice for ME/CFS patients in Norway. Not addressing PEM substantially increased the probability of a decline in health and functioning following the intervention and was strongly associated with reduced perceived care quality, satisfaction, and benefit. These findings may be related to the applied explanatory models for ME/CFS and are most likely of relevance to long COVID.

Perception of the Health-care Providers toward Telemedicine Practice: A Cross-sectional Study from Karnataka, India

Introduction: The major advantages of telemedicine can be saving time, cost, and effort, especially for rural patients, during challenging times such as COVID for obtaining consultation and treatment. Telemedicine, if properly implemented, can reduce gaps and strengthen the health-care delivery system in India. Objective: The objective of the study was to assess the perception and practice of health-care providers toward telemedicine. Methodology: We conducted a cross-sectional study among 141 health-care providers who ever practiced telemedicine consultation. Utilizing online Google Forms, we used snowball sampling. Four sections made up the pretested study questionnaire: demographic information, perceptions, and practices. Statistical Package for the Social Sciences (SPSS) version 21 was used for data analysis. Results: Among them, majority were aged between 35 and 44 years (49.6%), males (56%), had M.D./M.S. degree (57.4%), postgraduates (33.3%), worked in private sector (56.7%), and were from clinical specialty (80.8%) We had majority health-care workers who used telemedicine application for the first time after COVID (80.1%), used only mobile (82.2%), used only one application (83.6%), and gave 5–10 consultations per day (57.4%). Most of our study participants feel teleconsultation takes less time (61.7%), reduces waiting list at medical center (92.9%), has better communication (83.6%), gives better aid during emergency (53.9%), and saves money on transportation (97.1%). Conclusion: In this study, we could conclude that most participants started practicing telemedicine post-COVID. Health-care professionals still feel challenging to provide effective patient counseling through telemedicine; moreover, they are benefitted from telemedicine practice.

Impact of a capacity-building intervention on views and perceptions of healthcare providers towards the provision of adolescent sexual and reproductive health services in southeast Nigeria: a cross-sectional qualitative study

ObjectivesNegative views of healthcare providers towards adolescent sexual and reproductive health (SRH) services deter adolescents from seeking vital SRH services. This paper assessed the impact of an intervention on the...