Perspectives Of Healthcare Workers Research Articles

Factors influencing the transition from paediatric to adult HIV care in the Western Cape, South Africa: perspectives of health care providers

Transitioning to adult care for HIV-infected adolescents is a critical process in determining long-term health outcomes. Poor transitioning to adult care can lead to several adverse HIV-related outcomes for adolescents living with HIV, including disruption of care, non-adherence to ART and virological failure. In this qualitative study, we explore the barriers to and facilitators of the transition to adult care among HIV-infected youth from the perspectives of health care workers and allied staff. We enrolled 24 health care workers and allied staff from two infectious diseases clinics in the Western Cape of South Africa. Participants took part in a once-off, semi-structured interview that was conducted face-to-face at the respective clinics. Interviews were audio-recorded and transcribed verbatim for thematic analysis using ATLAS.ti. Two superordinate themes and seven subthemes emerged from the data. We found that barriers to the transition process were related to a lack of preparedness and readiness to transition at both an institutional level and at the level of the caregiver and adolescent. At the institutional level, a lack of a transition policy and limited time and resources available for the transition process were salient barriers. At the caregiver-adolescent level, adolescents’ desire for normality and caregivers’ reluctance to devolve responsibility of care to their children were important barriers to the transition process. Facilitators prepare adolescents and caregivers for transition from an early age. Our findings highlight the importance of considering both adolescent, caregiver and institutional factors when preparing for the transition process. Our findings also show that pressure on the health care system precludes the time required for this process. However, counselling for transition from an early age might be an important way to negate these issues.

Surveillance of hand hygiene practices in hospitals, its evaluation, and audit

Abstract Background: Healthcare-associated infections (HAIs) continue to pose a significant challenge within most intensive care units. The most straightforward and impactful approach to mitigate these HAIs remains proper hand hygiene. Consequently, evaluating documented hand hygiene routines and conducting direct observations are vital in identifying deficiencies. Thus, this enables the formulation of focused approaches to reduce HAIs. Study objectives: (a) To evaluate the hand hygiene practices among healthcare workers and (b) to analyze the factors contributing to non-compliance. Materials and Methods: The research was conducted at the Mayo Institute of Medical Sciences, Intensive Care Unit, Barabanki, Uttar Pradesh, India. This endeavor adopted an observational approach, involving 50 healthcare workers (HCWs) for direct observation and an additional 50 for the evaluation of documented hand hygiene practices. Data collection relied upon the utilization of questionnaires and observation instruments. Results: The investigation brought to light a contrast between the perspectives of healthcare workers and their actual hand hygiene practices. The collective adherence rate stood at 67.08% (with the observation study encompassing 75 HCWs and 111 instances where hand hygiene should have been carried out, out of which only 76 were performed). Notably, physiotherapists exhibited a notably higher compliance rate at 78%, whereas nurses and residents demonstrated a compliance rate of 68%. In contrast, technicians and unit helpers displayed a lower adherence rate of 60%. Regarding reported hand hygiene compliance among HCWs, the figures exceeded 90% (derived from a questionnaire administered to 50 HCWs, some of whom may or may not have been part of the observation study). Nurses reported an impressive 98% compliance, technicians reported 81%, and other personnel reported rates ranging between 90% and 95%. Conclusion: The researcher undertook two distinct investigations involving direct observation and the other based on reported data. The findings from the observational study indicated a collective hand hygiene compliance rate of 67.08%, whereas the reported study yielded a compliance rate exceeding 90% among HCWs.

Healthcare workers’ perspectives on barriers and facilitators to referral and recruitment to diabetes prevention programmes: a systematic review protocol

Background: Diabetes is a growing global health problem. International guidelines recommend identification, screening, and referral to behavioural programmes for those at high risk of developing type 2 diabetes. Diabetes prevention programmes (DPPs) can prevent type 2 diabetes in those at high risk, however many eligible participants are not referred to these programmes. Healthcare workers (HCWs) are pivotal to the referral and recruitment processes. This study aims to identify, appraise and synthesise the evidence on barriers and facilitators to referral and recruitment to DPPs from the perspective of HCWs. Methods: A “best fit” framework synthesis method will synthesise qualitative, quantitative, and mixed methods evidence on factors that affect HCWs referral and recruitment to DPPs, with the Theoretical Domains Framework (TDF) as the a priori framework. MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science and Scopus will be searched for primary studies published in English. Year of publication will be restricted to the last 25 years (1997–2022). Quality will be assessed using the Mixed Methods Appraisal Tool. A mix of deductive coding using the TDF and inductive coding of data that does not fit the TDF will be synthesised into themes representing the whole dataset. The relationships between the final set of themes will be explored to create a new model to understand HCWs’ perspectives on referral and recruitment to DPPs. Sensitivity analysis will be carried out this conceptual model. Confidence in the synthesised findings will be assessed using the GRADE-CERQual approach. One author will screen, extract, appraise the literature while a second author will independently verify a 20% sample at each stage. Discussion: Participation in DPPs is key for programme impact. HCWs typically identify those at risk and refer them to DPPs. Understanding HCWs’ perspectives of the barriers and facilitators to referral and recruitment will inform future implementation of DPPs.

Perspectives of healthcare workers on the challenges with obstetric referrals in rural communities in Ghana: a descriptive phenomenology study

ObjectiveWe explored and document healthcare workers’ (HCWs’) perspectives on the challenges encountered during obstetric referrals.DesignThe study adopted a qualitative research approach and a descriptive phenomenology design. HCWs permanently working in...

Prerequisites, barriers and opportunities in care for Q-fever patients: a Delphi study among healthcare workers

BackgroundQ-fever is a zoonotic disease that can lead to illness, disability and death. This study aimed to provide insight into the perspectives of healthcare workers (HCWs) on prerequisites, barriers and opportunities in care for Q-fever patients.MethodsA two-round online Delphi study was conducted among 94 Dutch HCWs involved in care for Q-fever patients. The questionnaires contained questions on prerequisites for high quality, barriers and facilitators in care, knowledge of Q-fever, and optimization of care. For multiple choice, ranking and Likert scale questions, frequencies were reported, while for rating and numerical questions, the median and interquartile range (IQR) were reported.ResultsThe panel rated the care for Q-fever patients at a median score of 6/10 (IQR = 2). Sufficient knowledge of Q-fever among HCWs (36%), financial compensation of care (30%) and recognition of the disease by HCWs (26%) were considered the most important prerequisites for high quality care. A lack of knowledge was identified as the most important barrier (76%) and continuing medical education as the primary method for improving HCWs’ knowledge (76%). HCWs rated their own knowledge at a median score of 8/10 (IQR = 1) and the general knowledge of other HCWs at a 5/10 (IQR = 2). According to HCWs, a median of eight healthcare providers (IQR = 4) should be involved in the care for Q-fever fatigue syndrome (QFS) and a median of seven (IQR = 5) in chronic Q-fever care.ConclusionsTen years after the Dutch Q-fever epidemic, HCWs indicate that the long-term care for Q-fever patients leaves much room for improvement. Facilitation of reported prerequisites for high quality care, improved knowledge among HCWs, clearly defined roles and responsibilities, and guidance on how to support patients could possibly improve quality of care. These prerequisites may also improve care for patients with persisting symptoms due to other infectious diseases, such as COVID-19.

Accreditation Impact on Quality of Healthcare Organization Services and Culture in a Tertiary Hospital in Saudi Arabia

Introduction: While accreditation is thought to promote healthcare quality, a literature review revealed a scarcity of studies conducted in Saudi Arabia addressing the relationship between accreditation and better care quality and healthcare organization culture. Objectives: This research examined the accreditation effect on care quality and culture presented in King Abdullah Medical City (KAMC), as a healthcare organization, from the perspective of healthcare workers. Methods: The study design is a cross-sectional quantitative using anonymous and self-administered questionnaire for data collection from healthcare employees. The total number of participants was 218. Descriptive analysis was used, including means, range, and standard deviation. Also, the χ² test was used for the association between the variables. Results: The result of the study showed that most of the dimensions associated with quality of care received high ratings. It revealed a significant beneficial association between employees’ perceptions of accreditation and quality of care across all these dimensions. The most dominant culture at KAMC was a group type demonstrated KAMC to be a personal environment. It revealed a strong relationship between employees’ views of the accreditation effect and a group culture type. Conclusion: This study’s findings matched those of a literature review that revealed a relation between accreditation and quality. Accreditation can help foster an organizational culture changing toward a culture that values skill development, cooperation, outcomes quality, and customer satisfaction. Accreditation processes have been found to promote a long-lasting and sustained improvement in quality of care and culture change. It demonstrated the crucial leadership influences in reaching this goal.

Determination of Knowledge Levels and Attitudes of Healthcare Workers on Coronavirus Disease-19 Vaccines

Objective: Healthcare workers (HCWs) are at the forefront of the fight against COVID-19, and vaccination is crucial. In addition, HCWs have the potential, both through their behaviours and their words, in controlling the pandemic. The aim of this study is to determine the vaccination statuses, knowledge levels and perspectives of HCWs regarding vaccination. Materials and Methods: This was a descriptive and cross-sectional study designed for medical students, assistant physicians, nursing students and nurses, in Turkey, between July 15, 2021 and July 30, 2021, using an online questionnaire. Results: Vaccination rate among 822 HCWs was 79.2%. HCWs did not have enough information about vaccines (correct response rates were between 21.6% and 73%). The most important sources of information were social media and the statements of Turkish Minister of Health and Scientific Committee (41.9% and 29.5%, respectively). Vaccination rate was statistically higher in HCWs over 25 years old, physicians, living in the western regions of Turkey, serving patients with COVID-19, those who did not have previous COVID-19, and those who answered the vaccination questions correctly (p=0.019, p<0.001, p<0.001, p=0.042, p<0.001, p<0.001, respectively). The most important reason for vaccine hesitation/rejection was lack of confidence (41.6%). Conclusion: Vaccine hesitation among HCWs in Turkey can be eliminated by paying attention to the correct and effective use of social media, and the Ministry of Health and the Scientific Committee to pay attention to more transparent and precise management of the pandemic

Healthcare facilities’ level of preparedness response on COVID-19 preventive measures in selected regions of Tanzania: A perspective of healthcare workers

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The Use of Social Media in Delivering Rehabilitation Services by Healthcare Professionals at a Rehabilitation Healthcare City in Riyadh, Saudi Arabia

Background: The growing popularity of social media has been welcomed by medical professionals. With an increase in the number of healthcare providers addressing healthcare issues by using social media, such as Facebook, Twitter, YouTube, Snapchat, and Instagram, as well as communicating and educating patients on public health, this new technology has a substantial impact on improving the overall public health. Objective: The primary purpose of this study was to examine the challenges and benefits of using social media in delivering rehabilitation healthcare services from the perspective of healthcare workers at a private institution in a rehabilitation healthcare city in Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted among rehabilitation department staff working at a selected rehabilitation healthcare city in Riyadh, Saudi Arabia. An online web-based questionnaire was developed based on previous studies. The survey was distributed to the employees of the rehabilitation department via their work email addresses. Results: The study population was 108 healthcare providers. Overall, 77.78% of participants had used social media for over five years. Participants reported using social media for numerous purposes. The majority (35.19%) used it for education purposes, 30.56% used it for networking, and others used it for other things, such as communication with patients, online consultations, and job hunting. Furthermore, 49.07% of participants were already using social media to deliver rehabilitation services. Conclusion: The study found that most healthcare providers agreed on the benefits of utilizing social media in the healthcare sector. Most of the benefits were expanding the knowledge of both healthcare workers and patients, easier communication with patients, and also a cost-effective means of communication. However, some of the concerns that were raised by healthcare providers were regarding patients’ privacy and confidentiality, the dissemination of false or misleading information, and legal and ethical considerations.

Justifying non-violent resistance: The perspectives of healthcare workers

Introduction: Non-violent resistance, carried out by healthcare workers, has been a common phenomenon. Despite this and despite the issues this type of action raises, we know little about the healthcare workers who engage in this action and their perspectives about its justification. This exploratory study sought to address this gap, examining these fundamental questions amongst a sample of healthcare workers who have engaged in acts of resistance, exploring their understanding of non-violent resistance, its justification and the barriers they faced in engaging in such action. Methods: Participants were recruited through Medact's ( https://www.medact.org/ ) member database and directed to an online survey hosted on Qualtrics. While participants were unlikely to be representative of the broader UK healthcare community, participants were in an advantageous position to comment on non-violent resistance. Descriptive quantitative analysis and a content analysis were conducted. Results: The majority of participants felt that non-violent resistance could be justified dependent on its cause and/or the action in question. Within this, most felt that if action were non-violent, that if it didn't harm patients and that if the issue in question had to do with health being compromised, action was often justified. A number of others framed their justification as being a right or duty to engage in non-violent resistance. In relation to barriers to engaging in non-violent resistance, these fell into three categories: personal, professional and broader concerns related to society or the general culture found in healthcare. Within these, time and concerns about registration or the consequences of engaging in action were cited as the greatest barriers. Conclusions: These results suggest that healthcare workers who regularly engage in non-violent action carefully thought through their actions, acknowledging the diversity of actions and issues that could be challenged, for many patient care remained a primary concern. There is a need for clarity from regulatory bodies and in particular the need for dialogue between healthcare bodies and healthcare workers who continue to engage in acts of non-violent resistance.

Using the Consolidated Framework for Implementation Research to evaluate a nationwide depression prevention project (ImplementIT) from the perspective of health care workers and implementers: Results on the implementation of digital interventions for farmers.

Depression has a significant impact on individuals and society, which is why preventive measures are important. Farmers represent an occupational group exposed to many risk factors for depression. The potential of guided, tailored internet-based interventions and a personalized telephone coaching is evaluated in a German project of the Social Insurance for Agriculture, Forestry and Horticulture (SVLFG). While user outcomes are promising, not much is known about actual routine care use and implementation of the two digital health interventions. This study evaluates the implementation from the perspective of social insurance employees to understand determinants influencing the uptake and implementation of digital interventions to prevent depression in farmers. The data collection and analysis are based on the Consolidated Framework for Implementation Research (CFIR). Health care workers (n = 86) and implementers (n = 7) completed online surveys and/or participated in focus groups. The surveys consisted of validated questionnaires used in implementation research, adapted items from the CFIR guide or from other CFIR studies. In addition, we used reporting data to map implementation based on selected CFIR constructs. Within the five CFIR dimensions, many facilitating factors emerged in relation to intervention characteristics (e.g., relative advantage compared to existing services, evidence and quality) and the inner setting of the SVLFG (e.g., tension for change, compatibility with values and existing working processes). In addition, barriers to implementation were identified in relation to the outer setting (patient needs and resources), inner setting (e.g., available resources, access to knowledge and information) and characteristics of individuals (e.g., self-efficacy). With regard to the implementation process, facilitating factors (formal implementation leaders) as well as hindering factors (reflecting and evaluating) were identified. The findings shed light on the implementation of two digital prevention services in an agricultural setting. While both offerings seem to be widely accepted by health care workers, the results also point to revealed barriers and contribute to recommendations for further service implementation. For instance, special attention should be given to "patient needs and resources" by raising awareness of mental health issues among the target population as well as barriers regarding the inner setting. German Clinical Trial Registration: [DRKS00017078]. Registered on 18.04.2019.

Predictors of Healthcare Workers' Compassionate Care Amid the COVID-19 Pandemic: A Cross-Sectional Study from Patients' Perspective in Kelantan, Malaysia.

Background: Compassionate care served by healthcare workers (HCWs) has been recognized as one of the most critical aspects of high-quality care. Unfortunately, there is still an unmet need for the assessment of compassionate care from the patient’s perspective. During the COVID-19 pandemic, many new rules were enacted to tackle the raging pandemic, which raised concerns about its effect on compassionate care. Methods: A cross-sectional study involving 315 patients from three public hospitals was conducted during the conditional movement control order (CMCO). A self-administered Malay version of the Relational Aspect of Care Questionnaire (RAC-QM) was used to assess compassionate care. Multiple linear regression was used to determine the predictors. Results: More than 90% of the patients were Malays, Muslims, and fell under the B40 household income category. Companions were present for 51.7% of the patients, but 75.2% had no visitors. All hospitals received scores of more than 90%. Occupation (student, p = 0.032), dependency level (total dependent, p < 0.001), and household income level (M40, p = 0.027) were the statistically significant predictors for compassionate care. Conclusions: The current study revealed that compassionate care to patients was not compromised during the pandemic. Patients with disabilities or financial constraints are more likely to experience less compassionate care, while students are generally more satisfied. This study may provide clues for hospital administrators and policymakers regarding the vulnerable group of patients. It also provides opportunities for future research to study the perspective of HCWs.

Perceptions of Kenyan healthcare workers: Assessing national and county governments' pandemic response

BackgroundDuring the coronavirus-19 pandemic (COVID-19), governments tailored various containment measures and the perspectives of health care workers (HCWs) directly affected by these policies are therefore indispensable. The purpose of this study was to investigate perceptions of both the National and Kiambu County governments' responses to the COVID-19 pandemic from the perspective of HCWs. MethodsWe conducted a mixed-methods cross-sectional study using a semi-structured questionnaire with 438 HCWs in Kiambu County, Kenya, from March 11 to August 12, 2021. Qualitative inductive and deductive data analyses was used in this research. ResultsThe majority of respondents were females (n = 276, 64.5%), middle aged (n = 170, 38.8%) and were caregivers (n = 322, 73.5%). Nine themes emerged: i) Adequate government response; ii) Laxity in public compliance; iii) Lack of healthcare resources; iv) Aggressive initial policy; v) A misinformed public; vi) Slow and inadequate response; vii) Optimism; viii) Decayed adherence to protocols; and ix) Breakdown of systems. ConclusionAlthough HCWs had a variety of viewpoints, both county and national governments received similar feedback. Most HCWs lauded the governments' early and sufficient actions as well as their confidence over the pandemic's future. However, there is still room for development. Concerning factors cited by HCWs included public apathy, false information, a lack of resources, a delayed first response, and systemic failure. HCWs should be included in government processes, such as healthcare budget allocation and guaranteeing prompt payment, to build trust in public institutions and prepare for future health crises. In addition, moderating social media, revising policies, and advancing public understanding are all necessary for combating public misinformation going forward. By putting these suggestions into practice, we can allay the grievances of HCWs and reduce inequities in response to health emergencies not just in Kenya, but similar low-to-middle income countries.

A call for culture-centred care: exploring health workers' perspectives of positive care experiences and culturally responsive care provision to Aboriginal women and their infants in mainstream health in South Australia

BackgroundAboriginal women and their infants experience significant disadvantage in health outcomes compared to their non-Aboriginal counterparts. Access to timely, effective, and appropriate maternal and child health care can contribute to reducing these existing health disparities. This research sought to explore factors that contribute to continuity of care for Aboriginal women and their infants living in metropolitan South Australia. This paper reports on the perspectives of health care workers in mainstream health services from the antenatal period to the end of an infants’ second birthday. It explores health workers’ perspectives of what contributes to positive care experiences and satisfaction with care provided to Aboriginal women and their infants in mainstream health.MethodsEight focus groups were held with 52 health professionals. Participants included Aboriginal Cultural Child and Family Support Consultants (n = 7), Aboriginal Maternal Infant Care Workers (n = 3), Midwives (n = 3) and Child and Family Nurses (n = 39). Data was inductively coded and thematically analysed.ResultsThree key themes emerged: the system takes priority, culture is not central in approaches to care, and ‘we’ve got to be allowed to do it in a different way’.ConclusionsThis research highlights a lack of continuity of care for Aboriginal families accessing mainstream health services from the antenatal period through to an infants’ first 1000 days of life. This research has implications for communities, and it calls for strategies to enhance continuity, and healthcare services to provide appropriate and culturally safe care. Findings will inform and guide future changes to improve continuity of care for Aboriginal families and infants in the first 1000 days.

Essential health services delivery in South Africa during COVID-19: Community and healthcare worker perspectives.

Between May 2020 and February 2022, South Africa's health system bore strain as it battled mitigating the coronavirus pandemic. The country's pandemic response was scrutinized. This period also brought into focus pre-existing shortcomings in the healthcare system and its governing bodies. Contextually, there is a paucity in literature on the experiences of healthcare providers and users. This study aimed to contribute information on COVID-19, with the intention of providing guidance on preparing for future infectious disease outbreaks. Cross sectional exploratory qualitative methodology was employed using semi-structured interviews and focus group discussions with community members (CM) and healthcare workers (HCW) from two South African study sites: (a) rural Bushbuckridge (run by Agincourt Health and Socio-Demographic Surveillance Site) and (b), Regions D and F in Johannesburg Metropole. After interviewing 42 CMs and 43 HCWs, it emerged that mandated process changes while minimizing COVID-19 exposure, necessitated healthcare personnel focusing on critical care treatment at the expense of less acute ones. COVID-19 isolation protocols, extensive absenteeism and HCWs with advanced skills being perceived as more adept to treat COVID-19 patients contributed to HCWs experiencing higher workloads. Fears regarding contracting and transmitting COVID-19, suffering financial losses, and not being able to provide adequate advice to patients were recurrent themes. Dissemination of relevant information among healthcare facility personnel and communities suffered due to breakdowns in communication. Concessions and novel strategies to avail medication to patients had to be created. Since providence was lacking, government needs to formulate health intervention strategies that embrace health literacy, alternate methods of chronic medication dispensation, improved communication across health care platforms and the use of telehealth, to circumvent the threats of possible further infectious disease outbreaks.

Conflict, healthcare and professional perseverance: A qualitative study in a remote hospital in an Anglophone Region of Cameroon.

Armed conflicts are a major contributor to global disease burden owing to their deleterious effects on health and healthcare delivery. The Anglophone crisis in Cameroon is one of the ongoing conflicts in Sub-Saharan Africa and has led to massive displacement of healthcare workers (HCWs). However, some HCWs have stayed back and continued working. An understanding of their experiences, perspectives and professional perseverance is lacking. We designed a phenomenological study using Focused Group Discussions (FGDs) and in-depth interviews to: understand the experiences of 12 HCWs in a remote hospital in the North West region of Cameroon with armed groups; evaluate how it affects healthcare delivery from HCWs perspective and examine HCWs coping mechanisms during the conflict with a view of informing HCW protection policies in conflict zones. Results revealed that HCWs go through all forms of violence including threats, assaults and murders. Overall insecurity and shortage of health personnel were major barriers to healthcare delivery which contributed to underutilization of healthcare services. Participants observed an increase in complications due to malaria, malnutrition and a rise in maternal and infant mortality. The hospital management and Non-Governmental Organizations (NGOs) played an essential role in HCWs adaptation to the crisis. Nevertheless they unanimously advocated for a cease fire to end the conflict. In the meantime, passion for their job was the main motivating factor to stay at work.

Preliminary considerations for electronic medical record (EMR) in the public hospitals of Gandaki province in Nepal

Electronic Medical Record (EMR) is the digital tool to keep records of valuable information on computer or computer-like equipment, regarding health systems, including patient’s records and stock management which can provide real time evidence for better patient record, clinical care and health policy making. As Nepal does not have a national EMR system, and it is a challenge to get real time data, information and evidence required for effective health policy making. With an effective national EMR system in Nepal, the health system can be improved with reliable information of patients for the continuity of clinical care.&#x0D; &#x0D; There are existing scientific evidence of EMR on the lessons of implementation in Nepal, opportunities for the use of EMR in Malaysia, perspectives of health care workers on EMR after its implementation in Canada, on the development of success measuring tools and the use of questionnaires for the EMR implementation in Canada, best practices, impact of EMR on physician practice, and barriers for EMR implementation.&#x0D; &#x0D; EMR can improve the quality, effectiveness, transparency and efficiency of healthcare services and its management. Gandaki province is one of seven provinces in Nepal and is exploring ways to implement EMR in all the hospitals operated under the province government. There can be step wise approach to have EMR in all of these hospitals. This can give more strategies for the national EMR system.

The Relationshiıp Between Organizational Commitment and Job Satisfaction: A Comprehensive Meta-Analysis Study from the Perspective of Healthcare Workers in Turkey

Bu kapsamlı meta analiz çalışması, sağlık sektörü çalışanlarının iş tatmini ve örgütsel bağlılık arasındaki ilişkileri baz alarak hazırlanan yurtiçi yayınların özetini sunmaktadır. Çalışma için veriler Ocak 2022 tarihinde toplanmıştır. Araştırmanın evrenini Ulusal Tez Merkezi üzerinde taranan yüksek lisans ve doktora tezleri, DergiPark Akademik ile TR Dizin tarafından endekslenmiş makaleler oluşturmaktadır. Taramalar ve dahil etme kriterleri neticesinde toplam 46 çalışmanın analiz için uygun olduğuna karar verilmiştir. Kapsamlı meta analiz programı kullanılarak gerçekleştirilen analizler sonucunda, sağlık sektörü çalışanlarının iş tatmini ve örgüsel bağlılıkları arasındaki randomize etki büyüklüğünün genel z ve p testi değerlerinin anlamlı, pozitif ve orta düzeyde olduğu ortaya çıkmıştır. Araştırma kapsamı içerisinde incelenen 2 adet çalışmaya ait güven aralıklarının alt limitlerinin diğer çalışmalara göre daha düşük olduğu sonucuna ulaşılmıştır. Uygun etki büyüklüğü modeline karar verme aşamasında önce gerekli heterojenite testleri yapılmış, Cohrane Q testinin ki kare test sonucu ve Higgins’in I2 test istatistikleri neticesinde araştırma verilerinin homojen dağılmadığı, orman grafiği sonuçları da göz önünde bulundurularak tespit edilmiştir. Çalışma kapsamında gerçekleştirilen yayın yanlılığı testleri, çalışmada yayın yanlılığı olmadığına ve elde edilen sonuçların güvenilir olduğuna işaret etmektedir. Elde edilen bulguların ileride yapılacak çalışmalara yol gösterici olduğu ve sağlık yöneticileri ile politika yapıcılar için kanıta dayalı bilgiler sunacağı düşünülmektedir.

Indispensable yet invisible: A qualitative study of the roles of carers in infection prevention in a South Indian hospital

ObjectivesWe investigated the roles of patient carers in infection-related care on surgical wards in a South Indian hospital from the perspective of healthcare workers (HCWs), patients, and their carers. MethodsEthnographic study included ward-round observations (138 hours) and face-to-face interviews (44 HCWs, 6 patients/carers). Data (field notes, interview transcripts) were coded in NVivo 12 and thematically analyzed. Data collection and analysis were iterative, recursive, and continued until thematic saturation. ResultsCarers have important, unrecognized roles. At the study site, institutional expectations are formalized in policies, demanding a carer to always accompany in-patients. Such intense presence embeds families in the patient care environment, as demonstrated by their high engagement in direct personal (bathing patients) and clinical care (wound care). Carers actively participate in discussions on patient progress with HCWs, including therapeutic options. There is a misalignment between how carers are positioned by the organization (through policy mandates, institutional practices, and HCWs expectations), and the role that they play in practice, resulting in their role, though indispensable, remaining unrecognized. ConclusionCurrent models of patient and carer involvement in infection prevention and control are poorly aligned with sociocultural and contextual aspects of care. Culture-sensitive infection prevention and control policies which embrace the roles that carers play are urgently needed.

Views of nurses and other healthcare workers on interventions to reduce disrespectful maternity care in rural health facilities in Kilifi and Kisii counties, Kenya: analysis of a qualitative interview study

ObjectiveThere is an abundance of evidence illuminating the factors that contribute to disrespectful maternity care in sub-Saharan Africa. However, there is limited documented evidence on how some of the key...