Pilot Questionnaire Research Articles

Delivering Cancer Care During a Pandemic: Patient and Healthcare Staff Experience in a High-Volume Radiation Oncology Department

Purpose/Objective(s)The COVID-19 pandemic has shifted practices in oncology to prioritize patient and healthcare staff safety while maintaining necessary treatment delivery. We obtained feedback from both patients and healthcare staff on pandemic-based practices in our radiotherapy department to adapt policies and procedures to improve safety and quality of care.Materials/MethodsWe developed a piloted questionnaire which quantitatively and qualitatively assessed patients’ pandemic-related concerns and satisfaction with specific elements of their care. Adult patients treated at the start of the pandemic with an initial consultation via telehealth and received at least 5 outpatient fractions of radiotherapy were invited to complete the survey by telephone or online. We simultaneously provided an online survey to our healthcare staff including radiation technologists, oncologists, dosimetrists, physicists and allied health professionals regarding workplace conditions and perceived safety. Relative frequencies of categorical and ordinal responses were calculated, and Mann-Whitney-U tests and t-tests were used to compare response rates between subgroups.ResultsA total of 53 patients (48% of eligible individuals) and 87 staff (44% technologists, 21% radiation oncologists, 36% other) responded to the surveys. Most patients responded positively to telehealth and pandemic department procedures, and all (100%) reported being satisfied with their treatment experience. Constructive criticism voiced in a minority of patients (13%) centered around hearing difficulties, appointment scheduling confusion, and a desire for access to more support services. In contrast, satisfaction with working conditions significantly decreased from 69% to 24% among staff, especially among technologists and oncologists. Multiple staff identified sub-optimal shift-scheduling, interprofessional communication gaps, and uneven assignment of tasks as the primary contributors to decreased morale. Of all the professionals surveyed, technologists were the most negatively affected, reporting increased workload, decreased efficiency, and dissatisfaction with work scheduling.ConclusionPatients have responded positively to new pandemic-related policies in our radiotherapy department and report overall satisfaction with their care. While patient satisfaction is high, the pandemic has resulted in decreased morale and the perception of increased workload among healthcare workers. Results from this study have been used to identify barriers to workplace satisfaction and have led to implementation of changes. This study highlights the importance of seeking feedback from both patients and healthcare workers to understand the complexities at play in preserving the quality of patient care and the work environment as we continue to work in the current reality.

Validity and reliability of new instruments for measuring patient satisfaction with removable dentures, Arabic Version

BackgroundThe psychometric properties of self-administered instruments for measuring patient satisfaction with removable dentures should be tested before inviting patients to express their opinions. This study aimed to evaluate the validity and reliability of new instruments in the Arabic language that measure patient satisfaction with all types of removable dentures.MethodsA three-step methodology was used to translate and test the instruments. In step one, the instruments were translated from tested German instruments to develop the pilot questionnaires. In step two, the face validity of the pilot questionnaires was tested through three rounds of interviews. There were 15, 13, and 15 participants per round, respectively. At the end of every round, the results of the interviews were discussed with an expert panel. The expert panel confirmed the form and the type of questionnaires’ adjustments before a new round of interviews began. At the end of step two, the final form of the questionnaires was reached. In step three, 235 questionnaires were distributed to 133 participants to estimate the construct validity of the upper jaw and the lower jaw questionnaires. After one week, the participants were asked to complete the questionnaires again. A total of 102 questionnaires were returned and used to assess the instruments’ reliability. Factor analysis was used to assess the construct validity. The intraclass correlation coefficient and Cronbach’s alpha were used to estimate the reliability and suitability of the items in the indexes.ResultsThe result of step one was two pilot questionnaires. The pilot questionnaires were adjusted in step two. At the end of step two, the questionnaires proved to have good face validity. Factor analyses in step three revealed that only one factor could be retained. The one-factor model explained 60.95% and 63.06 of the total variance of the upper jaw and lower jaw questionnaires, respectively. The items in every questionnaire shared the same cluster and could be summed to form an upper jaw index and lower jaw index that reflected patient satisfaction with removable dentures. Cronbach’s alpha values indicated excellent internal consistency and reliability for the upper jaw questionnaire (α = 0.91) and the lower jaw questionnaire (α = 0.92). Intraclass correlation coefficient values ranged from 0.72 to 0.95, which can be considered “moderate” to “excellent”.ConclusionsThe Arabic version of questionnaires and indexes assessing patient satisfaction with upper and lower removable dentures are reliable and valid self-administered instruments.

Construction and Validation of a Brief Pandemic Fatigue Scale in the Context of the Coronavirus-19 Public Health Crisis.

Objectives: The chronic restrictions to mitigate the new SARS-CoV-2 virus may result in pandemic fatigue. This study set out to develop a short, reliable, valid, and gender-invariant instrument—the Pandemic Fatigue Scale (PFS).Methods: In the first phase, 300 students responded to a pilot questionnaire that allowed the reduction and refinement of the items. In the second phase, the validity, reliability, and invariance of the scale were explored among a sample of 596 participants.Results: Factor exploratory and confirmatory analyses confirmed a robust adjustment for the bifactorial structure that explained 79,36% of the variance. The two factors identified were 1) people’s demotivation in continuing to follow the recommended protective behaviors (neglect) and 2) people’s boredom regarding the pandemic-related information (boredom). The pattern of relations between the Pandemic Fatigue Scale and other variables—find through correlation, mediation, and path analyses—and the gender differences—find in the ANOVA analyses—provided strong evidence of the construct validity. Moreover, the PFS was shown to be invariant regarding gender in a multigroup factor confirmatory analysis.Conclusion: The instrument can be of utility for professionals and researchers to assess pandemic fatigue, a variable that can affect the adoption of protective measure to avoid catching and spreading the virus.

Assessment of the Prevalence of Soil-Transmitted Helminth Infections and Associated Risk Factors among School-Aged Children in a Flood-Affected Area of Northeast India.

Soil-transmitted helminthiasis is a major disease burden in developing countries, with a considerable share borne by India. Currently, the principal strategy of the World Health Organization for the control of soil-transmitted helminths (STHs) is mass deworming in the high-risk population based on the prevalence and intensity of infection in a region. However, the disease load of STH remains unknown in many regions. A cross-sectional study was conducted in 2017 among children in the age group of 5-13 years in Barpeta, Assam, to ascertain the prevalence of STH infection in school-aged children and its probable risk factors. Socio-demographic and epidemiologic data were gathered using a piloted questionnaire. Geohelminths were identified by the Kato-Katz method. Association with probable risk-factors was analyzed by binomial logistic regression. Overall, 16.3% [95% confidence interval (CI) = 12.9-19.8] of children were found to be infected with one or more of the three STHs. Ascaris, hookworm, and Trichuris infections were observed in 9.4%, 7.4%, and 5.3%, respectively. The strongest predictors for the presence of any STH with multivariable analysis were open defecation (habitual or occasional), lack of proper handwashing, living in homes affected by flood, and age group of 8-10 years. The availability of proper handwashing stations in schools was found to be protective against Trichuris. Awareness among the people regarding sanitation and personal hygiene, particularly in the post-flood scenario, is imperative for sustainable control of STH infections. Preventive deworming should be continued; however, the time and frequency must be adjusted according to the prevailing climatic conditions in the region under study.

The Store-and-Forward Telemedicine Service User-satisfaction Questionnaire: Development and validation of a questionnaire to monitor and assess health care providers' experiences

Introduction With wider adoption of store-and-forward telemedicine accelerating, particularly post-coronavirus disease 2019, it is essential to understand health care providers’ (HCPs) satisfaction with digital solutions offered by telemedicine organizations to (continuously) guarantee service quality. We developed the Store-and-Forward Telemedicine Service User-satisfaction Questionnaire to monitor and assess HCPs’ experiences with contracted telemedicine organizations. Methods Questionnaire construction (phase 1) consisted of exploratory literature search on validated telemedicine satisfaction questionnaires, a telemedicine domain and human factors expert focus group, stakeholder focus group (customer service employee and telemedicine account managers), and two pre-testing rounds among 18 HCPs. The pilot questionnaire (phase 2) was sent to 2179 HCPs for validity and reliability assessment. Results Phase 1: Two validated questionnaires (73 items overall) were used as input for Store-and-Forward Telemedicine Service User-satisfaction Questionnaire. Revisions resulted in 61 items. Phase 2: the pilot 61-item Store-and-Forward Telemedicine Service User-satisfaction Questionnaire instrument was completed by 181 of 2179 invited HCPs. Forty-one mandatory items of the pilot Store-and-Forward Telemedicine Service User-satisfaction Questionnaire rated on a 5-point Likert scale were included in psychometric analyses and resulted in six reliable scales: training, communication, organization policy and strategy, interaction platform, usage platform, and working conditions. Discussion The Store-and-Forward Telemedicine Service User-satisfaction Questionnaire is a reliable and valid questionnaire for measuring HCPs’ satisfaction with store-and-forward telemedicine services as part of a continuous quality improvement cycle. Reimbursement questions were excluded due to low response. As adoption of telemedicine may be impeded by financial compensation issues, this requires consideration in future telemedicine questionnaires. Store-and-Forward Telemedicine Service User-satisfaction Questionnaire including video consultation items is needed to monitor also synchronous services as these expanded in the coronavirus disease 2019 pandemic.

Discharging patients; does it need to be done by a doctor?

Abstract Funding Acknowledgements None Background Patients undergoing angiography and percutaneous coronary intervention (PCI) were historically reviewed post procedure by a member of the medical team who assesses the patient’s suitability for discharge and completes the discharge letter. Over the past 10 years, the number of patients admitted for these procedures as day cases has increased significantly. In addition, there has been an expansion in nursing roles in the UK with the development of a variety of clinical nurse specialist (CNS) posts which have taken over many of the traditional medical roles. The majority of patients undergoing elective angiography and PCI are admitted to a day case unit at this tertiary cardiac centre. There is no designated medical cover for the unit and medical staff from the acute cardiac unit are called to review patients and complete their discharge paperwork in addition to their other duties. This frequently results in delayed discharge and patients going home without a discharge summary. It was therefore proposed that suitably qualified CNSs could be trained to discharge these patients and others undergoing day case cardiology procedures. From June 2017, the CNS team took over the role of reviewing patients post procedure and completing the discharge letter. Purpose The aim of the study was to evaluate if CNSs were able to discharge patients and provide a timely and effective service following elective cardiology procedures and to obtain patient feedback. Method Data on the number of patients reviewed by the CNSs from June 2017 to the end of December 2019, were prospectively collected in a dedicated database. A pilot study of patient experience was carried out in January 2020. Patients were given a questionnaire which asked about the explanation they received from the CNS regarding the procedure they had undergone, if their medication was reviewed and discussed with them, and if they received a discharge summary to take home. Results 1287 patients were reviewed by the CNS team during the above period. 811 (63.0%) patients had undergone angiography and 423 (32.9%) PCI. Informal feedback from the staff working on the day case unit included that patients were discharged earlier, had improved knowledge about their procedure and that the discharge letter was more detailed when completed by the CNS team. Eight patients completed the pilot questionnaire. Six were discharged by one of the CNS team, one by a doctor and one patient was not sure who did their discharge. All patients were very satisfied with the process and the information they were given. Conclusion Experienced CNSs can deliver high-quality, timely discharge of patients following cardiology procedures. This process is being used as a template to expand nurse-led discharge to other areas in cardiology. Patient experience will continue to be audited with a larger sample size in 2020.

Self-employment through ride-hailing: Drivers’ experiences in Johannesburg, South Africa

Orientation: Ride-hailing services have gained popularity in South Africa because of their ability to provide a reliable alternative to traditional modes of transport. However, little is known about ride-hailing drivers.Research purpose: The purpose of this study was to determine the ride-hailing drivers’ job satisfaction levels and the challenges they experienced.Motivation for the study: This study was motivated by the lack of scholarly information on the experiences of drivers involved in ride-hailing in the context of South Africa.Research design, approach and method: This study adopted a pragmatic approach through a mixed-method, survey-based design. Fifty-three ride-hailing drivers were randomly interviewed in Johannesburg, South Africa, using a pre-designed and piloted questionnaire. Data were analysed using methods of descriptive interpretation and inductive thematic analysis.Main findings: A descriptive statistical analysis showed that most ride-hailing drivers provide the service to earn their primary income. Furthermore, a thematic analysis found that ride-hailing drivers felt unsafe providing these services because of the violence they experienced from minibus taxi operators in the region.Practical/managerial implications: In a country plagued by unemployment, the development of small businesses is an important income-generating opportunity for many. To further develop the employment potential of the growing ride-hailing industry, governments at various levels should provide greater support and safety measures for ride-hailing drivers.Contribution/value-add: This study contributes a unique dataset in exploring ride-hailing drivers’ self-employment, job satisfaction and challenges in Johannesburg, South Africa.

Emotional Exhaustion and Professional Satisfaction during Covid-19 Pandemic at the Level of Emergency Department Staff

Introduction: Burnout is a syndrome conceptualized as result of the chronic stress at the work place which was not successfully managed. The possible negative effects on the medical staff, the patients and the health institutions have generated interest and motivated the research to understand the possible causes, these effects also influence the burnout predictors. The medical services suppliers within the emergency department have had one of the greatest exhaution occurences even before the pandemic. Being in the first line in contact with the suspected patients or confirmed with COVID-19 infection intensifies this fact. Both the working factors (working hours, years of practice, number of treated patients, professional development activities) and the socio- demographic factors (age, sex, civil status, income, education) are associated with the exhaustion at the work place. Material and methods: I have studied a total of 120 participants, receiving 115 valid questionnaires, the answering ratio being 95,83%. This was a descriptive, multicentre, transversal study of the medical and the auxiliary staff within the department UPU-SMURD of the County Clinic Emergency Hospital “Sf. Ap. Andrei” Galați. The staff gave their consent and attended a combined interview which consisted of a pilot questionnaire and a demographic questionnaire. Results and discussions: The average score of exhaustion at the staff level was 3.25, a great percentage of the doctors within the ED (45.8%), (n=24) indicates an increased level of exhaustion, only 26.8% (n=80) of nurses show an increased level of exhaustion. The average score of the stress level shown by the staff is 3.1, 66.6% (n=24) among which the doctors with an increased stress level 9.1% (n=9) auxiliary staff, 23.8% (n=80) of nurses. Conclusions: The results show us a high exhaustion, stress and depression ratio at the emergency doctors in comparison with the other professional categories within the ED. A high level of professional satisfaction is accompanied by an increased level of stress and of self-esteem.

Language Situation among the Armenians of Baghdad: A Sociolinguistic Study

This study investigates the language situation of the Armenian language among the Armenians of Baghdad. The researcher examines the domains of language where the Armenians use their ethnic language and the factors that support them use their ethnic language side by side with Arabic language. The researcher uses a pilot questionnaire that helped her to create a community profile which gives information about the community. She uses a sociolinguistic questionnaire, which is formed by the information taken from pilot questionnaire, to answer the main questions of the study. She distributed the questionnaire to 50 participants from different demographic background from Armenian community. The study concludes that the Armenians of Baghdad still preserve their ethnic language and use it restrictedly at home, church and in social religious events. The study also finds that the home, the family and the church are the major factors that maintain the Armenian language among the community in Baghdad. It also shows other factors that maintain the Armenian language such as schools, institutions, and the historic events that live in the memory of the community that contribute to the language maintenance.

CONGREGATIONAL RELIGIOUS PRAYERS AMID COVID-19 AND PANDEMIC SPREAD – EVIDENCE FROM SOUTHERN PUNJAB, PAKISTAN

Purpose of the study: This study explored how opening up mosques amid the COVID-19 pandemic may have increased the spread chances of disease and estimated how many individuals, attending mosques post-pandemic had experienced COVID-19 related symptoms in the study area. Furthermore, it evaluated how successful were the governmental Standard Operating Procedures (SOPs) for attending congregational prayers in protecting masses against the pandemic in its three dimensions 1) citizens’ following SOPs themselves in mosques, 2) implementation of mosque and prayer guidelines by mosques committee and 3) imams’ contribution in mobilizing the society against the pandemic.
 Methodology: Data were collected from 800 respondents between the ages of 18 to 50 years who were going to the mosques regularly during the lockdown using a purposive sampling technique. Descriptive statistics like frequencies and percentages were calculated. The 15 items self-constructed, a piloted questionnaire related to COVID-19 SOPs was used in the current study.
 Main Findings: The study’s findings revealed that religious gatherings played a vital role in COVID-19 spread as 66.25% sample that was attending communal prayers at mosques felt that they may have contracted COVID-19 symptoms because of offering prayers in the mosque. Further, evaluation of anti-COVID-19 policy measures namely degree of implementation for citizen SOPs in the mosque by people themselves, degree of implementation for prayers’ SOPs as per governmental announcement by the mosque committee, and imam’s mobilization against the pandemic as per the perception of the sample of people going to mosque post-pandemic were also found to be of the medium level at best.
 Applications of this study: The study gave an idea of whether the allowance of communal religious gathering with some anti-COVID guidelines as in the case of Pakistan a useful policy. It provided a useful framework for the evaluation of governmental covid-19 policies (SOPs). Finally, this study could also be useful to know the public response to SOPs and need of community stakeholders like Islamic Mosque imams in policy implementation on the grass-root level during the covid-19 pandemic.
 Novelty/Originality of this study: The study’s uniqueness is evaluation of success or failure of anti-COVID measures announced by the government to implement and monitor by the mosque committee. It measures how effective were local mosque imams in mobilizing people against the pandemic– an indeed missed out institutional means in policy debate of fight against the pandemic and creating awareness.

Az Instagram közösségének vásárlásra tett hatása és a szociogramban elfoglalt hely összefüggésének vizsgálata

THE AIMS OF THE PAPER Opinion leaders can be considered as one of the most important target groups in network marketing, as they facilitate the dissemination of product information and the adoption of products. However, the question may arise as to whether influencing the purchase behaviour of opinion leaders requires more resources compared to the average user. To explore this, the primary goal of the research is to assess the impact of Instagram’s community upon the purchases of opinion leaders in school communities. The secondary research question’s goal was to achieve deeper understanding of opinion leaders. METHODOLOGY Analysing the relationship between the impact of the Instagram community on shopping and the position in the sociogram. The study examined a group belonging to the 13-20 age group in high school students. The final sample size is 228 people. The questionnaire was completed by participants using Google Forms. Due to the sampling method and the number of sample items, the results are not representative. A semi-structured interview and pilot questionnaire were conducted to explore the research topic in more depth and develop the set of questions. MOST IMPORTANT RESULT In this regard, the results show that opinion leaders' purchases are not more (or less) influenced by the Instagram community than the rest of their class. This may suggest that sponsored advertising campaigns should be specifically targeted at opinion leaders, as they are more effective in supporting the distribution of products with the same incentive to buy. In doing so, a significant correlation was revealed between the role of opinion leadership and the number of Instagram followers. It was demonstrated that individuals who were nominated as influential, generally had more Instagram followers. However, in relation to the network indicators (degree centrality, degree prestige, betweenness centrality) the mentioned correlation was not significant. Thus, it can be concluded that there is a correlation between online and offline influence of individuals, but their online influence is not directly related to their observed network position.

Development of a questionnaire to assess clinician perspectives of the usefulness of the Functional Independence Measure (FIM) and cognitive screening tests.

A pilot questionnaire was developed to investigate the cognitive tests that clinicians employ in their clinical practice and whether they perceive the Functional Independence Measure (FIM) to add clinical value. A 10-item pilot questionnaire was created and distributed to 43 health professionals of a single health service in Australia. A snowballing approach to sampling was used. There were 39 respondents. Less than half of respondents thought the FIM added clinical value, and 15% stated that they would use the FIM to assess cognition on subacute wards. Ninety-seven per cent (97%) of respondents stated that they would rely more heavily on cognitive screening tests than the FIM. Participant responses to this survey of a single health service raise interesting questions about how useful clinicians perceive the FIM to be, beyond a costing and benchmarking role. Clinicians may prefer cognitive screening tests to the FIM, in clinical practice.

Challenges on Successful Completion and Delivery of Public Building Construction Projects: The Case of West Shoa Zone, Oromia, Ethiopia

Objectives: To identify the most common challenges or constraints on successful completion and delivery of construction projects in West Shoa Zone, Oromia, Ethiopia. Besides, this study focuses on stakeholder assessment on the identified constraints and rank challenges according to their impact on time, cost, and quality of the projects. Methods: A pilot study, questionnaire, and literature review were employed to collect primary and secondary data. For this purpose, 53 different challenges were identified, categorized into six major group factors, and analyzed by relative importance index and correlation analysis using the SPSS software. Findings: The identified challenges/constraints were examined by construction stakeholders and ranked according to their impact on building construction projects. Accordingly,Inflation (RII=0.811), Inadequate design, and specification (RII=0.794), Poor planning, monitoring, and feedback mechanism (RII=0.766), Delay in solving design problems (RII=0.766), and less financing capability of the owner (RII=0.760) are the top 5 challenging factors influencing construction project delivery. Finally, the case study was conducted on selected projects to assess how many of the projects were affected by the identified challenges using performance indicators such as scheduled performance index (SPI) and cost performance index (CPI). The average value of (CPI+SPI)/2 of the five selected projects was 0.785which reveals that the projects were under performance. Novelty: The impact ranking of most challenging factors affecting successful completion and delivery of construction projects in West Shoa Zone, Oromia, Ethiopia were identified. Economic related factors such as inflation, less financing capability of the owner, and economic instability in the country were the most challenging factors. The CPI and SPI values of selected projects were used as a control to clearly understand the project’s under performance. It is recommended that the concerned body should have a common understanding of those identified constraints and solve them according to their impact ranking. Keywords: Challenges; Successful Completion; Project Delivery; Impact Ranking; Performance Indicator

Satisfaction among Cancer Patients Undergoing Radiotherapy during the COVID-19 Pandemic: An Institutional Experience.

The COVID-19 pandemic has shifted oncology practices to prioritize patient safety while maintaining necessary treatment delivery. We obtained patient feedback on pandemic-based practices in our radiotherapy department to improve quality of patient care and amend policies as needed. We developed a piloted questionnaire which quantitatively and qualitatively assessed patients’ pandemic-related concerns and satisfaction with specific elements of their care. Adult patients who were treated at our Centre between 23 March and 31 May 2020, had initial consultation via telemedicine, and received at least five outpatient fractions of radiotherapy were invited to complete the survey by telephone or online. Relative frequencies of categorical and ordinal responses were then calculated. Fifty-three (48%) out of 110 eligible patients responded: 32 patients by phone and 21 patients online. Eighteen participants (34%) admitted to feeling anxious about hospital appointments, and only five (9%) reported treatment delays. Forty-eight patients (91%) reported satisfaction with their initial telemedicine appointment. The majority of patients indicated that healthcare workers took appropriate precautions, making them feel safe. Overall, all 53 patients (100%) reported being satisfied with their treatment experience during the pandemic. Patient feedback is needed to provide the highest quality of patient care as we adapt to the current reality.

An assessment of risk factors for contracting rabies among dog bite cases recorded in Ward 30, Murewa district, Zimbabwe.

Zoonoses are a major threat to human health. Worldwide, rabies is responsible for approximately 59 000 deaths annually. In Zimbabwe, rabies is one of the top 5 priority diseases and it is notifiable. It is estimated that rabies causes 410 human deaths per year in the country. Murewa district recorded 938 dog bite cases and 4suspected rabies deaths between January 2017 and July 2018, overshooting the threshold of zero rabies cases. Of the 938dog bite cases reported in the district, 263 were reported in Ward 30 and these included all the 4suspected rabies deaths reported in the district. This necessitated a study to assess risk factors for contracting rabies in Ward 30, Murewa. A descriptive cross sectional survey was used for a retrospective analysis of a group of dog bite cases reported at Murewa Hospital, in Ward 30. Purposive sampling was used to select dog bite cases and snowball sampling was used to locate unvaccinated dogs and areas with jackal presence. The dog bite cases and relatives of rabies cases were interviewed using a piloted interviewer-administered questionnaire. Geographical Positioning System (GPS) coordinates of dog bite cases, vaccinated and unvaccinated dogs and jackal presence were collected using handheld GPS device. QGIS software was used to spatially analyse and map them. Dog owners were 10 times more likely to contract rabies compared to non-dog owners (RR = 10, 95% CI 1.06-93.7). Owners of unvaccinated dogs were 5 times more likely to contract rabies compared to owners of vaccinated dogs (RR = 5.01, 95% CI 0.53-47.31). Residents of the high density cluster (area with low cost houses and stand size of 300 square meters and below) were 64 times more likely to contract rabies compared to non-high density cluster residents (RR = 64.87, 95% CI 3.6039-1167.82). Participants who were not knowledgeable were 0.07 times more likely to contract rabies, compared to those who had knowledge about rabies. (RR = 0.07, 95% CI 0.004-1.25). Our study shows that the risk factors for contacting rabies included; low knowledge levels regarding rabies, dog ownership residing in the high density cluster, owning unvaccinated dogs and spatial overlap of jackal presence with unvaccinated dogs.

Informed consent: What risks are material to patients consenting for urological procedures?

Objective: This study aimed to assess patient recall of the consent discussion for urological procedures and to identify which risks were material to urology patients. Methods: A total of 102 patients undergoing urological procedures were interviewed in the 24-hour period surrounding the procedure. A self-designed, piloted questionnaire recorded information from the patient’s signed consent form and patient-reported data of the consent discussion. Results: The mean patient recall was 2.06 risks, whereas the average number of risks listed by the operating surgeon on the consent form was 5.69 risks. The most frequently recalled risk was impotence (91%), followed by urinary incontinence (63%) and haematuria (61%). The risks associated with poorest patient recall were stent symptoms (0%), urethral catheter insertion (5%) and recurrence (8%). Conclusions: Poor patient recall of the consent discussion has again been demonstrated in this study. However, certain urological procedure risks are better recalled by patients, with impotence, urinary incontinence and haematuria being most frequently recalled. Medical terminology such as stent or catheter may be poorly recalled due to a disparity in understanding between patient and clinician. Clinicians should be aware of poor patient recall when consenting for urology procedures and should ensure precise documentation. Level of evidence: Level 2b.

Assessing decision-making in education of restorative and prosthetic dentistry: a pilot study.

To evaluate whether a concordance assessment (CA) software application is able to assess decision-making in restorative and prosthetic dentistry. Vignettes representing 10 different clinical situations were integrated into a software application. Each vignette included 3D digital models and a short case, as well as 5 therapeutic options rated on a 4-point Likert scale (-2 = strongly contraindicated; -1 = contraindicated; +1 = indicated; +2 = strongly indicated). A panel of 15 dental educators (9 educators from the prosthetic department [PD] and 6 from the conservative department [CD]) had to evaluate the indication of each of the 5 therapies for the 10 vignettes. This pilot questionnaire showed good internal consistency on most therapies (Cronbach's α = 0.86), with the exception of more recently introduced therapies (overlay/veneerlay and endocrown). On a maximum score out of 100, the average of CD educators (79.2 ± 3.2) was not significantly different (P = .73) from that of a PD educator (77.8 ± 3.5). Scores ranged from 66.8 to 89.6. Analysis of the expert panel's responses also reported mostly (34/50) a distribution of responses that was characteristic of CA and uncertain situations. The present software application was able to reproduce and assess decision-making in dentistry with satisfying internal consistency of educators.

Spiritual Well-Being Measurement of Older Adults in a Community-Dwelling: A Short-Form Development

This combination of quantitative and qualitative approaches was performed in Chiang Mai, Samut Prakan, Nakhon Ratchasima, and Nakhon Si Thammarat to develop the general measurement tool of spiritual well-being among older adults who are living in the community. The research was divided into two phases. The first phase was a pilot questionnaire with 41 questions for 106 older adults, and ten focus group discussions. The exploratory factor analysis extracted and reduced the questionnaire to 30 questions. The revised questionnaires were used in the second phase survey on 512 older adults. Exploratory and Confirmatory Factor Analysis affirmed the fit model of 12 questions on the four components of spiritual well-being (satisfaction, social participation, faith, and awareness), which explain the spiritual well-being condition of older adults, with a 73.8% extraction. Cronbach's coefficient of scale reliability (α) = 0.836, while the inter-item to total correlation was 0.328-0.682. Moreover, the reliability of each component was also high (0.759 < Cronbach α < 0.846). Therefore, the evaluation of spiritual health and well-being, as determined by the short-form (12 questions), is reliable and can apply as a screening tool for spiritual assessment, especially in the case of older adults in the Thai community.

Using Virtual Reality to Improve Health Care Providers' Cultural Self-Efficacy and Diabetes Attitudes: Pilot Questionnaire Study.

BackgroundIn southeastern Appalachian Ohio, the prevalence of diabetes is 19.9%, nearly double that of the national average of 10.5%. Here, people with diabetes are more likely to have a delayed diagnosis, limited access to health care, and lower health literacy. Despite the high rates of diabetes in the region, the availability of endocrinologists and certified diabetes care and education specialists is limited. Therefore, innovative strategies to address the growing diabetes care demands are needed. One approach is to train the primary care workforce in new and emerging therapies for type 2 diabetes to meet the increasing demands and complexity of diabetes care.ObjectiveThe aim of this study was to assess the effectiveness of a virtual reality training program designed to improve cultural self-efficacy and diabetes attitudes.MethodsHealth care providers and administrators were recruited from large health care systems, private practices, university-owned hospitals or clinics, Federally Qualified Health Centers, local health departments, and AmeriCorps. Providers and administrators participated in a 3-hour virtual reality training program consisting of 360-degree videos produced in a professional, cinematic manner; this technique is called virtual reality cinema (cine-VR). Questionnaires measuring cultural self-efficacy, diabetes attitudes, and presence in cine-VR were administered to providers and administrators before and after the program.ResultsA total of 69 participants completed the study. The mean age of the sample was 42.2 years (SD 13.7), 86% (59/69) identified as female, 83% (57/69) identified as White, 86% (59/69) identified as providers, and 25% (17/69) identified as nurses. Following the training program, we observed positive improvements in all three of the cultural self-efficacy subscales: Cognitive (mean change –1.29; t65=–9.309; P<.001), Practical (mean change –1.85; t65=–9.319; P<.001), and Affective (mean change –0.75; t65=–7.067; P<.001). We observed the largest magnitude of change with the subscale, with a Cohen d of 1.16 indicating a very large effect. In addition, we observed positive improvements in all five of the diabetes attitude subscales: Need for special training (mean change –0.21; t67=–6.154; P<.001), Seriousness of type 2 diabetes (mean change –0.34; t67=–8.114; P<.001), Value of tight glucose control (mean change –0.13; t67=–3.029; P=.001), Psychosocial impact of diabetes (mean change –0.33; t67=–6.610; P<.001), and Attitude toward patient autonomy (mean change –0.17; t67=–3.889; P<.001). We observed the largest magnitude of change with the Psychosocial impact of diabetes subscale, with a Cohen d of 0.87 indicating a large effect. We observed only one significant correlation between presence in cine-VR (ie, Interface Quality) and a positive change score (ie, Affective self-efficacy) (r=.285; P=.03).ConclusionsOur findings support the notion that cine-VR education is an innovative approach to improve cultural self-efficacy and diabetes attitudes among health care providers and administrators. The long-term impact of cine-VR education on cultural self-efficacy and diabetes attitudes needs to be determined.

The Acceptability and Efficacy of Electronic Data Collection in a Hospital Neurodevelopmental Clinic: Pilot Questionnaire Study.

BackgroundThere is a growing need for cost-efficient and patient-centered approaches to support families in hospital- and community-based neurodevelopmental services. For such purposes, electronic data collection (EDC) may hold advantages over paper-based data collection. Such EDC approaches enable automated data collection for scoring and interpretation, saving time for clinicians and services and promoting more efficient service delivery.ObjectiveThis pilot study evaluated the efficacy of EDC for the Child Development Unit, a hospital-based diagnostic assessment clinic in the Sydney Children’s Hospital Network. Caregiver response rates and preference for EDC or paper-based methods were evaluated as well as the moderating role of demographic characteristics such as age, level of education, and ethnic background.MethodsFamilies were sent either a paper-based questionnaire via post or an electronic mail link for completion before attending their first on-site clinic appointment for assessment. A total of 62 families were provided a paper version of the questionnaire, while 184 families were provided the online version of the same questionnaire.ResultsCompletion rates of the questionnaire before the first appointment were significantly higher for EDC (164/184, 89.1%) in comparison to paper-based methods (24/62, 39%; P<.001). Within the EDC group, a vast majority of respondents indicated a preference for completing the questionnaire online (151/173, 87.3%), compared to paper completion (22/173, 12.7%; P<.001). Of the caregiver demographic characteristics, only the respondent’s level of education was associated with modality preference, such that those with a higher level of education reported a greater preference for EDC (P=.04).ConclusionsThese results show that EDC is feasible in hospital-based clinics and has the potential to offer substantial benefits in terms of centralized data collation, time and cost savings, efficiency of service, and resource allocation. The results of this study therefore support the continued use of electronic methods to improve family-centered care in clinical practices.