Care Practices Research Articles

The Impact of Executive Function on Retention and Compliance in Physical Therapy in Veterans

ObjectiveTo examine retention and compliance to a novel Physical Therapy (PT) treatment among Veterans with and without executive function deficits (EFD+/EFD-). DesignThis study was a preplanned secondary analysis of an ongoing randomized controlled trial. SettingOutpatient PT at VA Boston Healthcare System (VABHS). ParticipantsSeventy-two community-dwelling middle-aged and older Veterans (mean age 72, (range 51-91); 87% male) with gait speed between 0.5 and 1.0 m/s were recruited from primary care practices. InterventionsEight-week moderate to vigorous intensity PT program. Main outcome measureVeterans’ baseline mobility, retention (dropouts), and treatment compliance and post-treatment exercise compliance to 8-week PT treatment were evaluated based on their baseline EFD status. ResultsOf the 72 participants, 22% (n=16) were EFD+. Veterans with EFD+ at baseline had worse mobility performance (Short Physical Performance Battery (SPPB), 7.7 vs. 9.5, p<0.001) and patient-reported mobility (Activity Measure for Post-Acute Care (AM-PAC), 57.6 vs. 62.2, p<0.01) after adjusting for age, gender, number of comorbidities, depressive symptoms, and pain interference. Dropout rates for EFD+ and EFD- were 44% and 25%, respectively (p>0.05). In multivariable logistic regression modeling, pain interference, depressive symptoms, mobility, and living alone but not EFD status were associated with dropping out. There was no evidence of significant differences in treatment compliance or post-treatment exercise compliance, measured by the number of attended sessions and the number of post-treatment exercise days by EFD status. ConclusionEFD+ was associated with poor baseline mobility. While the dropout rate was higher among Veterans with EFD+, we were unable to conclude whether EFD status impacts retention or compliance due to the small sample size. Further investigation is needed to determine whether EFD status may identify individuals who need additional support during and/or after rehabilitation treatment.

Issues in the Adoption of Online Medical Care: Cross-Sectional Questionnaire Survey.

Telemedicine, or online medical care, has gained considerable attention worldwide. However, it has not been widely adopted in Japan, and the detailed status of received and provided online medical care and the reasons for its lack of popularity remain unknown. This study aims to investigate the current status of online medical care in Japan and the factors limiting its adoption from the perspective of both patients receiving and medical professionals providing online medical care. In total, 2 nationwide questionnaire surveys were conducted. The first survey, targeting both patients and healthy individuals, screened approximately 40,000 participants among 13 million people. The participants were selected to match the age distribution of the Japanese population based on government data, and their online medical care experience and medical visit status were recorded. To further investigate online medical care use and satisfaction, a web-based survey was conducted with 15% (6000/40,000) of the screened participants. The second survey, targeting medical professionals, was administered to a physician, a nurse, and a member of the administrative staff in each of 4900 randomly selected medical facilities to inquire about their online medical care practices and impressions. In addition, both surveys investigated the factors limiting online medical care expansion in Japan. The response rates among patients and healthy individuals targeted for the screening and main surveys were 92.5% (36,998/40,000) and ˃80% (1312/1478, 88.77%; 1281/1522, 84.17%; 404/478, 84.5%; and 2226/2522, 88.26% in 4 survey groups), respectively. The survey of medical professionals yielded 1552 responses (n=618, 39.82% physicians; n=428, 27.58% nurses; n=506, 32.6% administrative staff). Although the facility-level response rate was low (794/4900, 16.2%), some facility categories had relatively high response rates. Only 5.29% (1956/36,998) of the patients and healthy individuals had online medical care experience. When there were more hospitals nearby and they felt it was more work to see a physician in person, they were more likely to use online medical care (more nearby hospitals: adjusted odds ratio [aOR] 1.33, 95% CI 1.18-1.50; more work: aOR 1.48, 95% CI 1.35-1.63 per survey response point in the patient group). Similarly, these factors were substantially associated with satisfaction (more nearby hospitals: aOR 1.40, 95% CI 1.14-1.73; more work: aOR 1.50, 95% CI 1.27-1.76 per survey response point in the patient group). In both surveys, the most frequently selected factor preventing the widespread use of online medical care was patients' need to switch to face-to-face medical care for mandatory tests and procedures. Inadequate awareness of and education on online medical care were also frequently selected. Our nationwide surveys provided insights into the current status of online medical care in Japan and simultaneously identified several problems and issues related to it, which will be useful in promoting its wider adoption.

Assembling the Pediatric Emergency Medicine Social Care Toolkit: A Modified Delphi Study

BackgroundThe pediatric emergency department is a high-value site for screening and resource referral for health-related social needs. However, best practices for this unique environment remain unclear. This study’s objective was to introduce a consensus-based social care training toolkit for the pediatric emergency medicine (PEM) setting. MethodsWe conducted a modified Delphi study to establish consensus on social care practice and develop a user-friendly toolkit. Initially, five priority areas (sections) were identified. Participants reviewed literature and shared their expertise to draft preliminary sections of the toolkit. Two rounds of the modified Delphi process were conducted, involving a ranking system, significant qualitative feedback, and a final approval stage, resulting in the finalized toolkit. ResultsSeventeen participants were included in the Delphi process, including pediatric and general EM faculty and trainees, as well as a social worker and public health professor. Forty-two content items were ranked in the first Delphi round. Based on a combination of score cut-off and extensiveness of qualitative comments, items were either minorly edited and kept (29%) or sent back to their section for review (71%). The second Delphi round integrated further suggested edits, and all participants in this final round approved the publicly available version of the toolkit. ConclusionBy utilizing diverse sources of information and a consensus-driven process of the modified Delphi, we generated best practice recommendations for the design, implementation, and training of social care programs in the PEM setting.

Common mental health diagnoses arising from or coinciding with menopausal transition and prescribing of SSRIs/SNRIs medications and other psychotropic medications.

Women with menopausal transition (MT) have an elevated risk of experiencing common mental health diagnoses (CMHD: depression or anxiety). There is no recent data comparing the rate, and treatment, of CMHD between men and women. In this population-based study, incidence rates (IR) per 100 person-years-at-risk (PYAR) for men and women ≥45years registered with an UK primary care practice between 2010 and 2021 were estimated. Incidence rate ratios (IRR) with 95% confidence intervals (CIs) of CMHD were estimated using men as a reference. We measured first prescriptions for psychotropic medications received within 12months after CMHD. For selective serotonin reuptake inhibitors (SSRIs) /selective norepinephrine reuptake inhibitors (SNRIs), we measured the IR of prescribing per 100 PYAR, by 10-year bands. Proportion of SSRIs/SNRIs prescribing was estimated per 100 persons. Rates of anxiety and depressive disorders were 1.68 and 1.69 per 100 PYAR in women aged 45-54years-old compared to 0.91 and 1.20 per 100 PYAR in men, with IRR of 1.84 (95% CI 1.72-1.97) and 1.44 (1.35-1.53) respectively. SSRIs/SNRIs were the most prescribed medication; in 2021, IRs for SSRIs/SNRIs were 13.4 per 100 PYAR in both sexes. In 2021, the proportion of SSRIs/SNRIs prescribing was 50.67 per 100 women and 41.91 per 100 men. MT is assumed based on women's age as menopause onset is rarely recorded in primary care databases. Women ≥45years experienced more CMHD compared to men, especially 45-54years-olds, which coincides with MT. The proportion of SSRIs/SNRIs prescribing was higher in women.

Effectiveness of technology-based psychosocial interventions for improving health-related outcomes of family caregivers of stroke survivors: A systematic review and meta-analysis.

To synthesize evidence regarding the effectiveness of technology-based psychosocial interventions in improving health-related outcomes among family caregivers of stroke survivors. A systematic review and meta-analysis was reported by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials that investigated the effects of psychosocial interventions delivered through information and communication technologies on self-efficacy, caregiving competence, caregiver burden, perceived social support, anxiety, depression, health-related quality of life and cost-effectiveness were included. Two researchers independently selected studies, extracted data, and appraised the quality of the included studies. Subgroup analysis, sensitivity analysis, and narrative synthesis were conducted. Ten electronic databases (PubMed, CENTRAL, Web of Science, Scopus, CINHAL, Embase, Institution of Electrical Engineers Xplore, Ovid Medline, PsycINFO, ProQuest Dissertations and Thesis) were searched up to February 2023. Nineteen studies involving 1717 participants fulfilled the eligibility criteria. Technology-based psychosocial interventions significantly improved self-efficacy (SMD = .62), caregiving competence (SMD = .55), depression (SMD = -.25) and anxiety (SMD = -.35). However, perceived social support, caregiver burden, and health-related quality of life did not show significant improvements. Subgroup analyses revealed that the interventions, lasting from 4 to 6 weeks and encompassing comprehensive contents, exhibited larger effect sizes. None of the studies measured cost-effectiveness. The technology-based psychosocial interventions are effective in enhancing self-efficacy and caregiving competence, as well as alleviating anxiety, and depression among family caregivers of stroke survivors. Future research should investigate interventions delivered through various digital platforms using well-designed RCTs with in-depth qualitative data collection and measurement of health and cost-effectiveness outcomes. Through psychosocial interventions, healthcare providers in clinical and community settings, particularly nurses, could incorporate technologies into current stroke care practices. It is not applicable as this is a systematic review. The protocol was registered on PROSPERO (CRD42023402871).

Pediatric Practices’ Experiences with Massachusetts’ Medicaid Accountable Care Organizations

ObjectiveTo examine the experience of Medicaid Accountable Care Organizations (ACOs) that include pediatric practices, including their motivations and experiences working together. MethodsThis mixed methods study is set within the first two years of the Massachusetts Medicaid ACO Program, which created 17 Medicaid ACOs across the Commonwealth in 2018. It combines qualitative interviews from organizational leaders across three Medicaid ACOs with pediatric representation (N=28; purposive sample; 2018) with a 44-item primary care practice leader survey (N=225 after 64% response rate; statewide stratified random sample of primary care practices; 2019). Interviews gathered information about organizational motivations and experiences with becoming a Medicaid ACO; the survey asked five domains of questions describing the experience of pediatric- and adult-focused primary care practices in joining Medicaid ACOs (e.g., how much practices solved problems jointly with the ACO). We used ordinary least squares regression to describe differences in experiences across pediatric vs. non-pediatric practices. ResultsLeaders of Medicaid ACO with pediatric representation expressed a desire to voice pediatric concerns regarding state Medicaid payment policy and to integrate social services as part of routine medical care. Relative to the experience of adult-focused primary care practice leaders, pediatric-focused practices reported less collaboration within the Medicaid ACO (95% confidence interval 0.81 to 0.05; p = 0.03) and less change toward standardization of policies such as physician compensation (95% confidence interval 0.61 to 0.02; p = 0.04). ConclusionsInitial Medicaid ACO experiences can differ based on the degree to which organizations joining Medicaid ACO programs serve pediatric populations. Article SummaryEarly in Massachusetts’ implementation of Medicaid Accountable Care Organizations (ACO), pediatric-focused practices reported less collaboration and standardization within their Medicaid ACOs than adult-focused practices.

Simulation for Systems Integration: A Win-Win to Achieve Your Education, Quality, and Safety Goals.

Health care education is a cornerstone of clinical excellence, ensuring the highest level of readiness to achieve high-quality and safe care. Integrating simulation into health care systems can provide a modality to address educational, quality, and safety goals. Simulation is a methodology used to immerse individuals, teams, and medical systems into clinical scenarios or environments. Through facilitation and debriefing, the immersive experience can be used to provide vital education, develop optimal health care practices, and identify prospects for improvement. Simulation provides an opportunity to blend the needs of continuing multiprofessional education while addressing quality and safety goals, and ultimately, promoting a positive safety culture. Applied comprehensively, simulation for systems integration can both promote the transformation of the health care system into a learning organization, as well as translate to improved health care outcomes. [Pediatr Ann. 2024;53(11):e408-e413.].

‘Making vulnerability’ while negotiating family care practices: evidence from multigenerational living

ABSTRACT The article draws upon in-depth interviews conducted in Czech multigenerational living with representatives of three generations. The repeated interviews took place in 2018–2019 and then in spring 2020 during the Covid-19 pandemic. The analysis focused on caring practices and dynamics of care between three generations and how these had been impacted by pandemic in 2020. We were interested in how the pandemic affected the daily lives of multigenerationally living family members and how through their caring practices they redefine what family in the era of super-diversity is. In order to do so, we particularly focus on how vulnerability has been constructed through the caring practices as a response to Covid-19. We followed the scholarship on vulnerability which emphasises its social character and sees it as a social construct. We put forward this discussion and aim at developing the concept of ‘making vulnerability’ – processes through which people make themselves and others vulnerable through daily taken-for-granted routines and rituals – as an essential part of family care practices.

Gambaran Praktik Pengasuhan Anak Kembar di Kabupaten Gayo Lues

The purpose of this study is to know the image of the practice of child care in gayo lues district. This study uses qualitative methods with a descriptive approach. Number of participants in the study are three subjects. The data is analyzed using thematic analysis techniques. The findings suggest that there are 7 themes illustrating the practice of foster care in gayo lues district, of which 7 include the following sub themes. Parenting stress that covers the subtheme of financial demands, the lack of time for yourself. Support system that includes sub themes of extended family help, husband support, local government assistance. Coping strategies that include the subtheme manage time through other work, not managing emotions in a healthy way. Teaching that includes sub themes that enhance understanding, direction and example. The culture that includes the sub theme educating children firmly, the high tone of voice and educating children independently. The vaforitism consists of the sub theme divide and contrast.

Validity And Reliability Of Digital Health Education On Diabetic Foot Care Based On Health Belief Model Among Type Ii Diabetic Patients

The study aims to evaluate the effectiveness of digital health education on diabetic foot care among type II diabetic patients using the Health Belief Model (HBM). A total of 30 participants were recruited from local diabetes clinics to receive digital health education focused on diabetic foot care practices. To ensure the validity and reliability of the assessment tools, we employed multiple methods. Content validity was established through expert reviews, while construct validity was examined using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), which confirmed a good factor structure aligned with the HBM constructs. Reliability was assessed using Cronbach’s alpha for internal consistency, which showed acceptable values ranging from 0.67 to 0.84, and test-retest reliability with Intraclass Correlation Coefficients (ICC) ranging from 0.74 to 0.78. The results indicate that the digital health education program significantly improved the participants' understanding and practices related to diabetic foot care. These findings underscore the potential of digital education interventions for chronic disease management, particularly for enhancing self-care behaviors in diabetic patients. Future studies should consider larger sample sizes to further validate these tools and results. Overall, this study provides evidence supporting the effectiveness of digital health education for diabetic foot care and validates the reliability and validity of the instruments used.

Analysis of Risk Factors for the Occurrence of Diabetic Foot Ulcers in Patients with Type II Diabetes Mellitus

Background: Diabetes Mellitus (DM) has become a prevalent disease, imposing a significant burden on public health due to its widespread occurrence and association with numerous disabilities and fatalities. Uncontrolled DM can lead to severe metabolic complications and long-term vascular issues, including microangiopathy and macroangiopathy. Additionally, individuals with DM are highly susceptible to foot infections, which can escalate into gangrene if not properly managed. Purpose: This study aimed to determine the risk factors for diabetic foot ulcers in patients with Type II Diabetes Mellitus at the Hospital Infatil e Maternidade Jardim Amalia Methods: The research employed an analytical survey method with a case-control study design. Purposive sampling was utilized to select a total of 134 participants, comprising 67 individuals in the case group (those with diabetic foot ulcers) and 67 in the control group (those without diabetic foot ulcers). Data collection was conducted using a structured questionnaire, and the results were analyzed using the Odds Ratio (OR) test to identify significant risk factors. Findings: The findings of the study indicated that age is a risk factor for developing diabetic foot ulcers in patients with Type II DM, with an OR of 3.15 (95% CI: 0.43-17.216). The duration of diabetes also emerged as a significant risk factor, with an OR of 3.13 (95% CI: 0.62-14.12). Furthermore, foot care practices were identified as a crucial risk factor, with an OR of 4.13 (95% CI: 0.72-12.45). Conclusion: this study demonstrates that age, the length of time a patient has had diabetes, and their foot care routines are significant risk factors for the development of diabetic foot ulcers in patients with Type II Diabetes Mellitus at Hospital Infatil e Maternidade Jardim Amalia. These findings underscore the importance of early intervention and targeted patient education to mitigate these risks and improve patient outcome

Korean nurses' knowledge, opinions and current practice of trauma-informed pediatric nursing care in South Korea: a descriptive study.

This study aimed to investigate the knowledge, opinions, competence, and barriers of nurses providing trauma-informed care (TIC) to children in hospitals. Data were collected from 198 nurses nationwide using the TIC Provider Survey developed by the Center for Pediatric Traumatic Stress in July, 2024. Descriptive statistics, t tests, and one-way ANOVA were conducted using the IBM SPSS Statistics software (ver. 23.0, IBM Corp.). Of the 13 items assessing knowledge of TIC, seven had a correct response rate of over 90%. However, the correct response rate for these three items were less than 30%. Regarding opinions on the TIC, more than 90% of participants agreed with five of the seven items. In self-rated competence in providing TIC, they were not competent in responding to a child's (or parent's) questions about whether the child is going to die or understanding how traumatic stress may present differently according to developmental stages. The major barriers to providing TIC were time constraints, lack of training, and organizational support. Items with relatively low performance rates were 'teach parents what to say to their child after a difficult/sick/scary experience, and teach child or parents the specific ways to cope with unpleasant experiences'. This study suggests that it can contribute to the development of specific guidelines for nurses to effectively apply TIC in pediatric and family nursing practice, emphasizing the need for educational programs to support this implementation.

Effects of nurse's knowledge and self-efficacy on nursing performance in pediatric intravenous fluid management in South Korea: a descriptive study.

This study aimed to identify the effects of nurse's knowledge and self-efficacy on nursing performance in pediatric intravenous fluid management and provide the primary data necessary for the efficient intravenous injection management of hospitalized children. This study was a descriptive study design with 141 nurses who perform pediatric intravenous therapy care at eight hospitals in the S, C, D, and S regions. Data were collected from September 1, 2023, to September 30, 2023. Nursing performance of pediatric intravenous injection management was significantly positively correlated with knowledge (r=.44, p<.001) and self-efficacy (r=.19, p=.022). Nurses' knowledge (β=.42, p<.001) and self-efficacy (β=.22, p=.004) of pediatric intravenous injection management and care were identified as significant predictors of nursing performance thereof, with these two factors explaining 21.9% of the variance. This study found that knowledge and self-efficacy of pediatric intravenous injection management are significant predictors of the practice of intravenous care among pediatric nurses. Therefore, considering these factors, education and intervention programs should be developed to enhance pediatric nurses' knowledge and self-efficacy regarding intravenous injection management.

Encounters of Care: Technological Kin and Nonhuman Care

Practices of care are not easily categorized. They are often embedded in encounters and interactions but are impossible to frame simply according to species boundaries or the supposedly positive or negative feelings they might elicit. This fluidity of care is also characterized by dualities and contradictions, forcing a reflection on who the participants in this caring network of ontologies are, and what the expected and often unexpected results of these interactions can be. This article explores possibilities of care beyond human agency. In a world in which the human is increasingly entangled with technology, practices of care are no longer only a human prerogative. Caring encounters between the technological other and the human become spaces for the redefinition of cross-species collaborations that defy anthropocentrism and human exceptionalism. Technological practices of care towards the human emphasize the emergence of symbiotic existences that disrupts the logic of a human centered approach to the nonhuman, challenging dominant ideas of merely gentle and positive care. Kawakami Hiromi’s Don’t Get Carried Away by Big Birds (2016) and Kazuo Ishiguro’s Klara and the Sun (2021) subvert the logic of anthropocentrism by describing practices of care enacted by technological others towards the human. In their awareness of the inherent complexities and contradictions embedded in nonhuman-human practices of care, they exemplify Elena Pulcini’s notion that fear for the world means an actual care for the world. The disruptive kinships between technology and the human epitomize the non-romanticized character of technological care. By choosing to avoid both technophobia and technophilia, the two novels express the awareness that human existence is always affected by contradictory but unavoidable encounters with the nonhuman other.

Knowledge And Practice Regarding Prehospital Care After Road Traffic Accidents Among Three-Wheel Drivers and Associated Factors in Selected Police Areas in Colombo District, Sri Lanka

Introduction: Road traffic injuries are an increasingly significant public health issue worldwide. Knowledge and practice of prehospital care is a crucial responsibility of every citizen of the country. Pre-hospital care is delivered by a civilian first responder, who is usually another driver. The study aims to describe the knowledge and practice of prehospital care after a road traffic injury among three-wheel drivers and associated factors in selected police areas in the Colombo District. Methods: A communitybased descriptive cross-sectional study was carried out in three Colombo Municipality police areas. A sample of 384 full-time three-wheel drivers above the age of 18 years, registered in these police areas were recruited using a simple random sampling method. A structured pre-tested intervieweradministered questionnaire was used for data collection. Descriptive analysis was used to determine the level of knowledge and practices regarding prehospital care. SPSS version 25 was used for data entry and analysis. Significance was taken as p&lt;0.05. Results: Mean age of three-wheel drivers was 40.98 (SD±11.01). Only 31.5% of the drivers had first aid training. The majority (52.9%) of the drivers had good knowledge and 65.2% had poor practice towards prehospital care. Advanced age (&gt;45 years) and having first aid training were significantly associated with good knowledge (p&lt;0.05). Drivers with previous training within the last ten years (p=0.031) and having less hires per day (&lt;10) were significantly associated with better first aid practice (p=0.001). Conclusion: Although knowledge regarding prehospital care was adequate, practice of prehospital care was inadequate. Findings of the study call for ongoing first-aid training for all three-wheel drivers.Keywords: Prehospital care, First aid, Knowledge, Practice, Road traffic accidents

A Real-Life Laboratory Setting for Clinical Practice, Education, and Research in Family Systems Care: Protocol for a Transformational Action Research Study.

Burdening health and illness issues such as physical or mental illnesses, accidents, disabilities, and life events such as birth or death influence the health and functioning of families and contribute to the complexity of care and health care costs. Considerable research has confirmed the benefits of a family systems-centered care approach for patients, family caregivers, families, and health care professionals. However, health care professionals face barriers in working with families, such as feeling unprepared. Family systems-centered therapeutic conversations support families' day-to-day coping, resilience, and health. A family systems care unit (FSCU) was recently established as a real-life laboratory at one of the Swiss Universities of Applied Sciences. In this unit, health care professionals offer therapeutic conversations to families and individual family members to support daily symptom management and functioning, soften suffering, and increase health and well-being. These conversations are observed in real time through a 1-way window by other health care professionals, students, and trainees and are recorded with video for research and education. Little is known about how therapeutic conversations contribute to meaningful changes in burdened families and the benefits of vicarious learning in a real-life laboratory setting for family systems care. In this research program, we aim to deepen our understanding of how therapeutic conversations support families and individuals experiencing burdening health and illness issues and how the FSCU laboratory setting supports the learning of students, clinical trainees, and health care professionals. Here we apply a transformational action research design, including parallel and subsequent substudies, to advance knowledge and practice in family systems care. Qualitative multiple-case study designs will be used to explore the benefits of therapeutic conversations by analyzing recordings of the therapeutic conversations. The learning processes of students, trainees, and professionals will be investigated with descriptive qualitative study designs based on single and focus group interviews. The data will be analyzed with established coding methods. Therapeutic conversations have been investigated in 3 single-case studies, each involving a sequence of 3 therapeutic conversation units. Data collection regarding the second research question is planned. Preliminary results confirm the therapeutic conversations to support families' coping. This renders the FSCU a setting for ethically sensitive research. This program will not only support the health and well-being of families, but also contribute to relieving the financial and workforce burdens in the health and social care system. DERR1-10.2196/53090.

Knowledge, attitudes, practices of cancer palliative care and their associated factors among nursing officers in Apeksha Hospital, Maharagama

Introduction: Nursing officers, having a good knowledge, favourable attitudes, and correct practices in cancer palliative care uplift patient’s quality of life. Objectives: To describe the level of knowledge, attitudes, practices of cancer palliative care and associated factors among the nursing officers in Apeksha Hospital, Maharagama. Methods: A descriptive cross-sectional study was carried out among 252 participants with more than one year of work experience at Apeksha Hospital, Maharagama. Stratified sampling technique was adopted to select the nursing officers from different wards. Data were collected using a validated self-administered questionnaire. Sum of points of each participant and the percentage was calculated. Depending on the mean score they were categorized into groups accordingly. Data were analysed initially by a descriptive analysis and then by Chi square test using SPSS software version 26. P&lt;0.05 was the significance level. Results: Response rate was 70. %. The mean age of the study participants was 32.9 (SD=6.55) years. The majority (59.5%) had good knowledge, 53.2% had favourable attitudes and 54% engaged in correct practices. Mean knowledge score was 26.4 (SD=3.44). Nurses above 30 years of age, married and having more than 10 years’ experience had significant association with knowledge (p&lt;0.05). Most of the participants who had good knowledge had correct practices (p&lt;0.001). Most of the participants those who had favourable attitude had correct practices (p&lt;0.001). Association of level of knowledge and attitude was not found to be statistically significant (p=0.109). Conclusion: The majority of the nurses had a good knowledge, favourable attitudes and were engaged in correct practices in palliative care. There is a significant association between the year of experience and the nurses’ knowledge on palliative care. Having a good knowledge and favourable attitude on palliative care were positive factors for correct practices.Keywords: Knowledge, Attitude, Practices, Cancer palliative care, Nurses

“When you provide abortion services, you are looked upon as a bad guy”: experiences of abortion stigma by health providers in Nigeria

ABSTRACT Background Abortion stigma as reported globally has been inadequately documented empirically in Nigeria, Africa’s most populous country with a restrictive abortion law and a high rate of unsafe abortions. Objective The objectives of this study were to investigate the ways in which abortion stigma is experienced by Nigerian health professionals and how such experiences influence health professionals’ practice of safe abortion and post-abortion care. Methods The study utilized qualitative research consisting of in-depth interviews with 10 abortion providers. We elicited information with an open-ended interview guide that investigated the understanding of participants’ experiences of abortion stigma in Nigeria. The data were analysed qualitatively and thematically using Atlas.ti. Results The themes centred on perceptions and experiences of stigma among the providers interviewed. Participants’ experiences of abortion stigma included the following: being treated differently to other health professionals; experiencing disapproval and disrespect; name-calling and societal judgement; tagging and profiling of clinics by anti-abortionists; and social isolation. Participants attributed stigma to cultural and religious beliefs, the restrictive national abortion law, and pointed to hypocrisy. Some reported effects of stigma on providers included a feeling of insecurity, social exclusion, secrecy, and insincerity in clinical practice, discouragement, and guilt feelings. Despite the negative impacts, many respondents reported a sense of satisfaction stemming from their views that they were saving lives. Conclusion Systematic efforts to address these adverse factors could reduce the level of stigma experienced by providers, with a potential follow-through effect of improving women’s access to safe abortion care in Nigeria.

Effectiveness of a Need-based Interventional Tracheostomy Care Protocol on Knowledge and Practice of Tracheostomy Care among Nurses

Effectiveness of a Need-based Interventional Tracheostomy Care Protocol on Knowledge and Practice of Tracheostomy Care among Nurses

Pedagogies to “hold on to life”: practices of body-territory care in the midst of the armed conflict in Buenaventura, Colombia

En este artículo analizo las prácticas de defensa del cuerpo-territorio que realizan maestras que trabajan en escuelas afectadas por el conflicto armado en la ciudad de Buenaventura, en el Pacífico colombiano. A partir de un trabajo etnográfico, pongo en evidencia cómo el conflicto armado y la depredación capitalista del territorio étnico de Buenaventura han afectado a las escuelas y la reproducción de la vida de las comunidades negras que allí habitan. Ante las prácticas de terror, despojo y desterritorialización agenciadas por los actores armados, las maestras negras bonaverenses han respondido con “pedagogías para agarrase a la vida”. Estas pedagogías articulan estrategias de enseñanza, relaciones de cuidado y conocimientos ancestrales que permiten sostener los cuerpos y los territorios escolares en medio de la desesperanza. Se concluye que el cuidado es una forma de agencia político-pedagógica para recuperar y sanar el territorio, pero también se trata de una práctica ambivalente, poblada de dolores, desigualdades y contradicciones. En este sentido, se destaca el cuidado como una clave analítica central para comprender las relaciones posibles entre educación, resistencia y defensa de los territorios ancestrales afrocolombianos.