Practice Of Healthcare Professionals Research Articles

The threat of Antimicrobial Resistance in Developing Countries: Causes and Control Strategies

The causes of antimicrobial resistance (AMR) in developing countries are complex and may be rooted in practices of health care professionals and patients’ behavior towards the use of antimicrobials as well as supply chains of antimicrobials in the population. Some of these factors may include inappropriate prescription practices, inadequate patient education, limited diagnostic facilities, unauthorized sale of antimicrobials, lack of appropriate functioning drug regulatory mechanisms, and non-human use of antimicrobials such as in animal production. Considering that these factors in developing countries may vary from those in developed countries, intervention efforts in developing countries need to address the context and focus on the root causes specific to this part of the world. Here, we describe these health-seeking behaviors that lead to the threat of AMR and healthcare practices that drive the development of AMR in developing countries and we discuss alternatives for disease prevention as well as other treatment options worth exploring. Keywords: Antimicrobial resistance, Causes and Control Strategies

Knowledge, attitude, and practice of healthcare professionals toward cognitive dysfunction in Parkinson’s disease and cognitive rehabilitation

BackgroundTo investigate the knowledge, attitude, and practice (KAP) of healthcare professionals regarding cognitive dysfunction and cognitive rehabilitation in Parkinson’s disease (PD).MethodsThis multicenter, cross-sectional survey enrolled physicians and nurses in 10 hospitals between October 2022 and November 2022. A self-administered questionnaire was developed to collect the demographic information of the participants and their knowledge, attitude, and practice toward cognitive dysfunction in PD and cognitive rehabilitation.ResultsThis study enrolled 224 physicians and 229 nurses. The knowledge, attitude, and practice scores were 12.57 ± 3.76 (total score: 22), 29.10 ± 3.71 (total score: 32), and 21.07 ± 8.03 (total score: 28) among physicians, and 9.97 ± 4.70 (total score: 22), 25.27 ± 8.96 (total score: 32), and 25.27 ± 8.96 (total score: 28) among nurses. Among physicians, the knowledge scores (OR = 4.23, 95%CI: 2.36–7.58, P < 0.001) and attitude scores (OR = 3.00, 95%CI: 1.67–5.37, P < 0.001) were independently associated with good practice. Among nurses, the knowledge scores (OR = 4.31, 95%CI: 2.31–8.05, P < 0.001), attitude scores (OR = 5.18, 95%CI: 2.82–9.53, P < 0.001), working department (Ref: rehabilitation; neurology: OR = 2.26, 95%CI: 1.01–5.08, P = 0.048; public health service/chronic disease follow-up center: OR = 2.98, 95%CI: 1.12–7.92, P = 0.028) were independently associated with good practice.ConclusionsPhysicians and nurses have insufficient knowledge, favorable attitudes, and active practice regarding cognitive dysfunction and cognitive rehabilitation in PD. This study identified gaps in KAP and suggested education activities to improve the KAP toward cognitive dysfunction in PD.

Análise do conhecimento, das atitudes e das práticas de médicos e enfermeiros sobre as vivências de cuidadores familiares de pessoas idosas com demência: um estudo CAP

Abstract Objective To analyze the Knowledge, Attitudes, and Practices (KAP) of healthcare professionals during the care of older individuals living with dementia, concerning the caregiving situations experienced by informal caregivers, and its association with sociodemographic and professional factors. Method A cross-sectional analytical KAP study was conducted in the municipality of Tangará da Serra, Mato Grosso, with 20 nurses and 20 physicians from Family Health Units. Data were collected through interviews using an instrument developed based on the available literature on KAP studies. Descriptive analysis and bivariate analysis of the association between the knowledge, attitudes, and practices of healthcare professionals and sociodemographic and professional variables were performed using the Fisher's exact test, with a significance level of 5%. Results Healthcare professionals demonstrated satisfactory knowledge and favorable attitudes towards caregiving situations experienced by informal caregivers of older individuals living with dementia. However, 65% of professionals exhibited insufficient practices directed at caregivers, including guidance, support groups, and health education. No significant association was found between knowledge, attitudes, practices, and sociodemographic or professional variables. Conclusion Despite healthcare professionals possessing satisfactory knowledge of caregiving situations and positive attitudes towards informal caregivers, their practices are inadequate in meeting their needs. This deficiency does not contribute to enabling caregivers to cope with the various challenges that arise during the course of the disease for both the older individual and the caregivers themselves.

A cross-sectional study on knowledge, attitude, and practice of health-care professionals about adverse drug reactions reporting in a tertiary care teaching hospital of southern Rajasthan

Background: Adverse drug reaction (ADR) reporting is the integrity of healthcare professionals (HCPs) to counteract fatal outcomes aroused by the use of medications during therapy. The underreporting of ADRs imposes major problems globally. The pharmacovigilance program plays a key role in detecting and preventing ADRs. Targeting the upcoming younger generation of HCPs and sensitizing them towards ADR reporting in their clinical practice is essential. Aims and Objectives: The main objective of our study is to measure the knowledge, attitude, and practice of interns and postgraduates at our institute towards ADR reporting and pharmacovigilance. Materials and Methods: This study was a cross-sectional study conducted on interns and postgraduates of a tertiary care teaching hospital in Udaipur, Rajasthan. A set of 28 standard questions related to knowledge, attitude, and practice of pharmacovigilance and ADR reporting were distributed among 106 students after taking the ethical approval from the institute. The collected data were analyzed using SPSS (version 20) software in percentage. The Chi-square test (χ2) was used, and P &lt; 0.01* was considered significant statistically. Results: In our study, we found most of the participants were in 21–30 age groups (84.19%); male participants were (67%) in comparison with females (33%). The majority of interns showed their interest in participation (66%) rather than postgraduates (34%) in this study. The overall knowledge (14.645, P = 0.01), attitude (14.64, P = 0.01), and practice (35.712, P = 0.01) of HCPs were found to be significant. Conclusion: We conclude from this study that both interns and postgraduates have good knowledge of ADR reporting, but interns lack practice in their daily duties due to fear of heavy paper work, and postgraduates lack attitude towards ADR reporting due to heavy duty schedules. Most of the participants, i.e., interns and postgraduates, felt ADR reporting was their primary responsibility along with patient safety. Recurrent training and sensitization of upcoming medical professionals about ADR reporting will impart better patient compliance and eradicate fatal outcomes. They also suggest a separate working body needs to keep by institutions to collect the ADR reports during their busy duty schedules.

An assessment of knowledge, attitude, and practices toward ecopharmacology among health-care professionals at a tertiary care center – A cross-sectional study

Background: Ecopharmacology, a field emerging at the intersection of pharmacology and environmental science, focuses on the impact of pharmaceuticals on ecosystems and public health. Given the increasing recognition of environmental issues associated with pharmaceutical waste, understanding the knowledge, attitudes, and practices (KAP) of health-care professionals (HCPs) toward ecopharmacology is crucial. Aims and Objectives: This study aims to assess KAP toward ecopharmacology among HCPs at a tertiary care center. Materials and Methods: This descriptive and cross-sectional study employed a pre-validated self-administered structured online questionnaire for data collection, conducted between October 2023 and December 2023. The questionnaire consisted participant’s demographic data, profession, designation, and department and 20 questions to assess the knowledge, attitude, and practices of HCPs regarding ecopharmacology. The data were subsequently analyzed and presented as percentages. Results: Out of 320 consenting participants 300 HCPs satisfactorily completed the questionnaire with a response rate of 93.75%. In our study, a significant majority of participants (97%) demonstrated awareness of the potential hazards posed to public safety by expired or unused medicines if not disposed of properly. A considerable proportion of participants (80.4%) acknowledged that pharmaceutical pollution can contribute to antibiotic resistance. Most participants strongly supported environmentally responsible medication disposal, advocating for guidelines, collection boxes in health-care facilities, and manufacturer involvement. Regarding practice, 76.5%, of participants admitted to pouring leftover syrup or lotion into the wash basin. A vast majority (95%) expressed their willingness to engage in proper medication disposal programs. Conclusion: The present study highlights a significant level of awareness and concern regarding pharmaceutical waste management among HCPs. However, there is an urgent need for initiatives to educate HCPs about appropriate medication disposal methods and to encourage the adoption of environmentally friendly practices.

Knowledge and Practice of Healthcare Professionals in the Medical Care of Asthma Adult Patients in Jordan with a Particular Reference to Adherence to GINA Recommendations.

This study aimed to evaluate Jordanian healthcare professionals' knowledge, skills, and experience in dealing with and treating adult asthmatic patients and assess healthcare professionals' compliance with the Global Initiative for Asthma (GINA) guideline recommendations for asthma treatment and management in Jordan. A cross-sectional survey was conducted in Jordan between May and June 2023. This study included physicians, pharmacists, and nurses working in clinical settings and directly interacting with asthma patients in Jordan's private and governmental healthcare facilities who were eligible to participate in this research. Three primary sections of an online survey were constructed using Google Forms and included demographic data, a diagnosis and management of the illness, and a list of worldwide medical references for asthma. A total of 300 healthcare professionals, including pharmacists (103), nurses (87), Doctor of Pharmacy (28), and physicians (82), took part in this research. The survey respondents' general knowledge of the nature and symptoms of asthma is quite high, exceeding 84% and 86%, respectively. The survey also showed a high degree of awareness of asthma diagnosis. It was also revealed that around one-quarter of participants consistently reported the severity of asthma. The most frequent factor influencing the decision to take controller or maintenance medicines is symptom severity (reported from 86% of participants). The GINA guidelines were selected as the asthma information source by almost half of the participants. Finally, 47% of participants were aware of the GINA's 2019 adjustments of the recommendations. This study showed that Jordanian healthcare professionals understand the nature, symptoms, and diagnoses of asthma disease. However, many of the survey participants lack adherence, awareness, and understanding of the GINA recommendations about asthma management. More research is required to assess the adherence to the evidence-based recommendations and evaluate the impact of training courses.

Knowledge, attitude, and self-medication practices among medical students in dysmenorrhea

Background: Dysmenorrhea and its associated pain disable adolescents in their daily activities and also affect the social and mental behavior. The vehement practice of self-medication alarms health-care professionals for conducting periodic awareness programs. Aims and Objectives: We aimed to assess the knowledge about dysmenorrhea and to compare the level of understanding and practices among medical students. Materials and Methods: It was a prospective, observational, cross-sectional, and questionnaire-based study conducted among medical students in a tertiary care hospital. Results: There was no difference in distribution regarding knowledge and attitude of the study population toward dysmenorrhea among the three groups regarding treatment of dysmenorrhea and health education. In contrast, response about contraindications and adverse effects of medications used was observed in only half of the 1st-year students. Half of the study participants, daily activities were affected and led to absenteeism. The negative emotions such as depression, anger, anxiety, and irritability are most noted and the majority of the students felt like distancing themselves during menstruation. Conclusion: The present study concludes that dysmenorrhea, a major problem among adolescents, had an impact on the quality of life including psychological disturbances. Thus, the awareness patterns and practices need to be analyzed periodically among adolescents for better improvement and management of dysmenorrhea.

Research Trends and Highlights Toward Virtual Reality in Patients With Cancer: Bibliometric Analysis.

This retrospective bibliometric analysis was conducted to explore research trends and identify studies in fields of nursing, virtual reality, and cancer. Data were obtained from the Web of Science database using an advanced search strategy. The study data were analyzed using the R Studio software and visualized using VOSviewer. A total of 594 studies were retrieved and analyzed from January 1995 to December 2021. It was determined that 59.4% of the studies were research articles and that these studies had been conducted by 2771 authors. The reviewed studies were produced by researchers from 25 countries and were published in 29 different journals. Of these, 169 were conducted by researchers in the United States. "Virtual reality" and "nursing" were found to be prominent topics. Studies on virtual reality in patients with cancer in the field of nursing have increased over the past 8 years. Researchers have actively conducted studies in this field. Prominent studies have covered various patients with cancer in all age groups and palliative care processes. It was seen that the majority of the studies were randomized controlled trials, reviews, and systematic reviews. In addition, studies have used virtual reality as a distraction method in the management of symptoms in patients with breast, lung, and pediatric cancers undergoing chemotherapy treatment. This study provides a detailed and up-to-date analysis of the findings obtained from the Web of Science database by emphasizing bibliometric models of virtual reality technologies in nursing patients with cancer. We believe that the current data on the use of virtual reality applications in patients with cancer will guide the clinical practice and scientific studies of healthcare professionals.

Exploring pharmacovigilance practices and knowledge among healthcare professionals: A cross-sectional multicenter study.

Healthcare professionals' awareness of adverse drug reaction reporting and pharmacovigilance practices differ by country. The study assesses healthcare professionals' knowledge, practice, and potential barriers to pharmacovigilance-related practices and reporting adverse drug reaction. A cross-sectional investigation was conducted in government and private healthcare settings. The study included licensed physicians, pharmacists, and nurses. To examine knowledge, practice, and potential barriers to pharmacovigilance-related practices and adverse drug reaction reporting, a 22-item validated questionnaire was used. The final analysis included 311 healthcare professionals. Most healthcare professionals, 59% (N = 182), mentioned encountering patients with adverse drug reactions during the last year. On the other hand, most healthcare professionals, 54% (n = 167), mentioned that they had not reported adverse drug reactions. A good proportion of respondents mentioned that it is essential to report adverse drug reactions (N = 288, 92.6%), availability of adverse drug reactions reporting forms in practice sites (N = 216, 69.5%), had awareness regarding how to report adverse drug reactions (N = 221, 71.1%), the necessity of reporting minor/less important adverse drug reactions (N = 265, 85.2%), and were trained on how to report adverse drug reactions (N = 201, 64.6%). Adverse drug reaction reporting program in the United Arab Emirates (N = 148, 47.6) was known to many healthcare professionals. Lack of time was the major impediment to reporting adverse drug reactions at 42.7% (N = 133). The predictor variable work experience does add to the model (p < 0.05) concerning association with filling of adverse drug reaction forms (Estimate = 0.380; SE = 0.452; p = 0.400), professional role (Estimate = 0.454; SE = 0.673; p = 0.500). In addition, the predictor variable practice setting adds to the model (p < 0.05) concerning the knowledge regarding the availability of adverse drug reaction reporting forms (Estimate = -1.229; SE = 0.298; p = 0.000), training on how to report adverse drug reactions (Estimate = -0.660; SE = 0.294; p = 0.025), and awareness regarding the adverse drug reaction reporting program in the United Arab Emirates (Estimate = -1.032; SE = 0.280; p = 0.000). Pharmacists had the most knowledge regarding adverse drug reaction reporting and pharmacovigilance. The underreporting of adverse drug reactions was documented among physicians and nurses. Lack of time was the most significant barrier to reporting adverse drug reactions, followed by uncertainty and complicated adverse drug reaction documentation forms.

Coping with the hospital environment during the COVID-19 pandemic: A qualitative study of the survivors' perspective during their stay at the ICU and inpatient ward

The COVID-19 pandemic has significantly affected the clinical practice of healthcare professionals. This study aimed to explore the perspectives of COVID-19 survivors regarding the healthcare they received during their stay in the Intensive Care Unit (ICU) and the inpatient COVID-19 ward.A qualitative case-study approach was implemented. Participants were recruited using non-probabilistic purposeful sampling strategy. Inclusion criteria included patients aged ≥18 years who received follow-up from the Pulmonology service at a Hospital in de North of Spain, were diagnosed with COVID-19 and bilateral pneumonia, and were admitted to the ICU before being transferred to a COVID-19 inpatient ward. Data was collected through in-depth interviews and researchers' field notes, and thematic analysis was performed. Techniques such as credibility, transferability, dependability, and confirmability were employed to ensure the trustworthiness of the data.A total of 25 individuals (six women) were included in the study. Three main themes emerged from the analysis: common challenges faced in both units, coping with the hospital stay, and developing strategies. Findings highlighted the need to improve information dissemination, individualize care, and enhance direct patient interaction. Moreover, the study shed light on the psychological impact of hospitalization and ICU experience, including feelings of loneliness, confinement, and the lack of memories from the ICU stay, as well as the influence of care and healthcare language. Finally, strategies such as keeping the mind occupied and maintaining self-discipline were identified as crucial during hospitalization. These findings provide valuable insights for healthcare professionals in delivering care to individuals with COVID-19 in the ICU and hospital ward settings.

Healthcare professionals' perception and practice of complementary and alternative medicine in Qassim region, Saudi Arabia.

Over the last few decades, use of complementary and alternative medicine (CAM) has grown in popularity, changing health professionals' knowledge and attitude toward CAM, and the treatment recommended by them. The aim of the study was to evaluate the perception and practice of CAM among healthcare professionals. A cross-sectional study was conducted among healthcare providers selected by multistage random sampling technique in two governmental hospitals and ten primary healthcare centers in two governorates in the Qassim region, Saudi Arabia. A web-based, self-administered questionnaire was distributed via social media platforms. A total of 350 physicians responded to the survey. Good basic knowledge about CAM was reported by 48.6% of the respondents; a positive attitude was adopted by 53%; and CAM was actively practiced by 9.7%. Being a physician > 40 years and consultant affiliation were significantly associated with higher knowledge level about CAM (p = 0.006 and 0.03, respectively), as well as having a proactive practice (p = 0.007 and 0.04, respectively). Practicing CAM was prevalent among non-Saudi and married physicians (p = 0.02 for both). Knowledge about CAM and its practice were strongly correlated (p = 0.007). The most frequent constraints facing CAM practice were lack of knowledge and training on CAM (81.4%) and lack of studies supporting CAM (74.3%). The practices of health professionals in Qassim region need to be improved despite their expertise and favourable perception of CAM. Educational interventions could play greater roles in providing evidence-based CAM knowledge and enhancing training for physicians.

Knowledge, perceptions and practices on healthcare waste management and associated occupational health hazards among healthcare professionals in the Colombo District, Sri Lanka: a cross-sectional study.

Proper Healthcare Waste (HW) management is directly influenced by the knowledge and attitudes of Healthcare Professionals (HCP). However, studies that characterize the knowledge and practices of HCP on HW management are limited in Sri Lanka. This study was conducted to characterize the knowledge, perceptions and practices of HCP on the management of HW and to determine the risk factors influencing HW related occupational health hazards in the Colombo District of Sri Lanka. A total of 407 HCP were recruited as the study population from selected hospitals in the Colombo District. Information on socio-demographic factors, knowledge, attitudes and practices on HW management were gathered using an interviewer-administrated questionnaire. The Binary Logistic Regression (BLR) was used to determine the socio-economic risk factors associated with the occurrence of HW related health issues among the respondents. The majority of respondents were characterized with a high knowledge level (76.9%) and positive attitudes (53.8%) on HW management. Incineration (82.6%) was recognized as the most widely used HW treatment method. Personal Protective Equipment (PPE) was used at a satisfactory level (85.5%), while liquid waste treatment was limited (57.5%). The occupational designation, level of training received in HW management, professional experience, vaccination status for tetanus, degree of knowledge and attitudes on HW management were recognized as significant risk factors (p < 0.05) associated with the occurrence of HW related occupational hazards. Even though, the treatment of HW was satisfactory, strengthening the existing mechanisms for monitoring of HW management, provisioning more resources and organizing training and awareness programmes on HW management for HCP are recommended.

On practicing magicine, from wonder to care: A systematic review of studies that apply magic in healthcare

RationaleMagic, traditionally perceived as entertainment, has been increasingly employed in healthcare to enhance health and well-being. Despite its potential benefits across various dimensions of health, including biological, psychological, and social, a comprehensive review highlighting its broad applications in healthcare remains unexplored. ObjectiveThis study aims to explore the diverse uses of magic within healthcare, progressing from entertainment to integral medical care, termed “magicine.” MethodsThis systematic review adopted a narrative synthesis approach, and an extensive database search was conducted including Embase Classic & Embase, MEDLINE (Ovid), Scopus, the Cochrane Collaboration Central Register of Controlled Clinical Trials, Cochrane Systematic Reviews, and CINAHL (EBSCOhost), from the earliest records to 22 June 2023. Potential applications of magic in healthcare were explored with an unrestricted search strategy. A quality assessment was conducted using the Mixed Methods Appraisal Tool. (Registration: PROSPERO number CRD42023417122.) ResultsThis review identified 82 journal articles, including 11 randomized controlled trials, four quasi-experimental designs, 10 pre-experimental designs, five qualitative studies, three mixed methods studies, two observational studies, five review articles, and 42 commentaries. The review resulted in the conception of “magicine ennead” — nine diverse areas where magic can be applied in healthcare including physical rehabilitation, cognitive training, psychotherapy, humor therapy, distraction therapy, social skills, health education, doctor-patient relationships, and surgical techniques. These applications demonstrate the potential of magic to enhance health outcomes for the general population and improve the clinical practice of healthcare professionals. ConclusionsMagic in healthcare shows potential for varied applications, and a deeper understanding of these applications could lead to optimized and cost-efficient intervention programs. Given the heterogeneity and varied methodological quality of the current research, future studies necessitate the adoption of rigorous designs with active controls.

Foodborne Diseases: A Study before and during the COVID-19 Pandemic in Brazil.

Foodborne Diseases (FBDs) are a worldwide problem and occur after contaminated food has been ingested, signaling a lack of food quality. Even though the SARS-CoV-2 virus is not transmitted through food, the COVID-19 pandemic has caused several challenges worldwide that have had direct implications on food production and handling, stimulating and reinforcing the adoption of good manufacturing and food handling practices. The aim of this study was to analyze data on notifications of FBD in Brazil in the years before (2018 and 2019) and during (2020 and 2021) the COVID-19 pandemic. Secondary data from the National System of Notifiable Diseases was analyzed, evaluating: overall incidence rate, lethality and mortality, contamination sites, and criteria for confirming the etiological agent. There were 2206 records of FBDs, and the mortality rate was 0.5% in both periods. The incidence rate before the pandemic was 6.48 and during the pandemic was 3.92, while the mortality coefficient was 0.033 before and 0.019 during the pandemic, both per 100,000 inhabitants. There was no significant difference in the number of FBD notifications in the evaluated periods. There was a migration of the location of FBD, with a significant increase in FBD notifications in hospitals and health units and a reduction in notifications from social events. There was a significant increase in the type of criteria used to confirm outbreaks, with an increase in clinical laboratory tests and clinical reports for bromatology. The increase in notifications in hospitals and health units demonstrates the necessity of improving food safety knowledge and the attitudes and practices of food handlers and healthcare professionals.

Identifying Areas for Development of the Law of Practicing Healthcare Professionals in Saudi Arabia: A Medicolegal Committee-Based Survey Study

Identifying Areas for Development of the Law of Practicing Healthcare Professionals in Saudi Arabia: A Medicolegal Committee-Based Survey Study

Investigating the Impact of Automation on the Health Care Workforce Through Autonomous Telemedicine in the Cataract Pathway: Protocol for a Multicenter Study.

While digital health innovations are increasingly being adopted by health care organizations, implementation is often carried out without considering the impacts on frontline staff who will be using the technology and who will be affected by its introduction. The enthusiasm surrounding the use of artificial intelligence (AI)-enabled digital solutions in health care is tempered by uncertainty around how it will change the working lives and practices of health care professionals. Digital enablement can be viewed as facilitating enhanced effectiveness and efficiency by improving services and automating cognitive labor, yet the implementation of such AI technology comes with challenges related to changes in work practices brought by automation. This research explores staff experiences before and after care pathway automation with an autonomous clinical conversational assistant, Dora (Ufonia Ltd), that is able to automate routine clinical conversations. The primary objective is to examine the impact of AI-enabled automation on clinicians, allied health professionals, and administrators who provide or facilitate health care to patients in high-volume, low-complexity care pathways. In the process of transforming care pathways through automation of routine tasks, staff will increasingly "work at the top of their license." The impact of this fundamental change on the professional identity, well-being, and work practices of the individual is poorly understood at present. We will adopt a multiple case study approach, combining qualitative and quantitative data collection methods, over 2 distinct phases, namely phase A (preimplementation) and phase B (postimplementation). The analysis is expected to reveal the interrelationship between Dora and those affected by its introduction. This will reveal how tasks and responsibilities have changed or shifted, current tensions and contradictions, ways of working, and challenges, benefits, and opportunities as perceived by those on the frontlines of the health care system. The findings will enable a better understanding of the resistance or susceptibility of different stakeholders within the health care workforce and encourage managerial awareness of differing needs, demands, and uncertainties. The implementation of AI in the health care sector, as well as the body of research on this topic, remain in their infancy. The project's key contribution will be to understand the impact of AI-enabled automation on the health care workforce and their work practices. PRR1-10.2196/49374.

Tradução e adaptação transcultural da Scale for the Assessment and Rating of Ataxia, para Português Europeu

Introduction: The Scale for the Assessment and Rating of Ataxia (SARA) is a valuable tool for evaluating the signs and symptoms of ataxia and grading its severity. Objectives: To contribute to the translation, cross-cultural adaptation of SARA for the Portuguese population, and to create and validate a manual for healthcare professionals. Materials and Methods: This study included two distinct phases: the first consisted of the translation and cultural adaptation, and the second involved the creation and validation of an application manual, composed of two sections: audiovisual and textual, to facilitate and standardize the application of the SARA scale. Results: In the first stage, a final version of SARA was obtained, translated, and adapted for European Portuguese with 100% concordance among experts; in the second stage, the 26 experts considered the application manual to be clear, comprehensible, and important for the clinical practice of health professionals. Conclusion: The Portuguese version of SARA showed semantic, conceptual, and content equivalence with the original scale, and the application manual proved to be clear, understandable, and significant. Future studies are suggested to analyze the psychometric properties of SARA, to enable its provision for the clinical practice of healthcare professionals.

Conversations about cannabis: The supply process in Australia

BackgroundIn 2016, Australia legislated medicinal cannabis supply as a pharmaceutical product; prescription is through two pathways dependent on product registration status with the Therapeutic Goods Administration. In 2021, down-scheduling of cannabidiol allowed for easier access through pharmacies. Little is known about the perspectives of those involved in medicinal cannabis supply regarding these legislative changes. This study captures the perspectives of stakeholders who access medicinal cannabis prior to patient provision and aims to shed light on the Australian medicinal cannabis supply process. MethodsStakeholders involved in medicinal cannabis supply from plant cultivation to dispensing products were recruited. Individual in-depth semi-structured interviews were followed by a single focus group. All sessions were conducted via Zoom or telephone, audio-recorded, transcribed ad verbatim, coded in NVivo Version 12 software and the findings were mapped into themes. ResultsOur interview sample comprised thirteen participants and the focus group eight participants. Two major themes emerged from discussions: (1) The supply chain pathway is complex and time consuming; (2) Supply lines adversely affect healthcare professional practice. These themes were complemented by six recommendations from focus group participants to improve current policy and practice. ConclusionsAustralia’s medicinal cannabis supply process is fragmented and underdeveloped with domestic production and product registration constrained by time-consuming protocols. Consequently most supplied products are unregistered and lack safety and efficacy evaluations. Healthcare professionals are ambivalent towards medicinal cannabis supply based on its current evidence-base and complex prescribing and dispensing processes. To address this product registration needs to be facilitated and the evidence base for specific preparations accumulated.

Achieving mastery in inhaler technique: An evaluation of training provided to general practice healthcare professionals

Abstract Introduction A local scoping questionnaire on previous training and confidence demonstrating inhaler technique in general practice (GP) healthcare professionals (HCP), identified that despite frequent consultations with patients with respiratory disease, 43% reported being self-taught on inhalers. In addition, the proportion of HCPs who reported confidence for demonstrating inhaler technique was low, approximately 60% for pressurised metered dose inhalers (pMDI), and 35-50% for the dry powder inhalers (DPIs) Ellipta, Easyhaler, and NEXThaler. Aim To evaluate the impact of an expert-led face-to-face inhaler technique workshop on HCP confidence and skills. Methods GP HCPs at seven Primary Care Networks (PCN) within Leeds Integrated Care Board (ICB) were invited to attend a multidisciplinary pilot inhaler training session in September 2022, led by a Consultant Respiratory Pharmacist and three facilitators. Inhaler technique was assessed at baseline and after education on the theory and practical issues of inhaler technique for the four most prescribed devices locally (Ellipta, Easyhaler, pMDI, NEXThaler). Inhaler technique was assessed using a seven-step checklist and scored as Optimal (no errors), Satisfactory (no critical errors, but some minor errors) or Unsatisfactory (at least 1 critical error).1 Each facilitator was allocated one inhaler device type and assessed all attendees with that same device. Attendees were asked to complete a post-training evaluation questionnaire, which asked about understanding of inhaler technique and confidence in demonstrating it. Data were subjected to descriptive statistical analysis. This evaluation of educational provision did not require ethical approval. Results Data was available for 23 of the 24 participants who completed the full session. Inhaler technique improved across all four devices post-training. The proportion of HCPs with satisfactory or optimal inhaler technique improved by 87% for Ellipta (from 4% to 91%), 65% for Nexthaler (from 22% to 87%), 17% for pMDI (from 0% to 17%) and 65% for Easyhaler (from 0% to 65%). The most common critical error made using pMDI, even after training, was inhaling too fast, whilst the most common critical error for Ellipta, Easyhaler and Nexthaler devices was not tilting the chin up prior to inhalation. This improved after training. 22 attendees completed a post-training session evaluation form. An improvement in understanding of correct inhaler technique was reported by 89% of HCPs, and 100% agreed they felt more confident demonstrating inhaler technique to patients. Discussion/Conclusion Evaluation of our expert-led inhaler technique training showed that HCPs were more likely to feel confident and achieve mastery in inhaler technique using DPIs than pMDI. Despite pMDIs being the device HCPs felt most confident using prior to training, this was the device HCPs performed poorly in. Post-training, many attendees described that to use a pMDI they inhale slowly and steadily, but on demonstration continued to inhale quickly and deeply, highlighting the difficulty in changing ingrained incorrect practice. Whilst understanding on how to use pMDIs correctly probably improved, it is likely that more practice is required. Consideration should be given to regular repeat training sessions, and the setting of these (in person, remote or eLearning) should be assessed in wider rollout of this initiative.

Co-design of patient information leaflets for germline predisposition to cancer: recommendations for clinical practice from the UK Cancer Genetics Group (UKCGG), Cancer Research UK (CRUK) funded CanGene-CanVar Programme and the Association of Genetic Nurse Counsellors (AGNC)

BackgroundTesting for germline pathogenic variants (GPVs) in cancer predisposition genes is increasingly offered as part of routine care for patients with cancer. This is often urgent in oncology clinics due...