Practice Of Healthcare Professionals Research Articles

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...

Journey to inpatient hospice care: A qualitative study on the decision-making process of Chinese family caregivers of persons with terminal cancer

ObjectiveTo understand family caregivers’ decision-making process to place their family members with terminal cancer in inpatient hospice care, especially in the social-cultural contexts whereby the caregivers have a dominant say about the care of their seriously ill family members. MethodsA qualitative study with a phenomenological approach was undertaken to understand the lived experience of caregivers of persons with terminal cancer in the decision-making process. Semi-structured qualitative interviews were conducted with a purposive sample of 17 caregivers in Shanghai, China. Thematic analysis was used to analyze the data. ResultsThe caregivers underwent a winding and socioculturally mediated four-stage process. The stages are (i) trigger for alternatives: lost hope for a cure, (ii) meandering the see-saw process, (iii) the last straws: physical limitations and witnessing unbearable suffering, and (iv) the aftermath: acceptance versus lingering hope. Caregivers’ attitudes towards death and their family members with advanced cancer expressed care wishes influence the state of the aftermath. ConclusionsChinese sociocultural values and beliefs about caregiving and death provide insightful explanations for the observed process. Practical implicationsTraining healthcare professionals in cultural competence, developing an effective hospice referral system, and delivering socioculturally acceptable death education are critical interventions to facilitate better decision-making experiences.

Determining Clinical Practice Gaps for HCPs in Treating CLL Using CME-Based Surveys

Background: Targeted therapies have revolutionized the care of patients with chronic lymphocytic leukemia (CLL). In this context, new evidence continues to accumulate with the goal of optimizing the clinical use of these treatments as additional novel therapeutics continue to emerge. In this study, we sought to analyze current clinical practices of healthcare professionals (HCPs) regarding the care of patients with CLL, along with their awareness of the latest evidence on novel investigational therapies for these patients. Methods: Between March 2022 and June 2023, we conducted multiple live and online continuing medical education activities designed for experts to provide HCPs with evidence-based recommendations for the treatment of CLL. Baseline polling questions and surveys designed to assess key aspects of HCP knowledge, practice patterns, and confidence in this area were assessed across the activities. Results: Among 124 HCPs participating in educational activities between September 2022 and June 2023, 40% reported high confidence in their ability to plan optimal treatment strategies using BTK inhibitors for patients with CLL based on available evidence and guideline and expert recommendations. There was considerable discordance between HCP and expert treatment choices for various case scenarios in multiple educational activities; for example, for patient cases without del(17p)/ TP53-mutated/ IGHV-mutated CLL andbulky disease with diminished creatinine clearance, experts would recommend acalabrutinib with or without obinutuzumab for 77% of scenarios, while HCPs selected this treatment 35% of the time (Table). Among 57 HCPs who participated in educational programs from March 2022 to February 2023, 26% reported high confidence in their ability to recognize and manage AEs with BTK inhibitors in patients with CLL. Challenging AEs associated with the currently available BTK inhibitors also were self-identified by HCPs (Figure). One half of responding HCPs (52%) were able to identify characteristics that would qualify a patient for inpatient administration of the initial doses of venetoclax because of increased risk of tumor lysis syndrome (n = 48). Finally, among 213 HCPs participating in educational activities from September 2022 to June 2023, 43% were aware of recent data regarding the use of pirtobrutinib, an investigational noncovalent BTK inhibitor, for treating patients with CLL. Conclusion: Our data suggest that many HCPs are challenged to optimally incorporate contemporary treatment recommendations into the care of patients with CLL and struggle to maintain knowledge of investigational therapies that may affect the treatment landscape in the near future. Continuing educational activities designed to improve the knowledge, competence, and confidence of HCPs in the care of CLL would benefit patients with this disease. A more detailed data analysis of treatment trends and knowledge by geographic location and role on the care team will be presented.

Identifying behaviour change techniques in 287 randomized controlled trials of audit and feedback interventions targeting practice change among healthcare professionals

BackgroundAudit and feedback (A&F) is among the most widely used implementation strategies, providing healthcare professionals with summaries of their practice performance to prompt behaviour change and optimize care. Wide variability in effectiveness of A&F has spurred efforts to explore why some A&F interventions are more effective than others. Unpacking the variability of the content of A&F interventions in terms of their component behaviours change techniques (BCTs) may help advance our understanding of how A&F works best. This study aimed to systematically specify BCTs in A&F interventions targeting healthcare professional practice change.MethodsWe conducted a directed content analysis of intervention descriptions in 287 randomized trials included in an ongoing Cochrane systematic review update of A&F interventions (searched up to June 2020). Three trained researchers identified and categorized BCTs in all trial arms (treatment & control/comparator) using the 93-item BCT Taxonomy version 1. The original BCT definitions and examples in the taxonomy were adapted to include A&F-specific decision rules and examples. Two additional BCTs (‘Education (unspecified)’ and ‘Feedback (unspecified)’) were added, such that 95 BCTs were considered for coding.ResultsIn total, 47/95 BCTs (49%) were identified across 360 treatment arms at least once (median = 5.0, IQR = 2.3, range = 1-29). The most common BCTs were ‘Feedback on behaviour’ (present 89% of the time; e.g. feedback on drug prescribing), ‘Instruction on how to perform the behaviour’ (71%; e.g. issuing a clinical guideline), ‘Social comparison’ (52%; e.g. feedback on performance of peers), ‘Credible source’ (41%; e.g. endorsements from respected professional body), and ‘Education (unspecified)’ (31%; e.g. giving a lecture to staff). A total of 130/287 (45%) control/comparator arms contained at least one BCT (median = 2.0, IQR = 3.0, range = 0–15 per arm), of which the most common were identical to those identified in treatment arms.ConclusionsA&F interventions to improve healthcare professional practice include a moderate range of BCTs, focusing predominantly on providing behavioural feedback, sharing guidelines, peer comparison data, education, and leveraging credible sources. We encourage the use of our A&F-specific list of BCTs to improve knowledge of what is being delivered in A&F interventions. Our study provides a basis for exploring which BCTs are associated with intervention effectiveness.Trial registrationsN/A.

Infection Prevention Knowledge, Practice, and Its Associated Factors among Healthcare Providers in Eradah and Mental Health Complex Jeddah, Saudi Arabia

Aim: This review aims to provide a clear understanding of the current state of infection prevention measures in this particular healthcare setting by synthesizing the available evidence. 
 Study Design: It is a systematic review that includes some previous studies and literature that are discussing with an emphasis on the Eradah Mental Health Complex in Jeddah, this systematic review employs a rigorous research design to investigate healthcare personnel’ knowledge and practices related to infection prevention in mental health settings. A thorough examination of the topic is provided by the methodical synthesis of the body of available literature.
 Results: The most important discoveries on the knowledge and practices of healthcare professionals in infection prevention in mental health settings are highlighted in this summary of the findings from the included research. The data are synthesized, combined and identifying patterns from several investigations. This summary not only identifies barriers to sustaining high compliance rates but also highlights elements that have a beneficial impact on infection prevention.
 Discussion: The discussion also includes any gaps in the literature that were found throughout the process of the systematic review. A thorough summary of the state of infection prevention techniques in mental health settings is given by synthesizing the findings. The field’s recommendations for upcoming studies and interventions are influenced by this insightful information. The research enhances patient safety and the standard of care in mental health facilities, particularly the Eradah Mental Health Complex in Jeddah, by addressing these important components of infection prevention.

Healthcare practitioners’ perspectives of providing palliative care to patients from culturally diverse backgrounds: a qualitative systematic review

BackgroundPalliative care practitioners are increasingly caring for patients and families from diverse cultural backgrounds. There is growing awareness of the influence of culture on many aspects of care in the palliative phase of an illness. However, disparities have been noted in the provision of palliative care to patients from culturally diverse backgrounds and challenges have been reported in meeting their needs and those of their families.MethodA qualitative systematic review of research papers identified through searching four databases. Papers were screened against inclusion criteria within the timeframe of January 2012 to March 2022. Data was extraction from all included studies and methodological quality assessed utilising the Critical Appraisal Skills Programme Tool. Thematic analysis followed Braun and Clarke’s framework and the review is reported in line with PRISMA guidelines.FindingsThe search yielded 1954 results of which 26 were included for appraisal and review. Four themes were identified: communication and connection, the role of the family in death and dying, the role of education in addressing uncertainty, and institutional and societal factors. The findings highlighted challenges of communication and a fear of acting in a culturally insensitive way, the pivotal role of the family, the need for an individualised approach to care, the universality of needs when approaching end of life and the need for education of practitioners.ConclusionThese findings suggest that healthcare practitioners draw on their existing skills to adapt their practice to meet the needs of patients from culturally diverse backgrounds. However, results also indicate a need for further education and identification of educational approaches best suited to supporting healthcare professionals in practice.

Teaching Social Determinants of Health in Undergraduate Medical Education: A Longitudinal Curricular and Experiential Program in the United Arab Emirates.

Social determinants of health (SDH) have a major impact on illness and wellness. However, research shows a lack of training on SDH in both undergraduate and postgraduate medical education, with studies confirming that the social needs of patients are not routinely identified or addressed by health care professionals in clinical practice. The medical education community is currently working to incorporate SDH into undergraduate training but has had limited guidance regarding educational topics, modes of teaching, and evaluation criteria in this domain. This article describes the evolution, process, and structure, along with student perceptions, lessons learned, and future directions, of an SDH educational program in the United Arab Emirates. Using the Institute of Medicine's behavioral and social science knowledge domains as a framework, the program includes a didactic component with workshops, reflective practice training, and an experiential component that integrates home visits with social activities in collaboration with community partners. The program began in 2019. To date, 114 students have completed the didactic sessions and at least 1 year of the experiential component. Student surveys and reflective narratives reveal positive perceptions of the program and improved SDH knowledge, skills, and attitudes.

The Preventive Effects of Platelet-Rich Plasma Against Knee Osteoarthritis Progression in Rats.

In recent years, the intra-articular administration of platelet-rich plasma (PRP), a novel therapeutic strategy for knee osteoarthritis (KOA), has gained attention. However, the efficacy of PRP in inhibiting degenerative joint changes remains unclear. The current study aimed to evaluate the therapeutic effect of the intra-articular administration of PRP in rats with induced KOA. PRP was prepared from the whole blood of nine-week-old male Wistar rats via centrifugation at 25°C, 200 × g, for seven minutes. KOA was induced in the right knees of the rats via destabilization of the medial meniscus (DMM) surgery. The animals were divided into the control, sham, DMM, and DMM + PRP groups (n = 5 each). The rats in the DMM + PRP group received 50 μL of intra-articular PRP in the right knee joint four weeks after surgery. The rotarod test was conducted to assess locomotive function. Eight weeks after DMM surgery, the degree of medial meniscus extrusion was measured via computed tomography (CT) images on the right knee. Then, a histological analysis of the harvested knees was conducted. KOA progression was assessed using the Osteoarthritis Research Society International (OARSI) score. The number of multinucleated tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts in the subchondral bone was counted via histological analysis. The degree of medial meniscus extrusion did not significantly differ between the DMM and DMM + PRP groups. Similarly, there were no significant differences in the walking time based on the rotarod test between the DMM and DMM + PRP groups. However, the DMM group had a significantly higher OARSI score than the DMM + PRP group. The number of TRAP-positive osteoclasts in the subchondral bone of the DMM group increased over time, peaking four weeks after surgery. The DMM + PRP group had a higher number of TRAP-positive osteoclasts in the subchondral bone than the control group. However, there was no significant difference between the number of TRAP-positive osteoclasts between the DMM group and the control and sham groups. The intra-articular administration of PRP may inhibitKOA progression in a rat model, especially in the articular cartilage degradation and osteophyte formation. The results can provide further evidence about the efficacy of PRP against KOA progression and can contribute to the current practice of healthcare professionals based on accurate knowledge.

IMP2ART: development of a multi-level programme theory integrating the COM-B model and the iPARIHS framework, to enhance implementation of supported self-management of asthma in primary care

BackgroundSupported asthma self-management, incorporating an asthma action plan and annual clinical review, has been recommended by UK/global guidelines for over three decades. However, implementation remains poor, as only around a third of individuals receive basic asthma care, according to the UKs leading respiratory charity Asthma and Lung UK. A systematic review of implementation studies recommended that a whole systems approach targeting patients, healthcare professional education, and organisations is needed to improve implementation of supported asthma self-management in primary care. The IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) is a national Hybrid-II implementation cluster randomised controlled trial that aims to evaluate such an approach. This paper describes the development of the implementation strategy for IMP2ART with particular focus on the integration of multiple level theories.MethodsThe Medical Research Council design and evaluation of complex interventions framework and the Person-Based Approach to intervention development were used as guidance for stages of strategy development. Specifically, we (i) set up a multidisciplinary team (including practicing and academic clinicians, health psychologists, public health and patient colleagues), (ii) reviewed and integrated evidence and theory, (iii) developed guiding principles, (iv) developed prototype materials, and (v) conducted a pre-pilot study before final refinement.ResultsThe implementation strategy included resources for patients, team-based and individual healthcare professional education, practice audit and feedback, and an asthma review template, as well as a facilitator role accessible to primary care practices for 12 months. The synthesis of the integrated Promoting Action on Research Implementation in Health Services (iPARIHS) and Capability, Opportunity, Motivation and Behaviour (COM-B) frameworks led to an evolved framework bringing together important implementation and behaviour change elements which will be used as a basis for the study process evaluation.ConclusionsA description of rigorous implementation strategy development for the IMP2ART study is provided along with newly theorised integration of implementation and behaviour change science which may be of benefit to others targeting implementation in primary care.Trial registrationISRCTN15448074. Registered on 2nd December 2019.

Using MCQ response certainty to determine how aspects of self-monitoring develop through a medical course.

Self-monitoring of clinical-decision-making is essential for health care professional practice. Using certainty in responses to assessment items could allow self-monitoring of clinical-decision-making by medical students to be tracked over time. This research introduces how aspects of insightfulness, safety and efficiency could be based on certainty in, and correctness of, multiple-choice question (MCQ) responses. We also show how these measures change over time. With each answer on twice yearly MCQ progress tests, medical students provided their certainty of correctness. An insightful student would be more likely to be correct for those answers given with increasing certainty. A safe student would be expected to have a high probability of being correct for answers given with a high certainty. An efficient student would be expected to have a sufficiently low probability of being correct when they have no certainty. The system was developed using first principles and data from one cohort of students. A dataset from a second cohort was then used as an independent validation sample. The patterns of aspects of self-monitoring were similar for both cohorts. Almost all the students met the criteria for insightfulness on all tests. Most students had an undetermined outcome for the safety aspect. When a definitive result for safety was obtained, absence of safety was most prevalent in the middle of the course, while the presence of safety increased later. Most of the students met the criteria for efficiency, with the highest prevalence mid-course, but efficiency was more likely to be absent later. Throughout the course, students showed reassuring levels of insightfulness. The results suggest that students may balance safety with efficiency. This may be explained by students learning the positive implications of decisions before the negative implications, making them initially more efficient, but later being more cautious and safer.

Knowledge, attitudes and practices of primary healthcare professionals regarding smoking and smoking cessation among the elderly in France.

Smoking remains a leading cause of preventable death in France, even among the elderly. Although smoking prevalence has decreased overall, it still affects a significant portion of older adults. This study investigates the knowledge, attitudes, and practices of primary healthcare professionals regarding smoking and smoking cessation among the elderly in France. A cross-sectional study involved 300 primary care professionals (general practitioners, pharmacists, nurses) in the Ile-de-France region. Data collection occurred via telephone interviews in September and October 2019. The study employed a questionnaire focusing on knowledge (10 questions), attitudes (12 statements), and clinical practices (7 questions) related to tobacco dependence in older adults. Responses were scored based on correctness for knowledge and appropriateness for attitudes and practices. The surveyed professionals were predominantly female (57.7%), with a mean age of 53.0 years, and most were non-smokers or former smokers (85.3%). While 66.7% believed older smokers had lower cessation rates, only 64.3% knew it was safe to prescribe nicotine replacement therapy for the elderly. Attitude scores averaged 8.8/12, with pharmacists scoring highest (9.9) and nurses lowest (8.2). Practices scores averaged 2.8/7, with physicians scoring highest (3.8) and pharmacists lowest (1.9). Primary healthcare professionals have a relatively good knowledge of the management of tobacco dependence in the elderly and consider it to be part of their mission. However, their confidence in their abilities needs to be strengthened, and many opportunities to counsel and assist this population to quit smoking are still being missed. Preventive approaches to older smokers are essential, in keeping with the concept that 'every contact with the healthcare system counts'. Improving practice will require education and training that will not only build knowledge but also change perceptions, leading to better attitudes and practices in the management of smoking cessation among older adults.

Knowledge, Attitudes, and Practices of European Healthcare Professionals towards Hepatitis A and Hepatitis B Vaccination in at-Risk Adults.

Despite the occurrence of several hepatitis A (hepA) and hepatitis B (hepB) outbreaks in Europe in the last few decades, not all European countries have implemented hepA and hepB vaccinations in their national immunization programs, especially for adults at risk for hepA and/or hepB infection, such as men who have sex with men or patients with chronic liver disease. Currently, little is known on the attitudes of European healthcare professionals (HCPs) towards hepA and hepB vaccinations for at-risk adults. We conducted an online survey among HCPs in Germany, Spain, and the United Kingdom to assess their awareness of and adherence to their national hepA and hepB vaccination guidelines for at-risk adults. Among the 698 HCPs who took the survey, most (91.1%) were familiar with their national vaccination recommendations and always followed them or followed them most of the time when advising or prescribing hepA or hepB vaccines. Major and moderate barriers for recommending or administering such vaccines were the non-disclosure of risk factors by the patient (53.0-57.6%) and the patient's lack of motivation or knowledge about the risk of the disease (50.3-52.9%). These results may help inform strategies to improve and accelerate hepA and hepB vaccination in European at-risk adults.

Analysis of the perception of health professionals regarding the incorporation of emerging technologies in their practice

Introduction: healthcare is currently in the midst of a technology-driven revolution. Emerging technologies (ETs) are disrupting the practice of healthcare professionals in ways that once seemed futuristic, but are now an everyday reality in clinics and hospitals around the world.Objective: to analyze the perception of health professionals regarding the incorporation of emerging technologies in their practice.Methods: it is a quantitative, descriptive, non-experimental, cross-sectional study, whose sample was 107 health professionals who work in different health centers in Lima. The survey technique was used and the instrument was the questionnaire.Results: the participants perceived the incorporation and use of TE in their practice by 63,55 % (68) at a moderate level, 20,56 % (22) reported a high level, while 15,89 % indicated a low level.Conclusions: it was possible to specify a moderate level in the incorporation and use of TE, suggesting an intermediate position in technological adoption in medical care. This provides a solid foundation for future advances and improvements in the implementation of TE in medical practice

Knowledge and attitudes towards medicinal cannabis and complementary and integrative medicine (CIM): a survey of healthcare professionals working in a cancer hospital in Australia

PurposeWe investigated attitudes and practices of healthcare professionals (HCPs) to medicinal cannabis (MC) and complementary and integrative medicine (CIM), including individual therapies, such as acupuncture, massage, herbs, dietary supplements, nutrition and exercise. We explored whether healthcare occupation influenced attitudes to CIM and MC; referral pathways for advice on CIM; and interest in a pharmacy service to evaluate herbs and supplements.MethodsCross-sectional survey. All clinical staff at a comprehensive cancer hospital were invited to complete an anonymous questionnaire about CIM and MC. We used descriptive analysis to describe the respondent’s knowledge and attitudes, and Fisher’s exact test to test for differences by occupation, length of time at the hospital and age.ResultsMost of the 116 HCPs respondents supported integrating CIM into cancer care (94.8%) and wanted to learn more (90%) and to understand benefits and contraindications. Most respondents believed that CIM (87.9%) could benefit patients with cancer, and MC could benefit those with advanced cancer (49–51%). Whilst just over half (52.6%) felt confident discussing CIM with patients, only 10% felt they had sufficient knowledge to discuss MC. Most felt they did not have sufficient knowledge to specifically discuss mind and body practices (63.8%) or herbs and supplements (79%). HCPs (63%) would be more inclined to allow use of herbs and supplements with cancer treatment if a pharmacy service was available to evaluate interactions. Occupation, length of time at hospital and age influenced confidence and knowledge about CIM.ConclusionsThe integration of evidence-based CIM and MC into cancer care is hampered by a lack of knowledge of benefits and contraindications, and gaps in education. Effective and safe integration may require targeted development of services such as pharmacy to evaluate the safety of herbs and supplements, and inclusion of cancer specialists who have received training in individual CIM therapies and MC.

PRINCIPLES AND METHODS OF RESEARCH ON THE QUALITY OF LIFE IN PATIENTS WITH DIABETES

In recent years, assessing the quality of life of patients with diabetes, as an indicator of the patient’s overall well-being, which affects not only the course of the primary condition but also the prognosis of the development of complications and associated conditions, has become particularly important.
 According to WHO experts, the quality of life is an integral characteristic of a person's physical, psychological, emotional, and social functioning, based on their subjective perception.
 The aim: to conduct analysis and synthesis of scientific publications on the selection of instruments for researching the quality of life of patients with diabetes.
 Materials and methods: The analysis and synthesis of scientific publications regarding the utilization of standardized questionnaires to assess the quality of life among patients with type 2 diabetes mellitus were conducted. The appropriateness and practicality of their utilization in the clinical practice of healthcare professionals were analyzed. The following methods were employed: a systematic approach, bibliosemantic analysis, as well as analytical and comparative methods.
 Results: Given that virtually any chronic illness can influence the structure of a patient's psyche and personality, it can be inferred that diabetes leads to similar consequences, which undoubtedly impact their quality of life.
 Quality of life is a multifaceted concept that encompasses the influence of disease severity and physical condition on the patient’s physical, social, economic, and emotional well-being. This is why assessing the patient’s quality of life is increasingly crucial in evaluating the effectiveness of diabetes therapy. Moreover, it is essential to assess several parameters, taking into consideration not only the patient’s physical state. We have conducted an analysis spanning almost 40 years to identify effective questionnaires for assessing the quality of life of diabetes patients.
 Conclusions: It is evident that assessing the quality of life of patients and identifying factors that impact it are crucial elements in the formulation of intervention strategies aimed at enhancing the quality of life for these individuals.

A Multicenter Cross-Sectional Survey of Knowledge, Attitude, and Practices of Healthcare Professionals towards Antimicrobial Stewardship in Ghana: Findings and Implications.

Antimicrobial stewardship (AMS) programs are part of the key activities that contribute to reducing antimicrobial resistance (AMR). Good knowledge, attitudes, and practices (KAP) among healthcare professionals (HCPs) are essential to improving future antimicrobial use and reducing AMR, which is a priority in Ghana. A multicenter cross-sectional survey was conducted in six public hospitals in Ghana among key HCPs to assess their level of KAP towards AMS using a validated self-administered electronic questionnaire. Data analyses included descriptive and inferential statistics using STATA version 14. Overall, 339 out of 355 HCPs responded to the questionnaire, giving a response rate of 95.5%. Most responders were nurses (n = 256, 78.2%), followed by medical doctors (n = 45, 13.3%). The study recorded both poor knowledge (8.9%) and practice levels (35.4%), as well as a good attitude (78.8%) towards AMS. Ongoing exposure to AMS structured training, exposure to continuous professional development training on AMS in the previous year, and the number of years of working experience were predictors of the HCPs' level of knowledge (aOR = 3.02 C.I = 1.12-8.11), attitude (aOR = 0.37 C.I = 0.20-0.69) and practice (aOR = 2.09 C.I =1.09-3.99), respectively. Consequently, concentrated efforts must be made to address current low levels of knowledge and poor practices regarding AMS among HCPs in Ghana as part of ongoing strategies in the National Action Plan to reduce AMR.