Professionals Encounter Research Articles

Does education in special care dentistry increase people's confidence to manage the care of a more diverse population?

Education in Special Care Dentistry (SCD) at undergraduate and postgraduate levels is often limited when compared with other dental specialities, even though dental professionals encounter people with Special Healthcare Needs (SHCNs) on a very regular basis. This literature review examined whether education at undergraduate and postgraduate level increases dental students' and professionals' confidence in managing a patient with SHCN. It also appraised whether there was a correlation between increased practitioner confidence and increased quality of care for people with SHCN. This review also examined educational efforts worldwide, and whether there is an increased emphasis on providing education in SCD to dental students. It was found that those who received high-quality practical and theoretical education on how to properly manage patients with SHCN reported having higher levels of confidence than those who did not. People also reported being far more likely to employ the proper behavior management techniques and were more likely to treat people with SHCN regularly. There has been an increased emphasis on providing education in SCD worldwide in recent years, but a number of barriers still exist to providing complete education in the area.

Difficult medical encounters in oncology: What physicians need. An exploratory study

ObjectiveThe objective of this study was to assess how often-medical oncology professionals encounter difficult consultations and if they desire support in the form of training. MethodsIn February 2022, a survey on difficult medical encounters in oncology, training and demographics was set up. The survey was sent to 390 medical oncology professionals part of the OncoZON network of the Southeast region of the Netherlands. ResultsMedical oncology professionals perceive a medical encounter as difficult when there is a dominant family member (n = 27), insufficient time (n = 24), or no agreement between medical professional and patient (n = 22). Patients involved in these encounters are most often characterized with low health literacy (n = 12) or aggressive behavior (n = 10). The inability to comprehend difficult medical information or perceived difficult behavior complicates encounters. Of the medical oncology professionals, 27–44% preferred a training as a physical group meeting (24%) or an individual virtual meeting (19%). ConclusionMedical oncology professionals consider dominant or aggressive behavior and the inability to comprehend medical information by patients during consultations as difficult encounters for which they would appreciate support. InnovationOur results highlight concrete medical encounters in need of specific education programs within daily oncology practice.

DEVELOPMENT OF AN IoT-BASED KNEE EXOSKELETON DEVICE FOR REHABILITATION THERAPY MONITORING

The COVID-19 pandemic has presented a multitude of challenges pertaining to medical treatments and patient care, creating a pressing need for innovative solutions. Constrained outdoor activities have hindered patients' ability to access essential healthcare, while healthcare professionals encounter difficulties in remotely monitoring and administering treatments. This study aims to address these pressing issues by proposing an Internet of Things (IoT)-based exoskeleton system designed for the monitoring of knee rehabilitation therapy. Through the utilization of the IoT platform ThingSpeak, this developed system enables patients to remotely monitor the status of their knee recovery from the comfort of their homes. The collected data is securely stored and made accessible to healthcare professionals, facilitating remote analysis and the formulation of treatment recommendations. This pioneering solution amalgamates advancements in exoskeleton technology with seamless IoT integration, establishing a dependable and easily accessible framework for the monitoring of knee rehabilitation. By empowering patients to actively participate in their own recovery process and enabling remote monitoring by healthcare providers, this system effectively surmounts the limitations imposed by the pandemic and financial constraints. The proposed IoT-based exoskeleton system possesses the potential to revolutionize knee rehabilitation therapy, thereby enhancing patient engagement, optimizing treatment outcomes, and circumventing traditional healthcare barriers.

Secondary traumatic stress and death anxiety in healthcare professionals: Moderating role of social support.

It's hard to deny the buffering impact of social support as it provides much-needed assistance to counter untoward circumstances that individuals face in their daily life. By focusing on the moderating role of social support, the present investigation studied the relationship between secondary traumatic stress and death anxiety that healthcare professionals encounter in their regular work life. Through a cross-sectional correlational design, 200 participants were included from various hospitals in Lahore (from June-August, 2022) by employing a non-probability purposive sampling technique. They provided basic sociodemographic information along with their responses on self-reported questionnaires for the current investigation. Results were analyzed through SPSS 21 which indicated that secondary traumatic stress had a positive association with death anxiety, unlike social support which had a negative relationship with death anxiety. Findings also revealed social support as a significant moderator for secondary traumatic stress and death anxiety. It can be concluded that increased social support could benefit healthcare professionals as it weakened the association between secondary traumatic stress and death anxiety. Other than academia and research, these findings have implications across a variety of professional settings including physical and mental healthcare professionals who can benefit from these indigenous findings.

Caring for patients with substance use disorders: a qualitative investigation of difficulties encountered by hospital-based clinicians

Background: Caring for patients with substance use disorders (SUD) is held in low regard and many clinicians resist treating them. To address this situation, numerous research projects assessed training program gaps and professional attitudes. In contrast, this study explored the actual clinical difficulties that a variety of hospital-based professionals encounter when treating patients with SUD. Methods: Qualitative multiple method design including: (1) individual semi-structured interviews with SUD experts and educators; (2) video-elicited, cross self-confrontation interviews with clinicians working in a specialist addiction unit; (3) paired semi-structured interviews with clinicians working in non-specialist units. Participants were recruited within one university hospital. Data collected at stages (1) and (3) relied on an interview guide and were analyzed using conventional content analyses. Data collected at stage (2) consisted of discussions of video recorded clinical interviews and were analyzed based on a participatory approach. Results: Twenty-three clinicians from seven hospital units participated. Forty-four difficulties were reported that we classified into six categories: knowledge-based; moral; technical; relational; identity-related; institutional. We identified seven cross-category themes as key features of SUD clinical complexity: exacerbation of patient characteristics; multiplication of medical issues; hybridity and specificity of medical discipline; experiences of stalemate, adversity, and role reversal. Conclusions: Our study, providing a comprehensive analysis of the difficulties of caring for patients with SUD, reveals a highly challenging clinical practice for a diversity of healthcare providers. They represent a complementary approach to addressing resistance as an important feature of a complex clinical system, and valuable material to discussing professional preparedness.

Challenges to implementing circular economy: empirical evidence among built environment firms in Ghana

This study examines the challenges built environment (BE) professionals (comprising Contractors/Construction Managers, Architects, Engineers, Project Managers, Real Estate Practitioners, and Quantity Surveyors) encounter in implementing the principles of circular economy (CE) in the Ghanaian building industry (GBI). A structured questionnaire survey was used to solicit the views of 162 industry professionals working in construction, consulting, and developer firms on the issue under investigation. The questions were developed through a review of related literature. Data obtained were analyzed via descriptive (i.e. mean score ranking) and inferential statistics (i.e. Kruskal-Wallis H test, exploratory and confirmatory factor analyses). The findings reveal that BE professionals encounter seven major categories of challenges. These are knowledge and facilities challenges, market orientation and operational challenges, financial challenges, environmental and regulatory challenges, preferential challenges, technological challenges, and industrial and consumer-related challenges. This finding can inform the various construction industry stakeholders of the challenges currently encountered in implementing CE principles. Furthermore, these identified challenges must encourage concerted efforts among stakeholders to find ways to boost the practice of CE principles in the GBI.

Existential Loneliness Among Older People from the Perspective of Health Care Professionals: A European Multicenter Study.

Health care professionals (HCPs) encounter different forms of loneliness in their work. It is essential that they have the courage, skills, and tools to deal with loneliness, in particular with existential loneliness (EL) which relates to meaning in life and the fundamentals of living and dying. The aim of this study was to investigate HCPs' views on loneliness among older people and their understanding, perception, and professional experience of EL in older people. In all, 139 HCPs from five European countries participated in audio-recorded focus group and individual interviews. The transcribed materials were locally analyzed using a predefined template. The participating countries' results were then translated, merged, and inductively analyzed using conventional content analysis. Participants described different forms of loneliness - a negative form that is unwanted and causes suffering, and a positive form where solitude is desired and sought. The results showed that the HCPs' knowledge and understanding of EL varied. The HCPs mainly related EL to different types of loss, eg loss of autonomy, independence, hope, and faith, and to concern alienation, guilt, regret and remorse, and concerns about the future. The HCPs expressed a need to improve their sensitivity and self-confidence to engage in existential conversations. They also stated the need to increase their knowledge and understanding of aging, death, and dying. Based on these results, a training program aimed to increase knowledge and understanding of older people's situation has been developed. The program includes practical training in conversations about emotional and existential aspects, based on recurrent reflections on the topics presented. The program is available at: www.aloneproject.eu.

Supporting recovery in persons with stress-related disorders: A reflective lifeworld research study of health care professionals in primary health care in Sweden

ABSTRACT Purpose The study aimed to describe primary health care professionals lived experiences of supporting recovery in persons with stress-related disorders. Methods This study was based on a phenomenological approach known as reflective lifeworld research (RLR). Seventeen health care professionals working in primary health care were included in the study. Lifeworld interviews were conducted to collect data. The data were analysed in accordance with the phenomenological RLR principles of openness, flexibility and bridling. Results Health care professionals experienced supporting recovery as a complex process with a need for a tailored approach, regardless of profession. In an alliance, the health care professionals encounter the persons where they are based on their own narratives about their life situation. In an interpersonal platform, the health care professionals use a lingering and flexible approach. Support is provided by encouraging existential reflection and learning as well as guiding the person to consider their own needs. This supports the person’s quest for a sustainable recovery process in his/her life situation. Conclusions We conclude that supporting recovery requires a genuinely person-centred care in which elements of existential care are crucial. Primary health care for persons with stress-related disorders could benefit from the development of additional research and models for such an approach.

Mental deterioration of refugees and asylum seekers with uncertain legal status in Australia: Perceptions and responses of legal representatives.

Many developed countries have introduced strict measures designed to deter people seeking asylum. Measures such as held detention, insecure visas, restrictions work and services all impact the mental health of asylum seekers. In 2014 Australia introduced a 'fast track assessment' (FTA) system of processing refugee claims for asylum seekers who arrived by boat, those found to be refugees were only eligible for temporary residence. Legal professionals play a pivotal role in protecting the rights of asylum seekers and gain unique insight into the impact of the legal system has on clients mental health. To investigate how legal professionals in Australia perceived the impact of the FTA process on their clients. Mixed methods comprising of two phases - (i) an online survey and (ii) follow-up focus groups and interviews with legal professionals involved in assisting asylum seekers in the FTA process. An inductive thematic analysis was used to analyse the data. Survey results were obtained from 38 legal professionals. Follow up in depth qualitative focus groups and interviews were conducted with 16 survey participants. The data demonstrate that legal professionals encounter clients in complex seemingly insurmountable mental health crises including deepening mental distress and deterioration, feelings of hopelessness, defeat and entrapment. Interviewees shared compelling examples of what they believed constituted a direct connection between asylum seekers experiencing uncertainty and deteriorating mental health over time with fluctuations in hopelessness, anger, withdrawal and suicidality. These negative impacts were often compounded by separation from family. The legal framework for determining whether an asylum seeker is a refugee can have a detrimental impact on the mental health of asylum seekers. The mental distress of asylum seekers and refugees is exacerbated by uncertainty linked to both delays in processing accompanied by sustained and ongoing uncertainty of legal status.

BORDERLINE PERSONALITY DISORDER: ATTITUDES OF PSYCHIATRY AND FAMILY MEDICINE RESIDENTS

Introduction Patients with Borderline Personality Disorder (BPD) require a significant amount of time and effort on the part of general practitioners and psychiatrists, resulting in longer visits and complex medical records, with a poor resolution of both physical and mental symptoms. These patients are likely to express feelings of anger and violence, compared to other patients which makes it difficult to deal with them. Objectives To determine attitudes toward patients with BPD among psychiatry and family medicine residents in Tunisia. To understand in addition the challenges that these professionals encounter in their everyday practice Methods An online anonymous questionnaires was distributed through social networks to psychiatry residents and family medicine resident. The attitudes of health professionals towards people with BPD was used to assess clinicians’ attitudes towards people with BPD. Results Thirty three clinicians were in the study. A high proportion of respondents (81.8%) were females .The age of the participants ranged from 25 to 34 years, with an average age of 28 years and 3 months (SD = 2.23).In our study 34% reported that they often see patients with borderline personality .The half of the participants (51.5%) reported a feeling being on guard when meeting borderlines while 36.4% were empathetic and neutral. The feeling of anger and frustration was reported with 12.1 % of the participants. The most frequent cause of these feelings was the difficulty of taking care of patients with BPD. The majority of the participants (51.5%) reported avoiding working with them. However, only 39.4% reported asking a colleague to replace them in their follow-up. The results of Attitudes of health professionals towards people with BPD Scale indicate that clinicians generally present a positive attitude towards patient BPD with a mean score 94.94(SD=18.60) Conclusions Working with patients with BPD can be challenging. Professionals’ attitude can create obstacles to effective communication and successful treatment. Therefore, all clinicians should receive more specific training to be able to deal with this condition. Disclosure of Interest None Declared

How Should Clinicians and Students Cope With Secondary Trauma When Caring for Children Traumatized by Abuse or Neglect?

When health care professionals encounter child abuse and neglect, they can experience a range of emotions, such as anger, sadness, and frustration. Such feelings can cloud judgment, compromise care, or even undermine one's capacity to complete evaluation of a child. This article discusses key ethical values of honesty, objectivity, compassion, professionalism, respect for persons, and justice, which can be used to guide one's approaches to navigating secondary trauma during and after clinical interactions with children who have suffered abuse or neglect. Strategies for coping with intense feelings, especially duringinteractions with abused and neglected children's families, are also offered herein.

The Impact of the COVID-19 Pandemic on Nurses and Its Relationship to the Level of their Performance In Buraidah Hospitals

Background and Aims: The COVID-19 pandemic has served as the ultimate disruptor in healthcare delivery, with the full impact to unfold over time. During a pandemic, healthcare professionals encounter various health hazards that affect their personal life and workplace. This study aimed to assess the impact of the COVID-19 pandemic on nurses and its relationship to the level of their performance in Buraidah Hospitals. Methods: A descriptive, correlational design was conducted at Buraidah central Hospital which is affiliated with the Ministry of Health Hospitals. 23 head nurses out of 25 head nurses and 195 staff nurses out of 381 staff nurses were included in the study. Data were collected by using a Job Performance questionnaire. Data were analyzed using the SPSS V25 computer software package. Results: Slightly more than one-half (52.3%) of studied nurses had a satisfactory perception level regarding total performance during the COVID-19 pandemic. Thus, less than one-half (47.7%) of studied nurses had an unsatisfactory perception level regarding total performance during the COVID-19 pandemic. Conclusions: The research comes to the conclusion that the COVID-19 pandemic impairs nurses’ performance as evidenced by the discovery of several disruptors during COVID-19. Managers and employees should collaborate with health authorities to prevent and control COVID-19. Protecting workers at higher risk of developing severe disease, such as those age 60 and over or with underlying medical conditions, requires special measures on occupational health services recommendation.

Barriers to primary care access for asylum seekers and refugees in the UK: a systematic review

Abstract Background Recent armed conflicts, in addition to the deterioration of humanitarian conditions across the world, has led to the biggest increase in civilian displacement since World War II. Exploration of the barriers and facilitators to primary healthcare access amongst asylum seekers and refugees (ASRs), from the perspective of both service users and service providers, is important for improving policy and practice to ensure more equitable health care. Methods Systematic searches of PubMed, EMBASE, MEDLINE, and CINHL databases were conducted to identify articles until May 2021 using a combination of relevant search terms. Studies were eligible if they were published in English and conducted in ASR populations in primary care settings the UK using qualitative approaches. Literature was thematically analysed using Braun and Clarke’s 6-step process. Quality assessment of included studies was conducted using the Mixed Methods Appraisal Tool. Results Nine studies were included in the review. Key themes identified included: accommodation within services; awareness of service navigation, negotiation and eligibility of care; accessibility; availability of appointments; acceptance; complexity within health needs; and cultural appropriateness. Healthcare professionals encounter barriers and facilitators within the healthcare setting, the overall healthcare system, and with regards to their understanding of migration policy. ASRs experience barriers and facilitators with regards to accessing and understanding the health system, cultural appropriateness of care, cost, stigma and prejudice, and availability of specialist services. Conclusions This study highlights the difficulties ASRs and healthcare professionals face in primary care settings, the need for consistent and unambiguous guidance that supports the cultural competence of the heath service, and the need for further research into the efforts made to eliminate health discrimination within primary care. Key messages • Barriers exist to primary healthcare amongst asylum seekers and refugees. • Specialised and incorporated healthcare and support is needed due to unique social, cultural, and demographical differences of this population.

Organizational Strategies to Creating a Culture of Well-Being Based on Human Caring Theory and a Self-Care ENERGY Model

As the world continues to face pandemic challenges, healthcare professionals encounter another epidemic, psychological issues. This study aimed to describe the organizational strategies implemented to help team members during the pandemic and nurses’ and patients’ experiences through the health system’s employee pulse-check surveys and patients’ Hospital Consumer Assessment of Healthcare Providers and Systems survey. The guiding frameworks for the strategies were Watson’s human caring theory and a self-care ENERGY model. The organizations’ strategies included creating caring-healing environments, supporting work–life balance, and creating space for self-care. The health system is committed to exploring innovative approaches to support a culture of well-being.

Risks and Safety of Women Healthcare Workers in Aizawl District, Mizoram, India

Introduction: The women healthcare workers, besides their role in the promotion, prevention, and protection of health for their patients, are exposed to different types of occupational risk at the workplace. The aim of this study was to explore the types of occupational risk encountered by the women healthcare workers and to assess the health and safety measures implemented for the women healthcare workers. Methods: A cross-sectional study was conducted among one hundred women healthcare workers in Aizawl district, Mizoram, India. A self-structured questionnaire was used to collect data on the respondents' demographic profile, workplace risks, and safety measures. The Work Safety Scale was used to measure the safety measures and was reframed to suit the study's context and person correlation was calculated. Results: The results show that women healthcare workers experience a greater number of physical risks at the workplace i.e., back pain, headache, eye problem, loss of appetite and needle syringe injuries which is followed by psychosocial (anxiety, insomnia, abuse by patients, low self-esteem and depression) and reproductive risks (irregular menstrual cycle, stillbirth, low birth weight and cervical cancer). The health and safety measures implemented for the healthcare workers are satisfied with an average mean score of 3.64. The study revealed that no clear regulations and recommendations on safety measures have been developed by healthcare settings. Conclusion: The study concluded that better regulation is needed, required to protect and safeguard the physical, psychological, and reproductive risks that women healthcare professionals encounter at the workplace.

Stature and sex estimation from shoulder breadth, shoulder height, popliteal height, and knee height measurements in a Bangladeshi population

Forensic anthropologists and medico-legal professionals encounter a range of cases in which the body has been severely disintegrated, dismembered, or mutilated beyond recognition. The most critical goal of any medico-legal inquiry is to be able to identify unknown human remains. To establish the biological profile in forensic investigation, estimations of stature and sex from a range of human body dimensions are fundamental issues. This study developed formulae to determine the stature and sex from a range of body measurements in Bangladeshi adult populations based on a sample of 300 healthy young Bangladeshi individuals (150 males and 150 females) aged ranging from 21 to 30 years. Stature and four body measurements (sitting shoulder height, shoulder breadth, sitting popliteal height, and sitting knee height) were measured for each individual. Linear and stepwise multiple regression analyses were utilized in stature estimation and logistics regression analysis was used to determine the sex of the individuals. This study found a good correlation between the stature and all parameters except for shoulder breadth. The left sitting knee height was the significant parameter in stature estimation because of the higher value of R, R2, and a lower SEE value. Moreover, the right-sitting popliteal height revealed a higher sex estimation accuracy rate than other parameters. The sex estimation accuracy varied from 78.000% to 97.000%. The findings of this study have great value in forensic science and research in determination of stature and sex estimation in the adult population of Bangladesh.

Ethical Decision-making of Health Professionals Caring for People Living with HIV/AIDS in Hunan, China: A Qualitative Study.

Numerous ethical issues surged the moment acquired immunodeficiency syndrome (AIDS) was discovered. As advocates of people living with HIV/AIDS (PLWHA), health professionals encounter many ethical dilemmas in clinical practice. However, it remains unclear how health professionals solve these issues. The descriptive qualitative research was conducted through semi-structured interviews with 22 health professionals from May to August 2018. Three themes emerged from data analyses of the interviews: (1) real ethical dilemma experienced by health professionals, (2) factors influencing ethical judgment, (3) ethical motivations. About two-thirds of participants failed to recall ethical dilemmas experienced in their clinical practice. Emotions, gender, occupation, and difficulty balancing different roles may influence the ethical judgments of health professionals. In the ethical decision-making (EDM) process, most participants took other people's interests into consideration and conformed to law and professional codes of conduct. However, the fear of medical disputes (conflicts with families and others) was experienced by many participants, influencing their ethical behaviors.

Personality Disorder Patients in A Pain Clinic

Approximately 9.6% of Americans have a personality disorder. 1, 2 These are common conditions, and all medical professionals encounter these patients in their practice. Early identification of these patients is ideal. In the following we discuss how patients with these psychiatric conditions may present to an outpatient pain clinic, and we provide suggestions for management.

The Green Sheep: Exploring the Perceived Risks and Benefits of Cannabis Among Young Military Members and Veterans.

Medical and recreational cannabis are becoming more accessible and socially accepted across the United States. Emerging adults (EAs; 18 to 29) are the largest group of cannabis users. Studies have found that veterans are more likely to report cannabis use compared to nonveterans. While research exists on the use levels of cannabis, limited knowledge is available on the perceived risks and benefits of using cannabis among EA military and veteran populations. Helping professionals encounter veterans who use cannabis and must consider military cultural factors and attitudes towards cannabis that may influence or exacerbate cannabis use. We conducted a qualitative study with 23 EA veteran and military members with high-risk substance use and asked about their thoughts on the acceptability, risks, and perceived benefits associated with cannabis. Two qualitative coders used NVivo to find themes following the six steps of thematic analysis. Results provide in-depth understanding of EA military members and veterans' perceptions of cannabis. Overall, we found participants were receptive to using cannabis for pain ailments, mental health issues, and as an alternative to benzodiazepines, opioids, and alcohol. However, they acknowledged restrictions are needed to moderate cannabis use and mitigate negative outcomes. Lastly, participants recognized the incongruence of cannabis use with military job responsibilities and expectations. These findings shed light on potential risk and protective factors related to using cannabis for recreational or medical reasons and should be considered when consulting EA military members and veterans.

Enacting evidence-based medicine in fertility care: Tensions between commercialisation and knowledge standardisation.

In this article we explore the recent enactment of evidence-based medicine (EBM) in the field of fertility care. We aim to contribute to the medical sociology literature through an analysis of how evidence is produced, interpreted and institutionalised in a relatively new medical field such as in vitro fertilisation (IVF), characterised by high uncertainty due to limited knowledge and high levels of commercialisation. Drawing on extensive ethnographic research conducted in England, this article explores the challenges IVF professionals encounter in producing credible data on the effectiveness of additional treatments, offering novel insights on the tensions between commercialisation and standardisation in the enactment of EBM. Extant medical sociology and Science and Technology Studies literature has shown the hidden professional work required to enact randomised control trials in practice. Our analysis shows that this hidden work is not enough when there is a broader lack of standardisation in both clinical and research practices, as producing 'good quality' evidence requires high levels of standardisation of knowledge production.