Program For Health Care Providers Research Articles

Design, implementation, and evaluation of a training on culturally sensitive care for nursing students: A pilot study

There is a need for culturally sensitive care for people with a migration background because of the increasing ethnocultural diversity in Western countries. Consequently, more and more training programs for health care providers are starting to implement these topics in curricula. However, while the content of culturally competent care is widely debated in nursing literature, a description of how students are and should be taught is lacking. Even more, studies have shown that merely increasing knowledge on ethnicity, culture or migration does not help to increase culturally sensitive behaviour of (future) healthcare providers. On the contrary it even leads to more stereotypical thinking. More critical self-awareness is needed among caregivers to overcome barriers such as othering (i.e., micro-racism by defining the other in an inferior way).
 
 In response to abovementioned shortcomings, we developed, implemented and evaluated a course on culturally sensitive care in the curriculum of nursing students. Nursing students and caregivers were involved in the development of the course. This program (4h) aimed to increase self-awareness among caregivers about othering, racism and exclusion in society and in healthcare. The paper will describe the content of the program (building on the Johari Window model developed to increase awareness in interpersonal relations (Luft & Ingham, 1961), the pilot implementation and evaluation among 34 students. The program was well received by the participants. Success factors (i.e. profile of the teacher, self-awareness positionality) and working points (i.e. ethnic/minority-matching) were detected. This program will be adapted and further implemented in the curriculum based on the feedback.

Disparities in HIV Testing among Adults with Adverse Childhood Experiences

Abstract Background It is estimated that more than 13% of persons 13 years and older living with HIV are unaware of their status. 80 percent of new HIV infections are transmitted by people who are not aware they have HIV or not receiving any HIV care in the US, presenting a major public health concern and stressing the importance of enhanced HIV screening. Adverse Childhood Experiences (ACEs) have been shown to be risk factors for HIV transmission and studying the relationship of ACEs and the likelihood of HIV screening is thus important to explore. Methods Using combined data (2019-2021) from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) dataset, adjusted analyses models were constructed to determine the likelihood of adults receiving HIV testing and their past history of ACEs. Results Overall, compared to individuals reporting no ACES, individuals reporting 1 to 3 ACEs were significantly more likely to be tested for HIV. However, despite higher prevalence of ACEs, significantly higher prevalence of men who have sex with men (MSM) remained unaware of their HIV status. Significant disparities in HIV testing were also observed by socio demographic characteristics. Conclusions Healthy People 2030 aims to increase the proportion of persons who know their HIV status to at least 95% by 2025. Our findings highlight the urgent need for targeted interventions that target high risk groups, promote testing benefits, and encourage increased testing among individuals with a history of ACEs. Given the importance of testing to HIV prevention outcomes, more research is needed to unpack the relationship between HIV risk and HIV testing for individuals with a history of childhood adversity. Key messages • New trauma-informed training programs for health care providers are needed to facilitate targeted HIV testing. • Ongoing research is critical to unpack the relationship between HIV risk and HIV testing for individuals with a history of childhood adversity.

Patient engagement in CPD in radiation oncology and radiation therapy across Canada: A national survey

BackgroundThe aim of this study was to investigate patient engagement (PE) in the development and delivery of Continuing Professional Development (CPD) programs for health care providers within radiation oncology, radiation therapy and medical physics across Canada. This study looked at the current state of PE in CPD programs across Canada and how to address the benefits and barriers to PE to advance these programs. MethodsA quantitative, exploratory survey was conducted among radiation oncologists, radiation therapists and medical physicists across Canada. The questionnaire was developed by a multi-disciplinary team and piloted among interprofessional (IP) faculty with a special interest in patient education. The survey was web-based and disseminated through the Canadian Association of Medical Radiation Technologists (CAMRT) and Canadian Radiation Oncologists (CARO) professional associations. ResultsA total of 97 responses were obtained, 43.3% (n = 41) were radiation oncologists 64% (n = 54) were radiation therapists and 2(2%) were medical physicists. There was representation from all provinces, except Newfoundland, with the majority 36% (n = 35) from Ontario. 57% (n = 46) of participants agreed that patients should be involved in CPD, and 11% (n = 9) disagreed. The most agreed-upon barriers are financial costs for patients and clinician bias when selecting patients. The most agreed-upon solutions were improving patient resources and creating training programs for patients. Radiation therapists agreed significantly more (p<0.05) with the potential benefits of PE in CPD, compared to radiation oncologists. DiscussionPE in CPD programs is a novel and controversial topic but is still highly rated and important. We intend to advocate for patients to take an active role in our CPD programs. Further research is warranted.

AMBAR: A midwifery-led training program to improve obstetric and neonatal practices among low-risk births in Mexico.

Birth care in Mexican health institutions is highly medicalized and of poor quality because of the prevalence of outdated and dangerous practices. AMBAR-a training program for health care providers on the use of evidence-based midwifery practices-was implemented during 2016-2018 and evaluated to assess the impact of training on key practices. For this mixed-methods study, we evaluated the effects of a training program implemented in three public hospital networks in Mexico. Qualitative data were collected and integrated into the program before evaluating the effects of the intervention on 10 birth practices, 5 beneficial and 5 potentially harmful. Quantitative data on birth practices and covariates were collected at six time points (baseline and 5 follow-ups) in a final sample of 330 direct observations. Effect estimates were obtained by longitudinal logistic and Poisson regression models, adjusted for confounding variables. AMBAR had a significant effect on 4 of the 10 birth practices that were evaluated. Beneficial practices, such as skin-to-skin contact (P= 0.003) and delayed cord clamping (P= 0.039), increased significantly. Harmful when overused birth practices, such as vaginal examinations (P= 0.001), and cesarean birth (P< 0.001) decreased significantly. Midwifery-based training programs for health care providers can have an impact on the quality of care of birthing people and newborns, increasing the use of evidence-based practices and decreasing frequently overused practices.

Designing and Implementing TeleBehavioral Health Training to Support Rapid and Enduring Transition to Virtual Care in the COVID Era

As telebehavioral health continues to advance and become part of routine care, there is a need to develop effective training methods. While a consensus on how to best train telebehavioral health has not yet been achieved, this commentary will describe how evidence-based implementation strategies were used to develop a framework to create and implement a telebehavioral health training program that is relevant and enduring for a given audience. Evidence-based implementation strategies included the PARiHS criteria which were used to organize the project. Re-AIM criteria was used to organize chosen outcome measures. Important partnerships were formed to help support infrastructure as well as regional and national reach. A series of Plan-Do-Study-Act loops were used to inform progressive training series. Since April 2020, the Behavioral Health Institute has developed and offered 6 unique telebehavioral health training series, employing both webinar and online formats, and addressing core components as well as more advanced concepts. These series have provided over 19,100 accredited continuing education hours of training through June 2022, to almost 3000 unique learners via webinar and nearly 6800 unique online learners, across 45 states. Evaluations rated these trainings as high quality, relevant, and that material would likely be implemented. Feedback from attendees was considered vital in series planning. This commentary discusses how evidence-based implementation strategies can be used to create a framework upon which to base a training program for health care providers. An example is given on how this framework was used to create successful, relevant, and enduring telebehavioral health training.

Uterine Rupture and its Fetomaternal Outcome: A Tertiary Care Hospital Study

Objective: To analyse the frequency, predisposing factors, site of rupture management and fetomaternal outcome in uterine rupture. Study design: prospective observational study Methods: This study was conducted at the Department of obstetrics and gynecology in Lalla Ded hospital, from august 2020 to august 2022. All cases of ruptured uterus, who were either admitted with this complication or who developed it in the hospital, were included in the study. Patients having ruptured uterus due to congenital abnormality were excluded from the study. Patient’s parity, age, details of predisposing factors, type of rupture, the management, maternal and fetal outcome were taken into consideration for analysis. Data was analyzed using SPSS version 20.0.(SPSS Inc., Chicago, Illinois, USA). Continuous variables were expressed as Mean ± SD and categorical variables were summarized as frequencies and percentages. Graphically the data was presented by bar and pie diagrams. Results: The total number of deliveries during the course of 2 years from august 2020 to august 2022 were 44236. There were 15 cases (0.034%) of uterine rupture. Out of these only three (20%) were booked. Most of the patients (53.3%) presented between the ages 30-35. Majority of uterine rupture occurred in para 3 (46.7%) followed by para 2 (33.3%). Common cause of uterine rupture was prolonged neglected obstructed labour (60%). Rupture of Previous caesarean section scar was found in 40%. Anterior uterine wall was involved in 46.7% of cases. Posterior wall rupture in 33.3% and posterior along with lateral wall in 20%. Hysterectomy was performed in 40%. There were two maternal (13.3%) and 8 intrauterine deaths (53.3%). Live birth rate was 46.6%. Conclusion: This study showed that prolonged neglected obstructed labour is the main cause of uterine rupture followed by scarred uterus in our setting. Proper antenatal care and timely intervention with prompt referral to higher center and updated training programs for health care providers is the need of time to prevent this catastrophic but avoidable complication. Keywords: uterine rupture, scarred uterus, obstructed labour (cephalopelvic disproportion)

Championing Dementia Education: Adapting an Effective Scottish Dementia Education Program for Canadian Acute Health Care Providers.

With increasing numbers of persons living with dementia and their higher rates of hospitalizations, it is necessary to ensure they receive appropriate and effective acute care; yet, acute care environments are often harmful for persons with dementia. There is a lack of dementia education for acute health care providers in Canada. Scotland presently delivers a dementia education program for health care providers, known as the Scottish National Dementia Champions Programme. The objective of this Policy and Practice Note is to present the collaborative work of Scottish experts and Canadian stakeholders to adapt the Dementia Champions Programme for use in Canada. This work to date includes: (a) an environmental scan of Canadian dementia education for acute health care providers; (b) key informant interviews; and, (c) findings from a two-day planning meeting. The results of this collaborative work can and are being used to inform the next steps to develop and pilot a Canadian dementia education program.

Provider and patient knowledge gaps on biosimilars: insights from surveys

Beyond the legal and regulatory limitations associated with biosimilar availability in the United States, the adoption of biosimilars is contingent on the willingness of health care providers (HCPs) to prescribe them and of patients to accept them. In this dynamic market, it is of paramount importance to understand the current awareness, attitudes, and preferences of a broad spectrum of stakeholders if uptake of biosimilars is to be optimized. In this article, we highlight knowledge gaps among US HCPs and patients regarding biosimilars for immune-mediated inflammatory diseases as assessed in published survey literature over the last 5 years. Although HCP familiarity and understanding of biosimilars appears to have improved over the last 5 years, survey data suggest that some physicians and pharmacists still approach use of biosimilars with caution owing to concerns regarding nonmedical switching, interchangeability, pharmacist-led substitution, and the extent of any cost savings. Patients understand the potential cost benefits of biosimilars but share many of the HCPs' concerns. A large majority of patients were also concerned that biosimilars would not treat their disease as well as the reference product and that switching may cause more adverse effects. Consequently, nonmedical switching is a major concern for patients, with the majority reporting that they would attempt to avoid a switch. Although patients trust their physicians' treatment recommendations and express confidence in biosimilars, they have mixed views on automatic substitution by pharmacists. The areas of concern identified can be used to guide further education programs for HCPs and patients, and, in doing so, improve biosimilar uptake.

Feasibility of project ECHO telementoring to build capacity among non-specialist emergency care providers.

The COVID-19 pandemic has led to global disruptions in emergency medicine (EM) teaching and training and highlighted the need to strengthen virtual learning platforms. This disruption coincides with essential efforts to scale up training of the emergency healthcare workforce, particularly in low-resource settings where the specialty is not well developed. Thus, there is growing interest in strengthening virtual platforms that can be used to support emergency medicine educational initiatives globally. These platforms must be robust, context specific and sustainable in low-resource environments. This report describes the implementation of Project ECHO (Extension for Community Healthcare Outcomes), a telementoring platform originally designed to extend specialist support to health care workers in rural and underserved areas in New Mexico. This platform has now been implemented successfully across the globe. We describe the challenges and benefits of the Project ECHO model to support a Point-of-Care Ultrasound (POCUS) training program for health care providers in Kenya who do not have specialty training in emergency medicine. Our experience using this platform suggests it is amenable to capacity building for non-specialist emergency care providers in low-resource settings, but key challenges to implementation exist. These include unreliable and costly internet access and lack of institutional buy-in.

A Review on Adverse Drug Reaction in Pharmacovigilance

Pharmacovigilance is a practice aimed to monitor drug safety in real life conditions and capture adverse drug events during the post marketing phase of drug's life cycle. But under reporting of adverse reactions is a major cause of concern and a threat to the pharmacovigilance systems. The present article looks into the major obstacles affecting the spontaneous reporting of adverse drug reactions (ADRs) in India and the possible solutions. As per available scientific literature, the major impediments to ADR reporting are inadequate knowledge and awareness among health professionals, clinicians' perceptions towards reporting, problems with establishing reporting systems in hospitals and insufficient training to recognize ADRs. Measures to improve the situation include greater involvement of nurses, pharmacists as well as consumers in the reporting of ADRs, making the process simpler and faster through electronic means, introducing educational interventions and training programs for health care providers and spreading awareness about the reporting system amongst caregivers and receivers alike. Providing a momentum to the pharmacovigilance system and ensuring a robust reporting process is a challenge but proper planning, feasible solutions and focussed efforts can help bring about the change ensuring patient safety - the ultimate goal of pharmacovigilance.

Researching the Effectiveness of an Online Human Trafficking Awareness Program Among Community Health Nursing Students

ABSTRACT Purpose To evaluate the effectiveness of an online human trafficking awareness program for healthcare providers. Design Mixed-methods study. Methods Sample (N=141) consisted of community health nursing students, who completed a pretest, watched one three-minute video a day for 20 days, and completed a posttest. Findings Participants indicated their knowledge of human trafficking increased, attitudes toward victims improved, and competence and confidence engaging with victims increased. Satisfaction with program, and information utilization plans for practice were revealed. Conclusions Human trafficking awareness program was effective in increasing participants’ knowledge, competence and confidence, and improving attitudes. Clinical Evidence Educational intervention is a strategy to improve students’ knowledge of human trafficking.

Who should talk with patients about their end-of-life care wishes? A nationwide survey of the Hungarian population

Objective To explore the needs and opportunities of the general population to communicate their end-of-life care wishes and to investigate what roles are assigned to healthcare providers and family members in end-of-life care discussions. Design A cross-sectional social survey was carried out in Hungary. Descriptive analysis and analysis of variance were performed. Setting Nationwide survey of the Hungarian general population. Subject The sample (n = 1100) was designed to represent the adult population as per distribution by gender, age and geographical region. Main outcome measures Needs and opportunities of the general population to communicate end-of-life care wishes. Results 72% of participants found it important to discuss their end-of-life care wishes with someone. Six out of ten believed that it was also the GPs’ task to talk with the patients about their end-of-life care wishes. An almost equal level of engagement was expected from healthcare providers (80%) -especially physicians (72%)- and family members (75%) in end-of-life conversations. However, only 36% of participants felt that there was someone among their healthcare providers, and 56% of them had a family member or friend with whom they could speak openly about death, dying and preparing for death. Conclusion Compared to their needs, the general population had fewer opportunities to speak about death, dying and preparing for death. Training programs for healthcare providers, particularly GPs, and public awareness campaigns may support the broader application of advance care planning in Hungary. Key Points Current guidelines recommend that GPs initiate advance care planning discussions. However, little is known with whom the general population wish to discuss their end-of-life care preferences and with whom there is an opportunity to do so. An almost equal level of engagement was expected from healthcare providers -especially physicians- and family members in end-of-life conversations. Most of the general population thought that participation in end-of-life discussions was also the GPs’ task. The majority of participants reported that there was no one among their healthcare providers and a sizable minority felt that there was no one among their family members or friends with whom they could talk openly about death, dying, and preparing for death. The highest levels of unmet needs regarding end-of-life conversations with healthcare providers were found among those who considered it important to discuss their end-of-life care wishes.

Good practice intervention for clinical assessment and diagnosis of atopic dermatitis: Findings from the atopic dermatitis quality of care initiative.

Atopic dermatitis (AD) is frequently misdiagnosed and undertreated, resulting in increased morbidity. In 2019, the Atopic Dermatitis Quality of Care Initiative was launched globally to investigate barriers to AD care and note good practice interventions to improve care. The initiative included a literature review to define the challenges in AD and a survey of 32 AD centers to define good practice interventions. One topic studied was best practices for clinical assessment and diagnosis. The literature review revealed the primary gaps included difficulty differentiating AD from other skin disorders, diagnosing atypical AD, staging AD severity in individual patients, and delays in assessment and treatment due to referral time lag. The best clinical practices used by leading AD centers included the use of validated diagnostic criteria, established AD scoring tools including patient-reported outcome measures and electronic health records (EHR), the formation of multidisciplinary teams (MDTs), and improved communication between health care providers (HCPs) and patients. Most centers worked with patient advocacy groups and implemented educational programs for HCPs. AD centers are overcoming issues in AD care. Educating health care providers and the public, using screening surveys, using established guidelines, and communicating with MCTs and patients through EHRs are the most frequently used strategies.

Support opportunities for second victims lessons learned: a qualitative study of the top 20\u2009US News and World Report Honor Roll Hospitals

BackgroundSecond Victim Programs (SVPs) provide support for healthcare providers involved in a near-miss, medical error, or adverse patient outcomes. Little is known about existence and structure of SVPs in top performing US hospitals.MethodsWe performed a prospective study and interviewed individuals representing SVPs from 20 US News and World Report (USNWR) Honor Roll Hospitals. Telephone interviews were recorded, transcribed, and de-identified. To allow identification of both quantitative and qualitative themes that unified or distinguished programs with SVPs from each other, a content analysis approach was used.ResultsOf the Top 20 UNSWR hospitals, nineteen individuals with knowledge of or involvement in SVPs were identified. One individual represented two hospital systems for the same institution. Thirteen representatives agreed to participate, 12 declined, and 5 did not respond. One individual who initially agreed to participate did not attend the interview. Among twelve representatives interviewed, 10 reported establishment of SVPs at their hospitals between 2011 and 2016. Most program representatives reported that participants sought support voluntarily. Four domains were identified in the qualitative analysis: (a) identification of need for Second Victim Program (SVP); (b) challenges to program viability; (c) structural changes following SVP creation, and (d) insights for success. Driving SVP creation was the need support medical providers following a traumatic patient event. Poor physician participation due to the stigma associated with seeking support was commonly reported as a challenge. However, acceptance of the mission of SVPs, growing recognition of the value of the program across hospital departments, and systematic safety enhancements were cited as key advantages. To ensure success, participants suggested training a variety of volunteers and incorporating SVPs within quality improvement processes.ConclusionsIn this convenience sample, programs for healthcare providers that experience psychosocial or emotional trauma from clinical care were uncommon. Variation in structure, performance, and measures of success among SVPs was observed. A systematic approach to evaluating SVPs is needed to help inform institutions of how to best serve their second victims.

Effect of Educational Guidelines about Preventive Measures of Acute Gastroenteritis on Mothers' Knowledge and Reported Practices

Background: Acute gastroenteritis is the fifth leading cause of death worldwide. Objective: current study aimed to evaluate the effect of application of educational guidelines about preventive measures of acute gastroenteritis on mothers' knowledge and reported practices. Methods: A quasi experimental design was used in this study. The study was carried out in outpatient clinics affiliated to Mansoura University Children’s Hospital, Egypt. Subjects of this study was a purposive sample of (100) mothers with their children attended outpatient clinics. A developed structured questionnaire sheet to assess mothers' knowledge and reported practice. Results: there was a statistically significant difference in mothers' knowledge and reported practice about preventive measures of acute gastroenteritis post implementation of educational guidelines. Conclusion: there was an enhancement in the mothers' knowledge and reported practice after application of educational guidelines about preventive measures of acute gastroenteritis. Recommendations: Continuous educational programs for health care providers and educators about gastroenteritis to be delivered at outpatient clinics.

The Current State of Donor Human Milk Use and Practice.

Human milk contains nutrients and immune factors that promote health and growth of an infant. Donor human milk is recommended as the best alternative for infants whose mothers' breast milk is unavailable. This article describes the current status of donor human milk practice and suggests the areas of educational and research needs. Articles published in the last 10 years were reviewed, and findings were summarized under 4 themes: (1) women's knowledge and concerns about donor human milk use, (2) hospital practices, (3) cost-effectiveness, and (4) access and affordability of donor human milk. Women were concerned about donor human milk contamination, disease transmission, cost, and access to bank donor human milk, due to lack of knowledge and awareness of donor human milk benefits and its processing procedures. The absence of health care providers' support for donor human milk adds to the confusion. There is a rising trend of donor human milk use in hospitals for both healthy and vulnerable newborns and infants with varying policies on screening for donor human milk use, cost coverage, or consent procedure. However, a shortage of safe and affordable donor human milk is a barrier to its adoption. A standardized guideline is needed for hospitals regarding donor human milk implementation and cost coverage. Education programs for health care providers are needed to improve knowledge and understanding of donor human milk benefits and safety to provide guidance to parents. It is crucial to develop legislation expanding insurance coverage to achieve donor human milk equity and optimizing long-term human milk diet outcomes.

Behavioral Health for the Front Line: Lessons from the Covid-19 Pandemic

Summary A large, university-based health system reorganized and expanded its behavioral health services to respond to the special needs of health care workers, students, faculty, patients, and caregivers across the Covid-19 pandemic. While patient services did not require much structural change, mental health support for employees, specifically frontline health care workers, required significant development. The Department of Psychiatry and Human Behavior, along with HR, launched a wide variety of mental health offerings at different levels of engagement beginning in March 2020. They adopted a four-tiered “pyramid” approach, with self-care resources (Tier 1) at the base; Tier 2 programs to teach supervisors how to support their employees; Tier 3 programs for peer support; and professional therapy at Tier 4. Most of the program development efforts targeted Tiers 1 and 3. Tier 1 self-care resources were well used, but Tier 3 group and individual support programs struggled with scheduling issues. They relaunched several programs in summer 2020 by moving scheduling responsibility to team leaders and managers, who were better able to determine the needs of their employees and the best times for everyone to gather. They adapted the programs to large-group and workshop formats. They established behavioral health liaisons for larger teams and departments to coordinate requests for services. They created four specialty targeted partnerships with the cancer center, the student counseling center, a new assisted coping program for health care providers, and institutional leadership, which has adopted mental health and wellness as a top priority.

Ready for SDM: evaluating a train-the-trainer program to facilitate implementation of SDM training in Norway

BackgroundHealthcare providers need training to implement shared decision making (SDM). In Norway, we developed “Ready for SDM”, a comprehensive SDM curriculum tailored to various healthcare providers, settings, and competence levels, including a course targeting interprofessional healthcare teams. The overall aim was to evaluate a train-the-trainer (TTT) program for healthcare providers wanting to offer this course within their hospital trust.MethodsOur observational descriptive design was informed by Kirkpatrick´s Model of Educational Outcomes. The South-Eastern Regional Health Authority invited healthcare providers from all health trusts in its jurisdiction to attend. The TTT consisted of a one-day basic course with lectures on SDM, exercises and group reflections followed by a two-day advanced course including an SDM observer training. Immediately after each of the two courses, reaction and learning (Kirkpatrick levels 1 and 2) were assessed using a self-administered questionnaire. After the advanced course, observer skills were operationalized as accuracy of the participants’ assessment of a consultation compared to an expert assessment. Within three months post-training, we measured number of trainings conducted and number of healthcare providers trained (Kirkpatrick level 3) using an online survey. Qualitative and quantitative descriptive analysis were performed.ResultsTwenty-one out of 24 (basic) and 19 out of 22 (advanced) healthcare providers in 9 health trusts consented to participate. The basic course was evaluated as highly acceptable, the advanced course as complex and challenging. Participants identified a need for more training in pedagogical skills and support for planning implementation of SDM-training. Participants achieved high knowledge scores and were positive about being an SDM trainer. Observer skills regarding patient involvement in decision-making were excellent (mean of weighted t = .80). After three months, 67% of TTT participants had conducted more than two trainings each and trained a total of 458 healthcare providers.ConclusionFindings suggest that the TTT is a feasible approach for supporting large-scale training in SDM. Our study informed us about how to improve the advanced course. Further research shall investigate the efficacy of the training in the context of a comprehensive multifaceted strategy for implementing SDM in clinical practice.Trial registration: Retrospectively registered at ISRCTN (99432465) March 25, 2020.

A review of pregnancy counseling with abnormal fetuses

IntroductionThis review study examines the cases of improving the therapeutic skills of therapists and areas of counseling and the important cases that midwives have to provide services and manage conditions if Diagnosis of an abnormal fetus requires attention.ObjectivesWe aim to find the best ways of counseling for helping parents with diagnosed abnormal fetusesMethodsA search conducted by using the keywords congenital anomalies, psychological counseling, prenatal counseling in PubMed, science direct, clinical key and Google scholar search engine. after screening, the complete data of 20 articles were included in this review article.ResultsThe results showed that pregnancy counseling with abnormal fetuses includes medical and psychological counseling. In medical counseling, knowledge of the types of tests and their interpretation is important, and prenatal screening training programs for health care providers should be revised based on their educational needs. In psychological counseling, to meet the needs of a changing population of clients Midwives in the context of the wider healthcare system need accurate knowledge of religious beliefs and cultural contexts of their clients in order to take the best approach to relevant care. The occurrence of a diagnosis of congenital anomaly during transmission to parents adds to the accumulation of stress-related events that may increase the risk of developing psychological symptoms in the early stages after diagnosis.ConclusionsConsidering the different cultures of different countries of the world, midwifery counseling skills play an important part in the diagnostic and therapeutic process. Therefore, creating extraordinary educational programs on university education is needed for midwives.DisclosureNo significant relationships.

Health Personnel's Knowledge, Attitudes, and Self-Efficacy Related to Providing Palliative Care in Persons with Chronic Diseases.

The purpose of this study was to examine the relationships of knowledge, attitudes, and self-efficacy related to palliative care among health care providers (doctors and nurses) in order to provide a basis to develop a training program for health care providers. A correlational and descriptive study design was used. Participants were recruited from a university-affiliated hospital located in Daejeon and an e-nurse community. After IRB approval, data were collected from July 12, 2018, to September 30, 2018. A total of 169 responses were finally analyzed using version SPSS 24. The data were analyzed in terms of descriptive statistics (frequency and percentage or mean and standard deviation, as appropriate), the t-test, analysis of variance (with the Duncan post hoc test), and Pearson correlation coefficients. Knowledge, attitudes, and self-efficacy were significantly higher in those who had received palliative care training or had been exposed to awareness-raising initiatives. There were positive relationships among knowledge, attitudes, and self-efficacy, with small to moderate effect sizes. Palliative care training for health care professionals is necessary to meet patients' needs. Such programs should take into account not only knowledge about palliative care, but also ways to improve empathy and resolve ethical dilemmas. Interprofessional training would be an excellent option to share therapeutic goals and develop communication skills among multidisciplinary team members.