Role Of Healthcare Professionals Research Articles

Information needs on vaccinations for older adults and the role of health care professionals in this

Abstract On behalf of all members of work package 4 from the VITAL project

Attitudes Towards Deprescribing Among Older Adults with Limited Life Expectancy and Their Relatives: A Systematic Review.

Deprescribing is of particular importance in older adults with limited life expectancy since this population group is highly susceptible to the potential harms of inappropriate medications. This systematic review aimed to explore attitudes towards deprescribing among older adults with limited life expectancy and their relatives. A systematic literature review was conducted in the MEDLINE and EMBASE databases from inception to October 2019. Inclusion criteria were studies specifically describing attitudes towards deprescribing among older adults (≥ 65years) with limited life expectancy and/or their relatives regardless of study type. Results were analyzed, inspired by the Joanna Briggs Institute's method for synthesis of qualitative data. A total of 842 studies were identified and screened; 84 were full-text assessed for eligibility and 7 were ultimately included. Two studies investigated the attitudes of older adults with limited life expectancy and their relatives towards deprescribing of statins and donepezil, respectively, while the five remaining studies related to attitudes towards deprescribing in general. Four main themes were identified: (1) the well-being of older adults with limited life expectancy; (2) involvement of older adults and their relatives in deprescribing; (3) the role of health care professionals in deprescribing; and (4) medication-related factors affecting deprescribing. Within each of these themes, several subthemes were identified. Attitudes towards deprescribing among older adults with limited life expectancy and their relatives vary and highlight several barriers and enablers to the deprescribing process. Several of these factors must be addressed to successfully implement deprescribing initiatives in this patient group.

Investigating Integrated Pathways for Infection Prevention and Antibiotic Stewardship in Surgery in India and South Africa: A Qualitative Study

Background: The surgical pathway remains a hard to reach, critical target for antimicrobial stewardship (AMS) and infection prevention and control (IPC) globally. We investigated the drivers for AMS and IPC across surgical teams, in two academic hospitals in South Africa (SA) and India. Methods: Between July 2018 and August 2019, we conducted an ethnographic study across cardiovascular and thoracic surgery (CVTS) and gastrointestinal surgery teams utilizing non-participant observations, face-to-face interviews, and in-depth case-studies. Data were analysed using an inductive-deductive approach, applying thematic framework informed by existing evidence. Observations totalling over 190 hours (138 India, 60 SA) included shadowing healthcare professionals (HCPs) attending daily ward activities and ward rounds. Patients (6 India, 7 South Africa), and HCPs (44 India, 61 SA) were interviewed. Six (4 India, 2 SA) patient case-studies were developed. Findings: Across surgical pathways, multiple steps in IPC and AMS include several key HCPs who have implicit roles. These existing roles of HCPs (including nurses, and senior surgeons) are overlooked as interventions target junior doctors, bypassing the critical roles of the wider range of HCPs. Critically, the ownership of decisions remains with the operating surgeons and entrenched hierarchies restrict the integration of other HCPs in IPC and AMS. Interpretation: IPC and AMS remain key priorities for safe surgery. Identifying the implicit existing roles in AMS and IPC is critical. Developing nurse leadership, empowering pharmacists and engaging surgical leads is essential for integrated care. Many lessons can be learnt from the integrated models of care in the ICU setting. Funding Statement: This study was funded by the Economic and Social Research Council (ESRC) as part of the Antimicrobial Cross Council initiative supported by the seven UK research councils, and the Global Challenges Research Fund (GCRF). Declaration of Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Ethics Approval Statement: Ethics approval for this study was granted by the University of Cape Town Human Research Ethics Committee (HREC ref. 499/2018) and the Amrita Hospital Institutional Research and Ethics Committee (IEC-AIMS-2018-INECONT-005A).

Development of an intervention to facilitate implementation and uptake of diabetic retinopathy screening

Background‘Implementation interventions’ refer to methods used to enhance the adoption and implementation of clinical interventions such as diabetic retinopathy screening (DRS). DRS is effective, yet uptake is often suboptimal. Despite most routine management taking place in primary care and the central role of health care professionals (HCP) in referring to DRS, few interventions have been developed for primary care. We aimed to develop a multifaceted intervention targeting both professionals and patients to improve DRS uptake as an example of a systematic development process combining theory, stakeholder involvement, and evidence.MethodsFirst, we identified target behaviours through an audit in primary care of screening attendance. Second, we interviewed patients (n = 47) and HCP (n = 30), to identify determinants of uptake using the Theoretical Domains Framework, mapping these to behaviour change techniques (BCTs) to develop intervention content. Thirdly, we conducted semi-structured consensus groups with stakeholders, specifically users of the intervention, i.e. patients (n = 15) and HCPs (n = 16), regarding the feasibility, acceptability, and local relevance of selected BCTs and potential delivery modes. We consulted representatives from the national DRS programme to check intervention ‘fit’ with existing processes. We applied the APEASE criteria (affordability, practicability, effectiveness, acceptability, side effects, and equity) to select the final intervention components, drawing on findings from the previous steps, and a rapid evidence review of operationalised BCT effectiveness.ResultsWe identified potentially modifiable target behaviours at the patient (consent, attendance) and professional (registration) level. Patient barriers to consent/attendance included confusion between screening and routine eye checks, and fear of a negative result. Enablers included a recommendation from friends/family or professionals and recognising screening importance. Professional barriers to registration included the time to register patients and a lack of readily available information on uptake in their local area/practice. Most operationalised BCTs were acceptable to patients and HCPs while the response to feasibility varied. After considering APEASE, the core intervention, incorporating a range of BCTs, involved audit/feedback, electronic prompts targeting professionals, HCP-endorsed reminders (face-to-face, by phone and letter), and an information leaflet for patients.ConclusionsUsing the example of an intervention to improve DRS uptake, this study illustrates an approach to integrate theory with user involvement. This process highlighted tensions between theory-informed and stakeholder suggestions, and the need to apply the Theoretical Domains Framework (TDF)/BCT structure flexibly. The final intervention draws on the trusted professional-patient relationship, leveraging existing services to enhance implementation of the DRS programme. Intervention feasibility in primary care will be evaluated in a randomised cluster pilot trial.

Virtual Reality Simulation in Interprofessional Round Training for Health Care Students: A Qualitative Evaluation Study

BackgroundInterprofessional rounds are increasingly applied in providing patient-centered team care delivery. Students from six health care courses in medicine, nursing, pharmacy, physiotherapy, occupational therapy, and social work formed interprofessional teams to undertake an interprofessional education (IPE) on virtual reality simulation–based interprofessional rounds. This study aimed to evaluate health care students’ perspectives on the transferability of the IPE virtual reality simulation learning to clinical practice. MethodThree focus group discussions were conducted. ResultsThree themes emerged: “gaining insights into mutual roles,” whereby students better understood the different interprofessional roles of other team members, “seeing the patient as a whole” to foster patient-centered care, and “gaps in real-world application” due to system and structure constraints. ConclusionsEarly exposure to team care through IPE virtual reality simulation can foster understandings of the interdependent roles of health care professionals toward patient-centered care. For greater clinical impact, a further recommendation is to supplement with workplace-based team training to contextualize learning with practice settings.

Words for pharma: a quantitative and qualitative analysis on vision, mission and values of multinational pharma companies.

Introduction: Pharma companies deal with the same important challenges that humans face: to grow and stay healthy. The crucial role of pharma companies in preserving health would suggest that they might rank highly in the reputation indexes. However, this does not seem to be the case. Our aim was to collect, cluster and analyse the words used by pharma companies in their mission, vision and value statements as a base to identify areas of improvement in their corporate communication.
 Methods: A total of 97 multinational pharma companies were selected based on their size and presence within major markets. Mission, vision and company values were captured from company websites and analysed. Word clouds were built to analyse the frequency of words in the statement. The influence of company size and location was also analysed.
 Results: Most companies (90.7%) have a mission and 54.6% have a clearly stated vision statement, 71.4% mention values. “Life/lives” “patients”, “innovative”, “people/persons” are the most frequently used words. “Innovation” and “integrity” are by far the most common values, followed by “respect”, “ethics”, “responsibility” and “passion”. References to healthcare professionals, access to treatment and sustainability, open science, transparency and care for the environment are more scanty.
 Conclusions: Most, but not all, pharma companies provide comprehensive statements focussing mostly on the innovation and its impact on patients. Topics such as role of health care professionals, economic sustainability and care for the environment are rarely listed. An in-depth analysis of their alignment with key needs and trending topics is warranted to further engage customers and build reputation and value. (Digital health)

Improving Lifestyle Behaviors After Breast Cancer Treatment Among African American Women With and Without Diabetes: Role of Health Care Professionals.

Little is known about the effect of health professionals' advice on promoting healthy lifestyle behaviors (diet and exercise) among breast cancer patients. To identify predictors of receiving lifestyle advice from health professionals and its impact on healthy lifestyle behaviors. We used data from a randomized controlled trial of an interactive, cancer-communication video program using African American breast cancer survivor stories for newly diagnosed African American breast cancer patients (Stages 0-III). Participants completed five interviews over 2 years. This intervention did not significantly affect changes in quality-of-life outcomes. In secondary analysis, we examined differences in baseline variables between women with and without diabetes. Logistic regression models identified independent predictors of receiving advice from "a doctor or other health professional" to improve diet and exercise and of self-reported change in diet and exercise habits at 2 year follow-up. Of 193 patients included (85% of 228 enrolled), 53 (28%) had diabetes. At 2 year follow-up, a greater proportion of women with (vs. without) diabetes reported receiving advice by a doctor/health professional to improve their diet (73% vs. 57%, p = .04,). Predictors of receiving dietary advice were obesity, diabetes, and breast-conserving surgery (each p < .05). Women receiving dietary advice were 2.75 times more likely to report improving their diet (95% confidence interval: 1.17, 6.46) at follow-up, but receiving physical activity advice was not significantly associated with patients reporting an increase in exercise. Although receiving dietary advice predicted dietary improvements, receiving exercise advice did not lead to an increase in physical activity. Trial Number NCT00929084.

Parents' use of information accessed through social media to make immunisation decisions for their young children.

Social media, while available to parents to inform decisions about their child's health, including immunisation, is a new area of exploration in public health. To effectively source, interpret and use such information, parents need to be health literate. This pilot study explored how parents of young children under 7years of age obtained, understood and used immunisation information available through social media to inform immunisation decisions for their children. Purposive sampling followed by a snowball technique was used to recruit parents with one or more children under 7years of age living in the Brisbane North and Sunshine Coast regions, Australia. Face-to-face interviews collected qualitative data in relation to how parents obtained, understood and used information sourced via social media to make immunisation decisions for their children. All participants were passively exposed to immunisation information on social media through Facebook, YouTube, Instagram, Pinterest, LinkedIn and Twitter, but did not report proactively searching for information. The majority understood the immunisation information obtained, however, did not perceive it as credible and used other sources to clarify credibility, including their health care professional. Some participants interacted with the information, but none used it to make immunisation decisions for their children. Whilst parents of children under 7years of age are exposed to immunisation information onsocial media, they do not use this information to make immunisation decisions for their children, and rely on health care professionals for credible information. SO WHAT?: Given health care providers are perceived by parents of young children as credible sources of immunisation information and parents are regularly exposed to immunisation information via social media, further exploration of the potential role of health care professionals in the dissemination of credible immunisation information via social media platforms is warranted.

Developing an Interprofessional Simulation with Nursing, Nutrition, and Speech-Language Pathology Students

This article presents an example of how simulation can be used at the undergraduate level to foster collaboration and communication among members of health care teams by first gaining an understand of the roles of each discipline involved. Results demonstrate that an interprofessional simulation among nursing, nutrition, and speech-language pathology students may be an effective strategy for increasing understanding of the roles of health care professionals and medical nutrition therapy knowledge for nutrition students.

Dramatic Rise in Cesarean Birth in Iran: A Coalition of Private Medical Practices and Women’s Choices

Objectives: Cesarean delivery without medical indication has regularly increased among Iranian women in the last three decades, and Iran has one of the highest rates of cesarean in the world. The present study aimed at reviewing the studies regarding the increase of cesarean in Iran and discussing the root causes for such an increase. Methods: This literature review focused on the existing quantitative and qualitative studies conducted from January 1990 to January 2019 regarding the reasons for an increase in the cesarean section in Iran. The combination of keywords including "cesarean section", "C-section", "cesarean delivery", and "Iran" was searched in several databases such as MEDLINE/PubMed, Embase, ISI Web of Science and Scopus, along with national databases (e.g., SID, MagIran, Iran Medex, and IranDoc). Results: A dramatic rise in cesarean birth stems from a number of factors including the role of health care professionals, insurance companies, socio-cultural factors, and the health policies, all of which have their roots in the medicalization of birth. Conclusions: In general, reducing the cesarean on maternal request necessitates the de-medicalization of birth, cultural awareness through the mass media, informing women of the long-term complications of cesarean, and physical and mental preparation of the mother. In addition, other contributing factors include encouraging inter-professional teamwork and collaboration between midwives and obstetrician-gynecologists, transforming the current curriculum of the midwifery and residency education, applying the midwifery-led care models, and decreasing the fear of litigation in midwifery and obstetrics-gynecology. Otherwise, maternal and fetal mortality will rise in the near future due to increased complications in subsequent pregnancies.

Coronavirus disease-2019 infection among health-care professionals: predisposing factors and preventive strategies

The Corona Virus Disease-2019 (COVID-19) infection has been reported among all, regardless of their region, nation, ethnicity, religion, age-group, gender, socioeconomic class and work profile. Against this novel viral infection, the health care workers are the only group of professionals who are working right from the day one, when the first case was reported and nothing was known about the infection. It is extremely important to protect health care professionals from infection both in the hospital and community settings. A wide range of factors has been attributed to the acquisition of infection among health workers in hospital settings. In conclusion, the role of health care professionals in the containment of the COVID-19 pandemic is of utmost importance and thus it is crucial to get more epidemiological insights about the infection and thus ensure their safety and well-being in the workplace.

Corona Virus Disease 2019 Pandemic: Encouraging Involvement of Community Workers in the Active Search of Cases

In the ongoing Corona Virus Disease-2019 (COVID-19) pandemic, the role of health care professionals and outreach workers is indispensable towards the prevention and control of the disease. Anticipating the risk that the disease might land up into stage 3, a wide range of interventions have been implemented. However, the most important strategy will be to spread awareness about the disease and intensify actively search for the suspect cases in the community and here comes the role of outreach community workers. As the doctors and other paramedical staff are overwhelmed with the COVID-19 related work and are also involved in the delivery of emergency services, the importance of the role discharged by these community workers is extremely vital. In conclusion, the role of outreach community workers in creating awareness about COVID-19 and the identification of the suspect cases in the community through active search is extremely crucial in containing the disease and interrupting the chain of the transmission.

Correlation of abnormal uterine bleeding with sonographic findings and histopathological examination of hysterectomy specimens

Introduction: Abnormal uterine bleeding (AUB) at menopausal transition is alarming and needs thorough evaluation, as it could be the only clinical manifestation of cancer. The aim of the study was to correlate abnormal uterine bleeding with sonographic findings and histopathological examination of hysterectomy specimens Methodology: This prospective study was done to evaluate the gynaecological causes of AUB in menopausal transition in OBG Department, LLRM Medical College, Meerut. These women were evaluated; clinical, ultrasound and histopathological findings were correlated. Results: In the present study, heavy menstrual bleeding (66.7%) was the commonest type of bleeding pattern. Leiomyoma, DUB and Adenomyosis were the principle causes of AUB. Leiomyoma accounts for the 60.6% of cases, DUB accounts for 15.9%, Adenomyosis accounts for 9.09% and Leiomyoma with Adenomyosis accounts for the 14.39% of cases.Conclusion: Endometrial biopsy and its interpretation play a pivotal role in the management of AUB cases in menopausal transition. It emphasizes the role of health care professionals to encourage teaching and implementation of alternative procedures to ensure that women receive the maximum benefits with least morbidity.

Medical professionals and health care fraud: Do they aid or check abuse?

This paper examines the role of health care professionals in combating health care fraud. It is not overall clear whether the share of the health professionals help control abuse. Using data across U.S. states, our econometric results show that greater employment of nurses consistently reduced health fraud, whereas more physicians did not have a significant impact. Further, more urbanized states and states with a greater proportion of the elderly experienced greater health scams. Identity thefts facilitated health care fraud, whereas different dimensions of health insurance (including the share of the population with Medicare, managed care, and no insurance) and hospital occupancy rates did not matter.

Health Care Professionals' Knowledge, Attitude, and Practice towards Adverse Drug Reaction Reporting and Associated Factors at Selected Public Hospitals in Northeast Ethiopia: A Cross-Sectional Study.

Background The role of health care professionals among other stakeholders in early detection, assessment, documentation, and reporting as well as preventing suspected adverse reactions is very crucial to mitigate drug-related problems in health facilities. Previous reports from literatures have indicated that adverse drug reaction reporting is highly linked to the knowledge and attitude of the health care professionals. Objective To assess knowledge, attitude, and practice of health care professionals about adverse drug reactions and the associated factors at selected public hospitals in Northeast Ethiopia. Methods A hospital-based quantitative cross-sectional study design was employed. A structured self-administered questionnaire was used to collect data on KAP of selected health care providers by the convenience sampling method. Data were entered into Epi info version 3.5.3 and analyzed using SPSS Version 20. Association between dependent and independent variables was found by using bivariate and multivariate logistic regression analysis where p < 0.05 was considered to be statistically significant. Results Out of 120 questionnaires distributed, 114 respondents filled and returned, giving a 95% response rate. From total, 49 (43%) were nurses, 26 (22.8%) physicians, 17 (14.9%) pharmacy professionals, 12 (10.5%) health officers, and 10 (8.8%) midwives. About 86 (75.44%) study participants had an inadequate knowledge towards ADR reporting, and half of participants failed to report the adverse drug reactions they encountered. But the majority of participants (84, 73.68%) had a favorable attitude towards ADR reporting. Nurses [AOR = 0.069, 95% CI (0.018–0.275)], health officers [AOR = 0.10, 95% CI (0.015–0.647)], and physicians [AOR = 0.14, 95% CI (0.03–0.64)] were found to be less likely to have adequate knowledge on ADR reporting compared to pharmacy professionals. Conclusion Even though the majority of health care professionals had a positive attitude, they had inadequate knowledge and poor practice towards ADR reporting.

Evaluation and histopathological correlation of abnormal uterine bleeding in menopausal transition in a tertiary care centre at Cheluvamba hospital, Mysore

Introduction: AUB at menopausal transition is alarming and needs thorough evaluation, as it could be the only clinical manifestation of cancer. Methodology: This prostective study was done to evaluate the gynaecological causes of AUB in menopausal transition in OBG Department, MMC&RI, Mysore. These women were evaluated; clinical, ultrasound and histopathological findings were correlated. Results: In the present study, heavy menstrual bleeding (66.7%) was the commonest type of bleeding pattern. Leiomyoma, DUB and Adenomyosis were the principle causes of AUB. Leiomyoma accounts for the 60.6% of cases, DUB accounts for 15.9%, Adenomyosis accounts for 9.09% and Leiomyoma with Adenomyosis accounts for the 14.39% of cases. Conclusion: Endometrial biopsy and its interpretation play a pivotal role in the management of AUB cases in menopausal transition. It emphasizes the role of health care professionals to encourage teaching and implementation of alternative procedures to ensure that women receive the maximum benefits with least morbidity.

The role of health care professionals in collaboration in primary health care

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)

Role of Health Care Professionals in Prevention of Hospital-Acquired Infections Caused By Carbapenemase Resistant Bacteria: Proactive Approach S in General Hospital Ptuj.

Background: Health-related infections represent a very important complication of health care treatment. They are associated with high morbidity, mortality, disability and high costs of treatment, care and rehabilitation. The problem is its rising incidence, mainly as pathogens have developed various antimicrobial resistance mechanisms. Enterobacterias that excrete carbapenemases are a significant problem, especially as the treatment options for infections is increasingly limited. Several guidelines dictate measures to prevent their spread and control at different levels of health care. Implementation of guidelines in practice is not easy, as it requires a lot of knowledge, cooperation, consistency, material, environmental and human resources. The role of health care professionals is indispensable in this field. The aim of the article is to present the role of health care professionals in the prevention of Carbapenem-resistant Enterobacteriaceae (CRE) infections and proactive approach of General hospital Ptuj in preventing and controlling CRE.

Counseling of inhalation medicine perceived by patients and their healthcare providers: insights from North Cyprus

Background In order to achieve patient adherence, individuals require different levels of information. Basic and adequate information must be provided by different health care providers to patients. Objective To assess the information level of patients with asthma and chronic obstructive pulmonary disease (COPD) and to determine the source of their information regarding the medicine they use in addition to their satisfaction, inhalation usage techniques and perception of the information providing role ofhealth care professionals. Setting Respiratory disease clinics in Nicosia and Famagusta state hospitals and community pharmacies in North Cyprus. Method A cross-sectional multicentered observational study was carried out in respiratory disease clinics and community pharmacies. Patients' knowledge and healthcare providers' perceptions of their roles were evaluated using "The satisfaction with information about medicines scale". Evaluation of patient's inhalation techniques was performed using a validated checklist. Main outcome measure (a) Patients' knowledge of their medication and satisfaction with the information provided byhealth care professionals, (b) the prevalence of critical inhalation mistakes, (c) health care professionals'perceptions of their patient counseling practice. Results A total of 110 patients were evaluated, and 6 physicians and 76 pharmacists were recruited for the interview. The health care professionalsreported that they talk about the action and theuse of medicines with the patients. The standardized average patients' satisfaction score for action and use was 0.35 (± 0.21), whereas for potential side effects, it was 0.26 (± 0.15). Even though 92% of patients believed that they use their inhaler properly, 75% of the patients made at least one critical mistake while using the inhalation demo, which would likely affect the delivery of the medicine to the lungs. Conclusion In spite of health care professionalsfeeling comfortable with their counseling practices, the majority of patients reported dissatisfaction with the information they provided about medicine, and three out of four patients were making critical mistakes in the use of inhalers. More effort is warranted by health care professionals on patient education to limit critical mistakes.

The IBD Pathway: From a Patient Perspective

The emergence of anti-TNF biosimilars has had significant implications for the biologic treatment of inflammatory bowel disease (IBD). Significant cost savings provide an incentive for healthcare providers to encourage the prescription of biosimilars instead of reference products. However, patients may have concerns about the switching process, the reason for the switch, or the biosimilar itself, and it is important for healthcare professionals (HCP) to take these into account to enable an informed, shared treatment decision. The aim of this symposium was to understand treatment of IBD from the patient’s perspective, especially when switching treatment to a biosimilar product. Beginning with a review of the current and future treatment landscapes, the implications of the increasing availability of biosimilars were discussed. The role of HCP in communicating information about the switch was explored by the multidisciplinary faculty who also compared switching practices at their own treatment centres and shared best practices. Alongside videos of interviews with patients who had undergone a switch to a biosimilar, a patient advocacy perspective was provided by Ms Luisa Avedano, CEO, the European Federation of Crohn’s and Ulcerative Colitis Associations (EFCCA).