Sample Of Healthcare Professionals Research Articles

Complexity of implementing a nationwide advance care planning program: results from a qualitative evaluation.

We evaluated Singapore's national advance care planning (ACP) program to understand challenges to its implementation within multiple clinical settings. We conducted focus group discussions (FGDs) with a purposive sample of health care professionals (HCPs) involved in ACP program delivery within acute care hospitals, primary care clinics and nursing homes. FGDs were stratified into three categories based on HCPs' role within the ACP framework-leaders versus facilitators and advocates versus nursing home heads. Using NVivo 11, we analysed data using thematic analysis and Conceptual Framework for Implementation Research. A total of 107 HCPs from 25 organisations participated in 22 FGDs. Findings revealed wide variation in ACP implementation among organisations and identified 12 themes organized within four domains-outer setting (lack of public awareness, shortcomings in inter-organisational partnerships, performance driven policies), inner setting (lack of commitment from organisational leadership, paucity of dedicated resources, absence of an institution-wide ACP culture, lack of physician engagement), characteristics of HCPs (language barriers) and process (inadequate training, complexity of conversations and documentations, challenges to retrieving ACP documents, absence of comprehensive monitoring and evaluation). ACP program implementation is complex and faces multiple health care system challenges. To integrate ACP within routine clinical care, ACP processes should be simplified, training framework be strengthened, physicians be engaged and an ACP supportive culture be created within and outside organisations. Findings will be used to guide ACP implementation within the country and globally.

Prevalence and Factors Affecting Willingness to Accept or Refuse Vaccination against COVID-19 among Healthcare Professionals in Southern Tunisia

Background: The COVID-19 pandemic continues to spread throughout the world causing serious morbidity and mortality. Health care professionals (HCP) are on the front line in the face of this pandemic and are identified as priorities for COVID-19 vaccination. This study aimed to estimate the acceptability rate of the COVID-19 vaccination among HCP and to identify their predisposing factors. Methods: This was a cross-sectional study using an anonymous self-administered questionnaire including a randomized sample of HCP in Southern Tunisia, on March–April 2021. Results: Among 300 participants, the COVID-19 vaccine acceptability rate was 65.3%. Factors independently associated with vaccine acceptability were age groups <30 years [Adjusted Odds Ratio (AOR)=4.36; p = 0.002)], urbanity of residence (AOR = 3.44; p = 0.027), medical professional category (AOR = 2.69; p = 0.023) and caring for coronavirus infected patients (AOR = 2.32; p = 0.047). Belief that COVID-19 vaccination is important to work safely as a health care provider (AOR = 3.26; p = 0.013), should be available for all HCP (AOR = 17.98; p = 0.004) and has been quickly developed before it has been thoroughly vetted and tested for efficacy and safety (AOR = 5.88; p < 0.01) were independently associated with willingness to accept vaccine. Planning to get a COVID-19 vaccine for the next years and recommending it to the family were independent predictive factors of accepting COVID-19 vaccine ((AOR = 6.88; p < 0.001) and (AOR = 25.03; p < 0.001), respectively).Conclusion: The acceptance rate of vaccination against COVID-19 among Tunisian HCP is still low in South Tunisian hospitals. Socio-demographic, cultural and professional factors predisposing to the vaccination willingness were highlighted. Combating the vaccine hesitancy of HCP through enhancing sensibilization campaigns is essential to promote vaccination in general population.

Expert consensus for a national essential antidote list: E-Delphi method

Antidote stocking represents a major challenge to hospitals all over the world, including Kuwait. In order to assist hospitals to reduce costs and improve patient care, an essential antidote list can be used as an initial foundation for securing sufficient antidote availability at healthcare institutions. The aim of our study is to generate a nationally relevant essential antidote list for emergency care hospitals in Kuwait using the e-Delphi method by establishing consensus through a multidisciplinary expert group of healthcare providers. An electronic survey with 47 essential antidotes was developed. The e-Delphi method was used, with three rounds of voting, to determine expert consensus on an essential antidote list for hospitals in Kuwait. A purposive sample of healthcare professionals from governmental and private hospitals were selected for this study (n = 30). Consensus was gained if ≥75% of the expert panel agreed on the inclusion of the antidote, without any strong disagreements. Round 1 of the e-Delphi resulted in 41 antidotes reaching consensus and seven new antidotes suggested by the expert panel. Round 2 had two antidotes (out of seven newly suggested ones) reaching consensus. Round 3 was a confirmatory round, where the expert group agreed on their previous rounds’ opinions. This resulted in the development of an essential antidote list with 43 antidotes. The optimal approach for ensuring adequate availability of antidotes is continuous monitoring of local poisoning incidence and antidote requirements through collaborations between academic researchers and emergency care clinicians. The development of an essential antidote list, with expert consensus, is one of the initial steps in securing a foundation for appropriate provision of antidotes at all healthcare institutions. This is the first study that the authors are aware of that demonstrates that the e-Delphi technique can consolidate recommendations of experts in emergency medicine to provide a list of essential antidotes.

The impact of leadership on perceived work-related stress in healthcare facilities organisations

PurposeEmployees in the private, public, and third sectors have experienced an increase in stress over the years. Amongst the sectors, people working in hospitals and other healthcare facilities were put under severe stress during the COVID-19 pandemic. Indeed, the World Health Organisation has clearly stated that defending people's mental health at this particular time of restless pandemic growth is an absolute necessity. The purpose of this article is to assess the perceived work-related stress (WRS) of healthcare workers (HCWs) as a result of the spread of COVID-19, as well as how a leadership role can help to reduce WRS.Design/methodology/approachBased on a multiple case study approach applied to two Italian health-care facilities, the questionnaire results were subjected to a regression analysis.FindingsThe results show an association in HCWs between the perception of supportive leadership and the perception of negative psychosocial risks whose exposure can lead to manifestation of WRS during COVID-19 pandemic.Originality/valueThe study addresses the role that the perception of supportive leadership can play in reducing exposure to occupational psychosocial risks in a sample of healthcare professionals.

Contributing factors for acute stress in healthcare workers caring for COVID-19 patients in Argentina, Chile, Colombia, and Ecuador

This study analyzed the frequency and intensity of acute stress among health professionals caring for COVID-19 patients in four Latin American Spanish-speaking countries during the outbreak. A cross-sectional study involved a non-probability sample of healthcare professionals in four Latin American countries. Participants from each country were invited using a platform and mobile application designed for this study. Hospital and primary care workers from different services caring for COVID-19 patients were included. The EASE Scale (SARS-CoV-2 Emotional Overload Scale, in Spanish named Escala Auto-aplicada de Sobrecarga Emocional) was a previously validated measure of acute stress. EASE scores were described overall by age, sex, work area, and experience of being ill with COVID-19. Using the Mann–Whitney U test, the EASE scores were compared according to the most critical moments of the pandemic. Univariate and multivariate analysis was performed to investigate associations between these factors and the outcome ‘acute stress’. Finally, the Kruskal–Wallis was used to compare EASE scores and the experience of being ill. A total of 1372 professionals responded to all the items in the EASE scale: 375 (27.3%) Argentines, 365 (26.6%) Colombians, 345 (25.1%) Chileans, 209 (15.2%) Ecuadorians, and 78 (5.7%) from other countries. 27% of providers suffered middle-higher acute stress due to the outbreak. Worse results were observed in moments of peak incidence of cases (14.3 ± 5.3 vs. 6.9 ± 1.7, p < 0.05). Higher scores were found in professionals in COVID-19 critical care (13 ± 1.2) than those in non-COVID-19 areas (10.7 ± 1.9) (p = 0.03). Distress was higher among professionals who were COVID-19 patients (11.7 ± 1) or had doubts about their potential infection (12 ± 1.2) compared to those not infected (9.5 ± 0.7) (p = 0.001). Around one-third of the professionals experienced acute stress, increasing in intensity as the incidence of COVID-19 increased and as they became infected or in doubt whether they were infected. EASE scale could be a valuable asset for monitoring acute stress levels among health professionals in Latin America.ClinicalTrials: NCT04486404.

Exploring the Motivational Roots of Getting Vaccinated against COVID-19 in a Population of Vaccinated Pediatric Healthcare Professionals: Evidence from an Italian Cross-Sectional Study.

Health care professionals (HCPs) working in pediatric and perinatal settings have a strong influence on parental vaccine decision making. Furthermore, HCPs’ motivations behind vaccine acceptance are associated with their likelihood of recommending vaccines to their patients. Understanding these motivations in the context of the COVID-19 vaccination campaign may aid in the development of interventions that improve pediatric practitioners’ vaccine confidence and prescription. We aimed at studying the motivations affecting COVID-19 vaccination behavior among a sample of vaccinated Italian HCPs working in pediatric settings. A sample (n = 162) of HCPs completed an online self-reported survey exploring motivations behind getting vaccinated against COVID-19. Emotions of HCPs at the moment of COVID-19 vaccination injection were also recorded to collect data about the main feelings connected to the vaccination decision-making process. Data were collected between 19 March 2021 and 21 April 2021. The most effective motivational incentives were the beliefs that vaccination helped protect vulnerable members of the community (97.5% agreement), could protect one’s own health (93.7%), health authorities could be trusted (58.7%), and the vaccine had been rigorously tested (53.8%). Actual personal exposure to COVID was less important (reported importance agreement 16–24%), and the influence of news and social media was still lower (4–6%). Differences between physicians’ and other HCPs’ ratings were also found. Finally, emotional status at vaccination showed high ratings for positive emotions surrounding the vaccination act. This study provided additional evidence about the multifaceted motivations behind COVID-19 vaccine acceptance and showed the potential of understanding the psychosocial roots of vaccine behaviors for shaping public communication campaigns. The highly emotionally charged response obtained underscores the importance of strengthening the community feeling among HCPs.

Validation of the All Wales Covid-19 Risk Assessment tool in Practice

Background: The All-Wales Covid-19 Risk Assessment tool (WRA) was developed to support managers in undertaking individual risk assessments for employees in public facing work settings, and put in place appropriate mitigation. Although a tool for all employees, it’s development was prompted in part by the observation that Covid-19 was disproportionately affecting Black, Asian and Minority Ethnic (BAME) employees, particularly those in health and social care settings. This simple, self-administered tool estimates an individual’s risk of severe Covid-19 disease by scoring personal risk factors, based on those previously identified in the emerging literature. The aim of this study was to assess the performance of this tool, by measuring concordance between an individual respondants self perceived risk and the risk indicated by the tool in a sample of healthcare professionals. Methods: The WRA was distributed amongst BAME healthcare professionals around Wales, UK with additional questions to understand participant concordance with the risk stratification from the tool. Statistical analyses were applied to establish the degree of concordance. The initial survey was followed by a more widespread survey across Wales where the sample size of the respondents was 3728 Results: A total of 136 participants responses were included in the analyses. The majority of participants were below 50 years of age (median age, range), male, and of BAME ethnicity. The weighted kappa coefficient indicated significant concordance between the tool outcome and respondent’s self perceived risk (k=) . Younger respondents considered themselves at lower risk, which was correctly predicted by the tool. The association between risk tool outcome and self-perceived risk was not affected by participant characteristic. Of the larger Welsh cohort of 3728 respondents, 93.8% felt that the tool correctly identified their risk and was in concordance with their own risk perception. Conclusions: There was a high level of concordance between the tool user's self-perceived risk and risk assessment tool outcome. Where there was disagreement, self-perception of risk was lower than that of the tool, indicating a more precautionary approach taken by the tool. The high concordance provides user confidence that the All Wales Covid-19 risk assessment tool is likely to provide a correct risk stratification and mitigation strategies in this occupational group.

Why is corneal donation so rare in children's hospices? A survey of multidisciplinary team members attitudes, knowledge, practice, and experience.

Corneal donation is a rare event among pediatric patients dying in children's hospices in Italy. Previous research suggests that lack of knowledge and negative attitude of Health Care Professionals (HCPs) are the most relevant factors for low donation rates in hospice, rather than patient ineligibility or public refusal. We conducted a national survey to explore children's hospice staff's knowledge and attitude toward corneal donation, to survey HCPs confidence in discussing the subject with patients and families, to investigate whether staff members receive specific training about corneal donation and its potential impact on the willingness to raise the topic with patients and families. An anonymous web-based survey with multiple-choice responses was delivered to the team members of seven Italian children's hospices to test their knowledge and attitude about corneal donation. Of the seven children's hospices approached, four agreed to participate with a response rate of 48.5%. Among respondents, 70% declared that they had not received specific training about corneal donation. Results of statistical analysis showed that there were no significant differences in responses between trained and non-trained staff and among the different professionals (nurses, doctors, psychologists, AND social workers) regarding confidence in discussing the subject with patients and families. In our sample of HCPs working in Italian children's hospices, there was no difference in self-reported trust between professionals who reported receiving specific cornea donation training and those who did not. It is remarkable that training on corneal donation was endorsed by a minority of the sample.

Insomnia episodes, new-onset pharmacological treatments, and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals.

To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on insomnia and other sleep disturbances in health care professionals. A survey was distributed using social media and organizational emails to Brazilian active health care professionals during the COVID-19 outbreak. We explored potential associated factors including age, sex, occupation, workplace, work hours, income, previous infection with COVID-19, recent/current contact with COVID-19 patients, regional number of incident deaths, anxiety, and burnout. We evaluated new-onset/previous insomnia worsening episodes (primary outcome), new pharmacological treatments, sleep quality, duration, nightmares, and snoring (secondary outcomes). A total of 4,384 health professionals from all regions of the country were included in the analysis (44 ± 12 years, 76% females, 53.8% physicians). Overall, 55.7% were assisting patients with COVID-19, and 9.2% had a previous COVID-19 infection. The primary outcome occurred in 32.9% of respondents in parallel to 13% new pharmacological treatments for insomnia. The sleep quality worsened for 61.4%, while 43.5% and 22.8% reported ≥ 1-hour sleep duration reduction and worsening or new-onset nightmares, respectively. Multivariate analyses showed that age (odds ratio [OR]: 1.008; 95% confidence interval [CI] 1.001-1.015), females (OR: 1.590; 95% CI 1.335-1.900), weight change (decrease: OR: 1.772; 95% CI 1.453-2.161; increase: OR: 1.468; 95% CI 1.249-1.728), prevalent anxiety (OR: 3.414; 95% CI 2.954-3.948), new-onset burnout (OR: 1.761; 95% CI 1.489-2.083), family income reduction > 30% (OR: 1.288; 95% CI 1.069-1.553), and assisting patients with COVID-19 (OR: 1.275; 95% CI 1.081-1.506) were independently associated with new-onset or worsening of previous insomnia episodes. We observed a huge burden of insomnia episodes and other sleep disturbances in health care professionals during the COVID-19 pandemic. Drager LF, Pachito DV, Moreno CRC, etal. Insomnia episodes, new-onset pharmacological treatments, and other sleep disturbances during the COVID-19 pandemic: a nationwide cross-sectional study in Brazilian health care professionals. J Clin Sleep Med. 2022;18(2):373-382.

Impact of COVID-19 Pandemic on the Sexual Function of Health Professionals From an Epicenter in Brazil.

IntroductionThe pandemic caused by the COVID-19 resulted in worldwide social isolation and leading to significant personal distress, particularly among health professionals on the front lines. Those factors' relevance and their impact on sexual function in this population have not yet been established.AimTo evaluate the impact of the pandemic on sexual function in healthcare professionals and medical students at a reference center in the treatment of COVID-19 in Brazil.MethodsA cross-sectional analysis with online questionnaires about sexual function was sent to health professionals and medical students from the HC-FMUSP medical complex. The questionnaire evaluated Total Sexual and Masturbatory Frequency prior and during the pandemic, libido and sexual satisfaction changes with a detailed inquire about demographics and personal factors. An objective assessment of sexual function was also made using the validated sexual quotient questionnaires.Main Outcome MeasuresDifferences in intercourse frequency, libido, and overall sexual satisfaction, in a sample of healthcare professionals particularly vulnerable to the pandemic effects.ResultsA total of 1,314 responses were available with a mean age of 37 years. Worsening of sexual satisfaction was reported by 44.5% of the participants, with the following associated factors: Lower libido, missing Nightlife, Higher Masturbatory Frequency, and isolation from the partner. Remaning sexualy actively and having higher sexual frequency appear to decrease the chance of worsening sexual function. Worsening of Libido was reported by 37% and had several associated factors, including missing of Nightlife, older age, isolation from the partner among others. Being male and sexually active was associated with a smaller chance of reporting lower libido.ConclusionWe were able to observe a sharp drop in Libido and General Sexual Satisfaction. Although an increase in pornography consumption and masturbatory frequency did occur, these factors were not associated with greater sexual satisfaction. The impact of COVID-19 on this population's sexual health is not to be underestimated and should be further studied in the follow-up of the pandemic. Neto RP, Nascimento BCG, Carvalho dos Anjos Silva G, et al. Impact of COVID-19 Pandemic on the Sexual Function of Health Professionals From an Epicenter in Brazil. Sex Med 2021;9:100408

Physical activity advice in the UK bowel cancer screening setting: qualitative healthcare professional perspectives.

Providing physical activity advice in the bowel cancer screening setting could help to reduce the risk of cancer and cardiometabolic disease in older adults. This study investigated the views of healthcare professionals (HCPs) regarding the provision of physical activity advice as part of the UK Bowel Cancer Screening Programme. A purposive sample of HCPs (aged 22-63 years, with 1-26 years of experience) from four bowel cancer screening disciplines (four endoscopists, four colorectal surgeons, four staff nurses and four specialist screening practitioners) were recruited from a large National Health Service gastroenterology unit. Data collection used individual interviews and focus groups, with topics being guided by an a priori topic guide. All interviews and focus groups were audio-recorded and transcribed verbatim. Three key themes, which contextualize the views and perceptions of HCPs recruited to the study, emerged from the framework analysis: (i) appraisal of the concept; (ii) perceived barriers to implementation; (iii) steps to implementation. While the general concept was viewed positively, there were differences of opinion and a range of perceived barriers were revealed. Ideas for effective implementation were also presented, taking into consideration the need for time efficiencies and importance of optimizing effectiveness. This qualitative study provided important insights into the perceptions of HCPs regarding the provision of physical activity advice in the bowel cancer screening setting, and yielded novel ideas for effective implementation.

Knowledge and attitudes towards the management of chronic pain among healthcare providers in outpatient departments at the University Teaching Hospital of Butare (CHUB)

Introduction: Chronic pain is a major source of suffering and is a leading reason for many patients to consult health care personnel. It interferes with, and disrupts, activities of daily living and may be accompanied by distress. Irrespective of its etiology or classification, health care professionals require a good understanding of chronic pain in order to provide appropriate treatment and care. Methods: A cross-sectional study was conducted involving a sample of 80 participants obtained by using a convenience sampling method. Data were obtained by completing a questionnaire entitled “Knowledge and attitude survey towards pain” and analyzed by using descriptive statistics, chi-square, Pearson correlation coefficient and cross tabulation using SPSS. Results: Overall knowledge was inadequate. More than two thirds of participants obtained a score below 50%. There was also negative attitude, almost 51% of the participants have negative attitude to pain management. Higher level of knowledge was associated with medical profession, highest of qualification and training on pain management. Conclusion: The knowledge and attitudes of this sample of health care professionals regarding the management of chronic pain was inadequate to provide appropriate quality care for patients presenting with chronic pain conditions. This study identified the need for appropriate training for all health care professionals in order to assure adequate knowledge and skills to manage chronic pain using a multidisciplinary approach.

Self-Perceived Health, Life Satisfaction and Related Factors among Healthcare Professionals and the General Population: Analysis of an Online Survey, with Propensity Score Adjustment

Healthcare professionals (HCPs) often suffer high levels of depression, stress, anxiety and burnout. Our main study aimswereto estimate the prevalences of poor self-perceived health, life dissatisfaction, chronic disease and unhealthy habits among HCPs and to explore the use of machine learning classification algorithms to remove selection bias. A sample of Spanish HCPs was asked to complete a web survey. Risk factors were identified by multivariate ordinal regression models. To counteract the absence of probabilistic sampling and representation, the sample was weighted by propensity score adjustment algorithms. The logistic regression algorithm was considered the most appropriate for dealing with misestimations. Male HCPs had significantly worse lifestyle habits than their female counterparts, together with a higher prevalence of chronic disease and of health problems. Members of the general population reported significantly poorer health and less satisfaction with life than the HCPs. Among HCPs, the prior existence of health problems was most strongly associated with worsening self-perceived health and decreased life satisfaction, while obesity had an important negative impact on female practitioners’ self-perception of health. Finally, the HCPs who worked as nurses had poorer self-perceptions of health than other HCPs, and the men who worked in primary care had less satisfaction with their lives than those who worked in other levels of healthcare.

Bullying in Ticino's healthcare contexts: Impact on employee's well being and organization

Bullying in health care setting has a globally prevalence between 1% and 87% and it's in constant increase described by "WHO" as: "Bullying is a major public health problem". It is defined as a repeated ill-treatment, harmful for the health of one or more individuals by one or more people. There are different types of behaviours and they vary from verbal abuse, offensive conduct, humiliating and intimidating attitudes. Those attitudes won't help you doing your job. Different are the outcomes that those actions have on victims: anxiety, sleep disturbances, generalized pain and reduced attention. The objective of the study was to investigate the presence of the phenomenon within the Ticino (Swiss Canton) on healthcare contexts and to explain its experiences. A qualitative study was conducted on a sample of healthcare professionals who are active in the Ticino (Switzerland) healthcare context through 18 semi-structured interviews and their thematic analysis. The results that emerged shows how the problem is also relevant in Ticino`s healthcare contexts, sometimes with different modalities and outcomes, moreover, experiencing these situations during one's working career leads to re-proposing such behaviours, as it is considered a rite of passage. What emerges in a predominant way is the lack of programs or structures aimed to prevent and support the victim and the perpetrator.

Perceptions of prescription opioid medication within the context of cancer survivorship and the opioid epidemic.

Prescription opioid medication can be of great benefit for cancer patients and survivors who suffer from cancer-related pain throughout their cancer care trajectory. However, the current opioid epidemic has influenced how such medications are perceived. The purpose of this study was to explore the perceptions of opioid use and misuse in cancer survivorship within the context of the opioid epidemic. pt?>A qualitative study using a semi-structured interview was conducted with a purposive sample of health care professionals (n = 24), community-level stakeholders (n = 6), and cancer survivors (n = 25) using applied thematic analysis techniques. Crosscutting themes include (1) fear of addiction and living with poorly managed pain, (2) the importance of good patient/provider communication and the need for education around the use/handling/disposal of prescription opioid medication, (3) preference for nonopioid alternatives for pain management, (4) cancer survivors perceived to be low risk for developing opioid use disorder (include inconsistent screening), and (5) impact of policies aimed at curbing the opioid epidemic on cancer survivors. This study illustrates the intersecting and sometimes conflicting assumptions surrounding the use of opioids analgesics in the management of cancer pain among survivors embedded within the national discourse of the opioid epidemic. A system of integrated cancer care using psychosocial screening, opioid risk mitigation tools, opioid treatment agreements, and specialist expertise that cancer care providers can rely on to monitor POM use in conjunction with patient-centered communication to empower patients informed decision making in managing their cancer pain could address this critical gap in survivorship care.

Perceptions and practices of health care professionals regarding coronavirus disease-19 pandemic: An online survey from two developing regions

Background/Aims: Healthcare professionals (HCPs) are among the frontlines of the battle against the Coronavirus Disease-2019 (COVID-19) pandemic. Adequate knowledge of prevention and treatment practices, alongside a positive and forward attitude, are all essential for the success of the defense against COVID-19. We aimed to scope the knowledge, attitude, and practices of HCPs toward the COVID-19 pandemic at its peak time from 2 developing regions: the Middle East and North Africa (MENA). Materials and Methods: We utilized an online, electronic survey consisting of a multiple-choice questionnaire including three domains: Knowledge, attitudes, and practices, targeting a convenience sample of HCPs from the MENA region. Results: Three hundred and seventy-four respondents were included in the analysis; 68.7% resided and practiced in the Middle East, while 31.3% were from North Africa. The majority (71.2%) had postgraduate degrees and were either hospital or non-hospital doctors. Regarding basic knowledge, the majority recognized the main clinical symptoms of COVID-19 and that there was no effective antiviral treatment at the time. The majority also recognized the role of supportive measures, social distancing, isolation, and treating those infected as effective ways to reduce the spread of the virus. In addition, respondents reported that through a general curfew, social distancing was either very effective (65.8%) or effective (31.9%). Respondents were mainly worried about the health of their family members, the risk of contracting the coronavirus, and the economic situation of their family. Two-thirds considered the government's reaction to the current pandemic appropriate, while about one-fifth (21.2%) reported it somewhat insufficient. However, high levels of confidence were reported in countries' abilities to control the pandemic successfully. Regarding practices, 18.5% reported having been too crowded recently, and 16.5% admitted having not worn a mask when leaving the house. Preventative measures varied widely; the best was reported for washing hands more frequently than before (80.3%), while the worst was for the likelihood of informing people around an individual if he/she developed symptoms of sickness (56.1%). Conclusions: HCPs exhibited a reasonably high level of basic knowledge about the COVID-19 pandemic in its early months. Despite a reportedly positive attitude toward the preventative measures, these were not matched by equally strict individual behaviors.

Knowledge of Healthcare Professionals Regarding Hepatitis B in Rania Hospitals

Hepatitis B virus (HBV) infection is a major public health problem worldwide especially for healthcare professionals (HCPs). It is a potentially life-threatening condition because leads to liver infection, and liver cancer. There is a shortage of research on undergraduate students. The main aim of this study was conducted to assess the level of knowledge of health care professionals regarding HBV at Rania hospitals in the Kurdistan region of Iraq during the period of 20th October 2019 to 16th April 2020. Non- probability purposive sample of (303) HCPs; for data collection, the study instrument was constructed and designed through reading literature, books, and articles which included (42) items. Reliability of the instrument was determined through the use of stability reliability (test and retest) approach which was estimated as r = (0.83.)The data were collected through the use of the interview technique then organized and coded into computer files. Statistical approaches were uses for data analysis, which includes: descriptive and inferential statistics and chi-square, data analysis (SPSS version 25). The results indicated that the majority of the study samples were in the age group (? 30)) years and the female participants was more than male, three-quarters of the participants were married, most of them were graduated from institute nursing and less than half of HCPs had 6-10 years of employment, but the majority of the participants were not trained at all, and most of them had not immunized against HBV vaccine. Three-quarters of HCPs had moderate knowledge regarding HBV infection. Also, the current study demonstrated a significant association between the educational level and HCP's knowledge regarding HBV, at a P value less than 0.05. on site other hand, there was no significant association between HCP's age, gender, marital status, years of employment, and training course concerning hepatitis with the level of knowledge regarding HBV. The researchers recommended to the ministry of health and directorate of health in Rania city to complete vaccinate against HBV for all HCPs and participating their staff in healthy scientific issues and symposiums.

The management of pediatric chronic pain in Spain: a web-based survey study

Objective To improve understanding of current practices in the treatment of children and adolescents with chronic pain in Spain. Methods A web-based survey was conducted with a representative sample of healthcare professionals (i.e. general practitioners [GP] and pediatricians [P]) in Spain. The survey included 23 questions on the pain education and training they had been given, and on organizational issues and current practices in the assessment and management of children and adolescents with chronic pain in their current work. Results The survey was completed by 191 professionals (75 GP and 116 P) with wide experience (mean number of years = 21; SD = 8) in the management of children and adolescents with chronic pain. Half of the participants reported that they had not been given any specific education or training on pediatric chronic pain management during their studies, and 80% acknowledged important gaps in their training. Although the majority assessed pain when attending children with chronic pain (80%), and almost all (96%) believed that protocols to guide the management of chronic pain in young people were necessary, only a third reported that they usually use a specific protocol. Less than 25% were part of a multidisciplinary team addressing the needs of children and adolescents with chronic pain. Conclusions This survey has identified considerable limitations in the management of children and adolescents with chronic pain in Spain. This information can now be used by policy makers to improve the care given to children and adolescents suffering from chronic pain and their families.

Clinical Decision Support Systems for Pressure Ulcer Management: Systematic Review.

BackgroundThe clinical decision-making process in pressure ulcer management is complex, and its quality depends on both the nurse's experience and the availability of scientific knowledge. This process should follow evidence-based practices incorporating health information technologies to assist health care professionals, such as the use of clinical decision support systems. These systems, in addition to increasing the quality of care provided, can reduce errors and costs in health care. However, the widespread use of clinical decision support systems still has limited evidence, indicating the need to identify and evaluate its effects on nursing clinical practice.ObjectiveThe goal of the review was to identify the effects of nurses using clinical decision support systems on clinical decision making for pressure ulcer management.MethodsThe systematic review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. The search was conducted in April 2019 on 5 electronic databases: MEDLINE, SCOPUS, Web of Science, Cochrane, and CINAHL, without publication date or study design restrictions. Articles that addressed the use of computerized clinical decision support systems in pressure ulcer care applied in clinical practice were included. The reference lists of eligible articles were searched manually. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies.ResultsThe search strategy resulted in 998 articles, 16 of which were included. The year of publication ranged from 1995 to 2017, with 45% of studies conducted in the United States. Most addressed the use of clinical decision support systems by nurses in pressure ulcers prevention in inpatient units. All studies described knowledge-based systems that assessed the effects on clinical decision making, clinical effects secondary to clinical decision support system use, or factors that influenced the use or intention to use clinical decision support systems by health professionals and the success of their implementation in nursing practice.ConclusionsThe evidence in the available literature about the effects of clinical decision support systems (used by nurses) on decision making for pressure ulcer prevention and treatment is still insufficient. No significant effects were found on nurses' knowledge following the integration of clinical decision support systems into the workflow, with assessments made for a brief period of up to 6 months. Clinical effects, such as outcomes in the incidence and prevalence of pressure ulcers, remain limited in the studies, and most found clinically but nonstatistically significant results in decreasing pressure ulcers. It is necessary to carry out studies that prioritize better adoption and interaction of nurses with clinical decision support systems, as well as studies with a representative sample of health care professionals, randomized study designs, and application of assessment instruments appropriate to the professional and institutional profile. In addition, long-term follow-up is necessary to assess the effects of clinical decision support systems that can demonstrate a more real, measurable, and significant effect on clinical decision making.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42019127663; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=127663

Psychological impact of COVID-19 on medical care workers in China

BackgroundMedical care workers experienced unprecedented levels of workload and pressure since the outbreak of coronavirus disease 2019 (COVID-19). Little is known about its exact impact on medical care workers and related factors in China. This study aims to identify the psychological impact of COVID-19 on medical care workers in China.MethodsFrom February 23 to March 5, 2020, a cross-sectional survey was conducted among 863 medical care workers from seven provinces in China using standard questionnaires measuring adverse psychological outcomes including Impact of Event Scale-6 (IES-6), Depression, Anxiety and Stress Scale(DASS)and related psychosocial factors like perceived threat, social support and coping strategies. Exploratory Factor analysis was performed to identify the dimensions of perceived threat by study participants. Multivariate regression was used to examine the determinants of adverse psychological outcomes.ResultsPosttraumatic stress (PTS) were prevalent in this sample of health care professionals, and 40.2% indicated positive screens for significant posttraumatic stress disorder symptoms. The proportion of having mild to extremely severe symptoms of depression, anxiety and stress were 13.6, 13.9 and 8.6%, respectively. Perceived threat and passive coping strategies were positively correlated to PTS and DASS scores, while perceived social support and active coping strategies were negatively correlated to DASS scores. Nurses were more likely to be anxious than others among medical care workers during the COVID-19 epidemic.ConclusionsAdverse psychological symptoms were prevalent among medical care workers in China during the COVID-19 epidemic. Screening for adverse psychological outcomes and developing corresponding preventive measures would be beneficial in decreasing negative psychological outcomes.