Care Skills Research Articles

Migration of Medical Doctors from Nepal: Analyzing Trends and Policy Implications

One way migration of health care professionals especially from low-income countries like Nepal has become a concerning issue where the already fragile health system of the country faces challenges of losing skilled health care professionals to high-income countries. This trend analysis provides insights into the dynamics of Nepal's healthcare workforce migration, it offers a tailored understanding of factors influencing migration patterns, and its impact on the general population of the country and globally. It helps formulate targeted policies for workforce retention, resource planning, and addressing the country's healthcare needs and comparison with the global context. Analyzing the migration trends of medical professionals enhances medical literature by offering a comprehensive understanding of the factors affecting healthcare systems, public health, economics, education, and policy development. This knowledge plays a vital role in shaping future policies in the field of medicine in Nepal.

Development and application of the mobile-based virtual nursing simulation training content: A mixed methods study

Purpose: Nursing clinical practice education is transforming with the advent of mobile education and the unique experiences it offers in caring for virtual patients. For this innovative approach, this study aims to evaluate the efficacy of mobile-based virtual women’s breast cancer nursing simulation training content on nursing students’ confidence, satisfaction, and learning flow. It also examines the nursing students’ virtual patient care experiences.Methods: A mixed methods approach using a convergent design was employed to examine students’ cancer care confidence and satisfaction, learning flow, and learning experiences. Quantitative data through online questionnaires and qualitative data through focus group interviews were collected, merged, and analyzed.Results: This study developed a virtual nursing training module aimed at caring for women with breast cancer, a novel approach to facilitate mobile-based simulation training for nursing students. Data were analyzed using descriptive analysis, a chi-squared test, Fisher’s exact test, t-test for participant homogeneity (experimental: 20, control: 20), independent t-test, and paired t-test. Satisfaction (t=3.53, <i>p</i>=.001) and confidence (t=4.07, <i>p</i>=.001), as well as flow (t=3.78, <i>p</i>=.001), significantly improved in the experimental group compared to the control group. Two core themes and five sub-themes were derived from the experimental group’s experiences acquired by caring for women with breast cancer virtually, including that the students “Virtually cared for breast cancer patients, learning as if real.”Conclusion: The mobile-based virtual nursing simulation training content allowed nursing students to upgrade their comprehensive nursing care skills by experiencing a fun and practical environment made possible by a new learning method.

Changes in Health Indicators Among Caregivers - United States, 2015-2016 to 2021-2022.

Caregivers provide support to persons who might otherwise require placement in long-term care facilities. Approximately one in five U.S. adults provides care to family members or friends who have a chronic health condition or disability. Promoting the well-being of this large segment of the population is a public health priority as recognized by the 2022 National Strategy to Support Family Caregivers. Although negative associations between caregiving and caregiver health are known, changes in the health status of caregivers over time are not. Data from the 2015-2016 and 2021-2022 Behavioral Risk Factor Surveillance System were analyzed to compare changes in the prevalence of 19 health indicators among cross-sectional samples of caregivers and noncaregivers at different time points. Caregivers experienced improvements in prevalence of four health indicators, whereas six worsened. Some health indicators, such as cigarette smoking, improved for both caregivers and noncaregivers, although smoking prevalence remained higher for caregivers (16.6% versus 11.7%). Prevalence of lifetime depression increased for both groups and remained higher among caregivers (25.6%) than among noncaregivers (18.6%). During 2021-2022, age-adjusted estimates for caregivers were unfavorable for 13 of the 19 health indicators when compared with noncaregivers. Strategies for supporting caregivers are available, and integrating these with existing programs to address mental health and chronic diseases among this population might improve caregiver well-being. For example, many community organizations support caregivers by offering interventions designed to relieve caregiver strain, including skills training, support groups, and care coordination.

Patient trust in nurses: exploring the relationship with care quality and communication skills in emergency departments

BackgroundPatient trust in medical staff is an important ethical issue that can influence various patient behaviors and attitudes, such as seeking healthcare, sharing confidential information, accepting treatment, and adhering to recommendations. This study aimed to assess patient trust in nurses and its relationship to the quality of care and communication skills of nurses in emergency departments.MethodsThis descriptive correlational study was conducted in 2023 in the emergency departments of medical training centers of Ardabil University of Medical Sciences, Iran. A total of 378 patients was selected using a quota sampling method. Data were collected using three valid and reliable tools: the Quality Patient Care (QUALPAC) scale, the Health Communication Feedback Questionnaire (HCFQ), and the Trust in Nurses Scale (TNS).The data were analyzed using independent t-tests, one-way analysis of variance, and Pearson's correlation coefficient tests using SPSS version 24.ResultsThe majority of patients (99.2%) rated nurses' communication skills as moderate, with none rating them as poor. The average scores were 27.59 ± 2.76 for patient trust in nurses, 72.43 ± 3.30 for nurses' communication skills, and 198.30 ± 14.60 for the quality of nursing care. A significant correlation was found between patient trust in nurses and the overall quality of nursing care (r = 0.256, P < 0.001) as well as its dimensions. However, there was no significant relationship between patient trust in nurses and patient's perception of the nurses' communication skills (r = 0.046, P = 0.369).ConclusionsThe findings indicate that patient trust in nurses is positively and significantly associated with the perceived quality of nursing care. As the quality of care improves, patient trust in nurses also increases. Therefore, nurses should focus on providing high-quality care to enhance patient trust.

Evaluation of the effect of stoma care training using the pechakucha method on stoma care skills and anxiety in nursing students: A single-blind randomized controlled trial

AimThis study aimed to evaluate the effects of stoma care training delivered using PechaKucha (PK) on the stoma care skills and anxiety of nursing students. BackgroundInnovative learning methods are needed to make the educational content of nursing courses more interesting and comprehensible. The PK presentation technique is used in various business sectors and can be considered as a novel teaching strategy for the development of stoma care skills in nursing education. The PK method is a visual and narrative slide-based presentation technique involving 20 slides (usually containing images only) that are shown for 20 s each, for a total presentation length of 6 min and 40 s. DesignA single-blind randomized controlled study was conducted according to the CONSORT guideline. MethodsThe study sample comprised 96 first-year nursing students (47 in the intervention group and 49 controls). Data were collected during the 2024 spring semester using a student information form, the Stoma Care Skill Rubric and the State-Trait Anxiety Inventory. Stoma care training was delivered using the PK method for the intervention group and a classic lecture presentation for the control group. SPSS version 25.0 was used for statistical analysis. Independent-samples t-test was used to evaluate differences in mean stoma care skill and anxiety scores between the intervention and control groups. ResultsThe mean stoma care skills score two days after training was significantly higher in the intervention group (mean 42.59, SD 4.44) than in the control group (mean 33.87, SD 7.52) (p<0.05). Mean state anxiety scores after training did not differ significantly between the intervention group (mean 41.74, SD 6.51) and the control group (mean 43.08, SD 6.62) (p>0.05; Table 3). ConclusionThe PK method can be used as an alternative to classic slide-based presentations in nursing education. This study offers the first literature data regarding the efficacy of PK-based education for nursing care skills. Concise and image-based PK presentations may make the skill steps easier to understand and remember.

Evaluation of The Relationship Between Communication Skills and Psychosocial Care Skills of Nurses

Objective: The aim of this study is to evaluate the correlation between nurses' communication skills and psychosocial care skills. Methods: The study was a descriptive and cross-sectional quantitative research that was conducted with nurses working in a training and research hospital between January and May 2022. Population of the study consisted of 255 nurses working in the related hospital. The study was completed with a total of 180 nurses who were voluntary to participate in the study and met the inclusion criteria, without using sample selection. A Participant Information Form, the Psychosocial Care Competence Self-Assessment Scale (PCCSAS), and the Communication Skills Inventory (CSI) were used to collect data. Results: It was found that the nurses' communication skills inventory total mean score was 169.65±13.72. There was no significant correlation between the total score of communication skills inventory and the socio-demographic and professional characteristics of the nurses (P&amp;gt;.05). The nurses' PCCSAS total mean score was 64.28±13.13. The PCCSAS total score differed significantly only according to the unit worked and the number of patients per nurse (P=.008; P=.040). There was a statistically significant and positive correlation between CSI total score and PCCSAS total score (r=0.242; P&amp;lt;.01). Conclusion: It is thought that training should be organised at regular intervals for nurses to improve their knowledge and skills about communication and psychosocial care, and the efficiency of the training should be evaluated periodically for patient and nurse groups.

Exploring Student Perspectives and Experiences of Online Opportunities for Virtual Care Skills Development: Sequential Explanatory Mixed Methods Study.

Caring profession students require skills and competencies to proficiently use information technologies for providing high-quality and effective care. However, there is a gap in exploring the perceptions and experiences of students in developing virtual care skills within online environments. This study aims to better understand caring professional students' online learning experiences with developing virtual care skills and competencies. A sequential explanatory mixed methods approach, integrating both a cross-sectional survey and individual interviews, was used to better understand caring professional students' online learning experiences with developing virtual care skills and competencies. A total of 93 survey and 9 interview participants were drawn from various faculties, including students from education, nursing, medicine, and allied health. These participants identified the barriers, facilitators, principles, and skills related to learning about and delivering virtual care, including teaching methods and educational technologies. This study contributes to the growing body of educational research on virtual care skills by offering student insights and suggestions for improved teaching and learning strategies in caring professions' programs.

An Investigation into how Primary Care Nurses Practices affect clinical competence in Emergency Maternal Obstetric and Newborn Care skills in Nakuru County

To reduce the risks of maternal morbidity, mortality and newborn death worldwide, the use of high-quality emergency obstetric and new born care (EMONC) was proposed to ensure women and their babies receive high-quality care. The government of Kenya with non-profit health programs have jointly invested resources with the aim of achieving SDG’s goal of zero rating maternal and neonatal death cases in the country. Despite these efforts, maternal and neonatal death cases have not reduced significantly. Most of the contributing factors to the deaths occur in the lower levels of the health care delivery system. Majority of the health care providers at these levels are the primary care nurses. It is on this background that the study sought to investigate how primary care nurses practice affect clinical competency in emergency maternal, obstetric, and new born care skills in Nakuru county. Madeleine Leininger’s Transcultural Theory of Nursing anchored the study. It deployed correlational cross-sectional survey design, targeting midwives and nurses in 184 KEPH level II and III facilities in all the 11 sub counties in Nakuru County. The study used stratified sampling technique to sample 126 health facilities distributed in every Sub County. A sample size of 196 primary health care nurses from the sampled facilities were involved. Key informant interview and questionnaires were used to collect both qualitative and quantitative data. To analyze data, SPSS version 26 was used to generate inferential and descriptive statistics, correlation analysis was carried using multiple regression model to ascertain the relationship between dependent and independent variables. Results found that Maternal and newborn care practice was found to have a significant positive relationship with competence in EmONC skills. (P&lt;0.05). This was achieved through clean and safe delivery, thermal care and cord care which were carried out in KEPH level II and III facilities. It was concluded that maternal and neonatal care practices had positive significant relationship with competent EmONC. The study advised that the practice of fundamental maternal and newborn care has to be improved. The primary care nurses should be culturally competent in engaging the community members. Through community-based health care efforts, mothers need to be sensitized about delayed bathing, umbilical cord care, feeding, and thermal care for newborns. Further, County Government of Nakuru should support programs that enables primary health care nurses pursue maternal and neonatal care courses. County Government of Nakuru should ensure ambulance services are easily accessible to all, equipment availability at all time, consistent supply of all drugs needed and the need to create awareness among women, family and community members on newborn and early neonatal care

Epley Maneuver Skills in Primary Care: 3D Semicircular Canal Models for Self-Learning.

Posterior canal-type benign paroxysmal positional vertigo (BPPV) is commonly treated using the Epley maneuver; however, the maneuver's use in primary care is limited by insufficient expertise. Therefore, this study aimed to evaluate the efficacy of a three-dimensional (3D) semicircular canal model as a self-learning tool for primary care physicians to improve their Epley maneuver technique. Thirty-one participants (18 family physicians, seven residents, and six medical students) performed the Dix-Hallpike maneuver on a nursing manikin, followed by the Epley maneuver on the covered 3D models before and after a 5-minute self-study period with the uncovered 3D model. We measured the number of moved beads from posterior canal into the utricle of the 3D model, time spent on the Epley maneuver, and head suspension angle of the Dix-Hallpike maneuver. Preintervention performance was divided into a skilled group (n=7) that could move almost all the beads and an unskilled group (n=24) that could move a few beads. Postintervention, the unskilled group members significantly improved their skill: The average moved beads increased from 0.35 to 8.00, maneuver time from 26.1 to 35.8 seconds, and head suspension angle from 10.3° to 16.4°. Most participants recognized the importance of correct positioning and spent adequate time. The 3D model was effective as a self-learning tool for improving Epley maneuver performance, particularly for less experienced practitioners. This approach could bridge the gap between evidence and practice in primary care for BPPV treatment, enhancing patient outcomes and reducing the need for specialist referrals.

A Serious Game for Enhancing Rescue Reasoning Skills in Tactical Combat Casualty Care: Development and Deployment Study.

Serious games (SGs) have emerged as engaging and instructional digital simulation tools that are increasingly being used for military medical training. SGs are often compared with traditional media in terms of learning outcomes, but it remains unclear which of the 2 options is more efficient and better accepted in the process of knowledge acquisition. This study aimed to create and test a scenario-based system suitable for enhancing rescue reasoning skills in tactical combat casualty care. To evaluate the effectiveness of the SGs, a randomized, observational, comparative trial was conducted. A total of 148 members from mobile medical logistics teams were recruited for training. Pre- and posttraining assessments were conducted using 2 different formats: a video-based online course (n=78) and a game simulation (n=70). We designed 3 evaluation instruments based on the first 2 levels of the Kirkpatrick model (reaction and learning) to measure trainees' satisfaction, knowledge proficiency, and self-confidence. There were 4 elements that made up the learning path for the SGs: microcourses (video-based online courses), self-test, game simulation, and record query. The knowledge test scores in both groups were significantly higher after the intervention (t154=-6.010 and t138=-7.867, respectively; P<.001). For 5 simulation cases, the average operation time was 13.6 (SD 3.3) minutes, and the average case score was 279.0 (SD 57.6) points (from a possible total of 500 points), with a score rate of only 44% (222/500 points) to 67% (336/500 points). The results indicated no significant difference in trainees' satisfaction between the 2 training methods (P=.04). However, the game simulation method outperformed the video-based online course in terms of learning proficiency (t146=-2.324, P=.02) and self-perception (t146=-5.492, P<.001). Despite the high satisfaction reported by trainees for both training methods, the game simulation approach demonstrated superior efficiency and acceptance in terms of knowledge acquisition, self-perception, and overall performance. The developed SG holds significant potential as an essential assessment tool for evaluating frontline rescue skills and rescue reasoning in mobile medical logistics teams.

Development and validation of a national clinical pharmacy competency framework for hospital pharmacists in Austria: a multi-method study.

Despite the publication of a European wide competency framework for hospital pharmacy by the European Association of Hospital Pharmacist (EAHP) in 2017, not all countries have adopted and implemented such a framework. This study aimed to develop and validate a bespoke national hospital pharmacy competency framework for Austria that supports the hospital pharmacy workforce development. A multi-method study was carried out in three phases. (I) A systematic literature review across 48 websites of healthcare-related associations and six scientific databases was conducted, identifying competency frameworks, guidelines and related documents. (II) Extracted behaviour competencies were reviewed for contextual national appropriateness by three researchers prior to mapping against the "Patient Care and Clinical Pharmacy Skills" domain of European Common Training Framework (CTF). (III) Validation of the resultant draft clinical skills competency framework took place by an expert panel (n = 4; Austrian Association of Hospital Pharmacists (AAHP) board members) discussion. Reporting of findings is aligned with the recommendations for reporting Competency Framework Development in health professions (CONFERD-HP guidelines) and the PRISMA 2020 checklist. The systematic review (SR) resulted in 28 frameworks, guidelines and related documents and the identification of 379 behaviour competencies, with nineteen mapped to the "Patient Care and Clinical Pharmacy Skills" domain of the CTF (after removal of duplicates). Expert panel discussion resulted in suggested changes to ensure contextual national appropriateness. This study resulted in the development and validation of the first clinical national pharmacy competency framework for Austria. Future studies should focus on political and practical structures necessary for its successful implementation.

The prevalence of pain catastrophising in nulliparous women in Nepal; the importance for childbirth.

In Lower-Middle-Income-Countries women are encouraged to present at a birthing facility for skilled care, but attending early can be associated with additional harm. Women admitted in latent labour are more likely to receive a cascade of unnecessary interventions compared with those attending a birthing facility during active labour. One reason that women present early is pain, with higher rates of admission among those who pain catastrophise. The aim of this study was to explore the prevalence of pain catastrophising in nulliparous women in Nepal and to identify predictors for pain catastrophising. A cross sectional study was conducted using a semi-structured survey. The survey was completed by 170 women (18-32 years) in one higher education institution in Kathmandu. The survey included the pain catastrophising scale (PCS), current and previous pain and information about period pain, sociodemographic variables of age, ethnicity, and religion. The prevalence of pain catastrophising reported at a cut off score of PCS≥20 was 55.9% and at a cut off score of PCS≥30 was 17.1%. All women with a PCS ≥30 reported having painful periods. Those with a PCS≥20 were four times [95%CI 1.93-8.42] more likely to report painful periods affecting their daily activities (p<0.001) and those with PCS≥30 three times [95%CI1.10-10.53] more likely (p<0.05). In both cases ethnicity and age were not associated. Women with higher PCS were less likely to take pain medication. A high prevalence of pain catastrophising was reported. It is important to understand how women's previous negative experiences of pain and pain catastrophising are perceived and if they are contributing to the rise in obstetric intervention, particularly caesarean births, in Nepal. We recommend repeating this study with a larger sample representing a more diverse population.

Entry-to-Practice Rehabilitation Competencies and the Rehabilitation Competency Framework: A Gap Analysis

ObjectivesThe demand for rehabilitation services is rising globally, necessitating a well-prepared and diverse rehabilitation workforce. The World Health Organization developed the Rehabilitation Competency Framework (RCF) to guide the development of contextually based competencies for various rehabilitation professions. This study systematically compared the entry-level competencies of different rehabilitation professions with the RCF, thereby discerning commonalities and gaps. By exploring these comparisons, the aim was to identify overlapping competencies and areas for collaboration, potentially informing the creation of unified educational materials to support the development of rehabilitation professionals. DesignThe competence frameworks of audiology, occupational therapy, physical and rehabilitation medicine, psychology, physiotherapy, prosthetics and orthotics, rehabilitation nursing, and speech and language therapy were researched online. In cases where international standards or competencies were unavailable online, expert colleagues in the related field were consulted to confirm the absence of an international document. A nationally recognized and freely available document was selected to represent the profession if no international document was found. The frameworks were then mapped to the RCF domains. SettingDesk-based research. ParticipantsNot applicable. InterventionsNot applicable. Main Outcome MeasuresNot applicable. ResultsThe professional documents demonstrated a stronger alignment with the competencies outlined in the RCF activities. The practice and professionalism domains showed the greatest congruence with profession-specific competencies, whereas the learning and development, management and leadership, and research domains had varying levels of alignment. This consistency in mapping may be attributed to the profession-specific competencies’ focus on the fundamental entry-level knowledge, skills, values, and abilities essential for delivering safe and effective patient care. ConclusionsThe mapping exercise revealed that competencies in the profession-specific frameworks primarily focused on individual-level skills for effective patient care rather than societal-level impact, such as acting as rehabilitation advocates. The study provides valuable insights into the alignment between profession-specific competencies among the rehabilitation professions. Identifying commonalities and gaps can facilitate the development of shared educational resources for foundational support across diverse rehabilitation disciplines. This effort can contribute to building a robust and unified rehabilitation workforce capable of meeting the emerging health needs of diverse populations worldwide.

Positive Impact on Critical Care Knowledge Acquisition and Skills of VietnameseNurses through an Online Standardized Training Program

Background Improved access to healthcare, increasing elderly population, growing incidence of chronic diseases, combined with the high prevalence of accidents and infectious diseases are driving the demand for critical care services in acute hospitals. However, low and middle-income countries not only have a shortage of critical care nurses, but there are also gaps in their graduate, post-graduate, and specialized training as well as in their continuing education to support them in their role. Methods This quality improvement project aimed to assess the effect of a web-based group study program on knowledge acquisition and skills and competency development of critical care nurses at seven private,not-for-profit hospital sites within a hospital system in Vietnam. The Essentials of Critical Care Orientation 4.0 course from the American Association of Critical Care Nurses was delivered to two cohorts of ICU nurses who worked in critical care. Course content was translated in Vietnamese. The program leveraged a preceptor-facilitator-learner model that depended on group discussions and self-learning. Program effectiveness was evaluated using quantitative pre- and post-test design, combined with a post-program survey. ResultsAverage post-test scores of the first cohort increased by 34.0% over pre-test while those of the second cohort increased by an average 41.0%.Post-program survey revealed that all learners were satisfied with the quality of content, the web-based delivery system, content translation and the overall teaching methodology. Learners also demonstrated greater confidence in delivering safe, proactive patient care. Conclusion The utilization of an online, standardizedwestern education program, translated to Vietnamese,delivered through a facilitator-group learning model is successful in increasing the knowledge level of Vietnamize critical care nurses.

Impact of a first-year medical student patient navigation initiative on healthcare access and students' skills

Background: Medical schools with complex patient populations, characterized by linguistic diversity and uncertain immigration status, face challenges in imparting essential skills in patient care, particularly in understanding healthcare barriers, building rapport, and fostering empathy. A South Florida medical school with a predominantly non-English-speaking and undocumented patient population piloted a Patient Navigation (PN) program within the first-year curriculum to address these challenges. We present the student feedback from the program’s first two years to guide medical schools in simultaneously caring for this unique patient population, with the aim of enhancing medical education. Methods: This program diverged from traditional Patient Navigation approaches by leveraging specialized hospital-associated translation services and collaborating with the Health System's Financial Assistance program. We performed a crosssectional study on student feedback surveys to identify program features significantly associated with a satisfying PN experience, and to provide insights to optimize and refine the program for future implementations. Results: The program engaged 245 out of 306 first-year medical students in PN for 118 patients. Successful contact was established with 55% of patients and 70% achieved their navigation objectives. Satisfaction metrics revealed that students given patients were nearly five times more satisfied than their counterparts. This positively impacts both student experience and patient outcomes, showcasing the program's effectiveness in bridging healthcare disparities. Discussion: The PN program proved successful in linking low-risk patients to follow-up care, offering medical students first-hand exposure to the challenges of care for primarily non-English-speaking and undocumented populations. The initiative aimed to enhance healthcare access for marginalized patients while providing medical students with an immersive understanding of patient-centric care beyond conventional curricular offerings. Key lessons learned include improving communication channels between students and patients, and optimizing community resources for streamlined patient support. Future iterations will prioritize these lessons, emphasizing cultural competence and patient advocacy to enhance both student education and patient care outcomes.

Evaluation of high-fidelity and virtual reality simulation platforms for assessing fourth-year medical students’ encounters with patients in need of urgent or emergent care

Background Medical students in the U.S. must demonstrate urgent and emergent care competence before graduation. Urgent and emergent care competence involves recognizing, evaluating and initiating management of an unstable patient. High-fidelity (HF) simulation can improve urgent and emergent care skills, but because it is resource intense, alternative methods are needed. Study Objective Our primary purpose was to use program evaluations to compare medical student experiences with HF and virtual reality (VR) simulations as assessment platforms for urgent and emergent care skills. Methods During their emergency medicine clerkship, students at The Ohio State University College of Medicine must demonstrate on HF manikins, competence in recognizing and initiating care of a patient requiring urgent or emergent care. Students evaluated these simulations on a five-point quality scale and answered open-ended questions about simulation strengths and weaknesses. Faculty provided feedback on student competence in delivering urgent or emergent care. In 2022, we introduced VR as an alternative assessment platform. We used Wilcoxon Signed Ranks and Boxplots to compare ratings of HF to VR and McNemar Test to compare competence ratings. Comments were analyzed with summative content analysis or thematic coding. Results We received at least one evaluation survey from 160 of 216 (74.1%) emergency medicine clerkship students. We were able to match 125 of 216 (57.9%) evaluation surveys for students who completed both. Average ratings of HF simulations were 4.6 of 5, while ratings of VR simulations were slightly lower at 4.4. Comments suggested that feedback from both simulation platforms was valued. Students described VR as novel, immersive, and good preparation for clinical practice. Constructive criticism identified the need for additional practice in the VR environment. Student performance between platforms was significantly different with 91.7% of students achieving competence in HF, but only 65.5% in VR (p≤.001, odds-ratio = 5.75). Conclusion VR simulation functions similarly to HF for formative assessment of urgent and emergent care competence. However, using VR simulation for summative assessment of urgent and emergent care competence must be considered with caution because students require considerable practice and acclimation to the virtual environment.

Undergraduate midwifery students' experiential learning of perinatal bereavement care: A qualitative analysis

BackgroundIt is widely acknowledged that midwives are essential in providing care for mothers experiencing perinatal death. However, midwifery students lack the knowledge and skills needed to deal with perinatal death, and. There is limited research on perinatal bereavement care training for midwifery students. AimTo investigate undergraduate midwifery students' experiential learning of perinatal bereavement care and serve as a reference for future perinatal bereavement care teaching and training. DesignQualitative descriptive design. SettingUniversity in Guangzhou, China. ParticipantsUndergraduate midwifery students at a university in Guangzhou, China. MethodThis research was conducted at a university in Guangzhou, China. The participants were recruited using purposeful sampling. Semi-structured, in-depth interviews were conducted with 11 midwifery students who participated in perinatal bereavement care training from May to June 2023. The Colalizzi 7-step data analysis method was used for data analysis. ResultsFrom the data, five themes emerged: 1) immersive experience of perinatal bereavement care, 2) formation of perspectives on perinatal bereavement care, 3) clarification of the service boundaries and internalization of the professional service spirit, 4) emotional impact and coping strategies, and 5)) factors influencing practice optimization. ConclusionsExperiential learning is an effective teaching strategy. However, participants continued to feel unprepared to provide perinatal bereavement care. Implementing relevant training, disseminating perinatal bereavement care knowledge and skills, and enhancing the ability of midwifery students to manage and cope with the psychological impact of perinatal death are important.

Estimates and determinants of health facility delivery in the Birhan cohort in Ethiopia.

Health facility delivery is one of the critical indicators to monitor progress towards the provision of skilled delivery care and reduction in perinatal mortality. In Ethiopia, utilization of health facilities for skilled delivery care has been increasing but varies greatly by region and among specific socio-demography groups. We aimed to measure the prevalence and determinants of health facility delivery in the Amhara region in Ethiopia. From December 2018 to November 2020, we conducted a longitudinal study from a cohort of 2801 pregnant women and described the location of delivery and the association with determinants. We interviewed a subset of women who delivered in the community and analyzed responses using the three delays model to understand reasons for not using health facility services. A multivariable poisson regression model with robust error variance was used to estimate the presence and magnitude of association between location of delivery and the determinants. Of the 2,482 pregnant women followed through to birth, 73.6% (n = 1,826) gave birth in health facilities, 24.3% (n = 604) gave birth at home and 2.1% (n = 52) delivered on the way to a health facility. Determinants associated with increased likelihood of delivery at a health facility included formal maternal education, shorter travel times to health facilities, primiparity, higher wealth index and having attended at least one ANC visit. Most common reasons mothers gave for not delivering in a health facility were delays in individual/family decision to seek care. The proportion of deliveries occurring in health facilities is increasing but falls below targets. Interventions that focus on the identified social-demographic determinants and delays are warranted.

Oral care interventions for autistic individuals: A systematic review.

Oral care-related challenges are well documented in the autistic community; dental care remains one of the most prevalent unmet health needs among autistic individuals. This review examined interventions designed to improve oral health in autistic individuals from children and adult populations. Through a systematic process, 36 studies were identified. These studies focused on improving home-based oral care skills and routines and reducing fear, anxiety, and/or negative behaviors in the dental clinic. Studies incorporated different types of techniques for facilitating oral care practice, including preparatory interventions to support home-based hygiene activities or improve an approaching dental encounter (n = 29), most often using visual aids, and/or strategies to manage behavioral difficulties exhibited in the dental office (n = 17). Some studies used both approaches (n = 10), combining visual aids prior to a visit with behavior management. Using an evidence-based rubric, we reviewed the methodological quality of the studies and found that most were only "adequate" (n = 8) or "weak" (n = 23) in reporting their evidence. This review has two key findings: (1) there is support for preparatory home-based visual interventions to improve toothbrushing and/or ready patients for dental visits; and (2) distraction or sensory-reducing interventions may also improve experiences in the dental clinic. Only one study purposefully recruited autistic adults, and no studies included intervention elements tailored to race/ethnicity, culture, and/or socioeconomic status. This review highlights the need for more studies investigating the impact of oral care-related interventions for autistic individuals of all ages and identifies a gap in interventions for autistic adults and those from minoritized populations.

Perception on hematology/oncology pharmacy practice and education needs in Nigeria: A national survey.

Nigeria is a low-middle income country located in sub-Saharan Africa. Although cancer burden has continued to increase over time, there is a lack of pharmacists who specialize in oncology providing pharmaceutical care. The objectives of this study were to understand the perception of hematology/oncology pharmacy practice in Nigeria as well as the unmet education needs. This is a cross-sectional survey conducted in December 2023. Pharmacists who were active members of various pharmacy organizations in Nigeria were invited to complete the survey. The survey focused on the perceptions of training needs in oncology pharmacy, current challenges and opportunities, as well as resources and support needed. Descriptive statistics were utilized for the data analysis. Of the 263 responders, the largest group fell between 25 and 34 years old (35%), over half received a Bachelor of Pharmacy as their highest degree (53%), and majority did not receive any oncology pharmacy training as part of their education (73%). Many respondents strongly agreed that pharmacists in Nigeria need specialized training to better serve cancer patients (79%). Cancer therapeutics and chemotherapy pharmacology were more prioritized compared to other training needs (mean (SD): 2.63(1.95) and 2.69(1.64), respectively). The main challenge that respondents faced was a lack of relevant skills and knowledge in oncology pharmacy (mean (SD): 2.23(1.53)). More than a fourth of the respondents were aware about the board certification process (28.8%), citing overcoming the cost barrier as the main obstacle for taking the board examination (mean (SD): 1.92 (1.38)). Respondents preferred online courses and onsite specialty training (75%) as the mode of training to address unmet needs. Despite the challenges and unmet education needs in hematology/oncology clinical practice, Nigerian pharmacists are very willing to expand their knowledge and improve their skills in patient care. The findings of this study can inform policy makers, healthcare administrators, and pharmacy educators in developing global partnerships among pharmacy organizations which employ targeted strategies like sponsorships to address such unmet needs.