Skills Of Health Professionals Research Articles

\u2018Snakes & Ladders\u2019: factors influencing access to appropriate care for children and young people with suspected juvenile idiopathic arthritis \u2013 a qualitative study

BackgroundMany children and young people with juvenile idiopathic arthritis (JIA) experience delay in diagnosis and access to right care. The reasons for delay are multi-factorial and influenced by patient and family, clinician and organisational factors. Our aim was to explore the experiences of care, from initial symptoms to initial referral to paediatric rheumatology.MethodsWe analysed one-to-one and joint qualitative interviews with families of children with JIA (n = 36) presenting to a regional paediatric rheumatology service in the UK. We interviewed 51 family members (including mothers, fathers, patients, grandmothers and an aunt) and 10 health professionals (including orthopaedic surgeons, paediatricians, paediatric immunologist, General Practitioner and nurse) and a teacher involved in the care pathway of these JIA patients. Interviews were audio-recorded and analysed according to the standard procedures of rigorous qualitative analysis - coding, constant comparison, memoing and deviant case analysis.ResultsThe median age of the children was 6 years old (range 1–17), with a spread of JIA subtypes. The median reported time to first PRh MDT visit from symptom onset was 22 weeks (range 4-364 weeks). Three key factors emerged in the pathways to appropriate care: (i) the persistence of symptoms (e.g. ‘change’ such as limp or avoidance of previously enjoyed activities); (ii) the persistence of parents help-seeking actions (e.g. repeat visits to primary and hospital care with concern that their child is not ‘normal’; iii) the experience and skills of health professionals resulting in different trajectories (e.g. no-real-concern-at-this-point or further-investigation-is-required). JIA was more likely to be considered amongst health practitioner if they had prior experiences of a child with JIA (moreso with a ‘protracted pathway’) or exposure to paediatric rheumatology in their training. Conversely JIA was more likely to be overlooked if the child had comorbidity such as learning disability or a chronic illness.ConclusionsCare pathways are often ‘turbulent’ prior to a diagnosis of JIA with physical and emotional distress for families. There is need for greater awareness about JIA amongst health care professionals and observations of change (from family and non-health care professionals such as teachers) are key to trigger referral for paediatric rheumatology opinion.

Training in communication skills for self-efficacy of health professionals: a systematic review

BackgroundCommunication skills are essential for health professionals to establish a positive relationship with their patients, improving their health and quality of life. In this perspective, communication skills training can be effective strategies to improve the care provided by professionals in patient care and the quality of health services.ObjectiveTo identify the best available evidence on training programs in communication skills to promote changes in attitude and behavior or self-efficacy of health professionals.MethodsSystematic searches were performed in eight databases, evaluating Randomized Controlled Trials and quasi-experimental studies with a control group, focusing on training communication skills for health professionals, who assessed self-efficacy or behaviors related to these skills. The phases of study selection and data extraction were carried out by two independent researchers, and the conflicts were resolved by a third. The risk of bias was assessed using the Cochrane method.ResultsEight studies were included in the review. Most programs lasted between 4½ h and 2 days, involved information about communication skills and the content was applied to the health professionals’ context. Several teaching strategies were used, such as lectures, videos and dramatizations and the evaluation was carried out using different instruments. Improvements in the performance and in the self-efficacy of communication skills were observed in the trained groups. The RCT had a low risk of bias and the quasi-experimental studies had a moderate risk.ConclusionTraining in communication skills can improve the performance and self-efficacy of health professionals. Programs that approach the conceptual issues and promote the space for experiential learning could be effective in communication skills training for professionals.PROSPERO: CRD42019129384

Understanding the complexities of unexplained stillbirth in sub-Saharan Africa: a mixed-methods study.

ObjectiveTo understand the complexities surrounding unexplained stillbirth for the development and implementation of culturally acceptable interventions to underpin care in Tanzania and Zambia.DesignMixed‐methods study.SettingTertiary, secondary and primary care facilities in Mansa, Zambia, and Mwanza, Tanzania.SampleQuantitative: 1997 women giving birth at two tertiary care facilities (one in each country). Qualitative: 48 women and 19 partners from tertiary, secondary and primary care facilities.MethodsCase review using data from a target of 2000 consecutive case records. Qualitative interviews with a purposive sample of women and partners, using a grounded theory approach.ResultsA total of 261 stillbirths were recorded, with a rate of 16% in Tanzania and 10% in Zambia, which is higher than the previous estimates of 2.24 and 2.09%, respectively, for those countries. Women in both countries who reported a previous stillbirth were more likely to have stillbirth (RR 1.86, 95% CI 1.23–2.81). The cause of death was unexplained in 28% of cases. Qualitative findings indicated that not knowing what caused the baby to be stillborn prevented women from grieving. This was compounded by the poor communication skills of health professionals, who displayed little empathy and skill when counselling bereaved families.ConclusionsThe stillbirth risk in both facilities was far higher than the risk recorded from national data, with women reporting a previous stillbirth being at higher risk. Women want to know the cause of stillbirth and an exploration of appropriate investigations in this setting is required. Providing health professionals with support and continuing training is key to improving the experiences of women and future care.Tweetable abstractStillbirths receive little investigation and are often unexplained. Communication with women about the death of their baby is limited.

Evaluation of a simulation program for management of cardiovascular emergencies in pregnant women

Medical education worldwide is undergoing a pedagogical renovation movement; medical simulation is one of the revolutionary educational tools whose aim is to improve the medical knowledge, technical and non-technical skills of health professionals, while ensuring patient safety. Many studies have dealt with the contribution of simulation in cardiology, however no studies have been done on the management of cardiovascular emergencies in pregnant women by simulation. The purpose of our work is to evaluate a simulation-based educational training program on cardiovascular emergencies in pregnant women by comparing it to a “traditional” training program and to assess the students’ satisfaction with this teaching method. We conducted anexperimental, comparative, randomized and multicentric studyon 60 medical students (≥ 6th year), the study started with a pre-test, followed by a theoretical training session on cardiovascular emergencies in pregnant women, a randomization of students into two groups, according to whether they had benefited or not from simulation sessions before taking a post-test. We selected 57 students: 29 in group 1 (SIM+) and 28 in group 2 (SIM−), both groups were comparable regarding their level of medical studies, hospital training in cardiology or gynecology and prior participation at simulation sessions. The pre-test results were comparable for both training groups. The progression of the marks between the pre-test and the post-test was significant P < 0.001 for both training groups, However a better progression of the marks in group 1 compared to group 2 has been observed P = 0.001. This preliminary study has demonstrated the considerable interest of medical simulation as an innovative teaching tool in training on cardiovascular emergencies in pregnant women and its added value compared to “traditional” training programs.

Abstract PO-014: Assessment of training needs for clinicians who provide reproductive health counseling for sexual and gender minority adolescents and young adults with cancer

Abstract Background: Adolescent and young adults (AYA) with cancer have distinct psychosocial needs, with reproductive health being a chief concern. Reproductive health includes fertility, contraception, romantic relationships, body image, sexuality and disease prevention. Along with the unique needs of AYAs with cancer, health disparities exist among sexual and gender minority (SGM) AYAs, and there is a gap in clinician training. Our NCI-funded R25 Enriching Communication skills for Health professionals in Oncofertility (ECHO) provides reproductive health communication training to psychologists, social workers, nurses, and physician assistants who provide care for AYA people diagnosed with cancer. To refine our curriculum to address the unique needs of SGM AYAs with cancer, we conducted a survey of prior ECHO trainees to evaluate knowledge and comfort in obtaining sexual orientation and gender identity (SOGI) information from patients and providing reproductive health counseling. Methods: A 28-item electronic survey was distributed to 601 prior ECHO trainees. Quantitative items assessed: SOGI data collection at their institution; SGM AYA cancer-related health knowledge; adequacy of ECHO training for SGM AYAs; desire for additional training; comfort discussing reproductive health with SGMs; and confidence in knowledge of SGM health needs (pre- and post-survey). Response options ranged from 1=strongly agree to 5=strongly disagree, or ‘prefer not to answer. Total knowledge score was computed and ranged from 0=no correct responses to 7=all correct. Self-perceived comfort and confidence were assessed with regard to specific patient subgroups (i.e., gay/lesbian; bisexual/queer; and trans/nonbinary patients). Four open-ended items invited respondents to describe personal experiences, reservations, and suggestions for improving SGM AYA cancer care. Quantitative responses were summarized with descriptive statistics. Paired t- tests were used to analyze changes in confidence. Content analysis was applied to qualitative responses. Results: Of the 346 who completed the survey (58% response rate), only 7.4% correctly answered all knowledge questions (M=3.76, SD=1.72). One- third thought ECHO training adequately addresses SGM needs, and the majority (89%) wanted additional training in SGM reproductive health. Confidence in knowledge of SGM health was neutral in all subgroups prior to survey completion (M=3.05, SD=1.02), but reduced significantly for bisexual/queer (M=-0.21 t(307)=4.70, p&amp;lt;.001) and transgender/nonbinary health(M=-0.12 t(307)=2.66, p=.008). Open-ended responses focused on experiences caring for SGM AYAs with cancer; training needs; and appreciation for the survey. Conclusions: Our findings demonstrate a need to expand our ECHO curriculum to include SGM reproductive health concerns and strong desire for SGM content among trainees. We are developing a module to improve reproductive health communication for the care of SGM AYAs with cancer and survivors. Citation Format: Rhyan J. Toldeo, Amani Sampson, Paige W. Lake, Megan E. Sutter, Ash B. Alpert, Matthew B. Schabath, Susan T. Vadaparampil, Gwendolyn P. Quinn. Assessment of training needs for clinicians who provide reproductive health counseling for sexual and gender minority adolescents and young adults with cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-014.

Cross-cultural Adaptation, Reliability, and Validity of the Turkish Version of the Health Professionals Communication Skills Scale

The aim of this study is to evaluate the psychometric properties of the Turkish version of the Health Professionals Communication Skills Scale (HP-CSS). The HP-CSS was translated into Turkish following an international instrument translation guideline. A convenience sample of 394 health professionals participated in this study. Internal consistency reliability, content validity, test-retest reliability, and convergent validity were assessed. A confirmatory factor analysis was conducted to evaluate the construct validity. The Turkish version of HP-CSS comprised four factors (empathy, informative communication, respect, and social skill). The HP-CSS-TR demonstrated adequate internal consistency (Cronbach'sα values .72-.79). In terms of the content validity, the scale-level content validity index (CVI) was .94, and the item-level CVI ranged from .83 to 1.00. The HP-CSS-TR showed good test-retest reliability (intraclass correlation coefficients were above .82). No statistically significant difference was found between the applications. There was a good agreement between the HP-CSS-TR and communication skills inventory (CSI) scales. Confirmatory factor analysis results (χ2/df, GFI, AGFI, IFI, TLI, CFI, RMSEA, and SRMR) showed a good fit for the original four-factor model. Results showed that the Turkish version of the HP-CSS is a valid and reliable tool for the assessment of communication skills of health professionals in Turkey. The use of the HP-CSS-TR measure in clinical settings could be useful in enhancing the quality of care by identifying inadequacies and improving communication skills.

CLINICIAN TRAINING NEEDS IN REPRODUCTIVE HEALTH COUNSELING FOR SEXUAL AND GENDER MINORITY AYA WITH CANCER

Adolescent and young adults (AYA) with cancer have distinct psychosocial needs, with reproductive health being a chief concern. Reproductive health includes fertility, contraception, romantic relationships, body image, sexuality and disease prevention. Along with the unique needs of AYAs with cancer, health disparities exist among sexual and gender minority (SGM) AYAs, and there is a gap in clinician training. Our NCI-funded R25 Enriching Communication skills for Health professionals in Oncofertility (ECHO) provides reproductive health communication training to psychologists, social workers, nurses, and physician assistants who provide care for AYA people diagnosed with cancer.

The Role of Parents, Teachers and Health Professionals in Forming Knowledge, Abilities and Skills of a Safe Use of Electronic Devices by High School Children

Introduction: A widespread intensive use of electronic devices by modern young people negatively affects their health emphasizing the importance of raising awareness of users about health risks of the uncontrolled use of gadgets and developing appropriate safety skills. High school students can get necessary information in medical institutions, at school, and at home. The objective was to study the role of parents, teachers, and healthcare professionals in forming knowledge, skills and abilities of the safe use of digital devices and related components of a healthy lifestyle in seniors. Materials and methods: In the light of the objective, a special online questionnaire-based survey was conducted in 2019 using Google Forms. It involved 200 schoolchildren in grades 9-11 (15-17 years of age), 251 parents, 389 school teachers, and 220 healthcare professionals. Results: The survey data demonstrated the lowest subjective assessment of risks of the uncontrolled use of digital devices among schoolchildren (p≤0.05) and, at the same time, the highest prevalence of the considered risk factors among them. About 30% of the schoolchildren, 20% of parents and 20% of teachers underestimate behavioral risk factors of the uncontrolled use of gadgets (p≤0.05). I established the leading role of parents in forming the skill of long-term screen time in young people and noted low competence of healthcare professionals in issues of the safe use of digital devices and related components of a healthy lifestyle (using devices in poor lighting, inappropriate places and positions, lacking regular breaks, underestimating risks of low physical activity and eating less than 3 meals a day). I also found that teachers, being aware of safety requirements, comply with them but do not use this experience in their professional activities. Only 65% of schoolchildren and parents and 60% of teachers (p≤0.05) have skills of a safe screen use and take measures to preserve and maintain visual acuity. Conclusions: The survey revealed the importance of improving awareness of the population in issues of the safe use of digital devices, increasing the number of school subjects providing knowledge on this issue and contributing to the development of related healthy lifestyle components, and using all possible sources of transmission of relevant information.

Systematic review of the effect of training interventions on the skills of health professionals in promoting health behaviour, with meta-analysis of subsequent effects on patient health behaviours

BackgroundWe aimed to identify, synthesise and evaluate randomised control trial evidence on the effects of healthcare professional training on the delivery quality of health behaviour change interventions and, subsequently, on patient health behaviours.MethodsSystematic review with narrative synthesis of effects on delivery quality and meta-analysis of health behaviour outcomes. We searched: Medline, EMBASE, PsychInfo, AMED, CINAHL Plus and the Cochrane Central Register of Control Trials up to March 2019. Studies were included if they were in English and included intervention delivery quality as an outcome. The systematic review was registered on PROSPERO (registration: CRD42019124502).ResultsTwelve-studies were identified as suitable for inclusion. All studies were judged as being high risk of bias with respect to training quality outcomes. However with respect to behavioural outcomes, only two of the six studies included in the meta-analysis had a high risk and four had some concerns. Educational elements (e.g. presentations) were used in all studies and nine included additional practical learning tasks. In eight studies reporting delivery quality, 54% of healthcare professional communication outcomes and 55% of content delivery outcomes improved in the intervention arm compared to controls. Training that included both educational and practical elements tended to be more effective. Meta-analysis of patient health behavioural outcomes in six-studies found significant improvements (Standardised mean difference (SMD): 0.20, 95% confidence interval: 0.11 to 0.28, P < 0.0001, I2 = 0%). No significant difference was found between short (≤6-months) and long-term (> 6-months) outcomes (SMD: 0.25 vs 0.15; P = 0.31).ConclusionsDelivery quality of health behaviour change interventions appears to improve following training and consequently to improve health behaviours. Future studies should develop more concise /integrated measures of delivery quality and develop optimal methods of training delivery.

Percepção de pacientes sobre sua relação com médicos

Resumo A comunicação adequada é fundamental para a relação médico-paciente e para melhorar a qualidade dos atendimentos. Diante disso, o objetivo deste estudo foi conhecer a percepção de 200 pacientes na cidade de Aracaju/SE sobre sua relação com os médicos. Trata-se de estudo exploratório, transversal, descritivo e quantitativo, com aplicação de questionário. A amostra foi composta majoritariamente por adultos jovens, do sexo feminino (71,5%), solteiros (50%), sem nível superior (47,5%), atendidos principalmente em hospitais da rede pública (26,5%). Um ambiente favorável para a boa relação médico-paciente depende não apenas da infraestrutura clínico-hospitalar, mas também da habilidade comunicativa dos profissionais. Quanto à relação com os médicos, a maioria relatou estar satisfeita (86%) e confiar nos profissionais (84%). A privacidade do paciente também foi respeitada na maioria dos casos.

Training in health coaching skills for health professionals who work with people with progressive neurological conditions: A realist evaluation.

BackgroundSupporting people to self‐manage their long‐term conditions is a UK policy priority. Health coaching is one approach health professionals can use to provide such support. There has been little research done on how to train clinicians in health coaching or how to target training to settings where it may be most effective.ObjectiveTo develop theories to describe how training health professionals in health coaching works, for whom and in what circumstances, with a focus on those working with people with progressive neurological conditions.DesignRealist evaluation using mixed methods (participant observation, pre‐ and post‐training questionnaires, and telephone interviews with participants and trainers). Realist data analysis used to develop and refine theories.InterventionTwo 1‐day face‐to‐face training sessions in health coaching with 11 weeks between first and second days.Setting and participantsTwenty health‐care professionals who work with people with neurological conditions in the UK, two training facilitators.ResultsFour theories were developed using context‐mechanism‐outcome configurations to describe how training triggers critical reflection; builds knowledge, skills and confidence; how participants evaluate the relevance of the training; and their experiences of implementing the training. Some participants reported a major shift in practice, and others implemented the training in more limited ways.DiscussionFully embracing the role of coach is difficult for health professionals working in positions and settings where their clinical expertise appears most highly valued.ConclusionsTraining should address the practicality of using coaching approaches within existing roles, while organizations should consider their role in facilitating implementation.

Development and Validation of a Novel Measure for the Direct Assessment of Empathy in Veterinary Students.

Empathy is a requisite clinical skill for health professionals and empathy scores have been positively associated with professionalism, clinical competency, confidence, well-being, and emotional intelligence. In order to improve empathy in the veterinary field, it is critical to measure the construct of empathy accurately. Most research has relied on self-reporting measures to assess empathy, while some studies have recently implemented the use of simulated client encounters in veterinary education. Building on this research, the aim of the current study was to develop and validate a novel quantitative assessment tool-the Empathy Clinical Evaluation Exercise (ECEX)-designed to measure empathy based on directly observable behaviors, using simulated clients. To evaluate empathy, evaluators used the ECEX to assess the performance of student clinicians in a simulated client encounter, which contained a pre-determined number of opportunities designed to elicit empathic responses from student clinicians. Statistical analysis suggests the test has a high degree of inter-rater reliability. In addition, there was moderate correlation between average empathy scores using ECEX and previously validated measures of empathy, compassion satisfaction, and burnout. Using these methods, we found the majority of students we studied had increased empathy scores at the completion of their primary care rotations. These results provide preliminary support for the use of the ECEX as a direct and quantitative tool for the assessment of empathy. Health professionals could use this novel empathy assessment tool to teach students, evaluate teaching strategies, and improve communication competencies in a wide variety of clinical settings. Our broad aim was to examine the utility of a direct and quantitative assessment tool for measuring empathy-the ECEX-in order to answer the following questions: (1) Does the tool have good inter-rater reliability? (2) Does the tool correlate with previously validated empathy measures? and (3) Does the tool correlate with similar constructs of compassion fatigue and burnout? Our secondary aim was to evaluate the change in empathy scores over the course of a 4-month (16-week) primary care rotation (pre- to -post).

Online behaviour change technique training to support healthcare staff \u2018Make Every Contact Count\u2019

BackgroundNational Health Service (NHS) staff support service users to change health-related behaviours such as smoking, alcohol consumption, diet and physical activity. It can be challenging to discuss behaviour changes with service users hence training is needed to equip staff with up-to-date, evidence-based behaviour change skills. In order to identify how training may help to improve health professional skills in this area, this study evaluated change in professionals’ behavioural determinants following an online behaviour change skills module as part of Making Every Contact Count (MECC) training.MethodsThis evaluation comprised a within-subject design in which staff from one Northwest England NHS Trust completed a 9-item survey immediately before and after training. This prospective survey identified behavioural determinants regarding adhering to MECC recommendations to hold health conversations with service users and provided written comments about their training experiences. Individuals working within the Trust in clinical or non-clinical roles were eligible to take part and were invited to contribute to the evaluation upon uptake of their usual NHS staff online training programmes.ResultsOf participants completing the evaluation (n=206), 12 professional cadres accessed the module, most being female (91%), nurses/midwives (43%), working in children and family services (48%), aged 22 - 62 years. Eight behavioural determinants increased significantly following training, with effect sizes ranging from sizes ranging from 0.27 to 0.51; ‘identity’ did not change. Content analysis of written feedback (n=256) indicates that training enhanced staff behaviour change skills, modelled a productive and specific method of adopting a patient-led approach to behaviour change conversations, and identified that staff may require further support with embedding skills in practice.ConclusionsBehaviour change science can be translated into useful learning for NHS staff. Online training can engage staff in learning about behaviour change skills and increase their behavioural determinants to adopt these skills in practice.

Evidence, theory and context: using intervention mapping in the development of a community-based self-management program for chronic low back pain in a rural African primary care setting - the good back program

BackgroundRural Nigeria has one of the greatest burdens of low back pain but there are no effective evidence-based interventions to manage it in this population. This paper presents the application of the intervention mapping (IM) approach in the development of a complex behavior change intervention – The Good Back program, aimed at reducing non-specific chronic low back pain (CLBP) disability in rural Nigeria.MethodsThe first four steps of IM were applied. A critical review of the literature, 2 qualitative studies and a population-based cross-sectional study in rural Nigeria helped to identify two key program objectives in order to reduce CLBP disability in this population: reduce the impact of illness perceptions, fear avoidance beliefs, catastrophising, anxiety and depression by targeting maladaptive illness perceptions about CLBP; and facilitate the adoption of exercises and good posture to limit disability. A systematic review plus these studies, identified the personal and environmental determinants of the performance objectives including health literacy, self-awareness, self-efficacy, personal preference, health professional skills, health facility structure and family/community support. The theory, techniques and strategies for modifying personal and environmental determinants were also identified from these studies. Intervention components and materials were then produced for practical application. The initial developed intervention was described.ResultsThe feasibility and acceptability of the developed program was then tested using a small pragmatic non-randomised controlled study incorporating qualitative exit feedback interviews in a rural Nigerian primary health care centre. The program appeared feasible and acceptable when delivered by a highly trained physiotherapist. There were promising clinical outcomes in disability, pain intensity, illness perceptions, fear avoidance beliefs and pain medication use. Suggestions for program improvement included shorter but ongoing sessions, video demonstration of exercises/good posture, spacious exercise/demonstration rooms, and community legitimisation of exercise as treatment for back pain. Subsequent modifications to program content and delivery were then described. Theoretical modification included the addition of aspects of the social cognitive theory to the Leventhal’s self-regulatory model of illness cognitions.ConclusionsIM appears to be a suitable framework for designing complex behavior change interventions in rural Nigeria. The need for further testing of the intervention was highlighted.

Initiating the Conversation of Oncofertility: The Creation of a Dedicated BMT Oncofertility Nurse Coordinator in the Transplant and Cellular Therapy Patient Population

Topic Significance & Study Purpose/Background/Rationale Patients undergoing hematopoietic stem cell transplantation face a high risk of infertility. Despite existing ASCO, ASRM and NCCN fertility preservation guidelines, as many as 68% of oncology patients report that fertility was not discussed prior to or during therapy. Since infertility in survivorship is known to increase distress and contribute to decreased quality of life, upfront oncofertility discussions must be more embedded into our programmatic education. To increase the prevalence and depth of fertility preservation counseling among Blood and Marrow Transplant (BMT) and cellular therapy patients, the BMT oncofertility coordinator role was developed. Methods, Intervention, & Analysis Two BMT advance practice providers and one transplant coordinator completed the ECHO (Enriching Communication Skills for Health Professionals in Oncofertility) training program through the Moffitt Cancer Center to deepen knowledge of oncofertility in our patient population. Through multidisciplinary working groups with institutional fertility specialists, the BMT team developed an algorithm and standardized workflow. A BMT oncofertility coordinator role was developed to ensure each BMT patient of reproductive age receives individual reproductive counseling, options to preserve, a same day referral to reproductive endocrinology, and support through complex coordination of care and financial support services once a fertility treatment option has been determined. If fertility preservation is not possible, the coordinator provides the information and counseling that increase patients' quality of life before, during and after cancer treatment. Findings & Interpretation Between September 2018 and September 2019, in the first year of this service the oncofertility coordinator has consulted with 102 patients of reproductive age. This role has assisted in addressing critical timeframes ensuring prompt referral to fertility preservation, access to fertility resources, as well as ensuring documentation of fertility preservation discussions in the medical record. Discussion & Implications The role of the BMT oncofertility coordinator has increased access to supportive oncofertility care at the time of cancer diagnosis for both BMT patients and patients across the health system as other clinics have begun consulting the BMT oncofertility coordinator. Increased awareness of the oncofertility services available is needed to ensure all patients of reproductive age are aware of their options for fertility preservation and are given the opportunity to have the family they may desire.

Encounters between children's nurses and culturally diverse parents in primary health care

The objective of this study was to analyze the healthcare encounters between nurses and parents of different cultural backgrounds in primary health care. An ethnographic study was carried out using participant observations in health centers and interviews with nurses. Data were analyzed using thematic content analysis and constant comparative method. Four main themes were identified when nurses met parents of other cultural backgrounds: lack of mutual understanding, electronic records hamper the interaction, lack of professionals' cultural awareness and skills, and nurses establish superficial or distant relationships. The concepts of ethnocentrism and cultural imposition are behind these findings, hampering the provision of culturally competent care in primary health services. There were difficulties in obtaining and registering culturally related aspects that influence children's health and development. This was due to e-records, language barriers, and the lack of cultural awareness and skills in health professionals making the encounters difficult for both nurses and parents. These findings show that there is a clear threat for health equity and safety in primary care if encounters between nurses and parents do not improve to enable nursing care to be tailored to any individual family needs.

Training and well-equipped facility increases the odds of skills of health professionals on helping babies breathe in public hospitals of Southern Ethiopia: cross-sectional study

BackgroundHealth professionals equipped with the adequate skills of helping baby breath remain the backbone in the health system in improving neonatal outcomes. However, there is a great controversy between studies to show the proximate factors of the skills of health care providers in helping babies breathe. In Ethiopia, there is a paucity of evidence on the current status of health care provider’s skills of helping babies breathe despite the improvement in neonatal health care services. Therefore, this study intends to fill those gaps in assessing the skills of helping babies breathe and its associated factors among health professionals in public hospitals in Southern Ethiopia.MethodsA facility-based cross-sectional study was conducted among 441 health professionals from March 10 to 30, 2019. A simple random sampling method was used to select the study participants. The data were collected through pre-tested interviewer-administered questionnaire and observational checklist. A binary logistic regression model was used to identify significant factors for the skills of helping babies breathe by using SPSS version 25. The P-value < 0.05 used to declare statistical significance.ResultsOverall, 71.1% (95%CI: 66.2, 75.4%) of health professionals had good skills in helping babies breathe. Age group from 25 to 34 (AOR = 2.24; 95%CI: 1.04, 4.81), training on helping babies breathe (AOR = 2.69; 95%CI: 1.49, 4.87), well-equipped facility (AOR = 2.15; 95%CI: 1.09, 4.25), and adequate knowledge on helping babies breathe (AOR = 2.21; 95%CI: 1.25, 3.89) were significantly associated with a health professionals good skill on helping babies breathe.ConclusionsEven though a significant number of care providers had good skills in helping babies breathe, yet there is a need to further improve the skills of the provider in helping babies breathe. Hence, health facilities should be equipped with adequate materials and facilitate frequent training to the provider.

Efficacy of adaptive e-learning for health professionals and students: a systematic review and meta-analysis

ObjectiveAlthough adaptive e-learning environments (AEEs) can provide personalised instruction to health professional and students, their efficacy remains unclear. Therefore, this review aimed to identify, appraise and synthesise the evidence regarding...

Training programs in communication skills to improve self-efficacy for health personnel: Protocol for a systematic review and meta-analysis.

Background:Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel.Methods:This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible.Results:This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy.Discussion:This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care.Dissemination and ethics:The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data.Systematic review registration:PROSPERO CRD42019129384.

Participant perceptions of virtual simulation to develop non-technical skills in health professionals.

Research has identified that virtual simulations may be effective in developing non-technical skills including communication, teamwork and decision making. However, little is known about how participants perceive learning non-technical skills via engagement in virtual simulation. The aim of this research was to investigate participant perceptions and the learning experiences when engaging in virtual simulations focused on developing non-technical skills. A descriptive exploratory approach was used. An online voluntary survey collected qualitative extended responses from participants after each virtual simulation. Ethics approval was obtained for the research and guidelines adhered to throughout the study. A total of 675 responses were obtained. Participants perceive that engaging with the virtual simulation made them aware of non-technical skills including communication, teamwork, decision making, critical thinking and problem solving, and, to a lesser extent, situational awareness. Additional categories of learning, clinical practice and limitations were identified. Engaging in virtual simulation can develop awareness of non-technical skills, as well as confidence and vigilance in practice and mindfulness of a person-centred approach to healthcare. Engaging in virtual simulation may support change in the professional performance of the participants through role modelling and learning through error.