Staff Attitudes Research Articles

Nature-based approaches: a mixed methods study of facilitators and barriers to implementation in CAMHS

BackgroundThere is growing evidence that spending time with or in nature can be beneficial for health and wellbeing. Emerging evidence suggests potential benefits for staff and service users in healthcare settings, yet little is known about how to put Nature-based approaches (NBAs) into practice within the Child and Adolescent Mental Health Services (CAMHS) setting. The CAMHS Goes Wild project in Southwest England aimed to explore the implementation of NBAs within CAMHS, examining staff attitudes and understanding to identify potential benefits and challenges through a mixed methods study.MethodsThe study involved three phases of data collection: an online survey with two waves, the first wave prior to the training, and the second four months post-training, and semi-structured interviews. Data collection was designed to fit around NatureWell training, attended by sixty-four CAMHS staff, which took place alongside the study. All participants were sampled from one NHS Trust and the study was open to both those who had attended the NatureWell training and those who had not. Data were synthesised to produce an understanding of staff attitudes towards NBAs and perceived barriers and facilitators to the implementation of this approach.ResultsNinety-seven staff responded to the wave 1 survey and 57 responded to the wave 2 survey. Fourteen staff members were interviewed. Data synthesis generated three themes: Tension between the culture of CAMHS and NBAs (Theme 1) and the need for buy-in and governance support (Theme 2). Theme three described the potential benefits of NBAs for staff and service users in CAMHS and is presented in a separate paper. The first two themes are presented in this paper.ConclusionsThe implementation of NBAs in mental health service settings for CYP presents both significant challenges and opportunities. Our findings suggest multiple barriers to implementation, often in the form of organisational or cultural factors, such as the risk averse nature of the service. Our work also elucidates several potential facilitators which may address or mitigate some of these barriers. These potential enablers, such as harnessing the role of firsthand experience, warrant further exploration in the implementation of NBAs in CAMHS.

Measures to support students’ research activities and scientific mentoring in Russian universities

The present paper is devoted to the search for successful experience and analysis of the problems of supporting students’ research work (R&D) and scientific mentoring in Russian universities. The relevance of the topic is due to the need to evaluate approaches to stimulating not only research and development, but also the activities of scientific mentors in terms of the sustainability and effectiveness of the impact of existing support measures on student involvement in science andteachers’ motivation to mentoring activities. Since the interaction of students and scientific mentors, implemented in the unique organizational conditions of each particular university, and a typical all-Russian context, forms an ecosystem, the article focuses on considering measures to support research and scientific mentoring in interrelation. The purpose of the article is to consider measures to support research and scientific mentoring in Russian universities. The results of an empirical study conducted in 2024 using the methods of traditional analysis of documents (normative legal acts on measures to support research and development at the federal, regional and local levels) and a semi-structured interview with scientific mentors from among academic staff of universities (n = 30) are presented. Main results: generalization of measures to support research and development at three levels (federal, regional and local) of higher education management. It is shown that, at the federal level, they are worded extremely broadly, allowing the regions and universities to specify and refine them.The uneven distribution of support measures by region and their emphasis on financial incentives are revealed. It is concluded that each university has a limited number of documents regulating the support of research and mentoring. The contradictions in the attitude of the academic staff to the measures of support for research and scientific mentoring were disclosed. The prospects for the development of a research programme to support research and scientific mentoring in universities are considered.

A New Approach to Assess Sustainable Corporate Reputation with Citizen Comments Using Machine Learning and Natural Language Processing

This study investigates the assessment of sustainable corporate reputation through citizen comments and how it can be measured by sentiment analysis methods based on machine learning and text mining. The research analyses citizen feedback on municipalities in the field of public services and examines their impact on the social reputation of the services provided by municipalities. Support vector machines, one of the machine learning methods, was used for sentiment analysis. In the study, Google Maps comments of the citizens receiving services from the municipality were used. The results of the sentiment analysis reveal that sustainable corporate reputation is directly related to citizen satisfaction and feedback. In this context, municipalities should continuously receive feedback and make strategic improvements based on citizens’ comments to ensure sustainable service quality. Municipalities are especially appreciated by citizens for their fast, effective, and high-quality services. However, some negative comments focus on issues such as the slowness of services, cleaning problems, and staff attitudes, indicating that certain improvements are needed. This feedback emphasises the need for continuous improvement in service quality.

Improving Interprofessional Provider Perceptions About Opioid Use Disorder in the Acute Care Setting Through a Blended Educational Simulation Intervention

Background The influx of patients in the acute care setting with opioid use disorder (OUD) has outpaced many hospitals’ ability to educate interprofessional staff. This creates distressing experiences for interprofessional staff and patients, leading to moral distress and burnout in staff and poor patient outcomes. Objective The purpose of this study was to improve interprofessional staff knowledge, attitudes, and perceptions toward working with patients who have OUD using a blended classroom-simulation–based curriculum. Methods A preintervention and postintervention design was selected. Interprofessional staff (n = 46) participated in a blended classroom-simulation educational intervention focused on the neurobiology of OUD, stigma reduction, pain management, and harm reduction principles, followed by 3 high-fidelity simulation scenarios. Participants completed the Drug and Drug Problems Perceptions Questionnaire to measure staff self-perceived knowledge, skills, and attitudes when working with patients who use drugs before, immediately after, and again 3 and 6 months postintervention. Results Most respondents were nurses with an average of 7.6 (SD, 9.6) years of experience. The majority did not have prior training in substance use disorder before (75.6%). There was a statistically significant decrease in mean Drug and Drug Problems Perceptions Questionnaire scores across the total score mean: 55.2 (95% confidence interval, 52.2-58.3) versus 45.5 (95% confidence interval, 43.9-47.1), P < .001. Decreased score indicates improved attitude and perception. Discussion A curriculum consisting of a blended classroom-simulation intervention was successful at improving several domains regarding perceptions of caring for patients with OUD. This educational intervention can serve as a model for health care systems with goal of improving patient outcomes and staff well-being.

Experience, knowledge, practices and attitudes of emergency department medical staff regarding teledermatology.

The present study aimed to assess self-reported experience, knowledge, practices and attitudes of ED medical staff regarding teledermatology. Online questionnaire of ED medical staff at Prince of Wales Hospital (Sydney, Australia). Seventy-nine staff completed the questionnaire. Photographic technique and compliance with medicolegal policies were variable: 1% obtained written consent and 45.6% documented verbal consent for photography. 54.4% of respondents had concerns about the quality of their photographs. Skin photography image quality, knowledge and adherence to medicolegal policy were poor among ED medical staff. Education could reduce risk and improve outcomes.

Experiences with paediatric hospital health care: a cross-sectional study among paediatric patients

Abstract Background The measurement of patient experiences is gaining importance in many healthcare systems, including the Slovenian one. The need for a national survey on patient experiences in the paediatric inpatient settings emerged recently. Methods The survey took into account various aspects of inpatient healthcare such as admission, hospital staff, safety, food and discharge from hospital. As part of the study, children/parents were able to give praise and suggestions for improvements. We used three different questionnaires adapted to the cognitive abilities of children - a child questionnaire for the age group 9-13 years in paper form, an online adolescent questionnaire for the age group 14-18 years, and an online parent questionnaire for the age group 0 (1 month)-8 years. The questionnaires were cognitively tested and piloted before national rollout. Results The national survey was conducted between September 2023 and March 2024 and included paediatric patients who spent at least one night in an acute paediatric hospital ward. The survey included 25 paediatric wards and totally 1965 questionnaires were valid for analysis. The rough response rate was 17,6 %. The first preliminary results of the qualitative analysis suggest that surveyed paediatric patients and their parents rate highly inpatient health care services received, however they point out also to areas that need improvement such as environmental factors (noise, temperature), food, infrastructure (outdated facilities & equipment) and in some cases attitude of hospital staff. Conclusions National institute of public health carried out the first national survey on paediatric patient reported experience measures in acute hospitals in Slovenia. The results of this survey will be used to improve the quality of inpatient health care services in paediatric wards, as well renew focus on the requirements of European charter of children rights and United Nations Convention on the Rights of the Child. Key messages • National institute of public health carried out the first national survey on paediatric patient reported experience measures in hospitals in Slovenia. • The results of this survey will be used to drive hospital quality improvements.

Associations between child protective services workers’ attitudes toward kinship foster care placement, sociodemographic characteristics, and job characteristics

ABSTRACT When necessary to separate children from their parents, placing a child with kin leads to better outcomes. Child Protective Services (CPS) staff attitudes toward kinship foster care placements are an understudied factor that may influence decision-making and vary based on staff characteristics. Using February 2023 survey data from 2,861 CPS staff and multivariate linear regression analyses, we assessed associations between staff’s sociodemographic and occupational characteristics and attitudes toward kinship placement. Gender, race, position, work unit, and employment duration with CPS were significantly associated with staff attitudes. Understanding how staff view kinship placement is an important step toward removing barriers to its use.

Interventions addressing care staff views of older LGBTQ+ people in residential and homecare settings: a scoping review protocol

IntroductionPrevious research has identified that lesbian, gay, bisexual, trans and queer (LGBTQ+) social care service users have concerns and/or negative experiences of their care due to staff views and attitudes...

Restaurant staff's knowledge, practices, and attitudes pertaining to food allergy in Qassim region, Saudi Arabia: A cross-sectional analysis.

Food allergies, often triggered by minute amounts of certain foods, affect people of all ages and frequently occur in dining-out settings. Previous research in Saudi Arabia has not investigated the extent of restaurant workers' knowledge of food allergies and their role in protecting patrons from allergic reactions. This descriptive study assessed the knowledge, attitudes, and practices of restaurant staff regarding food allergies in Qassim, Saudi Arabia between January and March 2023. Interviews and observations were conducted in four stages, and data were analyzed using the Environmental Health Specialists Network Food Allergen Study Protocol. Results showed that most restaurant staff had limited knowledge of food allergens and their symptoms, and a small proportion had received specific training on food allergies. Moreover, only 14% of restaurants provided allergen information on their menus. Despite these knowledge gaps, most staff exhibited positive attitudes toward managing food allergies. Findings also indicated that factors such as experience, training, and restaurant policies were associated with higher levels of knowledge and more positive attitudes. These results highlight the urgent need for the restaurant sector to implement food allergy measures, including clear policies and comprehensive training, to prevent potentially life-threatening incidents.

Reducing health disparities in providing care services in the intensive care unit: a critical ethnographic study

ObjectiveThe intensive care unit, with its structural complexity and the exposure of critically ill patients to various disparities, presents a significant setting for health disparities. This critical ethnographic study sought to uncover cultural knowledge and ethical practices for reducing health disparities in providing care services within the intensive care unit. The focus was on understanding how ethical considerations and cultural competence can address and mitigate these disparities effectively.MethodsThis critical ethnographic study was conducted in 2022–2023 at intensive care units in western Iran. Three interrelated phases were used to collect and analyze the data. More than 300 h of observation were done during the first phase. A horizon analysis was carried out in the next phase. To further enhance the dataset, 18 informants participated in semi-structured interviews and informal conversations. Following that, the analysis procedure was conducted to identify a culture of health disparities and factors that reduce it, as it had been in the prior stage. Trustworthiness data collection methods were implemented to ensure the validity and reliability of the study.FindingsTwo key themes emerged from the study: (A) Improved cultural competence, which encompassed empathy towards patients and their families, effective communication, prioritization of continuous learning, appropriate knowledge and awareness, sensitivity to cultural and religious beliefs, staff attitude and personality, and the delivery of customized care tailored to each patient’s needs. (B) Supporting role and compensating for disparities involved recommendations for upholding ethical standards, compensatory actions, maintaining professional behavior despite external factors, addressing gaps and deficiencies, and actively defending and supporting patients.ConclusionThe findings indicate that staff with high cultural competence can ethically mitigate health disparities through their supportive roles. Managers and health policymakers should create barriers to health disparity by improving staff cultural competence and knowledge about health disparities.

Client and program-level factors associated with planned use of medications for opioid use disorder in specialty substance use treatment programs: Evidence from linked administrative data and survey data

BackgroundMost patients in specialty drug treatment programs that are not federally licensed Opioid Treatment Programs (OTPs) programs do not receive medications for opioid use disorder (MOUD). MethodsWe linked results from a survey of non-OTP treatment program directors in New Jersey (n = 81) to statewide administrative records of admissions for opioid use to those programs between July 2021–June 2022. Using multi-level regression, we examined the association of three types of factors with planned MOUD use: program survey responses, client-level factors, and program-level client characteristic mix. ResultsOf 9583 opioid treatment admissions in non-OTP settings, 41 % included treatment plans involving MOUD. Programs where directors reported staff concerns about buprenorphine's efficacy or diversion had a lower proportion of clients with planned MOUD, as did programs reporting too little physical space to prescribe. Being self-referred to treatment, unemployed and not looking for work, aged 30–49, heroin use (vs. prescription opioid use), and stimulant use in addition to opioids, were positively associated with planned MOUD; while non-Medicaid insurance, and Black and Hispanic race/ethnicity, were negatively associated with planned MOUD. Clients were more likely to have planned MOUD if their programs had a higher proportion of clients aged 30 or older, heroin as primary “drug of abuse,” stimulant use, and not working but actively looking for work. ConclusionFindings suggest addressing program staff attitudes toward buprenorphine could help increase planned MOUD. There is also a need to improve access for clients with non-Medicaid insurance, address within-program race and ethnic disparities, and address employment-related barriers to medication.

Gender equity for student parents in higher education at an English further education college

ABSTRACT This small-scale research project explores policy and staff perspectives which affect student parents in higher education at an English further education college. Drawing on Nancy Fraser’s work on the welfare state and the social organisation of care work, the paper examines approaches to a marginalised student group. Qualitative data were collected via a desk-based policy search and semi-structured individual interviews with key female members of staff. Findings indicate that official approaches were broadly based on a gender equality model. Policy blindness to gender and care work affects student parents in higher education and their socioeconomic status. The research concludes that staff attitudes reveal an institutional approach to student parents which is based on difference but is more caring than the policies themselves signify.

Students’ perception of healthcare services and factors affecting their utilization at a Nigerian University: a cross-sectional study

Healthcare service utilization among university students is critical for ensuring their health and academic success. This study was performed to determine the level of utilization as well as the perception and factors influencing the utilization of healthcare services by students at Afe Babalola University, Ado-Ekiti (ABUAD). This research involved a cross-sectional survey in which a semi-structured online questionnaire was used to collect data and a multistage sampling technique was used to sample the students. The students’ perceptions were converted to scores by summing their responses across the questions. The total score for each student was compared against the midpoint of the possible score range. Perceptions with a total score greater than or equal to 12.5 were categorized as positive, while those with a total score less than 12.5 were categorized as negative. Logistic regression analysis was used to identify predictors of healthcare service utilization. Utilization of healthcare services, the key outcome variable, was defined as the frequency with which students accessed available health services. All analyses were carried out using Statistical Product and Service Solutions (SPSS) software. A total of 429 students participated in this study, majority of whom were females (304, 70.9%), with a mean age of 18.9 ± 1.7 years. Three hundred and seventy-five students (87.4%) reported utilizing healthcare services at the university of which 186 (43.4%) reported to occasionally utilize healthcare services in the university. A total of 33.1% perceived that the attitude of staff was poor, while 12.6% strongly disagreed that the healthcare staff were incompetent. Overall, the majority (287, 66.9%) of the students had a negative perception of the utilization of healthcare services. Approximately 16% agreed that the high cost of drugs affects their utilization, while 35.9% agreed that the services provided were too expensive. Predictors of healthcare service utilization included being over 20 years old (AOR = 3.6, 95% CI: 1.1–11.6), study level, with fourth-year students having the highest likelihood of utilization (AOR = 13.8, 95% CI: 5.1–37.4), and positive perception of healthcare staff attitude (AOR = 2.5, 95% CI: 1.1–5.9). Students from lower-income families (< 200,000 Naira) were significantly more likely to utilize healthcare services (AOR = 39.2, 95% CI: 12.6–121.5). The study revealed that, despite widespread usage of healthcare services, students have a predominantly negative perception of these services. Key factors influencing healthcare utilization include age, study level, attitude of staff and family income. Addressing these barriers through targeted interventions can improve health outcomes and promote equitable access to quality healthcare.

Quality improvement in hospital: How knowledge and attitude affect job performance across different professional groups

Objective: Improving the performance of healthcare organizations is a major concern within health systems. This study aims to explore the relationship between hospital staff’s knowledge and attitudes about continuous quality improvement (CQI) and their perceived job performance while determining if professional groups moderate this relationship.Methods: A total of 250 questionnaires were distributed among three main job groups at a public hospital in Iran. Statistical analysis included variance-based structural equation modeling and Pearson correlation coefficients.Results: Of the 250 distributed questionnaires, 196 were returned (response rate: 78%). The path coefficient between staff knowledge and performance was 0.390 higher in the physician group than in the non-physician group, and 0.207 higher in the administrative-financial group. The path coefficient for the non-physician group was 0.120 higher than that of the administrativefinancial group. For staff attitudes and performance, the path coefficient was 0.160 higher in the physician group than in the non-physician group, and 0.090 higher than in the administrative-financial group. The administrative-financial group had a 0.070 higher path coefficient than the non-physician group.Conclusions: The study indicates positive relationships between hospital employees’ knowledge and attitudes about quality improvement and their job performance. These relationships were not significantly moderated by professional groups.

Dealing with assisted suicide-knowledge, attitudes and experiences of members of the German Association for Palliative Medicine

In February 2020, the Federal Constitutional Court declared §217 of the German Criminal Code void. Ever since, assisted suicide services have been legal in Germany. This study aims to describe the knowledge, attitudes and experiences of members of the German Association for Palliative Medicine (DGP) regarding assisted suicide. Online survey with members of the DGP from July to September 2023 using Qualtrics®. The study group developed the questionnaire based on current literature; it was adapted following an initial application among young physicians and an interprofessional panel of experts with consensus voting. Data was analysed using descriptive and explorative statistics. 991 DGP-members (18%) participated, of which physicians made up 57.0% (n = 545/957) and nurses 23.4% (n = 224/957). Of the participants, 197/851 (23.1%) incorrectly stated that assisted suicide is prohibited by professional code, 430/914 (47.1%) rejected arestriction of palliative care teams to suicide prevention measures, and 766/930 (82.4%) rejected personal involvement in assisted suicide regardless of a patient's health status. For patients in palliative situations, 473/926 (51.1%) could imagine participating in assisted suicide, and 71% wantednew legislation regulating assisted suicide. There are gaps in the knowledge of the participating members of the DGP regarding the legal and professional status of assisted suicide. Further educational work is needed in this regard. The participants can more easily imagine assisted suicide for people in palliative disease trajectories. As in surveys of members of other medical societies, the attitudes of more experienced staff are reflected. Compared to younger healthcare professionals, they have amore restrictive attitude towards the concept of assisted suicide.

Health Care Workers' Perspectives on Collecting Sexual Orientation and Gender Identity in the Adult Primary Care Setting.

Despite numerous calls for standardized collection of sexual orientation and gender identity (SOGI) data in clinical settings, uptake of this practice still lags. This study conducted a preimplementation assessment of staff attitudes toward SOGI data collection within an adult primary care practice in an urban academic medical center in the northeastern United States. We created a process map of the flow of patient data from the point of registration to the clinical encounter to identify all staff roles associated with registration and patient demographic data collection. We purposively sampled staff members across these roles and conducted semistructured virtual interviews between November 2021 and February 2022. The research team used deductive and inductive coding and conducted a thematic analysis to identify barriers and facilitators to implementation. Nine clinical staff and eleven nonclinical staff were interviewed. Participants were asked about their general experiences with lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, their perspectives on collecting this data, and potential barriers and facilitators to incorporating this into the workflow. The main themes that emerged were the relevance of SOGI data to the clinical practice; concerns about patient acceptability; the prevalence of cis-gender, heteronormative assumptions; and concerns about linguistic, cultural, and generational differences. Differences were noted between clinical and nonclinical staff. Greater education is needed to help both clinical and nonclinical staff understand how patients' SOGI demographics can be used to provide affirming, patient-centered care. Implementation strategies can be tailored to address specific barriers at the individual, organizational, and social levels.

Food Poisonings at Hotels, Tripadvisor Reviews in Türkiye

Tourists travel long distances and visit attractive destinations. Problems that may occur in these destinations may affect visit preferences. Food poisoning is one of the health problems that may encounter during their holidays, which will create negative memories about their holidays. In this study, comments about food poisoning cases made by foreign tourists visiting Türkiye were examined. In this way, the points to be taken into consideration for hotels to avoid food poisoning cases will be revealed. Tourist comments on the Tripadvisor website constitute the examination area of the study. The study covers comments made between 2012 and 2022. The study is a qualitative research and 731 comments containing the concept of "food poisoning" on Tripadvisor were subjected to text/content analysis to obtain the data set. After the analysis, themes and categories associated with the subject of "food poisoning" were determined. The themes of these categories are “food safety, illness, staff attitude, feelings, cause and vulnerable”. Accommodation business managers should pay attention to these issues in order to reduce food poisoning complaints and prevent the formation of a negative image.

Effect of staff competence on customer loyalty in the hospitality industry in Sri Lanka

This research investigates the relationship between staff competence and customer loyalty within the Sri Lankan hospitality industry. This study addresses a critical gap in understanding how skilled and professional service personnel impact guest satisfaction and long-term patronage. Simple random sampling was utilized to gather data from the 384 respondents using a survey questionnaire. Five independent variables were identified from literature which are staff knowledge, staff skills, staff attitudes, staff friendliness and staff responsiveness. All five variables exhibited positive correlations with customer loyalty and significant association with customer loyalty. According to the findings, staff competence is vital in encouraging customer loyalty within the Sri Lankan hospitality industry. The recommendations include that hoteliers prioritizing employee development and cultivating a service-oriented culture can create lasting bonds with their guests, contributing to long-term business success. This research provides valuable insights for academics and industry practitioners to explore further and strengthen the crucial link between service quality and customer loyalty in the dynamic Sri Lankan market.

Communicating, Eating And Drinking With Dementia

Abstract Background Problems with eating and drinking can put patients at risk of malnutrition. Hospitalised patients with dementia are at a higher risk for eating/drinking difficulties and inadequate food/fluid intake. Dysphagia in dementia can contribute to malnutrition, dehydration, weight loss, choking episodes, repeat chest infections, pneumonia, and recurrent hospitalisations - all of which can cause strain on relationships between the person with dementia and carers. Where communication (and eating/drinking/swallowing) are impacted, the person with dementia can experience a decrease in quality of life, wellbeing, sense of personhood, and quality of relationships. Direct training and indirect feeding support for care staff results in fewer mealtime difficulties, more time spent assisting at mealtimes, and a positive changes in staff attitudes towards assisting in mealtimes for people with dementia. Using observational instruments to identify eating/drinking difficulties can lead to a positive influence for staff knowledge and skills to support patients/residents. Methods Create a Departmental Information Leaflet on “Communicating, Eating and Drnking with Dementia” for staff, visitors, service users, and their families.Select a tool to be used by nursing staff to better inform on behaviours around eating and drinking with dementia (Edinburgh Feeding Evaluation in Dementia Scale (EdFED-Q)).Create a training Powerpoint for Staff on “Communicating, Eating and Drnking with Dementia” and using the EdFED-Q tool. Results Departmental Information leaflet created.Selection of the EdFED-Q tool.Training programme for nursing staff developed on Communicating, Eating and Drnking with Dementia and using the EdFED-Q tool. Conclusion As outlined in the Irish National Dementia Strategy (2014), all people who provide care or interact with those with dementia should be trained and upskilled in working with and communicating with those with dementia. It is important to continue to develop our services and build on quality initiatives to do this.

Psychometric properties of the Turkish version of Staff Attitude to Coercion Scale

BackgroundThe aim of this study was to provide the Turkish version of the Staff Attitude to Coercion Scale (SACS) and to determine its psychometric properties.MethodsThis is a descriptive and correlation design. The sample of this study consisted of 100 psychiatric staff members. The validity and reliability of the scale were assessed through translation procedures, content validity analysis, and confirmatory factor analysis (CFA). Reliability was further evaluated using Cronbach’s alpha and item-total score correlations.ResultsThe content validity index was found to be 0.93. The scale has a three-factor structure and the Cronbach’s alpha values of the subscales are 0.70 for offence, 0.87 for safety and 0.74 for treatment, respectively. The Cronbach alpha reliability coefficient of the total scale was found to be 0.86.ConclusionThe Turkish version of the SACS showed good reliability and validity, and confirmatory factor analysis revealed the same factor structure with three factors as in the original SACS.