Hospital Staff Research Articles

Experiences of Intern Nurses Returning From Distance Education to Clinical Practice During the COVID-19 Pandemic: A Qualitative Study.

The present study aimed to understand the experiences of intern nurses returning to clinical practice after a year-long distance education during the pandemic. The study was conducted using the qualitative content analysis method. The participants were 32 intern nurses. The data included specific narratives on the experience of intern nurses returning from distance education to clinical practice during the pandemic. Data were collected through a total of four focus group interviews. Data analysis was conducted using an inductive qualitative analysis approach. The content analysis identified three main categories. The category 'Feelings during Clinical Practice' included the subcategories 'fear', 'uncertainty' and 'intolerance'. The category 'Challenges during Clinical Practice' included the subcategories 'sleep problems', 'alienation from clinical placement', 'lack of knowledge and experience', 'hospital staff', 'difficulty reaching nurse educator' and 'lack of protective equipment'. The category 'Suggestions for Clinical Practice' included the subcategories 'psychological support', 'case discussion and academic counselling' and 'protective equipment support'. The study revealed that intern nurses faced various challenges in clinical settings following their year-long distance education. The results may help nurse educators understand the experiences of intern nurses returning to clinical practice after a year-long distance education and determine the teaching strategies to be followed in specific situations like pandemics in the future.

Reducing Employee Injuries from Aggressive Patient Behavior at Children's Hospital by Implementing a Behavioral Response Team.

Among hospitalized children, episodes of aggressive patient behavior place healthcare staff at risk for serious injuries. By implementing a behavioral response team at a children's hospital, we aimed to reduce monthly employee injuries related to aggressive patient behavior from 3.4 to 2.4 per 1,000 acute care visits during 12 months. At a children's hospital, a multidisciplinary team used quality improvement methodology to implement a behavioral response team that provided proactive and reactive support to staff caring for children at risk for aggressive behavior. Full-scale implementation occurred in July 2022. We measured days between Occupational Health and Safety Administration (OSHA)-recordable employee injuries related to aggressive patient behavior and total monthly employee injuries related to aggressive patient behavior per 1,000 acute care visits (emergency department visits and/or hospitalizations) by patients 3 years of age or older. In the year after full-scale implementation, an average of 101 BRT rounds and 17 reactive responses occurred per month. The maximum number of days between OHSA-recordable employee injuries related to aggressive patient behavior increased from 163 days in the year before full-scale implementation to 271 days in the following year. Monthly employee injuries related to aggressive patient behavior decreased from 3.4 to 1.7 injuries per 1,000 acute care visits by patients 3 years of age or older. The BRT model, which provides proactive and reactive support to hospital staff caring for children at risk for aggressive behavior, should be considered a strategy to reduce employee injuries and promote workplace safety.

Assessment of serum levels of 8-hydroxy-2’ deoxyguanosine and f2-isoprostanes in newly diagnosed adult hypertensive with clinical depression in NAUTH, Nnewi, Nigeria

Despite the high prevalence of depression and hypertension, the relationship between the two diseases has received little attention. The potential roles of some biomarkes of oxidative stress in disease progression and management is very crucial. Aim: The present study therefore, evaluated the serum levels of 8-hydroxy-2’ deoxyguanosine (8-OHdG) and F-2 isoprostanes in newly diagnosed hypertensive individuals with and without depression at Nnamdi Azikiwe University Teaching Hospital, Nnewi. Method: This was a cross sectional study carried out on randomly selected 121 consented adult male and female participants within the ages of 18-65 years which comprises 30 newly diagnosed hypertensive individuals without depression (Hypertensive), 31 hypertensive individuals with depression selected from the department of internal medicine. 30 non hypertensive with depression (Depressive) and 30 apparently healthy non-hypertensive individuals without depression which served as control selected among the hospital staff. Their bio-data was obtained from their hospital records. 3 ml of venous blood were collected from each of the participants, dispensed into a plain container, centrifuged and serum separated into another container and stored at -20 0C for the assessment of serum 8-OHdG using Enzyme Linked Immunosorbent Assay (ELISA) Method. Result: The result showed that Hypertensive individuals with and without clinical depression (107.08±22.05, 129.16±82.49) had significantly higher serum level of 8-OHdG when compared with control group (53.95±28.25) (P<0.05 respectively). Hypertensive individuals (129.16±82.49) also had significantly higher 8-OHdG level when compared with non-hypertensive with depression (63.31±37.30) (P<0.05). Hypertensive individuals with depression (9.94±7.14) and depressive individuals (8.99±5.84) also had significantly higher F2-Isoprostanes level when compared with control (5.15±1.47) (P<0.05 respectively). There was a moderately strong positive correlation between 8-OHdG level and body mass index in both hypertensive and depressive individuals (r=0.682, P<0.05). Conclusion: The study observed higher 8-OHdG and F2-Isoprostanes in individuals with hypertension with and without clinical depression. In addition, there is evidence that oxidative stress is related to inflammation and endothelial activation in individuals with both conditions leading to disease severity.

Understanding the consumer, carer and stakeholder experiences of residential respite care.

Residential aged care respite clients are vulnerable and prone to poor health-care outcomes. Improvements in the quality of care for this cohort are urgently needed. However, before proposing changes in care models, a nuanced understanding of relevant issues affecting respite care consumers and professionals is required. We aimed to explore perspectives of consumers, carers, health-care workers and aged care workers involved in residential respite care (RRC). We used purposive sampling to recruit respite consumers, their family members, residential aged care staff and health-care workers across metropolitan Melbourne for semi-structured telephone interviews and electronic surveys regarding RRC. Thematic analysis of interviews and surveys was performed. Twenty-three semi-structured in-depth interviews (five family members, four residential aged care staff, five general practitioners, two nurse practitioners, seven hospital staff) and 12 electronic surveys (five family members, three general practitioners, four hospital staff) were completed. Five key themes were identified: (1) reasons for using respite care vary; (2) expectations and understanding of respite care vary; (3) structural and funding factors influence the experience and quality of care; (4) care professionals often lack timely access to accurate health-care information; and (5) medical management and health-care needs of respite residents are complex. These findings from multiple stakeholders highlight several issues regarding the benefits of and problems with RRC, and the interfaces between the aged care and health-care sectors. Understanding these issues is pivotal in informing targeted and systemic interventions to improve RRC.

Accessing medical records for research in South African public hospitals: a reflective narrative

BackgroundAccess to medical data is important for health system research in South Africa. Researchers must obtain authorization from gatekeepers to enter hospitals and access medical records. They engage with street-level bureaucrats to retrieve specific records and extract necessary data. This paper reflects on our experiences accessing patient records in a nationally representative sample of 60 public hospitals in South Africa.MethodsWe chose narrative inquiry to deeply explore researchers' experiences accessing medical records in South African public hospitals. This qualitative method focuses on individuals' stories and personal experiences, providing rich, detailed insights into complex, context-dependent phenomena. Field reports documented our reflections and experiences during each hospital visit. Additionally, we conducted debriefing sessions to further explore these experiences. The themes that emerged from the field reports and debriefing sessions prompted us to delve deeper into the research process. To explore these themes, we conducted a focus group discussion (FGD) with all researchers. The FGD transcript and field reports were analyzed using MAXQDA. We adopted Gibbs's reflective model, incorporating structured debriefing steps, to present our findings.ResultsOur reflections highlight the challenges encountered during the ethical review process, engagements with numerous gatekeepers, and street-level bureaucracy. The ethics review process experienced significant delays. Obtaining permission from various gatekeepers was arduous and complex, often presenting logistical challenges. We had both positive and negative experiences with the street-level bureaucrats, including hospital staff responsible for creating, curating, and safeguarding medical records. Some exhibited resistance that appeared to stem from their frustrations with superiors. Public hospital records were mostly poorly curated.ConclusionEthical review is essential for guiding complex research like access to abortion. However, an overcautious approach might impede needed research with vulnerable populations. Researchers need to be up to date with local processes and have sufficient resources to gain gatekeepers’ permission to access public hospitals. Understanding street-level bureaucracy is imperative for researchers who need to interact with various hospital personnel to access medical records. The state of record-keeping in South African public hospitals may reflect the overall state of the health system, including examples of excellence and mediocrity.

Smart oxygen monitoring in hospitals: a pilot study during COVID-19

During 2020-2021, the COVID-19 pandemic exposed significant vulnerabilities in hospital safety, with oxygen-related fires and explosions occurring at twice the usual rate. This highlighted insufficient preparedness for increased oxygen therapy demands and the associated risks of oxygen-enriched atmospheres. This study aimed to develop and test a smart monitoring system to detect increased oxygen concentrations in hospital environments, mitigating the risk of fires. Based on Internet of Things (IoT) technology, the system includes wireless sensors that measure oxygen levels at regular intervals and transmit the data to a database. Alerts are sent to hospital staff via short message service and e-mail when oxygen levels exceed predefined thresholds. The sensors were deployed in an intensive care unit and were validated through real-time measurements under hospital conditions. The system demonstrated high accuracy (±1%) in monitoring oxygen concentrations with low power consumption (345 µA for oxygen concentration measurements taken every minute). Notifications reliably informed staff of oxygen level thresholds, enabling timely interventions. The proposed IoT-based smart monitoring system is a cost-effective and efficient solution for improving safety in medical environments.

Quiet Quitting in the Hospital Context: Investigating Conflicts, Organizational Support, and Professional Engagement in Greece

Background/Objectives: Quiet quitting, defined as employees fulfilling only the minimal requirements of their roles without extra effort or engagement, poses unique challenges in high-stress environments like hospitals where commitment directly impacts patient care. This study investigates the phenomenon of “quiet quitting” within the healthcare sector, with a specific focus on hospital staff in Greece. Methods: A cross-sectional design was employed, surveying 186 healthcare professionals from the General Hospital of Argos using the Questionnaire for Conflicts in Healthcare Organizations and the Quiet Quitting Scale (QQS). Results: Descriptive and inferential statistical analyses revealed that 62% of participants exhibited characteristics of quiet quitting, with “lack of motivation” scoring highest (M = 2.80, SD = 0.987) among QQS subscales. Significant correlations were observed between perceived reward fairness and motivation levels (r = −0.194, p < 0.01) and between management awareness of contributions and both motivation (r = −0.313, p < 0.01) and initiative (r = −0.192, p < 0.01). Logistic regression identified perceptions of management awareness as a key predictor of quiet quitting (p < 0.05). Conclusions: The findings emphasize the critical role of equitable reward systems and managerial recognition in reducing disengagement. Strategies to enhance employee engagement and resolve workplace conflicts are essential for fostering a resilient healthcare workforce.

Knowledge, attitudes, and practices toward leishmaniasis and one health: a cross-sectional study among medical and veterinary professionals

Leishmaniasis is a significant zoonotic infection with global health implications, particularly in regions where human and animal health are closely interconnected. This cross-sectional study assessed the knowledge, attitudes, and practices (KAP) of 5,074 participants regarding leishmaniasis and the One Health concept. The socio-demographic data revealed that most respondents were young (82.6%), male (82.3%), and from rural areas (50.8%), with a majority based in Khyber Pakhtunkhwa (57.4%). Veterinary professionals (42.1%) and students (27.4%) constituted the primary respondents, with 32.4% working in government hospitals. Knowledge about leishmaniasis was high, with 97.5% of participants recognizing Leishmania and 86% correctly identifying it as a protozoan disease. The majority (71.8%) believed in the zoonotic transmission of Leishmania from animals to humans. Attitudes toward the One Health concept were positive, with 90.2% of respondents aware of it, and 95.5% acknowledged the zoonotic nature of the disease. Practices for controlling sandfly populations were observed by 56.4% of participants, with bed nets (44.9%) being the most common preventive measure. Results showed that younger participants had significantly better knowledge, attitude, and perception regarding leishmaniasis and One Health compared to older individuals. Veterinarians and government hospital staff demonstrated better KAP toward VL. This study underscores the importance of educational interventions and community-based control measures to enhance understanding and prevention of leishmaniasis, with the One Health approach playing a crucial role.

Patient Experiences and Perspectives When MyChart is Introduced in a Large Community Hospital: Mixed Methods Study.

Patient portals, or secure websites linked to electronic medical records, have emerged as tools to provide patients with timely access to their health information. To support the potential benefits of patient portals such as improved engagement in health care, it is essential to understand how patients and caregivers experience these portals. This study aimed to explore patient and caregiver experiences, facilitators, and barriers to accessing and using a patient portal called MyChart during the initial stages of its implementation. We applied explanatory sequential mixed methods to conduct a web-based questionnaire and semistructured interviews with MyChart users and nonusers at a large community hospital in Ontario, Canada. Among users, we explored user satisfaction with MyChart, its impact on care, and areas for improvement. For nonusers, we explored barriers to MyChart access and willingness to use it in the future. Descriptive statistics and thematic analysis were used for data analysis. A total of 5651 patients and caregivers completed the web-based questionnaire and 18 (12 users and 6 nonusers) participated in interviews. MyChart users primarily learned about the portal through email (n=1288, 39%), after-visit summaries (n=953, 29%), and hospital staff (n=408, 12%). Nonusers cited lack of awareness (n=1291, 59%) and registration difficulties (n=707, 32%) as some barriers to activation and adoption, but the majority would consider activating and using MyChart if they could learn more about it (n=1126, 54%). Users valued MyChart for preparing for health care encounters but expressed dissatisfaction with limited features and access to medical history and test results, whereas nonusers tended to be unsure about the benefits of using MyChart, especially if they were infrequent health care users. Patient portals offer benefits, but barriers to access and limited functionality can hinder widespread use. To enhance the adoption and potential benefits of patient portals, targeted outreach and comprehensive access to health information are essential to promote positive and seamlessly integrated health care experiences.

Opportunities to Improve Care Processes for Ventilator-Dependent Children: A Single-Center Study.

Children with chronic ventilator dependence are a complex and heterogeneous population with unique needs. We sought input from parents, clinicians, and hospital staff to identify opportunities for process improvement during hospitalization and discharge preparation. We conducted a qualitative study at a large referral center for children with chronic ventilator dependence. Participants included parents of children with chronic ventilator dependence, physicians, nurses, respiratory therapists, and support staff. Two group-level assessment (GLA) sessions occurred, followed by one-on-one semistructured interviews. Thematic analysis identified areas for process improvements in the care of children with chronic ventilator dependence. A total of 27 individuals participated in 2 GLA sessions followed by 9 interviews. Potential areas for process improvements included (1) acknowledging and addressing limited resources for children with long-term mechanical ventilation dependence; (2) advancing beyond a "one-size-fits-most" care model; (3) placing the patient and family at the center of care; and (4) improving support for families and staff. Families persistently noted a traumatic component of their experiences through hospitalizations and learning to care for a child with chronic ventilator dependence. There are multiple opportunities for process improvement during the hospitalization of children with chronic ventilator dependence. Protocols and practices that support efficient and safe care, such as education before discharge, may require modifications to better meet family needs, address system shortcomings, and mitigate trauma.

Bridging Health and Sustainability: Evaluating Siloam Hospital Denpasar's Role in Advancing Medical Tourism Aligned with SDG 3

Objective: This study investigates the readiness of Siloam Hospital, Bali, to become a competitive player in medical tourism, with a focus on its alignment with the United Nations’ Sustainable Development Goal 3 (SDG 3: Good Health and Well-being). The aim is to assess the hospital's operational network and propose strategies for sustainable growth in healthcare. Theoretical Framework: Utilizing Actor-Network Theory (ANT), the research analyzes the interactions between human and non-human actors within the hospital’s ecosystem. This provides insights into operational readiness and outcomes directly supporting SDG 3. Method: The qualitative case study incorporates semi-structured interviews, document analysis, and field observations. Key stakeholders, including hospital staff, government officials, and international insurance officers, were examined to map their interactions within the hospital’s network. Results and Discussion: Findings reveal the centrality of the Medical Tourism Package in achieving SDG 3, while identifying weaknesses such as limited external collaborations and underutilization of cultural identity. Recommendations include fostering stronger external partnerships and integrating Balinese cultural elements into patient care to enhance healthcare accessibility and sustainability. Research Implications: The study provides practical recommendations for aligning medical tourism with SDG 3, offering insights for healthcare providers aiming for sustainable growth in health systems.

Evaluating sleep quality of medical staffs in hospitals in Vietnam

Sleep plays a crucial role in maintaining overall well-being. It bolsters memory consolidation, problem-solving, creativity, and emotional regulation by enhancing the brain's ability to integrate, reinforce, and retrieve information. Therefore, 7-8 hours of sleep, depending on age, is vital for optimal health, while sleep deprivation significantly raises the risk of mortality. Chronic lack of sleep and poor sleep quality are linked to a range of mental and physical disorders, including high blood pressure, cardiovascular disease, diabetes, depression, and obesity. However, in the medical field, sleep deprivation is often seen as the norm. The idea that health professionals, such as doctors and nurses, achieve sufficient sleep is almost bizarre. This article will examine the quality of sleep among health professionals using the 'Pittsburgh Sleep Quality Index' to assess how sleep impacts their routine, lifestyle, and overall well-being, both mentally and physically.

Patient safety is our business! Staff perspectives on implementing hospital falls prevention education.

Providing patients with falls prevention education reduces falls in hospitals, yet there is limited research on what influences successful implementation at the staff, ward and hospital levels. We engaged hospital-based health professionals to identify multi-level barriers and enablers to patient falls education that could influence the implementation of a Safe Recovery program. Purposive sampling was used to recruit hospital staff (n = 40) for focus groups and one-on-one interviews. Data were analysed using content analysis and categorized using a socio-ecological framework to understand the micro, meso and macro level influences of hospital falls prevention. We identified five overarching themes, on the barriers and enablers to implementation of the Safe Recovery program. The enablers to falls prevention education included sharing the responsibility to implement the program, setting clear goals for staff, showing the impact of delivering the program, involving family to reinforce the messaging, using falls champions to upskill staff and making the resources (video and booklet) readily available to patients at all times. Barriers included insufficient time for staff to deliver falls prevention education, lack of falls prevention training for staff during their clinical training, absence of standardized protocols and clinical guidelines across hospital settings and insufficient hospital marketing to promote the program. Using a systems thinking approach, this study showed that implementation requires more advocacy and support for patient falls prevention across different tiers of the hospital system to integrate into usual care.

Digital health for early psychosis in Ghana: patient and caregiver needs and preferences

In West Africa, the long-term consequences of poor early psychosis recovery include poverty, neglect, and community ostracization. To understand the potential for digital health approaches to support early psychosis care in Ghana, we conducted a survey study among early psychosis patients and their caregivers about mental health needs, technology use and access, and interest in digital mental health. Hospital staff at Accra Psychiatric Hospital reviewed hospital medical records from January 2023 - December 2023 identifying young adults (≥18 years old) who had experienced psychosis symptoms for the first time within the prior five years. Trained data assessors contacted these individuals via telephone and invited them and their caregivers to participate; those providing informed consent were interviewed via phone in Twi or English. Overall, 256 individuals participated in the survey, including 121 young adults experiencing early psychosis and 135 caregivers of early psychosis patients. The majority (80%) of early psychosis patients and their caregivers expressed interest in digital mental health for early psychosis and had access to a mobile phone (91%) and necessary mobile infrastructure. Early psychosis patients were most interested in information about managing stress and improving mood via a digital resource (72%). Caregivers desired a digital tool to provide information about psychosis symptoms (86%). Our study among those experiencing early psychosis and their caregivers in Ghana suggests readiness and acceptability of digital mental health for early psychosis care.

Impact of family care on sleep quality in perimenopausal women: mediating roles of anxiety and depression

BackgroundThis study aimed to investigate the relationship between family care, anxiety, depression, and sleep quality in perimenopausal women. Furthermore, it also aimed to examine the role of anxiety and depression in mediating family care and sleep quality. The study findings aim to provide theoretical support for alleviating anxiety and depression levels and improving sleep quality in perimenopausal women.MethodsPerimenopausal women (n = 860) in Gansu Province were surveyed using the self-rating scale of sleep, self-rating anxiety scale, self-rating depression scale, and family adaptation partnership growth affection resolve.ResultsThe sleep quality, anxiety, and depression scores of the perimenopausal women in Gansu Province were 25.33 ± 5.00, 40.74 ± 10.89, and 40.77 ± 10.03, respectively, and the family care score was 6.64 ± 2.36. Family care was negatively correlated with sleep quality, anxiety, and depression scores; anxiety was positively correlated with depression and sleep quality scores, and depression was positively correlated with sleep quality scores. Anxiety and depression in perimenopausal women partially mediated family care and sleep quality, with mediating effects accounting for 15.74% and 60.69% of the total effect, respectively.ConclusionAnxiety and depression are mediating variables between family care and sleep quality in perimenopausal women. It is recommended that hospital and community staff pay attention to the role of good family care in perimenopausal women, actively implement intervention strategies aimed at reducing anxiety and depression pathways, and improve their sleep quality.

Enhancing Healthcare Efficiency at Almasara Hospital: Distributed Data Analysis and Patient Risk Management

This study presents a distributed system using RAY, K-means clustering, and Weka software to analyze clinical data from Almasara Hospital Group in Tripoli, Libya. The goal is to reduce patient risk and healthcare costs by providing daily feedback to hospital staff. The system utilizes a dataset containing information on 560 patients, including details like patient ID, gender, doctor ID, test IDs, medication, and a binary target variable. By implementing K-means clustering in Weka, the system categorizes patients and identifies patterns to reduce risks and costs for healthcare analytics. The study first reviews existing patient care and feedback practices and then details the implementation of the daily feedback system, which involves advanced data analysis for managing patient feedback and medical data continuously. The use of K-means clustering helps segment patient data, pinpointing specific risk factors and areas for improvement. Weka software aids in the in-depth analysis of these segments, leading to actionable insights. Results show significant improvements in patient outcomes, reduced hospital-acquired infections, and medication errors, and enhanced patient satisfaction scores. Moreover, the study notes a substantial decrease in overall healthcare costs due to more efficient resource allocation and lower hospital readmission rates. This integration of daily feedback with advanced data analysis tools like K-means and Weka emerges as an effective strategy for improving patient safety and operational efficiency in healthcare settings, demonstrating the value of data-driven decision-making and providing a scalable model for other hospitals aiming to enhance patient care and cost management.

Healthy Kai (Food) Checker Web-Based Tool to Support Healthy Food Policy Implementation: Development and Usability Study

Background Public health programs and policies can positively influence food environments. In 2016, a voluntary National Healthy Food and Drink Policy was released in New Zealand to improve the healthiness of food and drinks for hospital staff and visitors. However, no resources were developed to support policy implementation. Objective This study aimed to design, develop, and test a new web-based tool to support food providers implementing the National Healthy Food and Drink Policy in New Zealand. Methods The Double Diamond model, a structured framework with 4 design phases, was used to design and develop a web-based tool. Findings from our previous research, such as (1) systematic review of barriers and facilitators to workplace healthy food policy implementation; (2) scoping review of current tools and resources available in New Zealand, Australia, and Canada; (3) interviews with food providers and public health nutrition professionals; and (4) food and drink availability audit results in New Zealand hospitals were used in the “Discover” (understanding of current gaps) and “Define” (prioritizing functions and features) phases. Subsequent phases focused on generating ideas, creating prototypes, and testing a new web-based tool using Figma, a prototyping tool. During the “Develop” phase, project stakeholders (11 public health nutrition professionals) provided feedback on the basic content outline of the initial low-fidelity prototype. In the final “Deliver” phase, a high-fidelity prototype resembling the appearance and functionality of the final tool was tested with 3 end users (public health nutrition professionals) through interactive interviews, and user suggestions were incorporated to improve the tool. Results A new digital tool, Healthy Kai (Food) Checker—a searchable database of packaged food and drink products that classifies items according to the Policy’s nutritional criteria—was identified as a key tool to support Policy implementation. Of 18 potential functions and features, 11 were prioritized by the study team, including basic and advanced searches for products, sorting list options, the ability to compile a list of selected products, a means to report products missing from the database, and ability to use on different devices. Feedback from interview participants was that the tool was easy to use, was logical to navigate, and had an appealing color scheme. Suggested visual and usability improvements included ensuring that images represented the diverse New Zealand population, reducing unnecessary clickable elements, adding information about the free registration option, and including more frequently asked questions. Conclusions Comprehensive research informed the development of a new digital tool to support implementation of the National Healthy Food and Drink Policy. Testing with end users identified features that would further enhance the tool’s acceptability and usability. Incorporation of more functions and extending the database to include products classified according to the healthy school lunches program policy in the same database would increase the tool’s utility.

To Identify and Discuss the Enablers or Facilitators and Barriers to International Medical Graduates Adapting to the United Kingdom National Health Service in a Defined Surgical Trainee Population: A Qualitative Study

Background International medical graduates (IMGs) play a crucial role in the United Kingdom National Health Service (NHS), yet they encounter significant challenges adapting to the NHS environment. This study aims to identify the enablers and barriers affecting the adaptation of IMGs, specifically focusing on surgical trainees in the Master of Surgery (MCh) program at Edge Hill University. Methods A qualitative approach was employed, utilizing an interpretivist philosophy and descriptive design. Data were collected through focus group discussions with first-year MCh surgical trainees. Thematic analysis was conducted to extract key themes related to adaptation. Results Three focus groups with a total of seven participants revealed several enablers and barriers. Enablers included robust administrative support, effective communication courses, comprehensive mentorship programs, and supportive hospital staff. Barriers identified were limited access to formal teaching, a fast-paced academic environment, language and cultural differences, and variations in medical practice. Conclusions The successful integration of IMGs into the NHS hinges on strong support systems, including administrative assistance, mentorship, and cultural and communication training. Addressing these barriers can facilitate smoother adaptation, enhance retention, and improve patient care. Recommendations To enhance IMG adaptation, the study recommends extensive induction programs, improved mentorship and support networks, cultural competence training, and better access to formal teaching with feedback.

A qualitative study exploring the feasibility and acceptability of embedding an overdose prevention sites in a U.S. hospital.

Community-based overdose prevention sites (OPS) are recognized for reducing overdose deaths and the spread of HIV and hepatitis C among people who use drugs (PWUD). While some hospitals in Europe and Canada have successfully integrated OPS into their facilities, such integration remains illegal in the United States. This study explores the feasibility and acceptability of implementing an OPS at the Hospital of the University of Pennsylvania (HUP), situated in an urban area with high rates of overdose. Using semi-structured interviews, we engaged 28 stakeholders, including clinicians, hospital leadership, security personnel, and PWUD. The study presented participants with a hypothetical scenario depicting a PWUD hospitalized multiple times for injection-related endocarditis to elicit nuanced responses. Thematic analysis of the qualitative data revealed a complex landscape of perceived benefits and challenges associated with embedding an OPS at HUP. Stakeholders acknowledged potential advantages, such as harm reduction, including patient and community safety, education, and stigma reduction. However, concerns were raised regarding acceptability among PWUD, hospital staff, leadership, and the broader Philadelphia community. Hesitancy stemmed from uncertainties about trust-building, safety protocols, clinician stigma, and institutional support. Feasibility concerns, including patient eligibility criteria, drug policy, staffing, and suitable location, were also highlighted. Despite political and cultural barriers, participants proposed strategies to garner support for a hospital-based OPS, emphasizing clinical education, anti-stigma training, and community engagement. They discussed a vision for an OPS at HUP that could serve as a haven for PWUD during hospitalization, potentially reducing patient-directed discharges and improving adherence to medical treatments, thus decreasing morbidity and readmissions. This study underscores the need to address multifaceted concerns before implementing OPS within hospital settings. Once legal and cultural impediments are addressed, insights from this research can inform the design and operation of OPS at HUP and similar institutions, contributing to enhanced patient outcomes and community well-being.

Magnitude of depression and anxiety in patients with irritable bowel syndrome: A comparative cross-sectional study.

Objective: To find out the magnitude of depression and anxiety in patients with irritable bowel syndrome (IBS) presenting at a tertiary care Gastroenterology clinic of Karachi, Pakistan. Study Design: Cross-sectional study. Setting: Department of Gastroenterology, Liaquat National Hospital & Medical College, Karachi, Pakistan. Period: February 2022 to July 2022. Methods: Patients of both genders, aged 18 – 50 years and newly diagnosed IBS patients (as per ROME-IV criteria) were assessed. Patient’s attendants, hospital staff, and students without any symptoms of IBS were taken as healthy controls. Non-probability, consecutive sampling technique was adopted. Depression and anxiety were determined using hospital anxiety and depression scale (HADS). The collected data was entered and analyzed using IBM-SPSS Statistics, version 26.0. Chi-square test was applied to compare data taking p<0.05 as significant. Results: This study was conducted on 110 IBS and 110 healthy controls. The mean age of the IBS group was 32.81± 1.12 years while that of the healthy group was 37.60 ± 1.08 years. There were 47 (42.7%) males and 63 (57.3%) females in IBS group while 72 (65.5%) males and 38 (34.5%) females in healthy groups. The prevalence of anxiety was 52.7% and that of depression was 49% according to HAD Scale in IBS group (p<0.001). Conclusion: A strong association of IBS with anxiety and depression was noted, highlighting the necessity of screening for these disorders in gastrointestinal clinics.