Staff Attitudes Research Articles

Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis

BackgroundResearch examining young people’s healthcare-seeking behaviors in Sub-Saharan Africa has largely focused on university or out-of-school youth who are sexually active and/or HIV-positive. Healthcare-seeking behavior in younger adolescents has been less well studied even though it is during secondary school years that the majority of adolescents become sexually active. There is limited evidence to guide strategies that schools, health facilities, and social service agencies use to encourage adolescents to utilize sexual and reproductive health resources prior to sexual debut.MethodsThis study used cross-sectional data collected in 2021 during school hours from eleven secondary schools in the Northwest District of Botswana. Adolescents ages 14–19 years completed surveys using hand-held tablets. Descriptive statistics were run for all variables; bivariate analyses examined their association with skipped visits. Logistic regression identified correlates of forgone visits. The outcome variable of interest was whether a respondent had ever forgone a visit to a health clinic for sexual and reproductive health information or services.Results553 adolescents, provided information used for analysis. One fifth of respondents had had sexual intercourse (21%). Most had not been tested for HIV (54%), did not know their HIV status (60%), or had not had an STI other than HIV (92%). Teachers (31%) and female family members (31%) were the most frequently consulted sources on bodily changes during adolescence. In the bivariate analysis, age, gender, sexual experience, HIV testing, awareness of HIV status, and having had an STI were significantly associated with forgone visits. At the multivariate level, younger respondents and those who had never been tested for HIV or had an STI had lower odds of forgone visits compared to their older peers and those who had been tested or had an STI. The most common reasons for forgoing visits reflected perceptions that nurses were unfriendly and did not believe adolescents should have sex. Students identified logistical barriers, including not knowing where to go, long distances to services, and limited operating hours.ConclusionsWhile logistical barriers might be easily addressed, perceived barriers, including negative staff attitudes and behaviors towards adolescents, require concerted and collaborative efforts by educators, health professionals, and policy makers to change.

Physical Health Views Among Individuals Experiencing Mental Illness: A Mixed-Methods Study of Self-Reported Health and Contributing Factors.

Severe mental illness is linked to poor physical health and shorter life expectancy, yet research on how individuals experiencing mental illness view and on improve their physical health is limited. This study investigates the perceptions of individuals experiencing mental illness regarding their physical health, utilising a mixed-methods approach. Phase I involved quantitative and qualitative data from an online Qualtrics survey, which included the 12-item Short Form (SF-12) survey to measure participants' quality of life and assess self-reported physical and mental health. Key findings from Phase I revealed significant relationships between lower Physical Component Summary (PCS) scores and factors such as the frequency of GP visits. Additionally, exercise preferences were found to significantly impact Mental Component Summary (MCS) scores, with individuals who preferred a mix of exercise settings reporting higher MCS scores compared to those who exercised alone or with a training partner. Phase II explored these findings further through semi-structured interviews, where participants discussed themes including physical health perceptions, the role of medication and the importance of the general practitioner relationship. Thematic analysis revealed five main barriers to improving physical health: accessibility and availability of services, motivation, staff attitudes, medication side effects and the experience of diagnostic overshadowing. Participants reported viewing physical and mental health as interconnected and expressed a desire for more collaborative care. The results suggest that strengthening the relationship with GPs and increasing awareness of medication side effects may improve physical health outcomes for individuals experiencing mental illness. Mental health nurses can play a pivotal role in enhancing physical health outcomes by monitoring, supporting health-improving strategies and facilitating access to primary care services.

Assessment of Patient Satisfaction with Access to Healthcare Services at Mbozi District Hospital, in Songwe Region, Tanzania

This study assessed patient’s satisfaction on access to health services in public health facilities particularly at Mbozi District Hospital, using a convenience sample of 112 patients. Data were collected through interviews, observations, and documentary reviews. The study had two specific objectives: the first was to determine the level of customer satisfaction in accessing health services, and the second was to examine factors for patient satisfaction. Descriptive statistics were used to show the demographic characteristics of respondents and frequencies and percentages were obtained. The Likert scale was used to measure the level of patient satisfaction based on their opinions while a Multiple Linear Regression model was used to examine the determinant factors for patient satisfaction. The results revealed that the level of satisfaction was inadequate where availability of experts in the hospital, such as medical doctors and specialized doctors; staff attitude (traits towards the patient); availability of medicine, and improved sanitation infrastructure (clean washrooms) were the significant determinant factors. Therefore, more efforts should be made to improve patient satisfaction by providing better health services. The local government authorities should continuously sensitize health workers to be available at their working stations. Furthermore, the hospital Management should ensure that sanitation infrastructures, especially washrooms, are constantly cleaned and should also make follow ups to ensure medicines are always available.

Staff perceptions and experiences of using Key Word Signing with children with Down syndrome and their peers in the first year of mainstream primary education.

Key Word Signing (KWS) is one system that can be used to support the communication needs of children with Down syndrome (DS) who attend mainstream school. The success of KWS in schools is mediated by staff experiences and perceptions of KWS. The current study is one of the first to explore KWS use in mainstream schools. To explore the perceptions and experiences of teachers and special needs assistants (SNAs) with reported varying levels of experience, using KWS with children with DS and their peers in the first year of mainstream primary school. Secondly, we aimed to explore how those perceptions and experiences evolved throughout the year. Five mainstream schools were recruited where children with DS attended. A speech and language therapy (SLT) researcher taught 25 key word signs to the relevant class in each school at four time points across the year. Five teachers and eight SNAs from participating schools engaged in a series of semi-structured interviews to explore their perceptions/experiences of using KWS (Lámh) over the course of the year. Longitudinal data were analysed using inductive qualitative content analysis. Four categories were generated from the data: Challenges, Facilitators, Benefits, and Incorporation into the whole school environment. Findings suggest that the supported introduction of KWS in school by an SLT researcher can assist inclusive educational practices; facilitate children's comprehension and expression; reduce frustration in children with DS; and facilitate interaction with peers. Results also indicate an increasingly positive attitude among teachers and SNAs towards KWS as the year progressed. Teachers reported the absence of a pedagogical framework as an obstacle to the integration of KWS into the curriculum, while SNAs highlighted inconsistent access to funded entry-level training. Overall, using KWS was a positive experience that supported communication in children with DS in mainstream school. However, future training should embed knowledge on key facilitators and consider how challenges can be addressed to maximize the potential of all children with communication needs attending mainstream primary school. What is already known on the subject It is well established that the use of KWS is beneficial in supporting the language and communication needs of children with DS. It is also accepted that if KWS is to be effective as a system of communication, the system needs to be understood and used by the communicative partners of those who rely on it. However, many staff in mainstream schools (with children with DS in attendance) have had limited exposure to KWS, little to no experience of using KWS and limited support available to help them create a signing environment. What this paper adds to the existing knowledge This study provides a current account of the perceptions and experiences of teachers and SNAs to the use of KWS in mainstream primary schools in Ireland. Through qualitative approaches it identifies a number of benefits, facilitators and challenges to the use of KWS in schools, as well as the need for KWS to be incorporated into a whole-school approach to communication. Lastly, the study indicates that with ongoing support over the course of the school year, staff attitudes towards KWS changed and became increasingly positive. What are the potential or actual clinical implications of this work? To facilitate the successful implementation of KWS in schools there is a need to develop a whole school-tiered intervention approach to KWS in mainstream schools. This study also highlights the need for ongoing support for school staff to use KWS to ensure successful implementation.

“Presenting psychosis”: how is it triggered on a ward and interpreted by psychiatry and other health professionals?

Purpose The purpose of this paper is to explore the bias of psychiatrists and other healthcare staff’s perception of “presenting psychosis”. The purpose of this paper is twofold: first, to suggest that psychosis, rather than residing in the individual, can be triggered by a hostile ward environment (e.g. very loud emergency alarms) as well as the negative attitudes of staff and friction with other service users; second, to argue that psychosis is not just in the person’s mind but interpreted and negatively labelled by psychiatrists and other healthcare professionals. Design/methodology/approach This paper is based on the lived experience of Ben, who was first diagnosed with schizophrenia in 2003 (when he spent two years in and out of a mental health unit). Ben had a relapse in 2013 and spent six full months in the same unit. Ben has been working as a peer worker on the same ward he was on as a patient for the last 17 months. This paper is informed by participant observation as a patient and peer worker, particularly reflecting on the general ward environment, ward reviews and punitive action faced by Ben and other service users. The title of this paper is based on occasions when Ben has been told that he cannot interact or take service users on leave off the ward, because they were “presenting psychosis”. Findings Ways of judging whether someone is presenting psychotic behaviour sounds straightforward enough but in fact can be quite complex. Whether someone is presenting psychotic behaviour is open to interpretation. Psychotic behaviour is perceived as latent or inherent within the individual by psychiatry. This paper makes the case that presenting psychotic behaviour is in fact a construct or interpretation by psychiatrists that works to limit people’s freedom, coerce them, take away their leave off the ward and voice, and which expresses power imbalances between staff and service users. The impact for service users of psychiatrists and staff’s decision-making can lead to service users being angry and upset, a negative ward environment and feelings of unfreedom. A good example is that service users present psychotic behaviour due to a hostile and frightening ward environment, with loud emergency alarms (like sirens) and the threat of restraint, restrictive practice and seclusion in de-escalation rooms being used as a threat. Originality/value People with mental illness, particularly schizophrenia like Ben, can be stereotyped as psychotic, aggressive and dangerous or a risk to themselves and others. While this can sometimes be the case the majority of people with mental illness that Ben has interacted with for over 20 years could be described as “broken” and in need of care, fixing and giving them hope in their recovery. This paper is of value because it draws on over twenty years of experience of the lived experience of Ben and his diagnosis of the harmful label of schizophrenia. It describes the added value of peer work in an in-patient mental health unit. It also introduces the new idea of “clemency”.

Designing and validating an adaptation tool for endometriosis: an exploratory mixed method study protocol

BackgroundEndometriosis is a benign and chronic gynecological estrogen-dependent condition. Research findings have highlighted its impact on different aspects of women's lives. Enhancing quality of life and supporting the well-being of those affected is advised. Yet, none of the conducted studies have taken action toward these objectives. Therefore, the present study will be conducted with the aim of "Designing adaptation tool for endometriosis".Methods/designThe method used in this study is an exploratory mixed-method study. The study will consist of two phases, starting with a qualitative phase followed by a quantitative phase. Upon approval Ethics Code from the endometriosis clinic at Imam Reza Hospital in Mashhad, Iran. The research will involve women of reproductive age diagnosed with endometriosis. In-depth and semi-structured interviews with open-ended questions will be conducted. The research aims to explore the experiences of women with endometriosis in adapting to the condition, utilizing qualitative content analysis with an approach based on the "ROY adaptation model." Sampling will be purposive until data saturation is achieved. Data analysis will follow the suggested steps using Elo Kingas' method and MAXQDA20 software. Tool design will involve an inductive approach (informed by qualitative findings) and a comparative method (based on literature review) to develop and refine tool items.DiscussionThis study is the first to employ a mixed-method approach in developing an adaptation tool for endometriosis. It uncovers underlying issues in the attitudes of patients, medical staff, and healthcare providers, offering insight into factors that can enhance the health and quality of life of affected women. The research findings can inform the creation of a relevant strategy for policymakers, planners, and healthcare professionals to better address the needs of women impacted by endometriosis.Ethical code: IR.MUMS.NURSE.REC.1403.069.

Emotions of family caregivers of individuals with young-onset dementia when seeking support in the early stages after diagnosis

Objectives Family caregivers of individuals with young-onset dementia (YOD) often struggle to seek help, despite the heavy burden of care. This study explored their feelings when attempting to find support in the early stages after diagnosis.Methods This qualitative descriptive study conducted semi-structured interviews with eight family caregivers of patients with YOD at home. The analysis extracted and coded passages related to feelings in situations in which family caregivers sought support. By comparing and examining the meanings of the codes, we identified broader themes and developed categories iteratively.Results In the early stages after diagnosis, family caregivers were concerned about "fear and anxiety about developing dementia at a young age," "desire for any information about YOD," "desire to continue currently as long as possible for the future," "desire to protect the dignity of the individual with YOD as a member of society," "hesitation to tell others that he/she has YOD," and "desire to protect their life, mind, and body, which is still in the mid-life." These concerns prompted them to seek the support of others.Conclusion Family caregivers demonstrated earnest wishes for patients with YOD and themselves in the early stages after diagnosis. They dealt with unique YOD-related struggles, including prejudice, the impact on others, and personal hesitations. Seeking support helped alleviate negative feelings arising from the diagnosis process. Family support services should prioritize early outreach at diagnosis, proactively identify difficulties, and tailor them to patients and caregivers. The attitude of the support staff, who anticipate daily life challenges and approach the family, can significantly facilitate support-seeking by caregivers.

Exploring Attitudes of Physicians towards the implementation of Mobile Health technology in Saudi Arabia

This study aims to explore Attitudes of Physicians towards the implementation of Mobile Health technology in SaudiArabia. In order to fulfil such aim, qualitative methodology was adopted and textual data were collected from 12physicians who work in King Fahad General Hospital Jeddah in Saudi Arabia. The gathered data were analysed throughusing thematic analysis. Three themes were identified (i.e. Benefits of m-health adoption, Challenges of m-healthadoption, and attitudes of medical staff following the application of m-health on their performance). The benefitsof m-health include making remote patient monitoring possible and easy, improves provider communication andcoordination, and Gives patients faster access to providers and care. The challenges of m-health include issues relatedto its usability, system integration, data security and privacy, network access, and reliability. The attitudes ofmedical staff following the application of m-health on their performance are divided into positive and negativeattitudes. Positive attitudes that connect between m-health and Increasing performance instead of documentation,and negative attitudes that connect between decreasing performance and m-health due to time consuming and itneeds training courses. The findings of this study cannot be generalised to the whole population due to limitations interms of sample size.

One way or another, you are not going to fit: trans and gender diverse people’s perspectives on sexual health services in the United Kingdom

ObjectivesTrans and/or gender diverse (T/GD) people in the UK are less likely to access sexual health services (SHS) than cisgender people and are more likely to report negative experiences. The...

Healthcare Workers' Attitudes Toward Older Adults' Nutrition: A Descriptive Cross-Sectional Study in Italian Nursing Homes.

Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers' attitudes toward older people's nutrition using the validated Italian version of the Staff Attitudes to Nutritional Nursing Geriatric care scale (SANN-G), focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software (R-4.4.2 for Windows). Results: Most healthcare workers were female (68.59%) and aged 41-50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most exhibiting neutral or negative attitudes. Healthcare workers who attended a malnutrition course were more likely to exhibit positive attitudes toward nutrition, particularly in the dimension of norms, assessment, intervention, and individualization. Younger healthcare workers, with the role of nurses and who attended a course on malnutrition, were more likely to have positive attitudes, while older healthcare workers and with the role of physicians tended to show neutral or negative attitudes. Conclusions: Education on malnutrition improves healthcare workers' attitudes toward older adults' nutrition, especially among younger nurses. The low percentage of positive attitudes (23.48%) underscores the need for broader education programs to enhance nutritional care quality.

A Theoretically Informed Process Evaluation in Parallel to a Feasibility Study of a Complex Oral Health Intervention Using NICE Guidelines in a Care Home Setting.

A theoretically informed process evaluation was undertaken in parallel to a study examining the feasibility of an oral health intervention based on an existing guideline for care homes. The objectives were to explore the factors that influenced the implementation of the intervention in order to understand the potential pathway to impact. The research team initially utilised Pfadenhauer etal.'s framework, which focuses on a number of different implementation factors: intervention characteristics, context, theory, process, strategy, agents, outcomes and setting. Nine semi-structured interviews were undertaken with care home managers and staff, predominantly within the intervention arm of the study. Interview schedules were originally based on Pfadenhauer etal.'s framework. These were coded and analysed using thematic analysis. Given the range of themes that emerged, the research team ran a reflexive workshop to determine whether Pfadenhauer etal.'s framework was able to capture and frame the authentic voice of those interviewed. The research team found that a systems lens approach better fitted the data from the interviews, capturing the idiosyncrasy of the different settings and the importance of values and beliefs of the key stakeholders. It was clear that unlike the structure proposed by Pfaednhauer etal., many of the factors were interdependent and hierarchical in nature, that is, paradigm and goals within the care home had a direct impact on the system structure, which fed into how the care home was maintained, which led onto how the different actors behaved (care home managers and staff). The process also highlighted key factors for intervention delivery: time poverty, competing needs, staff turnover, differences between shift patterns and between permanent and agency staff. Cognitive capacity of the residents and staff attitudes were also key. Adding a reflexive workshop enabled the research to critically review the Pfadenhauer etal.'s framework and change to a systems lens approach, which better explained the interdependent and hierarchical nature of the findings. It also highlighted a number of key factors that could influence the pathway to impact for the intervention. ISRCTN10276613.

Организация работы приемного отделения многопрофильного стационара и ее условия: мнение пациентов.

Patient satisfaction is one of the criteria for the effectiveness of medical care. The conditions of medical care in the reception departments, the coherence of the staff, staffing, sanitary and hygienic conditions of stay are one of the factors ensuring the quality and accessibility of medical care in specialized departments. The purpose to study the satisfaction of patients of a multidisciplinary hospital with the organization of the work of the admission department and its conditions. Materials and methods. The basis of the study was a multidisciplinary hospital with the centralization of the admission department. The capacity of the hospital is 1000 planned deployed beds. Patient satisfaction with the organization of the reception department and its conditions was studied according to a survey of 1,690 patients. The questionnaire included questions characterizing patients by gender and age, by education and social status, by the method and time of admission during the day and week, and questions aimed at studying patient satisfaction with the organization of the admission department and its conditions. Results. Patients admitted to the emergency department were characterized by the fact that among them there were approximately the same number of men and women, the age groups 55–64 and 65–74 prevailed, the third part with higher education, mostly working, 25.8% of patients were admitted to the polyclinic, 44.5% were delivered by ambulance, 27.5% were admitted by self-treatment or appeals through relatives. Patients are more often dissatisfied with the insufficient number of waiting places for patients (25.6%), queues (25.4%), and the unfriendly attitude of staff (22.4%). There are more dissatisfied among women, in the age group of 40–60 years, who were taken to the emergency room by ambulance. Patients rated the work of the admission department lower in terms of the lack of specialists, the appearance of the staff, and the design of the admission department (3.8 points each). A higher score was given for the availability of equipment (4.2 points), the ratio between staff (4.2 points), the ratio of staff to patients (4.1 points). Conclusion. A study of patients’ opinions on the organization of work and its conditions showed that 18.5% were dissatisfied, and there were more dissatisfied patients among women than among women (21.2% and 16.2%). Most often, patients were dissatisfied with the lack of waiting areas for patients and relatives (25.6%), unfriendly attitude of the staff (22.4%), and queues due to the flow of patients (25.4%).

Quality of hypertension management and health insurance impact: an assessment of insured and uninsured patients with systemic hypertension in a teaching Hospital in Ilorin, Nigeria.

Patient satisfaction is an important indicator used to measure quality of care and the performance of healthcare services. This study assessed patient satisfaction with the quality of hypertension care received by both insured and uninsured patients with systemic hypertension. This comparative cross-sectional study was conducted among insured and uninsured patients with systemic hypertension attending the Medical Outpatient Department clinics of the University of Ilorin Teaching Hospital, Kwara State, Nigeria, from May to July, 2023. Data were collected from 95 patients from each group, selected by systematic random sampling; using an interviewer-administered, anonymous, structured close ended questionnaire. Different aspects of the healthcare services were assessed; these include patient registration process, waiting time, staff attitudes, laboratory services, availability and cost of prescribed drugs etc. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 27.0 software. The insured patients with systemic hypertension had a higher overall mean satisfaction (74.1±20.8) compared to the uninsured group (69.3±23.2), though this was not statistically significant (p value = 0.417). However, the insured patients with systemic hypertension had significant satisfaction scores compared to uninsured hypertensive group in the domains of waiting time (63.6 ± 24.9 vs 48.0 ± 25.8, p=0.000), drug cost and availability (73.9 ± 24.1 vs 56.2 ± 25.0, p=0.000), and cost of service and care (74.1±24.0 vs 59.8±26.0, p=0.000). This study concluded that both insured and uninsured patients with systemic hypertension had comparable treatment, though the insured group had some better satisfaction scores in some of the assessed healthcare domains. The healthcare policy makers should endeavour to improve health insurance coverage, and utilize identified factors in policy formulation and implementation to encourage utilization of health insurance among patients.

Exploring the experiences and attitudes of qualified staff working with a psychologist responsible clinician on a specialist inpatient dementia assessment and treatment unit

This paper aims to explore how a responsible clinician (RC) from a psychology background has been received by qualified members of staff working on a specialist dementia assessment and treatment unit in the North of England. Thirteen qualified members of the multidisciplinary Team (MDT) participated in a staff questionnaire. The questionnaire used open ended questions and likert scale(s) to explore the staff’s experiences of and attitudes towards psychologists as RCs within this service. Participant comments were coded and thematically analysed, and percentage agreement with how strongly staff agreed with the seven key statements was also analysed. The team identified four core advantages of working with a psychologist responsible clinician; a focus on non-pharmacological interventions, joint working within the MDT, a holistic view of the patient and working systemically to support future care. Further research is needed to gain a better understanding of psychologists working into different specialist services within mental health trusts as responsible clinicians.

Introduction of molecular point-of-care testing for SARS-CoV-2 in a triage unit of a large maternity hospital: An evaluation of staff experiences.

Recent advances in the development of rapid SARS-CoV-2 point of care (POC) testing provided an opportunity to aid clinical decision making in front-line healthcare settings. Perspectives of POC COVID-19 screening of pregnant women are under-researched. To assess the impact of a SARS-CoV-2 POC testing platform implemented in a busy maternity hospital, with limited isolation capacity, during the third wave of the COVID-19 pandemic. We conducted a before and after comparison of two consecutive 12-month periods and a retrospective evaluation of staff attitudes and POC test acceptance. Turnaround Time (TAT) and testing numbers were assessed by computer audit. Qualitative data was collected using confidential questionnaires. Mean TAT for the POC platform was 5.3x quicker (p < 0.001, chi-square test) when compared with local virus laboratory PCR testing. Samples sent for laboratory testing reduced by almost one third, following introduction of the POC device. A total of 27 staff members completed a POC testing satisfaction survey, which documented ease of use and benefits for diagnosis assistance, patient management and patient experience. In this single-center maternity setting, POC testing decreased laboratory testing volume and SARS-Cov-2 result TAT for symptomatic women and those awaiting crucial investigations. POC COVID-19 investigation was deemed acceptable by the clinical team for facilitating patient placement, management, and use of limited isolation capacity.

Evaluating the impact of staff attitudes and behaviours on hospital-associated deconditioning

Evaluating the impact of staff attitudes and behaviours on hospital-associated deconditioning

Assessing ambulance staff attitudes toward mental health conditions: translation and psychometric evaluation of the medical condition regard scale among ambulance staff

IntroductionAmbulance staff play a crucial role in responding to mental health crises. However, negative regard toward patients with mental health conditions can hinder care. The Medical Condition Regard Scale (MCRS) assesses regards or attitudes but has not previously been validated for educated ambulance staff and has never been translated into Norwegian. This study aims to translate the instrument into Norwegian, test it on a population of ambulance staff, explore the psychometric properties of the Norwegian version, and measure regard for patients with psychosis.MethodThe MCRS is an 11-item instrument with a Likert scale of 1–6. Possible sum scores range from 11 to 66 (higher score = more positive regards). We chose “psychosis” as the condition to investigate. Translation followed eight steps: (1) preparation, (2) forward translation, (3) backward translation, (4) first expert panel review, (5) harmonisation, (6) cognitive debriefing, (7) second expert panel review, and (8) writing of the final version. The instrument was tested and re-tested regarding the condition “psychosis” on a representative sample of 114 Norwegian ambulance staff in 2023, with a temporal gap of one month. We explored item scores and distribution, as well as floor and ceiling effects. We tested the internal consistency of the items using Cronbach’s Alpha and consistency in answers over time (test and re-test) using the Paired Sample-T test. We used factor analyses to explore the inter-item relationships of the items.ResultsThe 114 participants had a mean sum score of 47, which is mid-range. The scale has a ceiling effect on five items, which was not described in detail earlier. Two items regarding the monetary spending on patients with the given condition had the largest ceiling effects. However, the Norwegian translation showed adequate internal consistency (Cronbach’s Alpha = 0.82) and is reliable over time. Test and re-test showed no significant differences in the scale’s total score (Paired sample T-test, p > 0.05). Exploratory and confirmatory factor analyses indicate that the scale should be used as a one-dimensional instrument in a Norwegian setting in ambulance staff populations.ConclusionThe Norwegian translation of the MCRS is a reliable instrument for ambulance staff measuring medical condition regards. However, the ceiling effect limits the ability to discern differences among high-scoring individuals. Ambulance staff’s regard for patients with psychosis is medium positive (mid-range level), but slightly more positive than what is reported in the international literature regarding patients with mental health issues.

Implementation and impact of NHS-funded tobacco dependence services in England: a mixed-method evaluation protocol

IntroductionTobacco smoking remains a leading cause of ill-health, premature mortality and a driver of health inequalities. To support smokers in England, a comprehensive approach to treating tobacco dependence is being...

Assessment of Pregnant Women's Satisfaction With the Model of Care Initiative: Antenatal Care Services at Primary Health Care Centers in the Qassim Health Cluster, Saudi Arabia.

Patient satisfaction is a critical indicator of healthcare quality, including high-quality antenatal care (ANC), and it directly impacts care continuity and health outcomes. This study assessed the satisfaction levels of pregnant women with ANC services provided at primary healthcare centers (PHCs) within the Qassim Health Cluster, Saudi Arabia. A cross-sectional survey was conducted among 646 pregnant women attending ANC services in the Qassim region. Participants completed a validated questionnaire assessing demographic characteristics, healthcare interactions, and satisfaction levels across various ANC service aspects, including waiting times, healthcare provider communication, and healthcare service quality. Statistical analyses, including Pearson's chi-squared tests, Fisher's exact tests, and regression analyses, were performed to identify predictors of satisfaction. The majority of participants (N=366, 90.6%) reported successfully booking their appointments, and 368 (91.1%) faced no challenges during the process. While 393 (97.3%)and 398 (98.5%) reported receiving weight and blood pressure measurements, respectively, only 312 (77.2%) were advised on diet, and 298 (73.8%) received explanations about alarming symptoms. Communication gaps were noted, with 71% (N=287) of participants indicating that physicians did not introduce themselves, and 307 (76%) reported that physicians did not disclose their specialties. Satisfaction levels were highest for maintaining privacy (273 (67.6%) highly satisfied) and healthcare staff attitudes (247 (61.1%) highly satisfied), with an overall satisfaction mean score of 4.31±0.869. Regression analyses identified healthcare service levels and years of marriage as significant predictors of satisfaction (p<0.05). While overall satisfaction with ANC services was high, areas such as physician communication and health education require improvement. Interventions focusing on enhancing patient-provider interactions, providing comprehensive health education, and optimizing service delivery could further improve satisfaction.

Analisis Kualitas Pelayanan Perpustakaan Daerah di Kota Depok

The reading interest index in Indonesia according to the UNESCO survey is still relatively low, so support from various parties is needed, one of which is quality library facilities and infrastructure. Therefore, it is necessary to analyze the quality of library services. This study aims to assess the quality of regional library services in Depok City using a qualitative descriptive approach. The focus of this study refers to the five dimensions of Prasuraman's theory, namely Responsiveness, Assurance, Tangible, Empathy, and Reliability.Data collection was carried out through observation, interviews, and documentation. The results of the study showed that the library succeeded in providing accurate, timely, and consistent services in accordance with strict SOPs and routine evaluations, reflecting a high level of reliability. In terms of responsiveness, the library is responsive to visitor needs through mobile library services, digital services, and efficient complaint management. Service quality is guaranteed through regular training for staff and friendly attitudes of officers, creating a comfortable and trusted environment. Empathy is shown through an approach that is tailored to visitor needs, providing personal attention that makes visitors feel appreciated. Despite limitations in facilities, the library strives to provide adequate services, including facilities for people with disabilities, especially the blind and deaf.