Support Health Care Professionals Research Articles

TRACHES Toolkit: A Report on the Creation and Implementation of a Novel Digital Educational toolkit for Tracheostomy Care in Wales

In the United Kingdom, more than 17,000 patients per year require a tracheostomy, of whom up to 30% will experience some form of avoidable harm. Education is key to supporting healthcare professionals in caring for people with a tracheostomy. However, delivering standardised education at a national level is challenging. In response to this challenge, we developed and implemented a ‘TRACHES toolkit’ for utilisation across all acute hospitals in Wales, United Kingdom. The toolkit is an online resource including tutorials, a Checklist poster, case-based assessments, certification, National Tracheostomy Safety Project resources, and webinars on various topics. The toolkit was implemented in August 2020 utilising implementation science methodology. Since then, the content has been accessed 19,183 times by 976 healthcare professionals across NHS Wales, with representation from the multi-professional workforce. As of December 2023, 471 healthcare professionals had completed the online competency across Wales. Further work is now underway to demonstrate the impact of the Toolkit on patient outcomes. Additionally, future developments aim to incorporate education on community care for adults with a tracheostomy and for children in both hospital and community settings.

Machine Learning First Response to COVID-19: A Systematic Literature Review of Clinical Decision Assistance Approaches during Pandemic Years from 2020 to 2022

Background: The declaration of the COVID-19 pandemic triggered global efforts to control and manage the virus impact. Scientists and researchers have been strongly involved in developing effective strategies that can help policy makers and healthcare systems both to monitor the spread and to mitigate the impact of the COVID-19 pandemic. Machine Learning (ML) and Artificial Intelligence (AI) have been applied in several fronts of the fight. Foremost is diagnostic assistance, encompassing patient triage, prediction of ICU admission and mortality, identification of mortality risk factors, and discovering treatment drugs and vaccines. Objective: This systematic review aims to identify original research studies involving actual patient data to construct ML- and AI-based models for clinical decision support for early response during the pandemic years. Methods: Following the PRISMA methodology, two large academic research publication indexing databases were searched to investigate the use of ML-based technologies and their applications in healthcare to combat the COVID-19 pandemic. Results: The literature search returned more than 1000 papers; 220 were selected according to specific criteria. The selected studies illustrate the usefulness of ML with respect to supporting healthcare professionals for (1) triage of patients depending on disease severity, (2) predicting admission to hospital or Intensive Care Units (ICUs), (3) search for new or repurposed treatments and (4) the identification of mortality risk factors. Conclusion: The ML/AI research community was able to propose and develop a wide variety of solutions for predicting mortality, hospitalizations and treatment recommendations for patients with COVID-19 diagnostic, opening the door for further integration of ML in clinical practices fighting this and forecoming pandemics. However, the translation to the clinical practice is impeded by the heterogeneity of both the datasets and the methodological and computational approaches. The literature lacks robust model validations supporting this desired translation.

Empowering Second Victims: Supporting Healthcare Professionals after Adverse Health Events

Purpose: This essay provides a comprehensive analysis of support programs for healthcare professionals following an adverse health event. Through the use of electronic health records, health information exchange, and interoperability with data standards, these programs aim to address the effects on second victims.
 Methodology: The methodology utilized includes a thorough review of the literature on the topic and presents key findings and implications for future research.
 Findings: Overall, these results highlight the importance of supporting healthcare professionals to improve patient outcomes and minimize negative impacts within the healthcare system.
 Unique contribution to theory, policy and practice: As healthcare evolves ceaselessly, we must cultivate an environment where the shaken can recover their footing. Collaborative efforts and advances can weave together a support structure sturdy enough to hold up all harmed by mishaps as second victims.

Rewiring care delivery through Digital Therapeutics (DTx): a machine learning-enhanced assessment and development (M-LEAD) framework

BackgroundDigital transformation has sparked profound change in the healthcare sector through the development of innovative digital technologies. Digital Therapeutics offer an innovative approach to disease management and treatment. Care delivery is increasingly patient-centered, data-driven, and based on real-time information. These technological innovations can lead to better patient outcomes and support for healthcare professionals, also considering resource scarcity. As these digital technologies continue to evolve, the healthcare field must be ready to integrate them into processes to take advantage of their benefits. This study aims to develop a framework for the development and assessment of Digital Therapeutics.MethodsThe study was conducted relying on a mixed methodology. 338 studies about Digital Therapeutics resulting from a systematic literature review were analyzed using descriptive statistics through RStudio. Machine learning algorithms were applied to analyze variables and find patterns in the data. The results of these analytical analyses were summarized in a framework qualitatively tested and validated through expert opinion elicitation.ResultsThe research provides M-LEAD, a Machine Learning-Enhanced Assessment and Development framework that recommends best practices for developing and assessing Digital Therapeutics. The framework takes as input Digital Therapeutics characteristics, regulatory aspects, study purpose, and assessment domains. The framework produces as outputs recommendations to design the Digital Therapeutics study characteristics.ConclusionsThe framework constitutes the first step toward standardized guidelines for the development and assessment of Digital Therapeutics. The results may support manufacturers and inform decision-makers of the relevant results of the Digital Therapeutics assessment.

Causes and Ways of Death in Patients With Head and Neck Cancer

There is limited literature on the exact causes and ways of death in patients with head and neck cancer. To provide optimal care, especially in the palliative phase, more information on this is needed. To provide insights into the causes and ways of death among patients with head and neck cancer. This retrospective cohort study included a consecutive population of patients who received a diagnosis of primary squamous cell carcinoma of the head and neck between January 2006 and December 2013 who were treated in the Erasmus MC. Patient data were merged with nonpublic microdata from Statistics Netherlands. Follow-up time was specified as the date of diagnosis until death or December 3, 2019, whichever came first. The data were checked and reanalyzed in November 2023. Causes (eg, head and neck cancer, other cancer) and ways (eg, natural death, suicide) of death. A total of 1291 patients (59.2%; 342 women [26.5%]) died during follow-up (median [IQR] follow-up, 2.7 [1.2-5.6] years). The main cause of death was head and neck cancer (557 [43.1%]), followed by the competing cause of other cancers (344 [26.6%]). In total, 240 patients (18.6%) received palliative sedation and 70 patients (5.4%) euthanasia. Compared with patients with head and neck cancer as the underlying cause of death, lower odds ratios (ORs) were observed for receiving palliative sedation (OR, 0.32 vs 0.07; 95% CI, 0.22-0.46 vs 0.03-0.12) and euthanasia (OR, 0.22 vs 0.01; 95% CI, 0.11-0.41 vs 0-0.107) in patients with other causes of death. Patients with a middle and high income had higher ORs for receiving palliative sedation (OR, 1.46 vs 1.86; 95% CI, 1.05-2.04 vs 1.22-2.85) or euthanasia (OR, 2.25 vs 3.37; 95% CI, 1.18-4.3, 1.6-7.12) compared with low-income patients. Retired patients had lower ORs for receiving palliative sedation or euthanasia compared with employed patients (OR, 0.56 vs 0.44; 95% CI, 0.39-0.8 vs 0.24-0.82). The results of this cohort study suggest that more than half of the patients died of competing causes and palliative sedation and euthanasia were more common in patients with head and neck cancer as the underlying cause of death. Patients with a higher socioeconomic status had higher odds of receiving palliative sedation and euthanasia. These insights may support health care professionals in providing patient-centered care, especially for patients in the palliative phase.

Enabling personalised disease diagnosis by combining a patient’s time-specific gene expression profile with a biomedical knowledge base

BackgroundRecent developments in the domain of biomedical knowledge bases (KBs) open up new ways to exploit biomedical knowledge that is available in the form of KBs. Significant work has been done in the direction of biomedical KB creation and KB completion, specifically, those having gene-disease associations and other related entities. However, the use of such biomedical KBs in combination with patients’ temporal clinical data still largely remains unexplored, but has the potential to immensely benefit medical diagnostic decision support systems.ResultsWe propose two new algorithms, LOADDx and SCADDx, to combine a patient’s gene expression data with gene-disease association and other related information available in the form of a KB, to assist personalized disease diagnosis. We have tested both of the algorithms on two KBs and on four real-world gene expression datasets of respiratory viral infection caused by Influenza-like viruses of 19 subtypes. We also compare the performance of proposed algorithms with that of five existing state-of-the-art machine learning algorithms (k-NN, Random Forest, XGBoost, Linear SVM, and SVM with RBF Kernel) using two validation approaches: LOOCV and a single internal validation set. Both SCADDx and LOADDx outperform the existing algorithms when evaluated with both validation approaches. SCADDx is able to detect infections with up to 100% accuracy in the cases of Datasets 2 and 3. Overall, SCADDx and LOADDx are able to detect an infection within 72 h of infection with 91.38% and 92.66% average accuracy respectively considering all four datasets, whereas XGBoost, which performed best among the existing machine learning algorithms, can detect the infection with only 86.43% accuracy on an average.ConclusionsWe demonstrate how our novel idea of using the most and least differentially expressed genes in combination with a KB can enable identification of the diseases that a patient is most likely to have at a particular time, from a KB with thousands of diseases. Moreover, the proposed algorithms can provide a short ranked list of the most likely diseases for each patient along with their most affected genes, and other entities linked with them in the KB, which can support health care professionals in their decision-making.

Primary care provision for young people with ADHD: a multi-perspective qualitative study.

Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder. UK guidance states that primary care has a vital role in effective ADHD management, including referral, medication prescribing and monitoring, and providing broader mental health and wellbeing support. However, many GPs feel unsupported to provide health care for young people with ADHD. Inadequate health care is associated with rising costs for patients and society. To investigate the experiences of young people with ADHD accessing primary care in England, from the perspectives of people with lived experience of ADHD and healthcare professionals (HCPs). A qualitative study. Interviews were conducted with HCPs (GPs, practice managers, and a wellbeing worker) and people with lived experience of ADHD (young people aged 16-25 years and their supporters) located in integrated care systems across England. Semi-structured interviews were conducted with participants at five purposively selected general practices (varying by deprivation, ethnicity, and setting). Questions focused on experiences of accessing/providing health care for ADHD. Reflexive thematic analysis was undertaken within a critical realist framework to understand how provision works in practice and to explore potential improvements. In total, 20 interviews were completed with 11 HCPs and nine people with lived experience. Three themes were generated: a system under stress, incompatibility between ADHD and the healthcare system, and strategies for change in ADHD primary care provision. Standardisation of ADHD management in primary care, providing better information and support for HCPs, and advising on reasonable adjustments for people with lived experience could help improve access to effective treatments for young people living with ADHD.

Expert United Kingdom consensus on the preservation of joint health in people with moderate and severe haemophilia A: A modified Delphi panel.

For people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia-related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript. Fifteen HCPs experienced in the management of PwHA in the UK participated in a three-round Delphi panel. Consensus was defined at ≥70% of panellists agreeing or disagreeing for Likert-scale questions, and ≥70% selecting the same option for multiple- or single-choice questions. Questions not reaching consensus were revised for the next round. 26.8% (11/41), 44.8% (13/29) and 93.3% (14/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of ≤5 IU/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level ≥15 IU/dL and maintain a longer period with FVIII levels of ≥20-30 IU/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50-150 IU/dL) FVIII levels. The panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs.

How to Support Health Care Professionals in Emergencies

ABSTRACT In recurring emergencies, frontline health care professionals (HCPs) have taken on a dual responsibility of not only serving as medical professionals for patients but also disseminating medical knowledge online for the public to alleviate their anxiety. They are expected to perform both online and offline organizational citizenship behavior (OCB). However, HCPs carry out their duties with high risks, inhibiting their OCB. This study aims to understand how to effectively and efficiently integrate online and offline support to facilitate HCP’s online and offline OCB in recurring emergencies. Data was collected from a survey among HCPs amid the second wave of the COVID-19 pandemic from March to April 2021. It was found that perceived support helps promote HCPs’ OCB through increasing optimism and resilience. Moreover, offline problem-focused support is more helpful than online emotion-focused support for HCPs with more knowledge of the emergency.

Effects of Digitization of Self-Monitoring of Blood Glucose Records Using a Mobile App and the Cloud System on Outpatient Management of Diabetes: Single-Armed Prospective Study.

In recent years, technologies promoting the digitization of self-monitoring of blood glucose (SMBG) records including app-cloud cooperation systems have emerged. Studies combining these technological interventions with support from remote health care professionals have reported improvements in glycemic control. To assess the use of an app-cloud cooperation system linked with SMBG devices in clinical settings, we evaluated its effects on outpatient management of diabetes without remote health care professional support. In this multicenter, open-label, and single-armed prospective study, 48 patients with diabetes (including type 1 and type 2) at 3 hospitals in Japan treated with insulin or glucagon-like peptide 1 receptor agonists and performing SMBG used the app-cloud cooperation system for 24 weeks. The SMBG data were automatically uploaded to the cloud via the app. The patients could check their data, and their attending physicians reviewed the data through the cloud prior to the patients' regular visits. The primary outcome was changes in glycated hemoglobin (HbA1c) levels. Although HbA1c levels did not significantly change in all patients, the frequency of daily SMBG following applying the system was significantly increased before induction at 12 (0.60 per day, 95% CI 0.19-1.00; P=.002) and 24 weeks (0.43 per day, 95% CI 0.02-0.84; P=.04). In the subset of 21 patients whose antidiabetic medication had not been adjusted during the intervention period, a decrease in HbA1c level was observed at 12weeks (P=.02); however, this significant change disappeared at 24 weeks (P=.49). The Diabetes Treatment Satisfaction Questionnaire total score and "Q4: convenience" and "Q5: flexibility" scores significantly improved after using the system (all P<.05), and 72% (33/46) patients and 76% (35/46) physicians reported that the app-cloud cooperation system helped them adjust insulin doses. The digitization of SMBG records and sharing of the data by patients and attending physicians during face-to-face visits improved self-management in patients with diabetes. Japan Registry of Clinical Trials (jRCT) jRCTs042190057; https://jrct.niph.go.jp/en-latest-detail/jRCTs042190057.

Quality of Life, Fatigue and Social Support Among Healthcare Professionals During the COVID 19 Pandemic: A Systematic Review

Background: With the demanding nature of their work, healthcare professionals often face challenges that can affect their overall well-being. Understanding the factors that affect their quality of life is crucial to developing effective interventions and support systems. Aim: The present systematic review investigated the relationship between quality of life, fatigue, and social support among healthcare professionals during the COVID-19 pandemic. Methods: The search for studies included in the study was performed using four online databases: PubMed, Embase, Scopus, and Web of Science. The search was limited to articles published in English between January 1, 2020 and March 31, 2023. In total, 14 articles were included in the systematic review. Results: The findings of this work showed a negative correlation between fatigue and quality of life in health professionals, as well as a positive correlation between social support and quality of life. Furthermore, it was found that the increased social support of healthcare professionals during the period of COVID-19 is associated with a better quality of professional life. Conclusion: It seems that higher levels of social support are associated with lower levels of anxiety and depression among health professionals.

Health literacy of patients with chronic diseases – quantitative results of a mixed methods study in primary healthcare / Gesundheitskompetenz von Menschen mit chronischer Erkrankung – quantitative Ergebnisse einer Mixed-Methods-Studie in der Primärversorgung

Abstract Background In research and practice to promote health literacy, people with chronic illnesses represent an important target group. They are confronted with complex demands during the course of their illness. And, they utilize healthcare services more frequently. Patients are often dependent on the support of healthcare professionals. Population-based studies in Germany conducted that the majority of people find it most difficult to assess health information. The studies emphasize the enhancement of professional‘s health literacy, e. g. in nursing profession, as a prerequisite for improving capabilities in the population. In order to achieve better access and a needs-based care for people with chronic illnesses, a project in northern Germany has developed and offered a care-led concept. Methods As part of this project, data on self-assessed health literacy of chronically ill patients from a community health center was collected and analyzed using a quantitative survey in a mixed-methods study. Results The data analysis shows that more than half of the participants, regardless of gender and age, rate their health literacy as inadequate. On every level of information requirements and areas difficulties were reported. Conclusion The involvement of patients is needed in order to establish suitable strategies to empower health literacy for people with chronic illnesses. Particularly, the promotion of professional and organizational health literacy is essential for this.

Quality of Life in the Management of Anaphylaxis in Food-Allergic Adults.

Anaphylaxis is a life-threatening allergic reaction that can significantly affect the quality of life of those affected. Factors including undiagnosed allergies, lack of allergen information, and insufficient emergency training can impact the quality of life for food-allergic individuals. Well-informed patients are less likely to experience severe allergic responses, ensuring their safety and quality of life. This study aims to evaluate the effectiveness of following preventive behavior, focusing on routine counseling and training provided by healthcare professionals in preventing anaphylaxis and assessing the impact of strict adherence to an allergen avoidance regimen against anaphylaxis. This study was a descriptive, cross-sectional survey conducted in the Makkah region of Saudi Arabia. It involved adults aged 18 and above who had food allergies. A structured online questionnaire of seven items was developed and distributed to achieve the study's goals from October 2023 to January 2024. The data collected was automatically exported to Excel and then analyzed using the Statistical Package for the Social Sciences. The study involved 93 participants, 65.6% female and 34.4% male. Among those with food allergies, 34.4% had experienced anaphylaxis, with 50% allergic to eggs and seafood. The study found no significant association between specific food allergens and a history of anaphylaxis, but strict allergen avoidance was linked to lower anaphylaxis rates. Counseling or training for managing food allergy reactions also showed potential benefits. The research indicated that males were less likely to have anaphylaxis than females, and age increased the severity of anaphylaxis reactions regardless of gender. The study emphasizes the importance of preventive behaviors and healthcare professional support in reducing the risk of anaphylactic reactions for food-allergic adults. Future research could focus on improving their quality of life through education programs, policy development, and better access to emergency medications and psychosocial support strategies.

Supporting health and social care professionals in serious illness conversations: Development, validation, and preliminary evaluation of an educational booklet.

Serious illness conversations aim to align the care process with the goals and preferences of adult patients suffering from any advanced disease. They represent a challenge for healthcare professionals and require specific skills. Conversation guides consistent with task-centered instructional strategies may be particularly helpful to improve the quality of communication. This study aims to develop, validate, and preliminarily evaluate an educational booklet to support Italian social and healthcare professionals in serious illness conversations. A three-step approach, including development, validation, and evaluation, was followed. A co-creation process with meaningful stakeholders led to the development of the booklet, validated by 15 experts on clarity, completeness, coherence, and relevance. It underwent testing on readability (Gulpease index, 0 = lowest-100 = maximum) and design (Baker Able Leaflet Design criteria, 0 = worst to 32 = best). Twenty-two professionals with different scope of practice and care settings evaluated acceptability (acceptable if score ≥30), usefulness, feasibility to use (1 = not at all to 10 = extremely), and perceived acquired knowledge (1 = not at all to 5 = extremely). After four rounds of adjustments, the booklet scored 97% for relevance, 60 for readability, and 25/32 for design. In all, 18 (81.8%), 19 (86.4%) and 17 (77.3%) professionals deemed the booklet acceptable, moderate to highly useful, and feasible to use, respectively; 18/22 perceived gain in knowledge and all would recommend it to colleagues. The booklet has good readability, excellent design, high content validity, and a high degree of perceived usefulness and acquired knowledge. The booklet is tailored to users' priorities, mirrors their most frequent daily practice challenges, and offers 1-minute, 2-minute and 5-minute solutions for each scenario. The co-creation process ensured the development of an educational resource that could be useful regardless of the scope of practice and the care setting to support professionals in serious illness conversations.

The NeoPACE study: study protocol for the development of a core outcome set for neonatal palliative care

BackgroundNeonatal death is the leading category of death in children under the age of 5 in the UK. Many babies die following decisions between parents and the neonatal team; when a baby is critically unwell, with the support of healthcare professionals, parents may make the decision to stop active treatment and focus on ensuring their baby has a ‘good’ death. There is very little evidence to support the clinical application of neonatal palliative care and/or end-of-life care, resulting in variation in clinical provision between neonatal units. Developing core outcomes for neonatal palliative care would enable the development of measures of good practice and enhance our care of families. The aim of this study is to develop a core outcome set with associated tools for measuring neonatal palliative care.MethodThis study has four phases: (1) identification of potential outcomes through systematic review and qualitative interviews with key stakeholders, including parents and healthcare professionals (2) an online Delphi process with key stakeholders to determine core outcomes (3) identification of outcome measures to support clinical application of outcome use (4) dissemination of the core outcome set for use across neonatal units in the UK. Key stakeholders include parents, healthcare professionals, and researchers with a background in neonatal palliative care.DiscussionDeveloping a core outcome set will standardise minimum reported outcomes for future research and quality improvement projects designed to determine the effectiveness of interventions and clinical care during neonatal palliative and/or end-of-life care. The core outcome set will provide healthcare professionals working in neonatal palliative and/or end-of-life support with an increased and consistent evidence base to enhance practice in this area.Trial registrationThe study has been registered with the COMET initiative (https://www.comet-initiative.org/Studies/Details/1470) and the systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023451068).

Content, Mechanism, and Outcome of Effective Telehealth Solutions for Management of Chronic Obstructive Pulmonary Diseases: A Narrative Review.

Telehealth (TH) solutions for Chronic Obstructive Pulmonary Disease (COPD) are promising behavioral therapeutic interventions and can help individuals living with COPD to improve their health status. The linking content, mechanism, and outcome of TH interventions reported in the literature related to COPD care are unknown. This paper aims to summarize the existing literature about structured TH solutions in COPD care. We conducted an electronic search of the literature related to TH solutions for COPD management up to October 2023. Thirty papers presented TH solutions as an innovative treatment to manage COPD. TH and digital health solutions are used interchangeably in the literature, but both have the potential to improve care, accessibility, and quality of life. To date, current TH solutions in COPD care have a variety of content, mechanisms, and outcomes. TH solutions can enhance education as well as provide remote monitoring. The content of TH solutions can be summarized as symptom management, prompt physical activity, and psychological support. The mechanism of TH solutions is manipulated by factors such as content, mode of delivery, strategy, and intensity. The most common outcome measures with TH solutions were adherence to treatment, health status, and quality of life. Implementing effective TH with a COPD care bundle must consider important determinants such as patient's needs, familiarity with the technology, healthcare professional support, and data privacy. The development of effective TH solutions for COPD management also must consider patient engagement as a positive approach to optimizing implementation and effectiveness.

Making prediabetes visible in primary health care: a qualitative study of health care professionals’ perspectives

BackgroundPeople with prediabetes are at high risk of developing type 2 diabetes and its complications, such as cardiovascular diseases and premature mortality. Primary prevention and health maintenance are therefore imperative. Evidence has shown that prediabetes can be prevented or delayed with behavioural change, mainly in eating habits and physical activity. Interventions that use a person-centered approach can lead to improvements in self-management, quality of life, and health outcomes. Nevertheless, there is a need for further research that engages healthcare professionals and people with prediabetes in constructing and implementing preventive programs. The purpose of this study is to explore and describe how healthcare professionals perceive prediabetes, the current challenges in its detection and treatment, and what is needed to improve quality of care.MethodsThis qualitative study was conducted in Region Stockholm. A total of 26 primary health care professionals participated in individual interviews: 15 diabetes nurses and/or district nurses, five general practitioners, five dietitians, and one physiotherapist. Interview transcripts were analyzed with qualitative content analysis.ResultsThe analysis revealed two main themes that emphasize the need to make prediabetes more visible in primary health care. Despite the healthcare professionals’ engagement and their motivation to improve prediabetes care, ad hoc practices and the absence of clear screening guidelines and referral pathways made it harder to focus on primary prevention. Supporting professionals in implementing structured care for people with prediabetes might encourage more efficient interprofessional collaboration and contribute to better strategies for promoting behavioural change.ConclusionsEstablishing prediabetes care guidelines, supporting health care professionals´ knowledge and skills in prediabetes care, and implementing interprofessional referral pathways are some steps to enhance prediabetes detection and care precedence in primary health care. These steps could lead to more preventive care and ensure patient safety and health care equity.

Development of an eLearning intervention for enhancing health professionals' skills for addressing COVID-19 vaccine hesitancy.

Like many countries, Greece has faced resistance to coronavirus disease 2019 (COVID-19) vaccination among residents for both the initial and booster doses. Supporting healthcare professionals with delivering brief advice on COVID-19 vaccination may assist with reaching national vaccination targets. We sought to rapidly develop, pilot test, and deploy an eLearning intervention on skills training on effective techniques for addressing COVID-19 vaccine hesitancy for primary health and social care professionals in Greece. A five-part, 1.5-h eLearning was produced in Greek which featured two behavior change techniques, Very Brief Advice (VBA) and Motivational Interviewing (MI) adapted for use in addressing COVID-19 vaccine hesitancy. Six-film-based case studies modeling the use of VBA and MI in the context of challenging scenarios typically seen in Greek health and social settings were produced for the eLearning. The CME was pilot tested using a pre-post design in a small convenience sample (n = 17) of health care professionals. Pilot study results found the training provided new knowledge (80%), improved provider skills (80%), and was useful to provider's clinical practice (90%). There was a mixed effect in provider capability, motivation, and opportunity. Ninety percent of providers strongly agreed or agreed that they planned to use the information and skills provided by the training in their clinical practice. This project has resulted in new training assets for use by health and social professional tailored to the nationally context in Greece including supporting uptake of booster doses of the COVID-19 vaccine.

Qualitative study of COVID-19 patient experiences with non-invasive ventilation and pronation: strategies to enhance treatment adherence

IntroductionNon-invasive ventilation (NIV) treatment combined with pronation in patients with COVID-19 respiratory failure has been shown to be effective in improving respiratory function and better patient outcomes. These patients may...

Sensortechnology for monitoring challenging behavior in nursing home residents with dementia

Background:Neuropsychiatric symptoms (NPS) are common in affected individuals and can be challenging for (in)formal caregivers. Therefore, they are also referred to as challenging behaviors (CBs). Sensor technology measuring context and behavior can be assistive to effectively manage CBs in an objective fashion. Sensors can help support healthcare professionals, such as nurses, by enabling remote monitoring and alarming on early-stage behavioral changes associated with CBs. This might/ will improve the quality of life (QoL) for both caregivers and clients living in a nursing homes (NH).In the project “MOnitoring Onbegrepen Gedrag bij Dementie met sensortechnologie” (MOOD-Sense), we aim to develop such a monitoring system. Our research focuses on two questions 1) How to develop and implement a monitoring system within the context of nursing homes with parameters on environment, physiology, and behavior, identify and process relevant precursors of challenging behavior with this monitoring system and 2) gain insight in which behaviors are challenging according to nurses and how they are described. This will be represented in an ontology such that sensor data can be translated into the same conceptual information.Methods:The first research question will be examined with a set of experiments in the field (in NH) with an iterative approach. Insights from previous experiments on usability and added value of sensors will be used to improve successive experiments. During each experiment, multiple participants (clients with dementia and CBs) are monitored with both ambient and wearable sensors. For the second research question a qualitative approach is employed, using focus groups (FG) and consensus methods. These FGs will be held amongst nursing staff who are involved in daily care tasks for people with dementia. Subsequently, consensus methods are used to align behavioral descriptors/labels.Results:early findings will be presented at the symposiumDiscussion:Within this project we expect to find precursors of challenging behavior in a personalized fashion based on nurse’s expert knowledge and sensor data. In order to develop a monitoring system that can be embedded within NH’s, real-time alarming, in-situ behavior recognition and trustworthiness are part of our technological requirements. Just-in-time interventions may then be deployed to prevent behavior escalation or the persistence of undesirable situations.