Care Training Research Articles

Enhancing Paediatric and Strabismus Ophthalmology Departments in Spain Through the Inclusion of Orthoptists: Insights from a Nationwide Survey

Background and objectives: The absence of the orthoptic profession in Spain contrasts with its value and recognition in other countries. This study aimed to gauge Spanish ophthalmologists’ interest in including and promoting orthoptists in paediatric and strabismus departments. Secondary objectives included assessing interest in requesting orthoptists, involvement in their training, and aligning their competencies with European standards. Methodology: Participants were recruited via WhatsApp and flyers during the 30th SEEOP Congress in May 2023 and invited to review a report on orthoptists’ significance followed by completing a 12-question online survey. Profile questions were asked via multiple-choice options. Opinions on integrating orthoptists to enhance care quality, training involvement, and alignment with European standards were rated using a Likert scale. Open-ended questions captured themes, and comments. Results: Forty-two paediatric and strabismologists in Spain participated, mostly hospital-employed with advanced degrees, 90% supported integrating orthoptists into their teams, with 83% interested in having them in their workplace. Nearly 90% believed that collaboration between ophthalmologists and orthoptists would improve care quality and reduce waiting lists, and 83% supported promoting this within national medical organisations. Additionally, 90% advocated level 4 advanced European-standard training for orthoptists and 25% were neutral about participating in training orthoptists. Participants emphasised the importance of qualified orthoptists for treating eye movement abnormalities, distinguishing them from other eye healthcare professionals and advocating for collaboration rather than replacement. Conclusions: This initial survey of paediatric ophthalmologists and strabismologists in Spain highlights support for orthoptists as allied health professionals, though garnering support for their training could be challenging. These conclusions should be considered in light of methodological, sample size, and resource limitations. The survey serves as a pilot for the future, suggesting improvements to explore the feasibility of introducing orthoptists in Spain.

Effect of a Standardized Education Program for Interhospital Transport of Critically Ill Patients on Knowledge and Confidence in South Korea: A Pilot Study

Critical care transport (CCT) education and training for health care providers are important for patient safety. In this study, a structured education and training program for CCT was implemented as a pilot in South Korea, and the effects of improving knowledge and confidence among health care providers were evaluated. This retrospective observational study analyzed pre- and post-test scores and survey responses from participants in the education program. The education program consisted of a didactic lecture, skill practice, and simulation for 9 categories lasting 80 hours. The participants included nurses and emergency medical technicians with experience in emergency or critical care. The study consisted of 2 phases, with data collected through web-based evaluation forms and structured questionnaires. The program involved 20 participants across the 2 phases. Posteducation assessments revealed significant improvements in knowledge and confidence in CCT practices. The participants were especially satisfied with their skill in trauma management and advanced CCT simulations. The Korean Critical Care Transport Curriculum education program effectively enhanced the knowledge and confidence of health care providers in CCT. This standardized education model should be considered by policy makers and stakeholders to improve patient safety in emergency medical systems.

Care Needs of Elderly Patients With Cancer Receiving Treatment

Cancer incidence is closely related to age. With the sharp increase in the elderly population in recent decades, the number of older adults with cancer has increased each year. Compared to middle-aged patients, older adults with cancer have relatively more-complex health problems during treatment, with aging, debilitation, comorbidities, cognitive dysfunction, and polytherapy important factors affecting the benefit received by these patients from their treatment. In view of the prevalence and particularities of cancer in the elderly population, health professionals must focus on individual needs in treatment and care as well as provide complete assessments and appropriate care plans to enable their safe and complete care management. Health professionals may use interprofessional teamwork and comprehensive geriatric assessments to understand the functional and cognitive statuses, comorbidities, nutritional status, treatment tolerance, and personal preferences of their patients and then provide care that meets their specific physical, mental, social and spiritual needs. In addition to having professional cancer care training, oncology care specialists should have professional knowledge of geriatric care to increase their sensitivity in assessing the needs of their elderly patients with cancer, provide treatment and care plans that meet their needs, and improve quality of care.

The Effect of Stoma Care Teaching Based on the ARCS Motivation Model on Nursing Students' Learning Motivation, Self-Efficacy and Knowledge Levels

AimThis study aims to examine the effect of stoma care education based on the ARCS (Attention-Relationship-Confidence-Satisfaction) motivation model on nursing students' learning motivation, self-efficacy and knowledge levels. BackgroundNursing education is pivotal in ensuring that students gain the necessary knowledge and skills to provide quality care. Motivation and academic self-efficacy are key factors in student success. DesignThe study employed a randomized controlled pre-test-post-test experimental design. MethodsThis study, conducted between May and July 2024 at Atatürk University Faculty of Nursing, included 46 students attending the Fundamentals of Nursing course. Participants were divided into experimental and control groups, both receiving traditional stoma care training. The experimental group additionally received training based on the ARCS motivation model, designed to enhance attention, relevance, confidence and satisfaction. Data were collected using the "Introductory Information Form," "Motivation Scale for Instructional Material," the "Academic Self-Efficacy Scale," "Stoma Care Practice Knowledge Level Assessment Form." Pre-tests and post-tests covered motivation, knowledge and academic self-efficacy. ResultsStudents in the experimental group showed significant increases in post-test scores for "Attention," "Relevance," "Confidence," "Satisfaction," "Academic Self-Efficacy," and "Knowledge Test"(p<0.05). In the inter-group comparison, the post-test scores of the experimental group were significantly higher than those of the control group across all these dimensions (p<0.05). The most notable difference was observed in the "Knowledge Test" results (ES=4.786, p=0.001), where the experimental group outperformed the control group. ConclusionsAs a result, it was concluded that stoma care teaching based on the ARCS motivation model increased nursing students' nursing students' learning motivation, self-efficacy and knowledge levels.

Development of an Education and Training Program for New Intensive Care Unit Staff: Ladders to Success

The nursing manpower shortage intensified during the COVID-19 pandemic. Moreover, inadequate clinical internship durations during this period led to recent nursing graduates reflecting insufficient clinical skills. These issues, coupled with the inherent complexity of work in intensive care units (ICUs), have increased stress and decreased self-confidence among new staff, leading to higher turnover rates. This study was designed to develop and then evaluate the effectiveness of a tailored ladderized training program for improving clinical care skills and self-confidence in new ICU staff. An individualized ladderized training program for new staff was developed based on the conceptual PDDRO (plan, design, do, review, outcome) framework. In addition to the program, a 3-stage critical care training regimen was implemented to strengthen technical, physical assessment and judgment, and communication and teamwork skills. A multivariate evaluation approach was employed to evaluate the level to which participants improved in terms of clinical skills and self-confidence, and a competency-related personalized training model was used to guide their progress until all of the training goals were achieved. Fifty new staff members completed the 3-stage critical care training program. In terms of program effectiveness, mean scores increased from 79.3 (pretest) to 92.3 (posttest) for awareness and 1.69 to 2.53 for work competency self-confidence. These increases were significant, and indicated the participants had collectively improved from "some self-confidence" to "a lot of self-confidence". Moreover, the retention rate of new staff increased from 75% before the intervention to 84% afterward. Interviews with the participants found the program had improved their mastery of clinical care skills and confidence in their future ability to perform care tasks. Advance implementation of ladderized training can facilitate the establishment of a new nursing staff training system in hospitals to improve the post-pandemic recovery and reconstruction of nursing manpower systems in Taiwan. This program may serve as a successful model for training new staff and retaining human resources as part of the ongoing effort to promote a stable and high-quality workplace environment for nurses.

Factors Influencing Health Literacy Among Migrants in Taiwan.

With increasing migration from the Asian countries, enhancing migrant health literacy in Taiwan is crucial. This study addresses a significant gap in health literacy research, particularly concerning immigrants of both genders and from diverse countries. Its purpose is to assess health literacy levels among migrants and identify associated factors to provide a comprehensive understanding of this issue. This quantitative cross-sectional study was conducted between December 2022 and January 2024, involving first-generation migrants aged above 20 years. Data were collected anonymously using the HLS-EU-Q47 questionnaire, available in English, Vietnamese, and Indonesian. Participants, mainly of Asian background, generally had low health literacy. Significant factors associated with higher health literacy included marital status, father's education, employment, health care training, transportation usage, ability to pay medical fees, income, and household arrangements. Educational courses and health seminars also improved health literacy. The findings highlight the need for targeted interventions to enhance health literacy among migrants, considering demographic and socioeconomic factors.

Research on Advances in Early Rehabilitation Intervention for Dysphagia

Dysphagia is a common clinical symptom caused by various factors, significantly affecting patients’ quality of life and prognosis. This paper aims to review recent advancements in early rehabilitation intervention for dysphagia, covering the significance of early rehabilitation, standards for functional assessment of dysphagia, timing for early rehabilitation training, psychological care, and rehabilitation training methods. The importance and latest research findings on early rehabilitation intervention for dysphagia are comprehensively discussed to provide a reference for clinical practice.

Designing the Spiritual Care Training Courses for Healthcare Staff

Designing the Spiritual Care Training Courses for Healthcare Staff

QUALITY OF LIFE OF ONCOLOGICAL PATIENTS: PSYCHOLOGICAL AND SOCIAL ASPECTS OF CANCER

Cancer has a profound impact on patients’ lives, requiring approaches that go beyond physical treatment to include psychological, social, and spiritual dimensions. This narrative review explores how these aspects influence the quality of life of cancer patients, highlighting the importance of a multidisciplinary and humanized approach. Studies indicate that cancer diagnosis and treatment often generate high levels of anxiety and depression, aggravated by bodily changes and stigmas, affecting self-esteem and social interaction. Social and family support are identified as essential for coping, while spirituality offers comfort and resilience, promoting adaptation and acceptance. The review also emphasizes the need for public policies that ensure access to comprehensive and humanized support, such as home care programs and training of professionals for emotional and spiritual care. It is concluded that comprehensive cancer care is essential for a full quality of life and for healthy coping with cancer.

Evaluating the Effectiveness of Trauma Care and Emergency Preparedness Training Programs on Prehospital Primary Survey Skills: A Systematic Review

Evaluating the Effectiveness of Trauma Care and Emergency Preparedness Training Programs on Prehospital Primary Survey Skills: A Systematic Review

Improving Residency Training in Refugee and Immigrant Health Care at an Urban Academic Family Medicine Residency

Improving Residency Training in Refugee and Immigrant Health Care at an Urban Academic Family Medicine Residency

Preparation for Rural Practice with a Multimodal Rural Emergency Medicine Curriculum

Rural regions face emergency medicine (EM) physician shortages. Most training programs are located in cities and lack rural clinical experiences, didactics, and mentorship to excite and prepare residents for rural EM practice. There is limited data on optimal training methods for preparing residents for rural practice. To address this need for rural EM training and workforce, we developed a rural EM curriculum. We began with a two-year case review from critical access emergency departments. Rural EM skills were defined and taught using lectures, simulation cases, and clinical rotations. We obtained quantitative and qualitative feedback from the first ten residents participating in the curriculum. Qualitatively, 10/10 residents gained new skills and found these experiences valuable to their training and career choice, with 100% expressing interest in rural practice and 75% choosing a rural practice. Quantitatively, residents managed a greater variability in patient acuity and volume and performed a greater variety of procedures compared to their academic center rotations, all while gaining unique skills from the challenges of a rural environment. Focused rural emergency medicine clinical experience and didactic training during residency are a promising approach to bridge the gap between urban tertiary care training programs and rural emergency care needs.

Mentalizing Care: Adult Attachment and Structural Factors as Predictors of Representational Mind-Mindedness in Early Child-Care Professionals.

Out-of-home childcare is increasingly essential in many children's lives, significantly impacting their wellbeing and development. Central to high-quality care is the concept of caregiver mind-mindedness (MM), the ability to recognize a child as a unique psychological individual with thoughts, feelings, intentions etc., as this capacity is linked with more optimal responsiveness to children's needs. Despite its importance, the factors influencing MM in professional caregivers remain under-researched. We examined the association between structural factors, self-reported adult attachment, and caregiver representational MM assessed in an interview. The sample consisted of 128 childcare professionals from 30 Danish early childcare centers (children aged 0-2.9 years), participating in a randomized controlled trial. Overall, our results showed that longer employment in the current position was associated with higher levels of representational MM, i.e., increased tendency to describe children in terms of their mental states as opposed to more behavioral or external features. In contrast, more years of experience working in childcare as well as attachment-related avoidance were associated with lower levels of representational MM. These results indicate that personal characteristics, like adult attachment, may be a relevant focus for early education and care research and training.

Physicians’ perspectives on cancer-related fatigue management and their suggestions for improvements in medical training: a cross-sectional survey study in Germany

PurposeContrary to guidelines, many cancer patients are not screened for cancer-related fatigue (CRF) and do not receive information or adequate treatment. As physicians play a key role in cancer therapy, their knowledge of this common sequela and perspectives on its management are of major interest.MethodsFor an online survey, physicians working in oncology in Germany were systematically drawn from registers and invited by using institutional newsletters or colleagues. Descriptive analyses, logistic regression analysis of physicians’ knowledge, and Mann‒Whitney U tests were performed.ResultsTwo-thirds of the 148 surveyed physicians felt (rather) well informed about CRF and capable of counseling patients. Only 32% of the sample were aware of CRF-specific guidelines. Despite of this, participants rated the scientific evidence for recommending physical activity, exercise programs, and psychotherapeutic interventions in accordance with guidelines as being mostly (very) strong. However, despite 82.4% of the physicians being (rather) aware of its evidence, only 56.1% often to almost always recommended psychotherapeutic interventions. CRF was rarely covered in medical studies and medical specialist training. The completion of advanced training for palliative care increased the likelihood of knowing guidelines (OR = 2.6, 95% CI [1.1–6.0], p < 0.05). Suggestions for improving training included the mandatory coverage of CRF in medical training or its consideration in interprofessional supportive care workshops.ConclusionAlthough awareness and recommendation rates were adequate for some interventions in CRF treatment (such as physical activity), there were lower recommendation rates for others, including psychotherapy. Studies are required assessing for the reasons of this knowledge-to-practice gap. Moreover, training is needed among physicians in order to enhance knowledge of CRF guidelines.Trial registrationClinicaltrials.gov, identifier: NCT04921644. Registered in June 2021.

Relationship between characteristics of health professionals and the respect for the autonomy of cancer patients at the end of life.

This study investigated whether providers respected patient's autonomy, investigating providers' pattern of decisions and their associated characteristics. Cross-sectional study, conducted through anonymous questionnaire with hypothetical clinical cases, presented to providers at one oncology center. Decision-making patterns were pre-stablished accordingly to the response´s pattern. Of 151 responses, decisions patterns were paternalistic in 38%, shared in 38%, obstinate in 10.6% and consumerist in 13.2%. The consumerist providers reported never having participated in an EOL class in 35% and 30% had never trained in palliative care. Among providers with paternalistic pattern, 35.1% had never attended ethic lectures. In the obstinate group, 31.2% had no training in palliative care. When asked how subjects saw themselves about their pattern of decision, 100% of obstinate, 95% of consumerist and 89% of paternalistic patterns exhibited cognitive dissonance. Significative differences between decisions and how the providers judge themselves were observed.

Empowering primary care physicians in child and adolescent psychiatry: a needs assessment on collaborative care in Dubai.

Child and adolescent psychiatric disorders pose significant public health concerns necessitating prompt intervention. Primary care physicians (PCPs) play a critical role as initial points of contact, facilitating early detection, management, and referral of these conditions. In Dubai, integrating mental health services into primary care faces unique challenges, highlighting the need for systemic reforms and enhanced PCP training. This study investigated perceptions, barriers, and systemic challenges encountered by PCPs in managing child and adolescent psychiatric conditions in Dubai's primary care setting. It also assessed family physicians' involvement and preparedness in this domain. Using a mixed-methods approach, we conducted a survey among family physicians in Dubai Health facilities and analyzed patient data from family medicine clinics. The survey evaluated formal training, preparedness, encounter frequency, and referral patterns for psychiatric care in young patients. Qualitative insights from open-ended survey questions provided additional understanding of specific challenges. Findings revealed significant gaps in formal training, with only 33.3% of respondents trained in child and adolescent psychiatry during medical education, and 21.1% participating in Continuing Medical Education (CME). A majority (54.4%) of PCPs felt unprepared to manage psychiatric care in young patients. Patient data analysis showed a predominance of male patients (59.9%) and identified Autism Spectrum Disorder (43.1%) as the most common condition, emphasizing the reliance on specialized care through a high referral rate (63.1%). Major barriers included time constraints, limited psychiatric knowledge, resistance to mental health services, systemic and structural issues, communication challenges, and resource shortages. Enhanced training and systemic reforms are urgently needed to integrate mental health services effectively into Dubai's primary care. Implementing structured collaborative care models, fostering interdisciplinary collaboration, and addressing systemic barriers are crucial for improving child and adolescent psychiatric condition management. These initiatives promise better patient outcomes and more efficient healthcare resource utilization.

EOLP-02. END-OF-LIFE CHALLENGES IN NEURO-ONCOLOGICAL PATIENT CARE: A YOUNGNOA SURVEY

Abstract BACKGROUND Malignant brain tumors inevitably relapse, almost always causing significant functional and neurological impairments. Thus, palliative care is crucial in managing individuals with malignant brain tumors. It is essential for neuro-oncologists to be well-prepared to openly communicate about and meet the palliative needs of these patients. With this survey, we sought to evaluate palliative care practices in Germany and their impact on the treatment of neuro-oncological patients. METHODS We conducted an anonymous, interdisciplinary survey targeting palliative care practices among neuro-oncologists in Germany, all members of the Neuro-oncology Working Group of the German Cancer Society. The questionnaire, designed in close coordination with board-certified palliative care specialists, was distributed to 450 physicians. It collected personal information and assessed respondents’ knowledge of and access to palliative care structures. The survey was conducted online from March 31 to April 30, 2023. RESULTS Ninety-two physicians completed the survey. Of these, 81 (88%) reported feeling comfortable with end-of-life conversations, while 11 (12%) did not. No significant differences were observed between the two subgroups regarding their level of medical education (p=0.7140), workplace (p=0.4966), sex (p=0.9999), medical specialty (p=0.5478), or region of practice (p=0.9999). However, those comfortable with end-of-life discussions had significantly more palliative care training either during specialty training (p=0.0475) or through active participation in palliative care courses (p=0.0254). Further detailed analysis is in progress. CONCLUSIONS The survey indicates that while the majority of participants are comfortable with end-of-life discussions, a clear correlation exists between their comfort level and the extent of palliative care training received. This highlights the critical need for enhanced and targeted palliative care education within neuro-oncology training programs to prepare physicians for the complex communication and care challenges in neuro-oncological palliation. Further analysis will continue to explore additional educational and systemic factors that could increase the quality of palliative care in neuro-oncology.

Empowering Dementia Communication via Virtual Reality AI-Driven Simulations

The use of effective communication skills is essential for direct care workers to provide quality care for persons living with dementia (PLWD) in long-term service and support settings (LTSS). However, direct care workers often report feeling unprepared, lacking competence in care, and fear interacting with PLWD. This proof-of-concept study proposes Virtual reality Communication Training Optimizing Real-world Interactions (VICTORI) intervention, aiming to develop and evaluate the usability, acceptability, and preliminary effectiveness of virtual reality (VR) simulated communication training for direct care workers using artificial intelligence (AI)-generated patients with dementia. Care-related and social communication scenarios in dementia care will be developed, based on current literature, our validated communication instrument, and AI technology. Six modules consisting of pre-briefing, simulation facilitation, and de-briefing will be developed, refined, and evaluated based on an advisory board of experts and direct care workers’ quantitative and qualitative feedback. To test the usability, acceptability, and effectiveness of the VICTORI intervention, we will use a single group pre- and post-test intervention design, integrating quantitative measures and qualitative semi-structured interviews in this mixed-methods study. Thirty direct care workers will be recruited at two LTSS in North Texas. Direct care workers will participate in six VR-AI simulation commu-nication training sessions that include communication with AI-generated patients, real-time feedback, and detailed evaluation of communication behaviors. Each simulation will be recorded to further evaluate the partici-pant’s communication skills using the Dyadic Communi-cation Observational coding scheme in Dementia care (DCODE). Additionally, participants' potential side effects during VR simulation will be assessed using continuous physiological data and self-reported questionnaires at each simulation session. Communication knowledge and com-petence in dementia care will be assessed before and after training using self-reported questionnaires. Direct care workers will also be interviewed to assess acceptability and satisfaction with the VICTORI training. This proposal will introduce innovative training methods that leverage AI technology into communication training in dementia care. Objective assessments, including AI-based feedback, physiological data, and observational assessments, ensure the reliability and validity of the data to evaluate plausibility of VICTORI intervention.

Evaluation of a trauma-informed care (TIC) training program across community health centers in Texas: a qualitative study

BackgroundIn April 2019, Texas Association of Community Health Centers launched the Trauma-Informed Care (TIC) program in community health centers across Texas. This initiative aimed to transform organizational culture for consistent delivery of TIC by providing training and coaching opportunities for Trainers and Champions in each health center. This study is an interim qualitative evaluation to gain participants’ insights into their experiences of and perceptions about TIC training as part of the TIC initiative.MethodsWe conducted semi-structured key informant interviews via Zoom with Trainers across four cohorts of participating health centers between February 2020 and April 2023. We used rapid assessment procedures to conduct analysis in tandem with data collection given the ongoing TIC training. We present salient quotes to illustrate the emergent themes.ResultsWe interviewed a total of 36 Trainers and identified the following emergent themes from the interviews: (1) Perceived need for the TIC training, (2) Perspective shift in patient care, (3) Increased support for staff wellness, (4) Importance of equal involvement of staff at all levels, (5) Need for leadership buy-in, and (6) Lack of self-efficacy and empowerment to train others.ConclusionsA trauma-informed environment in a healthcare setting can bolster patient-centered care as well as a culture of staff wellness. This qualitative evaluation revealed that after TIC training, Trainers had improved attitudes and behaviors to commit to organizational TIC transformation to prevent unintended consequences of trauma for both patients and staff. Trainers’ experiences with and suggestions for enhancing the TIC training should be considered for training future cohorts as they continue to strive for TIC transformation in their health centers.

Intervention with institutional caregivers for the purpose of supportive education for disadvantaged children: 3C.

Children in institutional care may have limited access to educational opportunities compared to children in parental care. Improving and enriching the educational practices of these children is important for their well-being. In this study, the Child Development, Communication and Care (3C) Training Program was prepared by the researchers. The 3C education approach emphasizes early childhood development and education. Particular focus is on the use of communication techniques in the education of young children. Our goal with 3C is to increase caregivers' knowledge of child development and support them to communicate effectively with children. Through this curriculum framework, children are encouraged to interact effectively and empathically with others. Therefore, the curriculum framework emphasizes understanding emotions and building trusting relationships as key components in the holistic development of young disadvantaged children. A quasi-experimental design with pre-test-post-control group was used in the study. 16 sessions of 3C were applied to the personnel in the experimental group via distance education. Data were collected from the participants before and after the start of the training program by using the Child Education Competence Scale-Parent Form, Personal Information Form, and Training Evaluation Questionnaire. As a result, significant differences were obtained between the experimental and control groups in favor of the group receiving training (z = 3.57, p<0.05). Accordingly, it can be said that 3C contributes to the holistic development of the child. It is hoped that such work could enhance the developmental outcomes of young children in institutional care and improve the quality of early childhood education.