Work Of Health Care Providers Research Articles

Intention to Use Mobile-Based Partograph and Its Predictors Among Obstetric Health Care Providers Working at Public Referral Hospitals in the Oromia Region of Ethiopia in 2022: Cross-Sectional Questionnaire Study.

A partograph is a pictorial representation of the relationship between cervical dilatation and the time used to diagnose prolonged and obstructed labor. However, the utilization of paper-based partograph is low and it is prone to documentation errors, which can be avoided with the use of electronic partographs. There is only limited information on the proportion of intention to use mobile-based partographs and its predictors. The objective of this study was to determine the proportion of obstetric health care providers at public referral hospitals in Oromia, Ethiopia, in 2022 who had the intention to use mobile-based partographs and to determine the predictors of their intention to use mobile-based partographs. We performed an institution-based cross-sectional study from June 1 to July 1, 2022. Census was conducted on 649 participants. A self-administered structured English questionnaire was used, and a 5% pretest was performed. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for descriptive analysis and AMOS (analysis of moment structure; version 23) for structural and measurement model assessment. Descriptive and structural equation modeling analyses were performed. The hypotheses developed based on a modified Technology Acceptance Model were tested using path coefficients and P values <.05. About 65.7% (414/630; 95% CI 61.9%-69.4%) of the participants intended to use mobile-based electronic partographs, with a 97% (630/649) response rate. Perceived usefulness had a positive influence on intention to use (β=.184; P=.02) and attitude (β=.521; P=.002). Perceived ease of use had a positive influence on attitude (β=.382; P=.003), perceived usefulness (β=.503; P=.002), and intention to use (β=.369; P=.001). Job relevance had a positive influence on perceived usefulness (β=.408; P=.001) and intention to use (β=.185; P=.008). Attitude positively influenced intention to use (β=.309; P=.002). Subjective norms did not have a significant influence on perceived usefulness (β=.020; P=.61) and intention to use (β=-.066; P=.07). Two-thirds of the obstetric health care providers in our study intended to use mobile-based partographs. Perceived usefulness, perceived ease of use, job relevance, and attitude positively and significantly influenced their intention to use mobile-based electronic partographs. The development of a user-friendly mobile-based partograph that meets job and user expectations can enhance the intention to use.

The Adequacy of Health System Measures in Reducing Vulnerability to COVID-19 Among the Health Care Providers Working in Primary Health Care in Rajasthan, India: A Cross-sectional Study

This article examines the role of individual, facility and system-level preparedness in reducing physiological and psychological vulnerability among primary-level health care providers (HCPs) during the COVID-19 pandemic in Rajasthan, India. Online and telephonic interviews are conducted among 274 HCPs working in 24 primary health centres (PHCs) (17 rural and 7 urban) across 13 districts of Rajasthan. Five dimensions of vulnerability, covering awareness, exposure to infection (daily contact; contact with high-risk individuals), physical and mental health conditions, while three aspects of preparedness—at individual (personal care) and facility (provider safety; management and supervision) level—are measured by employing factor analysis. Generalised ordered logit regression model is used to measure the effect of preparedness on COVID-19-related vulnerability. Among the 274 HCPs, majority of the staff are from rural PHCs (76%), less than 35 years old (87%), female (57%) and married (57%). Almost half have high level of exposure to COVID-19, with mean contact rate of 90. Overall, 26% have comprehensive knowledge of COVID-19, and 32% have any mental health issues. Although more than 70% of HCPs have reported more than one individual-level preparedness, mental health measures adopted by the HCPs are comparably low. The facility-level preparedness for enhancing safety is high such as social distancing (79%) and maintaining record of each visitor (75%). However, management-related measures adopted by the PHCs are perceived to be lower than the safety measures. The regression analyses suggest that safety-related preparedness is significantly associated with reduction of vulnerability by 50%. The management-level preparedness has statistically no significant effect in explaining the variations in level of vulnerability. The facility-level safety measures, which lower chances of acquiring infection, have a positive effect on reducing vulnerability to COVID-19. However, the HCPs do not have adequate preparedness at individual, facility management (PHC) and system levels to reduce COVID-19 vulnerability. Findings suggest that there is a need for a non-conventional approach of monitoring and supervision. In the absence of such measures, there is a chance of moral injury that will make the HCPs at the primary level vulnerable both physiologically and psychologically.

2014 The experience of frailty in the Tanzanian hospital system: A qualitative exploration service user and provider perspectives

Abstract Background Frailty is becoming increasingly prevalent in Low- and Middle-Income Countries (LMICs). However, little is known about the lived experience of older people with frailty in their interactions with the healthcare systems in LMICs. This study aimed to explore the experiences, attitudes and needs of hospitalised older people with frailty in a low-income setting, from the perspective of service users and providers. Methods A purposive sample of older people with frailty recently admitted to hospital, their carers and healthcare providers, were recruited from four hospitals in the Kilimanjaro Region of Tanzania. One-to-one and dyad interviews were conducted in Swahili, based around a structured topic guide. Recordings were transcribed and translated into English in an iterative process aimed at preserving the original meaning through “transliteration”. Transcripts were analysed using a reflexive thematic paradigm. Results Interviews with 43 service users and 15 service providers highlighted the cultural norm of respect and value placed on older people; as such it is considered the role of everyone in society to provide care. However, many working age adults struggle with the competing responsibilities of supporting their parents and their children. Maintaining strong relationships with family and financial preparation were therefore considered critical to healthy ageing. The complex health problems and significant care needs of older people with frailty pose a considerable challenge during hospital admission. On the ward, family often take responsibility for personal care and feeding to reduce the work of healthcare providers. Economic worries and resource scarcity impact every part of the patient journey from struggles in accessing hospital services, to quality of care during admission and after discharge. Conclusion Frailty is understood as a communitywide issue in Tanzania, and family are expected to take a much larger role in care during acute hospital admission, partly mitigating the impact of resource scarcity.

Organizational Communication Skills and Its Associated Factors Among Healthcare Providers Working at Wolaita Sodo Health Facilities, Southern Ethiopia: A Cross-Sectional Study.

Communication in healthcare organizations is an important factor in quality care, patient safety, and financial function. However, there was a dearth of evidence on the organizational communication skills of healthcare providers in Ethiopia, including the current study area, Wolaita Sodo. This study is aimed at assessing the level of organizational communication skills and their associated factors among healthcare providers working at Wolaita Sodo health facilities, SNNPRS, Ethiopia. An institutional-based cross-sectional study design was conducted. A pretested and structured questionnaire was utilized using the self-administration method. The data were entered into Epi Data version 3.1 and analyzed using STATA version 17.0. Pearson correlation, a binary logistic regression analysis was carried out to identify factors associated with outcome variables. Accordingly, variables that fulfilled p-values <0.25 on the bivariate logistic regression were considered candidates for multivariate logistic regression to control for possible confounders. The odds ratios along with the 95% confidence interval were used to present the finding, and statistical significance was reported at a p-value of 0.05. In the current study, about 45.8% (95% CI: 40.9-50.7) of the health professionals experienced good organizational communication skills. Males [AOR = 2.29; 95% CI = 1.38, 3.82], who had training in communication skills [AOR = 2.30; 95% CI = 1.46, 3.63], and those working at laboratories [AOR = 3.22; 95% CI = 1.07, 9.65] were significantly associated with organizational communication skills. Less than half of the participants practiced good organizational communication skills. Sex, training on communication skills, and working units were important factors affecting the communication skills of healthcare providers. Interventions to improve the communication skills of healthcare providers should be instituted targeting females, those who have never taken training on communication skills, and those who are working at the ward.

Telehealth use and work stress among Chinese health care providers during the COVID-19 pandemic

Telehealth services in China rapidly expanded during the COVID-19 pandemic. The work stress of health care providers (HCPs) associated with providing telehealth care services in China has been less studied. Our study describes the telehealth services provided by hospitals in China and examines the relationships between telehealth use and work stress of HCPs in China during the COVID-19 pandemic. With a survey research design, HCPs aged 18 or older in China were electronically recruited from October 19 to November 10, 2021 (n=1,073). After preprocessing, data from 1,036 HCPs were used for further analyses, which included descriptive statistics and multiple linear regression models. Results showed that 64.29% of Chinese hospitals reported virtual physician-to-physician consultations, and 59.94% of Chinese HCPs conducted online physician consultations. Lower levels of HCP work stress was associated with live video conferencing (p=0.04), online physician consultations (p=0.00), and higher levels of team collaboration (p=0.00) and team trust (p=0.00). Work stress was also positively correlated with COVID-19 stress (p=0.00), working hours (p=0.00), and the interaction between live video conferencing and COVID-19 stress (p=0.04). HCPs’ work stress decreased by using live video conferencing and online patient care. However, the positive effects of live video conferencing may decrease with the increase in COVID-19 stress for HCPs. Our findings encourage efforts to develop extensive coverage of telehealth service systems in China to promote HCPs’ virtual communication and collaboration to relieve HCPs’ work stress and support their well-being.

Breaking the unvirtuous cycle: barriers and opportunities for research and development in Paraguay. A case study.

Medical research and development (R&D) is an undoubtedly relevant activity to drive innovation, improve healthcare policies and bring patients treatment opportunities for common and rare diseases. Equity and inclusion are matters of concern in research. High-income countries' research teams are more likely to have more impactful publications, grant funding, and clinical trials than middle or low-income countries. Low budget allocations to R&D and existing gaps in regulatory frameworks are some obstacles to growth. This unvirtuous cycle results in scarce advances in common endemic diseases and the underrepresentation of specific populations in innovative therapeutics research. We conducted a policy review and qualitative research to determine the principal characteristics of basic and clinical medical research in Paraguay, as well as barriers and facilitators to improve innovative R&D strategies in this country. To this aim, we examined published articles from 2005 to 2020, the organizational structure of national research agencies, the current regulation framework, and the composition and experience of local research groups and ethical review boards (ERBs). In addition, we performed semi-structured interviews to evaluate perceptions and expectations from different stakeholders, including investigators, ERBs members, sponsor associates, and Regulatory Agency executive staff. In 2018, Paraguay ranked 10th out of 12 South American countries in total number of publications and cumulative h-index score. Total Gross Domestic Product (GDP) allocation for R&D was 0.15%, ranking eighth out of 12 in the region. In 2021, the number of trials registered on ClinicalTrials.gov was 52, with only 16 ongoing recruiting studies at that time.Some of the main barriers identified included low incentives for academic careers and lack of experience in pharmaceutical research. An emergent necessity to develop a straight- forward normative framework was detected. Main facilitators included the development of two research initiative programs (PRONII and PROCIENCIA) from CONACYT (National Council of Science and Technology) which were associated with higher budget allocation and total number of publications in the 2011 to 2017 period. A total of six stakeholders participated in the semi-structured surveys. Interviewees highlighted the necessity of a centralized policy to promote R&D, which incorporates investigators and ERBs training, the development of standardized procedures, and the dissemination of research activities. Sponsor associates underlined that real-world evidence may represent a distinctive opportunity to enhance local research. Coordinated efforts are needed to break the unvirtuous cycle. There is an increasing interest in enhancing health research in Paraguay, materialized in the creation of specific programs that encourage the collaborative work of healthcare providers, basic scientists, and private investors. Nonetheless, a comprehensive approach is needed also to strengthen regulatory agencies and attract external sponsorship. While modern and currently popular topics, including artificial intelligence, real-world data, and translational research may represent key opportunities to seek investment, special policies should be adopted to prioritize research on the determinants of health in the Paraguayan population.

Als die Diagnose kam … Wo steht die deutsche Trauerversorgung im Jahr 2020/2021?

BackgroundIn Germany, numerous health care providers work in the field of bereavement care. An epidemiological study of the field immediately after the introduction of the ICD-11 diagnosis “Prolonged Grief Disorder” (PGD) is pending. MethodsThe second survey of the trend study, which is designed over a total of three measurement points at intervals of one decade each, explores whether and to what extent the field of bereavement care has evolved after the introduction of the grief-specific diagnosis PGD. For this purpose, providers of bereavement care at various organizational levels were asked to participate in an online survey. The survey was conducted from October 2020 to January 2021. Results456 questionnaires were included in the study. Data analysis was descriptive. 80.5% of the participants have an additional grief-specific qualification, 59.4% base their work on a grief-specific concept. In view of the PGD diagnosis, only a few respondents have participated in a PGD-related advanced training. Most are afraid that the topic of grief will increasingly be subsumed in the medical-psychological-therapeutic field. An increase in bereavement research and the number and quality of continuing education is also expected. DiscussionSome positive trends in German bereavement care can be identified. However, there is a need for further development in the areas “designation of the activity”, “diagnostics”, and “intervention”. Also, there is a need for training with regard to PGD. ConclusionAfter the introduction of PGD, the field of bereavement care in Germany turns out to be slightly different. The diagnosis is viewed skeptically.

Health Care Providers Working Cross-Culturally: Pitfalls, Pearls, and Preparation Resources for Culture Shock.

Health care providers engaging in cross-cultural work will likely experience culture shock, a psychological, behavioral, and physiologic response to new cultural environments that can significantly affect travelers. Culture shock has the potential for both negative and positive outcomes. Well-being, health, and professionalism can be negatively influenced during the peak of culture shock, but the experience may also positively promote transformative learning and professional identity formation. Culture shock has been carefully researched for different types of sojourners, such as undergraduate students and business personnel, but minimally for health care providers. This article defines culture shock, describes different health care-related cross-cultural opportunities, identifies factors contributing to culture shock, describes complexities related to measuring culture shock, depicts common cross-cultural challenges encountered by traveling health care providers, and offers tangible guidance to help prepare for culture shock. We conclude with a call for further research and resource development to support the well-being of an increasingly global health care workforce. [Pediatr Ann. 2023;52(9):e335-e343.].

Knowledge, Attitude, and Associated Factors towards Prehospital Care among Emergency Health Care Providers Working in Selected Prehospital Care Centers in Addis Ababa, Ethiopia: A Cross-Sectional Study.

Patients' health outcomes can suffer as a result of poor knowledge and unfavorable attitude towards prehospital emergency care. The purpose of this study was to assess emergency health care providers' (EHCPs') knowledge, attitude, and associated factors towards prehospital care in selected prehospital Emergency Medical Service institutions in Addis Abeba, Ethiopia. An institutional-based cross-sectional study design was conducted among EHCPs working in the three selected prehospital emergency medical care centers in Addis Ababa. Data were collected using a standard self-administered questionnaire, cleaned, coded, and entered into EPI Data Version 6, and then exported to SPSS Version 26 for further analysis. The generated data were compiled using frequency tables, charts, and percentages. Logistic regression analysis was used to see the association between independent and dependent variables. One hundred thirty-five (135) study participants were included in this study, with a response rate of 95.7%. The mean age of the respondents was 29.2 years (SD = 4.86). Almost three-quarters of the respondents (71.1%) were aged between 26 and 35 years. Of the total participants, 58.5% and 62.2% of EHCPs had good knowledge and a favorable attitude towards prehospital care, respectively. The study revealed that profession (AOR = 3.2; 95% CI, 1.03 - 7.65), educational status (AOR = 1.17; 95% CI, 1.08 - 4.93), and having training (AOR = 2.25; 95% CI, 1.33 - 4.52) were significantly associated with the knowledge of EHCPs. This finding also revealed that the respondent's knowledge (AOR = 1.36; 95% CI, 1.05 - 2.32) and having training (AOR = 3.2; 95% CI, 1.24 - 7.83) were significantly associated with EHCPs' attitudes towards prehospital care. The knowledge and attitude of EHCPs regarding prehospital care were found to be good and favorable as compared to previous studies. In-service training regarding emergency health conditions and the time needed to care for the patient is important for quality prehospital emergency medical care.

Healthcare Professionals’ Emotional Labor and Management of Workplace Violence with Underserved Patients in the Safety Net Context

ABSTRACT Healthcare providers (HP) work in high-stress situations, interacting with patients and families who are often in crisis. HPs who work in safety net clinics, which provide care to uninsured, Medicaid recipients and other vulnerable populations, interact with patients who are frequently frustrated by long wait times, extensive paperwork, short appointments, and have generally lower health literacy. Many patients have chronic conditions and substance use disorders which has been associated with higher likelihood to be perceived as verbally aggressive and/or perpetrate workplace violence (WPV). Using interviews with 26 HPs at safety net clinics, we investigated how HPs manage interactions with aggressive patients and avoid burnout. Findings are based on emotional labor constructs describing why and how workers use emotion management strategies to smooth communication and relationships with clients/patients. According to our participants, HPs perform emotional labor to de-escalate interactions, prevent WPV, and to develop relationships with patients who might become regular clinic patients. We found that HPs perceive an influence of the clinic context on patient aggression management, hold initial perceptions that shape engagement with aggressive patients, and report emotional labor and burnout that came from interacting with aggressive patients to prevent WPV. We offer implications that extend research on emotional labor and burnout, provide guidance to healthcare organizations, and offer directions for future theory and research.

The consequences of emotionally evocative patient behaviors on emergency nurses' patient assessments and handoffs: An experimental study using simulated patient cases

BackgroundEngaging with human emotions is an integral but poorly understood part of the work of emergency healthcare providers. Patient factors (e.g., irritable behavior; mental illness) can evoke strong emotions, and evidence suggests that these emotions can impact care quality and patient safety. Given that nurses play a critical role in providing high quality care, efforts to identify and remedy factors that may compromise care are needed. Yet to date, few experiments have been conducted. ObjectiveTo examine the effects of emotionally evocative patient behavior as well as the presence of mental illness on emergency nurses' emotions, patient assessments, testing advocacy, and written handoffs. DesignExperimental vignette research. SettingOnline experiment distributed via email between October and December 2020. ParticipantsConvenience sample of 130 emergency nurses from seven hospitals in the Northeastern United States and one hospital in the mid-Atlantic region in the United States. MethodsNurses completed four multimedia computer-simulated patient encounters in which patient behavior (irritable vs. calm) and mental illness (present vs. absent) were experimentally varied. Nurses reported their emotions and clinical assessments, recommended diagnostic tests, and provided written handoffs. Tests were coded for whether the test would result in a correct diagnosis, and handoffs were coded for negative and positive patient descriptions and the presence of specific clinical information. ResultsNurses experienced more negative emotions (anger, unease) and reported less engagement when assessing patients exhibiting irritable (vs. calm) behavior. Nurses also judged patients with irritable (vs. calm) behavior as more likely to exaggerate their pain and as poorer historians, and as less likely to cooperate, return to work, and recover. Nurses' handoffs were more likely to communicate negative descriptions of patients with irritable (vs. calm) behavior and omit specific clinical information (e.g., whether tests were ordered, personal information). The presence of mental illness increased unease and sadness and resulted in nurses being less likely to recommend a necessary test for a correct diagnosis. ConclusionsEmergency nurses' assessments and handoffs were impacted by patient factors, particularly irritable patient behavior. As nurses are central to the clinical team and experience regular, close contact with patients, the effects of irritable patient behavior on nursing assessments and care practices have important implications. We discuss potential approaches to address these ill effects, including reflexive practice, teamwork, and standardization of handoffs. Tweetable abstractSimulated experimental study found that despite having received identical clinical information, emergency nurses believed that patients displaying irritable behaviours were less likely to return to work soon and were less likely to recover than patients who displayed calm behaviour.

Determining the Effect of Stress and Anxiety on Eating Attitudes in Healthcare Providers Working on COVID-19 Wards

ABSTRACT The purpose of this study was to determine the stress, anxiety and eating conditions of health personnel working in COVID-19 clinics, to evaluate how they interact with each other with a holistic approach, and to examine the role of variables such as gender and BMI in these relationships. It was determined that 1-unit increase in the TFEQ-18 score decreased stress and anxiety levels 1.09 and 1.028 times, respectively. We were able to show that stress and anxiety levels of participants negatively affect their eating behavior and anxiety levels of health personnel negatively affect their eating behavior.

Commentary on Healthcare and Disruptive Innovation

Exploits of technology have been an issue in healthcare for many years. Many hospital systems have a problemwith “disruptive innovation” when introducing new technology. Disruptive innovation is “an innovation thatcreates a new market by applying a different set of values, which ultimately overtakes an existing market”(Sensmeier, 2012). Modern healthcare systems are historically slow to accept new technological advancements .This may be because patient-based, provider-based, or industry-wide decisions are tough to implement, giving wayto dire consequences. One potential consequence is that healthcare providers may not be able to provide the bestpossible care to patients. For example, if a healthcare provider does not adopt new technologies or approaches tomedical treatment, they may not be able to offer the same level of care as a provider who has embraced thoseinnovations. This leads to lower quality of care and poorer patient outcomes.Another consequence is that healthcare providers who do not adapt to disruptive innovations may lose marketshare to competitors who are more forward-thinking and willing to embrace new technologies and approaches.This can harm the provider&amp;#39;s financial performance and sustainability.Not adapting to disruptive innovations inhealthcare can result in missed opportunities to improve the efficiency and effectiveness of medical treatment. If ahealthcare provider does not adopt electronic medical records, they may miss out on the benefits of faster andmore accurate information sharing, improving patient care.Once the decision to implement technology in a specific healthcare industry is made, concerns about patientsafety, an aversion to change, and hospital-wide compliance with regulations begin to arise (WynHouse, nd.). Thehealthcare technology industry also boomed with the COVID-19 outbreak. The COVID-19 outbreak has led tosignificant advancements and innovations in medical technology. In order to diagnose, treat, and prevent thespread of the virus, healthcare providers and researchers have had to develop and deploy new technologies andapproaches. The COVID-19 outbreak has highlighted the importance of the medical industry and the essential roleit plays in society. This has led to increased funding, support for medical research and development, as well as agreater appreciation for the work of healthcare providers. This has created opportunities for growth andinnovation in the medical industry. It also placed enormous strain on global health systems, disrupting healthcareby increasing the risk of fraud and deception; the risk of hospital operations and assets being compromised,disrupted, or altered; and the increased use of telehealth resulting in a breakdown between providers andconsumers (Kuehn,2021). This article will cover the effects/impact of disruptive innovations/technologiesintroduced into healthcare industries over the short term through a light review of disruptions and responses,followed by commentary and policy recommendations.&#x0D;

Challenges in Care for Non-COVID-19 Patients with Severe Chronic Illnesses during COVID-19 Pandemic: A Qualitative Study of Healthcare Providers Working around Acute Care Hospitals in South Korea.

The COVID-19 epidemic has afflicted patients with severe chronic illnesses who need continuous care between home and hospitals. This qualitative study examines the experiences and challenges of healthcare providers around acute care hospitals who have cared for patients with severe chronic illness in non-COVID-19 situations during the pandemic. Eight healthcare providers, who work in various healthcare settings around acute care hospitals and frequently care for non-COVID-19 patients with severe chronic illnesses, were recruited using purposive sampling from September to October 2021 in South Korea. The interviews were subjected to thematic analysis. Four overarching themes were identified: (1) deterioration in the quality of care at various settings; (2) new emerging systemic problems; (3) healthcare providers holding on but reaching their limit; and (4) a decline in the quality of life of patients at the end of their lives, and their caregivers. Healthcare providers of non-COVID-19 patients with severe chronic illnesses reported that the quality of care was declining due to the structural problems of the healthcare system and policies centered solely on the prevention and control of COVID-19. Systematic solutions are needed for appropriate and seamless care for non-infected patients with severe chronic illness in the pandemic.

An urgent call for the environmental sustainability of health systems: A 'sextuple aim' to care for patients, costs, providers, population equity and the planet.

Health systems have a duty to protect the health and well-being of individuals and populations. Yet, healthcare contributes about 4.6% of global greenhouse gas emissions. Health systems need to question and improve established practices, assume strong environmental leadership, and aim for ambitious, sometimes radical, actions in favour of the climate. In this paper, we interrogate the suitability and feasibility of integrating the aim of 'environmental sustainability' to form the 'Sextuple Aim.' Environmental sustainability may be in tension with, but also a potential lever to meet the other cardinal aims: (1) quality and experience of patient care; (2) population health; (3) quality of work and satisfaction of healthcare providers; (4) equity and inclusion; and (5) cost reduction. We propose policy and practical avenues to help move towards the Sextuple Aim.

A Study of The Attitude of Health Care Providers Working in Ganjavian Hospital in Dezful City towards Normal Vaginal Delivery and Cesarean Section

A Study of The Attitude of Health Care Providers Working in Ganjavian Hospital in Dezful City towards Normal Vaginal Delivery and Cesarean Section

Barriers to Delivery of Enteral Nutrition in Intensive Care Settings in Saudi Arabia: A Comparative Study of the Perceptions of Health Care Providers Working in Adult and Paediatric ICUs.

Achieving optimal nutrition prescription is challenging in critically ill patients. Many factors can hinder the adequate delivery of enteral nutrition (EN) in intensive care units (ICUs). In this study, we aim to describe EN barriers and compare the perceptions of health care practitioners working in adult and paediatric ICUs regarding these barriers. In this cross-sectional study, data were collected via online survey. All physicians, dietitians, and nurses working in adult or paediatric ICUs across Saudi Arabia were eligible to participate. The survey contained 24 potential EN barriers and participants were asked to rate their importance on a scale from 1 to 5. A total Likert rating score of the 24 items was later calculated. We recruited 244 health care providers working in adult and paediatric ICUs. The most important perceived barriers were "Delay in physician ordering EN initiation" (3.33 ±1.32), and 'Waiting for dietitians to assess patients' (3.22 ±1.20). There was a statistical difference between the responses of health care providers based on their work settings for the following items; "Nurses failing to progress feeds according to feeding protocol" (p=0.006) and 'Feeding being held too far prior procedures or operating-room visits' (p=0.021). Profession significantly influenced the total Likert rating score of the 24 items (r=-0.234, p=0.001). This study identified some barriers of EN delivery in ICUs and showed that participants' perceptions regarding these barriers were influenced by their roles. These findings shed light on the nutritional practices in Saudi hospitals and identify areas of improvement in EN practice and advancements in the field of critical care nutrition in the region.

Covid-19 Prevention Measures among Refugees: Perspectives of Healthcare Providers Working In Refugee Camps in Rwanda

Background The coronavirus disease 2019 (COVID-19) that emerged from Wuhan, China in 2019 rapidly spread throughout the globe in less than 6 months. In June 2020, Rwanda was a home of approximately 149,602 refugees. About 92% of the refugees were living in camps including Kiziba, Gihembe, Nyabiheke, Kigeme, Mugombwa, and Mahama. While entire world was in some level of lockdown, people living in refugee camps and other similar settings were more vulnerable to the pandemic than their counterparts who were staying in their homes. Prevention measures such as social distancing, handwashing, and face mask wearing were often difficult to implement in these settings. Current study aimed to assess perspectives of HCPs working in refugee camps on prevention of COVID-19 in camp settings. Methods This study was a cross-sectional study and due to movement restriction from March 14 to November 3, 2020, we collected data remotely by sharing a structured questionnaire, in google form, to HCPs via WhatsApp and email. The questionnaire collected HCPs’ perspectives on the feasibility of COVID-19 prevention measures, the prevalence of COVID-19 comorbidities, and how the pandemic can be prevented in refugee camp settings. Data were analyzed using descriptive statistics of IBM SPSS V.21. Results This study shows that handwashing, social distancing and wearing masks are feasible measures in refugee camp settings, voted by 71 to 100% of the HCPs. However, lockdown or stay home can be hardly applied in such settings, supported by 80.6% of the respondents. Regarding COVID-19 comorbid conditions, pregnant women in their late or recent term and Heart disease like Hypertensive disorders were voted the most common in refugee camps by 56% and 50% of the HCPs, respectively. Steps to COVID-19 prevention in camps include community awareness, preparing and activating the pandemic response task force, stopping non-essential mass gathering activities, and monitoring of COVID-19 prevention measures during essential service delivery. Conclusions All in all, except lockdown or stay home, other COVID-19 prevention measures like social distancing, handwashing, and facemask wearing can be easily applied in refugee camp and other similar settings.

Facing the Post-Pandemic Challenges: The Role of Leadership Effectiveness in Shaping the Affective Well-Being of Healthcare Providers Working in a Hybrid Work Mode.

The COVID-19 pandemic has brought new challenges to the medical industry, including hybrid work, in which specialists can perform some of their duties remotely, in addition to physical contact with patients and their teams. Hybrid work provides opportunities, but also generates difficulties (e.g., accurate long-distance diagnosis); therefore, there is a need to ensure the well-being of healthcare workers, especially in the context of leadership strategies. As there is little research on leadership practices in remote and hybrid medical worker management, this study analyses the relationship between certain behavioural strategies and competencies of leaders and the affective well-being of hybrid employees. The research was conducted among a group of employees (N = 135) from seven countries who provide healthcare in a hybrid model. The correlations between the variables showed the statistical significance of all leadership strategies introduced into the model and focused on building involvement (employee empowerment and team orientation), creating a shared vision, defining clear goals and strategies, promoting adaptability (change management, promotion of organisational learning and patient focus), managing consistency through shared values, agreement and effective coordination, as well as competencies such as communicativeness, credibility, self-development and digital readiness. Despite the significance of all the relationships, the linear regression showed that the variability of affective well-being was explained mainly by the adaptability leadership strategy. The results of the study expand the knowledge on the competencies of healthcare leaders, and shed new light on the management of medical employees performing remote and hybrid work. Because such research into well-being has not been published to date, the analysis begins an important discussion on redefining leadership in the healthcare sector, taking into account the digital transformation.

Cultural Competence Interventions for Health Care Providers Working With Racialized Foreign-born Older Adults: Protocol for a Systematic Review.

BackgroundIntegrating culturally competent approaches in the provision of health care services is recognized as a promising strategy for improving health outcomes for racially and ethnically diverse populations. Person-centered care, which ensures patient values guide care delivery, necessitates cultural competence of health care providers to reduce racial/ethnic health disparities. Previous work has focused on interventions to improve cultural competence among health care workers generally; however, little investigation has been undertaken regarding current practices focused on racialized foreign-born older adults.ObjectiveWe seek to synthesize evidence from existing literature in the field to gain a comprehensive understanding of interventions to improve the cultural competence of health professionals who care for racialized foreign-born older adults. The aim of this paper is to outline a protocol for a systematic review of available published evidence.MethodsOur protocol will follow the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Protocols) for systematic review protocols. We will conduct a systematic search for relevant studies from four electronic databases that focus on health and social sciences (PubMed, CINAHL, Scopus, and Cochrane Database). After selecting relevant papers using the inclusion and exclusion criteria, data will be extracted, analyzed, and synthesized to yield recommendations for practice and for future research.ResultsThe systematic review is currently at the search phase where authors are refining the search strings for the selected databases; the search strings will be finalized by July 2022. We anticipate the systematic review to be completed by December 2022.ConclusionsThis study will inform the future development and implementation of interventions to support culturally competent, person-centered care of racialized foreign-born older adults.Trial RegistrationPROSPERO CRD42021259979; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259979International Registered Report Identifier (IRRID)PRR1-10.2196/31691