Workload Of Health Care Professionals Research Articles

Assessing Health Care Utilization and Feasibility of Transurethral Catheter Self-Discontinuation

ABSTRACT Common issues after pelvic reconstructive surgery are incomplete bladder emptying and urinary retention, often resulting in placement of an indwelling transurethral Foley catheter, which then remains until a patient returns to the office. Catheterization is significantly distressing for women undergoing these procedures and burdensome due to travel to the office during the postoperative period. In addition, in-office voiding trials add to the workload of health care professionals and staff. A potential alternative is at-home self-discontinuation of the Foley catheter. This study's primary aim was the comparison of the rates of health care utilization (calls, messages, office visits, and emergency department [ED] visits) and postoperative complications within 30 days of surgery among patients with voiding trials on the day of surgery, versus those with Foley placement and void trials on postoperative day 1. Secondary objectives included identifying risk factors for unsuccessful voiding trials and exploring any complications associated with catheter self-discontinuation. This study was designed as a prospective observational cohort study at 1 academic institution and included outpatient women undergoing outpatient urogynecologic or minimally invasive gynecological surgery for benign indications between August 2021 and January 2022. Qualifying patients included cisgendered English-speaking women of at least 18 years of age who exhibited postoperative urinary retention on the day of surgery. Excluded were patients with any preoperative degree of urinary retention (defined as any observation of a postvoid residual more than 200 mL), known upper motor neuron disease, and patients undergoing surgeries with concomitant extra pelvic procedures or minor procedures not requiring a postoperative voiding trial. Based on the exploratory nature of this study, primarily for determining safety and feasibility, the convenience sample size of 50 was set, and patients were recruited at the time of their unsuccessful voiding trials on the day of surgery. On the day of surgery, medical staff performed voiding trials in the postoperative anesthesia care unit, backfilling the bladder with 200 mL of sterile fluid. The void trial was successful if this was followed by a patient void of at least 150–200 mL, otherwise the voiding trial was marked as unsuccessful. Unsuccessful trials resulted in the insertion of an indwelling Foley catheter, followed by verbal and written instruction for performing a home-based, patient-led catheter self-discontinuation at 6:00 am on postoperative day 1. Instructions for catheter removal included pictures and written information. After removal, if the patient failed to void 150 mL within 6 hours, they were instructed to return to the office for additional care. Perioperative data collected from charts included age, parity, body mass index, self-reported race, surgical location, smoking status, periprocedural antibiotics, operative indication, procedures performed, operative time, surgeon type, anesthesia type, estimated blood loss, and intraoperative complications. Results of the study demonstrated 140 patients eligible for day 0 postoperative voiding trials. Of these, most patients were postmenopausal, White, and one third were obese. A majority (82.8%) had a urogynecologist perform their surgery, and the overall rate of voiding trial failure on the day of surgery was 35.7%. The majority of patients (48/50) proceeded with at-home voiding trials according to protocol. Of these, 39 had no further voiding difficulty. Of the 9/50 (18.8%) requiring additional assessment, 6 had a repeat void trial in the office of which 4 were successful, 1 voided spontaneously in the office, 1 required prolonged clean intermittent self-catheterization, and 1 was successful with repeat Foley self-discontinuation on day 3 postoperatively. Only 2 of the 39 patients with successful self-discontinuation on postoperative day 1 had retention later, with 1 presenting to an ED and 1 presenting to the office. Patients with unsuccessful postoperative day 0 void trials had an average of 1 additional call or message to the office, and patients with unsuccessful postoperative day 1 void trials had an average of 1 additional office visit. Although both of these comparisons to those with successful day of surgery void trials were statistically significant, they did not indicate excessive care requirements. Risk factors for failure of day of surgery void trial included older age (also a risk factor for failure on the following day), smoking history, and vaginal hysterectomy. Strengths of the study include its diverse population of women undergoing a wide array of minimally invasive gynecological and urogynecologic surgeries, as well as its prospective nature. Limitations of the study include a lack of control groups, the singular institution in which the study was performed, and the small sample size that limited the potential identification of rare complications. These factors also limit the generalizability of the findings to other settings. Ultimately, catheter self-discontinuation was largely straightforward and efficient for patients and office staff, with low subsequent retention rates. Although further research is required, data currently point to catheter self-discontinuation as a safe and feasible option for women undergoing advanced gynecological surgery, providing a valuable management option for acute postoperative voiding dysfunction.

The other side of COVID-19: A cross-sectional study on mental health in a sample of Italian nurses during the second wave.

The COVID-19 pandemic has led to a drastic increase in the workload of healthcare professionals, particularly nurses, with serious consequences for their psychological well-being. Our study aimed to identify demographic and work-related factors, as well as clinical predictors of post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD), in nurses employed during the COVID-19 pandemic. We carried out a cross-sectional study between December 2020 and April 2021 on nurses employed during the COVID-19 second wave (October - December 2020). We evaluated PTSD and GAD using two validated questionnaires: i) the Impact of Event Scale - Revised (IES-R); and ii) General Anxiety Disorder -7 (GAD-7). Overall, 400 nurses, whose mean age was 34.3 years (SD ± 11.7), were included in the study. Most were female (78.5%), unmarried (58.5%) and employed in the central (61.5%) regions of Italy. A total of 56.8% of all participants had clinical predictors of PTSD, recording a median IES-R score (IQR) of 37.0 (22.0, 51.0) (range 1-84; cut-off >33 for PTSD). Furthermore, 50% of respondents reported moderate-to-severe symptoms consistent with GAD, recording a median GAD-7 score (IQR) of 9.5 (6.0,14.0) (range 0-21; cut-off >10 for GAD). Multivariable analysis showed that moderate-to-severe GAD (aOR = 4.54, 95% CI: 2.93 - 7.05), being employed in the critical care area (aOR = 1.74, 95% CI: 1.01 - 3.00) and being female (aOR= 1.88, 95% CI: 1.09 - 3.22) were significantly associated with the presence of clinical predictors of PTSD. The levels of PTSD symptoms and anxiety among nurses were high during the pandemic. PTSD and GAD represent a public health problem that should be addressed in the post-pandemic period. Healthcare organizations need to activate specific support and rehabilitation networks and programs for healthcare professionals employed during the COVID-19 pandemic.

Detection of melanoma with hybrid learning method by removing hair from dermoscopic images using image processing techniques and wavelet transform

Melanoma is one of the most dangerous types of skin cancer. Detecting melanoma is complicated and takes too much time, which doctors and healthcare professionals accomplish with the help of dermoscopic images. In the last few years, artificial intelligence-based (AI) systems have emerged to detect melanoma and save healthcare workers' time. In addition, with AI-based systems, the need for an expert is eliminated, and diagnoses can be made with a high accuracy rate. Thanks to these systems, the workload of healthcare professionals will be reduced, and patients will gain time on the way to early diagnosis and treatment. This paper proposes the detection of melanoma with hybrid learning techniques. In the system, first of all, using image processing techniques (masking for saturation and wavelet transform) removes obstacles such as hair, air bubbles, and noise in dermoscopic images to increase the algorithm's detection speed. Another critical point of this process is to make the lesion more prominent for detection. As an AI block, an original hybrid model combining deep learning and machine learning has been used for the first time in melanoma detection. After stabilization, the Hamm 1000 (ISIC 2018) and ISIC 2020 datasets were used to measure the performance ratio of the designed system. The best accuracy score in the literature is obtained at 99.44% and 100%, thanks to these two methods.

Digital Platform for Automatic Qualitative and Quantitative Reading of a Cryptococcal Antigen Point-of-Care Assay Leveraging Smartphones and Artificial Intelligence.

Cryptococcosis is a fungal infection that causes serious illness, particularly in immunocompromised individuals such as people living with HIV. Point of care tests (POCT) can help identify and diagnose patients with several advantages including rapid results and ease of use. The cryptococcal antigen (CrAg) lateral flow assay (LFA) has demonstrated excellent performance in diagnosing cryptococcosis, and it is particularly useful in resource-limited settings where laboratory-based tests may not be readily available. The use of artificial intelligence (AI) for the interpretation of rapid diagnostic tests can improve the accuracy and speed of test results, as well as reduce the cost and workload of healthcare professionals, reducing subjectivity associated with its interpretation. In this work, we analyze a smartphone-based digital system assisted by AI to automatically interpret CrAg LFA as well as to estimate the antigen concentration in the strip. The system showed excellent performance for predicting LFA qualitative interpretation with an area under the receiver operating characteristic curve of 0.997. On the other hand, its potential to predict antigen concentration based solely on a photograph of the LFA has also been demonstrated, finding a strong correlation between band intensity and antigen concentration, with a Pearson correlation coefficient of 0.953. The system, which is connected to a cloud web platform, allows for case identification, quality control, and real-time monitoring.

Analgesic Role of Breastfeeding: Analysis of Effectiveness, Implementation Barriers, and Strategies to Promote Evidence-Based Practice

Objective:Exposure to painful stimuli serves as toxic stress for infants, increasing their subsequent pain sensitivity and resulting in neurodevelopmental impairments. Besides offering nutritional, psychological, immunological, and economic benefits, breastfeeding is reported as the most effective analgesia for the management of minor procedural pain in infants. Although breastfeeding holds several advantages, implementation of this nonpharmacological intervention is still uncommon in many clinical settings.Methods:This scoping review presents an analysis of 29 clinical trials that compare the effectiveness of breastfeeding with other nonpharmacological methods.Findings:Breastfeeding is an efficacious analgesia compared with sucrose, sweet solutions, and other nonpharmacological methods. When used alone or in combination with other nonpharmacological interventions, breastfeeding reduces infants’ biobehavioral responses to pain and promotes faster physiologic recovery after painful procedures. Breastfeeding is recommended as the first choice whenever feasible. Barriers to the uptake of this effective pain management method in clinical practice include misinformation/inconsistent use of evidence, an infant’s impaired sucking reflex, maternal–child separation, the workload of healthcare professionals, a lack of parental involvement, assumptions of healthcare providers, and a lack of adequate information/guidance for parents. Strategies to promote the uptake of breastfeeding for the management of procedural pain in infants include an effective partnership between healthcare providers and breastfeeding mothers, knowledge mobilization resources in multiple languages, informational support and media campaigns, and experiential learning opportunities for breastfeeding mothers.Conclusions:Successful implementation of baby-friendly hospital initiatives, a patient-centered approach, family-centered care, and the collaborative efforts of healthcare providers in all healthcare settings is recommended to promote the uptake of breastfeeding as analgesia.

Analgesic Role of Breastfeeding: Analysis of Effectiveness, Implementation Barriers, and Strategies to Promote Evidence-Based Practice

Objective:Exposure to painful stimuli serves as toxic stress for infants, increasing their subsequent pain sensitivity and resulting in neurodevelopmental impairments. Besides offering nutritional, psychological, immunological, and economic benefits, breastfeeding is reported as the most effective analgesia for the management of minor procedural pain in infants. Although breastfeeding holds several advantages, implementation of this nonpharmacological intervention is still uncommon in many clinical settings.Methods:This scoping review presents an analysis of 29 clinical trials that compare the effectiveness of breastfeeding with other nonpharmacological methods.Findings:Breastfeeding is an efficacious analgesia compared with sucrose, sweet solutions, and other nonpharmacological methods. When used alone or in combination with other nonpharmacological interventions, breastfeeding reduces infants’ biobehavioral responses to pain and promotes faster physiologic recovery after painful procedures. Breastfeeding is recommended as the first choice whenever feasible. Barriers to the uptake of this effective pain management method in clinical practice include misinformation/inconsistent use of evidence, an infant’s impaired sucking reflex, maternal–child separation, the workload of healthcare professionals, a lack of parental involvement, assumptions of healthcare providers, and a lack of adequate information/guidance for parents. Strategies to promote the uptake of breastfeeding for the management of procedural pain in infants include an effective partnership between healthcare providers and breastfeeding mothers, knowledge mobilization resources in multiple languages, informational support and media campaigns, and experiential learning opportunities for breastfeeding mothers.Conclusions:Successful implementation of baby-friendly hospital initiatives, a patient-centered approach, family-centered care, and the collaborative efforts of healthcare providers in all healthcare settings is recommended to promote the uptake of breastfeeding as analgesia.

Comparison of artificial intelligence-assisted informed consent obtained before coronary angiography with the conventional method: Medical competence and ethical assessment.

At the time of informed consent (IC) for coronary angiography (CAG), patients' knowledge of the process is inadequate. Time constraints and a lack of personalization of consent are the primary causes of inadequate information. This procedure can be enhanced by obtaining IC using a chatbot powered by artificial intelligence (AI). In the study, patients who will undergo CAG for the first time were randomly divided into two groups, and IC was given to one group using the conventional method and the other group using an AI-supported chatbot, chatGPT3. They were then evaluated with two distinct questionnaires measuring their satisfaction and capacity to understand CAG risks. While the satisfaction questionnaire was equal between the two groups (p = 0.581), the correct understanding of CAG risk questionnaire was found to be significantly higher in the AI group (<0.001). AI can be trained to support clinicians in giving IC before CAG. In this way, the workload of healthcare professionals can be reduced while providing a better IC.

The Mediation Effect of Job Stress and Burnout on the Relationship between Workload and Turnover Intention: An Application in the Healthcare Sector

Sağlık sektörü, emek yoğun ve çalışanların iş yükünün oldukça yüksek olduğu bir sektördür. 2019 yılında koronavirüs küresel salgınının (COVID-19) ortaya çıkması, sağlık çalışanlarının iş yükünün daha da artmasına neden olmuştur. Çalışanların iş yükünün artması iş streslerinin, tükenmişliklerinin ve işten ayrılma niyetlerinin de artmasına neden olabilmektedir (Thompson vd., 2005: 204; Sheraz, 2014: 220). Bu çalışma, COVID-19 döneminde sağlık çalışanlarının iş yükünün iş stresine, tükenmişliğe ve işten ayrılma niyetine olan etkisini; iş stresi ve tükenmişliğin işten ayrılma niyeti üzerindeki etkisini; iş yükünün işten ayrılma niyeti üzerindeki etkisinde iş stresi ve tükenmişliğin aracılık etkisini belirlemek amacıyla yapılmıştır. Bu amaçla 227 sağlık çalışanına anket uygulanmıştır. Çalışmanın bulgularına göre, iş yükü ile işten ayrılma niyeti (β=0.12, p&gt;0.05) arasında istatistiksel olarak anlamlı bir ilişki tespit edilememiştir. Ancak, iş yükünün iş stresine (β=0.36, p

Sağlık Bakım Uygulamalarında Tıbbi Hata Şikayet Olgularının İncelenmesi: Retrospektif Bir Çalışma

Amaç: Araştırma, bir İl Sağlık Müdürlüğü’ne 2012-2019 yılları arasında ulaşan, sağlık bakım uygulamaları sonucunda açılan tıbbi hataya ilişkin şikâyet olgularını incelemek amacıyla yapıldı. &#x0D; Yöntem: Retrospektif kohort olarak tasarlanan araştırmada, 2012-2019 tarihleri arasında bir İl Sağlık Müdürlüğü’nün Disiplin Şube Müdürlüğü’ne ulaşan 170 adet tıbbi hata şikâyet dosyasına ait kayıtlar incelendi. Çalışmada, olgulara ait dosya kayıtları araştırmacılar tarafından hazırlanan “Bilgi Formu” doğrultusunda değerlendirildi. Verilerin analizinde, sayı-yüzde dağılımları, ortalama ve standart sapma kullanıldı.&#x0D; Bulgular: Araştırma kapsamında incelenen, daha çok 2012 (%24.1) ve 2013 (%23.5) yıllarına ait olan şikâyet olgularının %46.5’inde maruz kalan kişinin şahsen kendisi tarafından şikayet yapıldığı gözlendi. Olguların %81.2’si ihmali taksir (özen göstermeme, yetersiz tedavi veya değerlendirme) biçiminde sıklıkla eğitim-araştırma (%37.6) ve devlet hastanelerinin (%34.7) kadın-doğum (%22.9), acil (%21.8) ve cerrahi (%14.7) birimlerinde meydana geldiği belirlendi. Olgularda şikâyet konusu olan fiilin daha ziyade hastanın tedavisinden sorumlu olan (%30 uzman hekim, %24.7 operatör hekim ve %21.2 pratisyen hekim) ve mesleki deneyimi 10 yıl ve üzeri olan sağlık profesyonelleri tarafından gerçekleştiği ve %27.1’inde yapılan hataların hastaların kaybedilmesinde etken olduğu belirlendi. Neredeyse tüm şikâyetlerde maddi hasarın oluştuğuna dair ibareye rastlandı. &#x0D; Sonuç: Yapılan hataların, ihmali taksir niteliğinde olduğu, zaman içerisinde tıbbi hata olgu sayısında azalma olduğu gözlenmiştir. Şikâyet konusu olan hatalar mağdurda işlev kaybı ve engellilik oluşmasına ve maddi hasara neden olmuştur. Araştırma sonucu doğrultusunda, sağlık çalışanlarından kaynaklanan olası tıbbi hataları önlemeye yönelik özellikle bu konuda riskli klinikler (cerrahi, kadın-doğum, acil vb.) başta olmak üzere çalışma saatleri, iş yoğunluğu vb. konuda düzenlemelerin yapılması ve konuya farkındalık oluşturacak hizmet içi eğitim gibi müdahalelerin planlanması önerilir.

The importance of professional factors in the formation of stress reactions in medical workers during the pandemic of the new coronavirus infection COVID-19 (according to a questionnaire survey)

Introduction. In the context of the pandemic of a new coronavirus infection, crises in the field of economy, education, politics and health have intensified. Medical workers turned out to be the most vulnerable category of the population in terms of the risk of developing emotional burnout. The additional challenges faced by healthcare professionals have multiplied the workload of healthcare professionals, as well as increased susceptibility to stress and burnout. The purpose of the study is to conduct a comparative analysis of the phases of the burnout syndrome among medical workers and to study the factors associated with the burnout syndrome during the COVID-19 pandemic. Materials and methods. The study involved healthcare workers in COVID hospitals (n=201); medical workers of the outpatient-polyclinic level (n=186); medical workers of multidisciplinary hospitals (n=195); control group (n=190). The following research methods were used: a questionnaire survey and a questionnaire by Boyko V.V. «Diagnosis of the level of emotional burnout», which is a questionnaire of 84 questions. Results. A high level of emotional burnout was revealed in the general sample of medical workers compared to the control group. The most pronounced signs of emotional distress: tension, resistance, exhaustion are found in medical workers in COVID hospitals compared to medical workers in multidisciplinary hospitals and outpatient clinics. Potential sources of stress for medical workers include: high workload, restrictive measures being introduced, fear of illness, lack and shortage of PPE, the threat and risk of contracting a new coronavirus infection, a long period of isolation, financial instability, insufficient (in the first stage) accumulated knowledge about a new little-studied disease, a feeling of discrimination and / or stigmatization.

The other side of COVID-19: a cross-sectional study on mental health in a sample of Italian nurses

BackgroundThe COVID-19 pandemic and the resulting drastic increase in the workload for healthcare professionals, particularly nurses, has had serious consequences on the psychological well-being of these professionals. Our study aimed at (i) identifying demographic, work-related factors, and clinical predictors of Post-traumatic stress disorder (PTSD) and Generalized Anxiety Disorder (GAD) in nurses employed during COVID-19 pandemic and (ii) assessing problem-focused coping strategies implemented by nurses.MethodsWe carried out a cross-sectional study between December 2020 and April 2021, addressed to nurses employed during the COVID-19 second wave (October - December 2020). PTSD and GAD were assessed by Social Readjustment Rating Scale, Impact of Event Scale - Revised (IES-R) and General Anxiety Disorder -7 scale.ResultsOverall, 359 nurses were included in the study, whose mean age was 31.75 years (SD ± 9.77). Most were female (80.8%), unmarried (53.2%) and employed in the central (52.5%) and northern (36.4%) regions of Italy. A total of 59.7% of all participants had clinical predictors of PTSD, recording a mean score of IES-R of 38.2, SD ± 19.2, range 1- 84 (cut-off >33 for PTSD). Furthermore, 45.6% of respondents reported moderate - severe symptoms consistent with generalized anxiety disorder. Statistical significance was found between GAD and nurses being employed on the front line (Intensive care unit and emergency department) during the COVID-19 second wave (p = 0.016), and between GAD and clinical predictors of PTSD (p = 0.001). Furthermore, we found a statistically significant association between PTSD and nurses who were employed in hospitals or institutions dedicated to COVID-19 (p = 0.028).ConclusionsPTSD and GAD represent a public health problem to be addressed in the post-pandemic period. Healthcare organizations need to activate specific support and rehabilitation networks and programs for healthcare professionals employed during the COVID-19 pandemic.Key messages The levels of PTSD symptoms and anxiety among nurses were high during the pandemic.It is necessary for health systems to differentiate between temporary and long-term mental disorders in order to provide the health workforce with appropriate rehabilitation.

RELATIONSHIP BETWEEN PSYCHOLOGICAL RESILIENCE AND SELF-CARE STRATEGIES OF HEALTHCARE PROFESSIONALS DURING COVID-19 PANDEMIC IN LATVIA

As the worldwide pandemic of Covid-19 continues, health-care professionals (HCP) have been exposed to different hazards, and there is a need to explore psychological resilience in crisis situations, and to give recommendations for its strengthening. The aim of this study was to examine relationship between psychological resilience and self-care strategies in HCP of Latvia, controlling for gender and age during Covid-19 pandemic, and to determine whether the psychological resilience and self-care strategies differ between HCP and professionals in other fields (POF) unrelated to healthcare. Method. The sample consisted of 1723 employees, who during the state of emergency continued to work in their profession; they were divided in two groups - 77 HCP (18 men, 59 women, age M = 46.23 (SD = 14.43)) and 1646 POF (720 men, 926 women, age M = 44.98 (SD = 11.93)) as comparison group. Specific data of national representative cross-sectional online survey (N = 2608), performed in July, 2020, were selected – demographic items, 7 items forming Psychological Resilience Scale and 17 item forming Self–care Strategies Questionnaire (consist of 4 scales: “Spiritual resources”, “Social support”, “Free time activities”, “Time management”). Results. “Time management” was only predictive for Self-care strategy for psychological resilience in both HCP and POF group. Neither age nor gender predicted psychological resilience in HCP group. No statistically significant differences for major variables between HCP and POF were found. Conclusions. The results suggest that performing such Self-care activity as time management can help to promote psychological resilience of the employees regardless of profession. Given the workload of HCP in pandemic, this is an important result. HCP psychological resilience and used self-care strategies during COVID-19 are not different from POF.

Identifying the Value of an eHealth Intervention Aimed at Cognitive Impairments: Observational Study in Different Contexts and Service Models.

BackgroundValue is one of the central concepts in health care, but it is vague within the field of summative eHealth evaluations. Moreover, the role of context in explaining the value is underexplored, and there is no explicit framework guiding the evaluation of the value of eHealth interventions. Hence, different studies conceptualize and operationalize value in different ways, ranging from measuring outcomes such as clinical efficacy or behavior change of patients or professionals to measuring the perceptions of various stakeholders or in economic terms.ObjectiveThe objective of our study is to identify contextual factors that determine similarities and differences in the value of an eHealth intervention between two contexts. We also aim to reflect on and contribute to the discussion about the specification, assessment, and relativity of the “value” concept in the evaluation of eHealth interventions.MethodsThe study concerned a 6-month eHealth intervention targeted at elderly patients (n=107) diagnosed with cognitive impairment in Italy and Sweden. The intervention introduced a case manager role and an eHealth platform to provide remote monitoring and coaching services to the patients. A model for evaluating the value of eHealth interventions was designed as monetary and nonmonetary benefits and sacrifices, based on the value conceptualizations in eHealth and marketing literature. The data was collected using the Mini–Mental State Examination (MMSE), the clock drawing test, and the 5-level EQ-5D (EQ-5D-5L). Semistructured interviews were conducted with patients and health care professionals. Monetary data was collected from the health care and technology providers.ResultsThe value of an eHealth intervention applied to similar types of populations but differed in different contexts. In Sweden, patients improved cognitive performance (MMSE mean 0.85, SD 1.62, P<.001), reduced anxiety (EQ-5D-5L mean 0.16, SD 0.54, P=.046), perceived their health better (EQ-5D-5L VAS scale mean 2.6, SD 9.7, P=.035), and both patients and health care professionals were satisfied with the care. However, the Swedish service model demonstrated an increased cost, higher workload for health care professionals, and the intervention was not cost-efficient. In Italy, the patients were satisfied with the care received, and the health care professionals felt empowered and had an acceptable workload. Moreover, the intervention was cost-effective. However, clinical efficacy and quality of life improvements have not been observed. We identified 6 factors that influence the value of eHealth intervention in a particular context: (1) service delivery design of the intervention (process of delivery), (2) organizational setup of the intervention (ie, organizational structure and professionals involved), (3) cost of different treatments, (4) hourly rates of staff for delivering the intervention, (5) lifestyle habits of the population (eg, how physically active they were in their daily life and if they were living alone or with family), and (6) local preferences on the quality of patient care.ConclusionsValue in the assessments of eHealth interventions need to be considered beyond economic terms, perceptions, or behavior changes. To obtain a holistic view of the value created, it needs to be operationalized into monetary and nonmonetary outcomes, categorizing these into benefits and sacrifices.

Does parental presence affect workload during neonatal resuscitation?

Parents often prefer being present during neonatal resuscitation and benefit from this experience. We aim to determine if parental presence during neonatal resuscitation affects the perceived workload of healthcare providers. Perceived workload was measured using the multidimensional retrospective National Aeronautics and Space Administration Task Load Index survey. Over 3 months, healthcare providers were asked to complete a paper and pencil survey following their participation in a neonatal resuscitation. Surveys also collected healthcare providers' reports of parental presence during resuscitation. 204 surveys were completed. Of these 183 (90%) had complete information about parental presence. Overall workload of healthcare professionals was significantly lower when at least one parent was present (33; 16-47) compared with when no parents were present (46; 29-57) during the resuscitation (p=0.0004). This work supports the presence of parents during neonatal resuscitation. Parental presence during neonatal resuscitation was associated with decreased overall workload experienced by healthcare providers.

An Artificial Intelligence Application in Health Developed on Covid-19 Documents

With the developments in computer science, the concept of artificial intelligence has appeared more frequently in recent years. The concept of artificial intelligence, which is basically defined as computers (machines) thinking like people and making decisions, has become very popular today. Artificial intelligence is used in many fields, especially computer science, education, law, trade, tourism and economy. The health sector is one of these areas. The importance of the applications developed in health sciences has emerged once again, especially during the pandemic process. The development of systems that help reduce the workload of healthcare professionals and make decisions by processing medical data is also an important and real problem that can be solved with artificial intelligence. In this study, natural language processing which is one of the main study subjects of artificial intelligence, has been developed a system that automatically determines the concepts such as disease, medication and treatment on medical data with artificial intelligence by the system. During the experimental studies, it was observed that 91% accurate estimation was made with the model developed. For this study, a Turkish dataset was created by scanning medical articles and studies related to Covid-19 disease. Keywords: Artificial Intelligence, Turkish natural language processing, Name entity recognition, Covid-19 DOI: 10.7176/JHMN/75-08

De implementatie van 'Samen beslissen' in het ziekenhuis en de werkdruk van zorgprofessionals

Deze studie onderzoekt het effect van de interventie 'Samen beslissen' op de werkdruk voor zorgprofessionals in een ziekenhuis. 'Samen beslissen' is een vorm van gezamenlijke besluitvorming waarin patiënten actief worden betrokken. Internationaal empirisch onderzoek laat zien dat dergelijke interventies een positief effect hebben op patiëntgerelateerde uitkomsten, maar er is nog nauwelijks onderzoek gepubliceerd naar de effecten hiervan voor zorgprofessionals. Met het Job Demands-Resources model als theoretische lens hebben we bestudeerd welke mechanismen een rol spelen als 'Samen beslissen' wordt toegepast bij patiënten die werden gediagnosticeerd met prostaatkanker. We hebben kwalitatieve data verzameld rondom de besluitvormingsprocessen bij tien patiënten waarbij twee zorgprofessionals betrokken zijn. Naast een bevestiging van de positieve effecten voor patiënten laten de resultaten zien dat ook de zorgprofessionals de nieuwe manier van besluitvorming als positief ervaren. In termen van werkdruk zien we een goede balans tussen werkeisen en energiebronnen. Deze positieve effecten zijn te relateren aan de zorgvuldigheid waarmee een dergelijke andere manier van werken wordt ingevuld en geïmplementeerd. Dat betekent dat een zorgvuldige implementatie van een nieuwe manier van werken kan bijdragen aan het in de hand houden van werkdruk en zelfs kan bijdragen aan het welzijn van medewerkers in een sector die kampt met hoge werkdruk.

Remote monitoring, healthcare costs, and workload for healthcare professionals.

Remote monitoring, healthcare costs, and workload for healthcare professionals.

The role of internet-based healthcare services in the healthcare process: the example of a Hungarian health portal

E-health plays an increasingly important role in healthcare since it can improve the access to health information. In this article, we are seeking to answer the following questions with respect to online health services: To what extent can they reduce the workload of healthcare professionals in the healthcare system? What kind of health benefits can e-health produce for patients? In our study, we conducted a content analysis based on 'the doctor answers' columns of a Hungarian online health portal. We examined the direct and indirect references to two indicators (seeing the doctor, therapeutic advice) in the responses in relation to ten disease groups. Our results suggest that online health portals can moderately reduce the workload of healthcare professionals and at the same time they can produce considerable health gain for patients.

A stage model of information technology in healthcare

The healthcare industry faces significant challenges such as spiraling costs, shortage of qualified personnel, a rapidly aging population, and increase in chronic diseases as well as epidemics. Healthcare information technology (IT) has been suggested as a mitigator for some of these challenges. Particularly, IT can enable the automation, integration, and management of clinical and administrative functions in healthcare. This has the potential to lower costs, relieve the workload of healthcare professionals, and obtain improvements in healthcare quality as advances in IT take place. In this regard, studying the stages of healthcare IT progression is essential to understand the past trends, address the current challenges, and make use of IT to enhance the provision of healthcare in future. However, although there is considerable literature on the stages of IT evolution, studies specific to healthcare IT are sparse. With the unique challenges of the healthcare sector, we aim to address such a gap in our study. Drawing on the Nolan stage model, we propose a model to explain the stages of IT evolution in the healthcare sector, incorporating initiation, contagion, control, and integration stages. The model was developed with a focus on healthcare IT in Singapore, due to Singapore’s advanced IT and medical infrastructure and relatively lower spending on healthcare compared to other developed countries. In this manner, this study contributes to the understanding of the role of IT in healthcare from a dynamic and evolutionary view.

Rapid screening for influenza using a multivariable logistic regression model to save labor at a clinic in Iwaki, Fukushima, Japan

To lighten the workload of health care professionals, we conducted a clinical test of a newly developed automated infection screening system using a multivariable logistic regression model. The system was tested with 44 influenza patients and 45 healthy control subjects based on 3 vital signs: facial temperature, heart rate and respiratory rate. The system showed a high accuracy for distinguishing influenza patients from control subjects within 15 seconds.