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Abstract Background As person centred care (PCC) is being implemented globally, higher educational institutions (HEI) have begun to play a crucial part in enabling this transition. In Sweden, however, the delivery of PCC is inconsistently implemented in medicine, nursing, occupational therapy, and physiotherapy study programmes. This inconsistency is partly the result of a lack of a national strategy across HEI. Program directors are responsible for the PCC content of their programs, so their views influence how PCC is taught. Using interviews with programme directors in higher education, we aim to deepen the understanding of the preconditions needed to implement PCC by exploring discourses and identifying subject positions of how PCC is taught and learned. Methods We performed a discourse analysis based on interviews with program directors in the above-mentioned national study programmes. A discourse can be seen as a struggle over identity. The subject position – i.e., discourses designate positions for persons to occupy as subjects – guided our analysis and identification of the subject positions of the teacher and the student in teaching and learning PCC. Results This study unfolded in two main antagonistic aspects with respect to teaching and learning PCC, resulting in four subject positions for the teacher and four corresponding subject positions for the students. First, the teacher and student were given a subject position as change agents towards a more egalitarian healthcare and were assigned a subject position to cope with a practical reality they could not change. Second, the teacher and student were assigned a subject position that embodied profession-specific identities, navigating and valuing these boundaries. Simultaneously, both teachers and students assumed a subject position that required interprofessional interaction and co-creation for teaching and learning PCC. Conclusion This study demonstrates the discursive tension surrounding the implementation of PCC in HEI, and the findings can serve as a basis for creating future relevant and high-quality learning activities. The process of negotiating diverse and co-existing perspectives as well as building interprofessional trust when incorporating PCC into higher education is essential and requires further exploration.

Abstract Background Many factors can decrease job productivity and cause physical and psychological complications for health care professionals providing maternal care. Information on challenges and coping strategies among healthcare professionals providing maternal healthcare services in rural communities is crucial. However, there needs to be more studies, especially qualitative research, to explore challenges and coping strategies for providing maternal health care services in Ethiopia among health care professionals, particularly in the Wolaita zone. Objective To explore the challenges and coping strategies of professionals providing maternal health care in rural health facilities in Wolaita Zone, Southern Ethiopia, in 2023. Method A phenomenological qualitative study design was applied from May 20 to June 20, 2023. The study was conducted in rural areas of the Wolaita Zone, southern Ethiopia. Healthcare professionals from rural areas were selected using purposive sampling, and in-depth interviews were conducted. A qualitative thematic analysis was employed to analyze the data. Field notes were read, recordings were listened to, and each participant’s interview was written word for word and analyzed using ATLAS.ti 7 software. Result Five main themes emerged from the data analysis. These themes included inadequate funding from the government, societal barriers to health and access to health care, professionals’ personal life struggles, infrastructure related challenges and health system responsiveness, and coping strategies. Reporting to responsible bodies, teaching mothers about maternal health care services, and helping poor mothers from their pockets were listed among their coping strategies. Conclusion Healthcare professionals have a crucial role in supporting women in delivering babies safely. This study revealed that they are working under challenging conditions. So, if women’s lives matter, then this situation requires a call to action.

Abstract Background Competence in delirium care begins with pre-registration education for health care professionals. Although a common complication for hospitalised patients, delirium is avoidable and reversible. Delirium requires early recognition in person-centred care. Students need to learn how to identify and effectively care for ‘at risk’ patients. Aim To identify and examine literature on how pre-registration health care professional students are prepared to recognise, assess, and deliver interventions to prevent delirium in practice, using digital/web based educational interventions. Method Mixed methods systematic review with narrative synthesis. A protocol was registered with PROSPERO. The review questions and search strategy were guided by the Population, Phenomena of Interest, Context (PICo) framework. The PRISMA framework guided the screening, data extraction and analysis. Database searches (MEDLINE, Web of Science, Embase, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO & Scopus) were undertaken in April 2023 for publications from 2012 to 2023. Covidence software [30] was used to extract and manage the data. Quality appraisal was guided by the Crowe Critical Appraisal Tool (CCAT) [31]. Findings Ten papers were included: mixed methods (2), qualitative (1) and quantitative (7). Medical students were the most studied group (n = 5), followed by student nurses (n = 4) and mixed nursing and medical students (n = 1). Length of learning experience varied from 12 min virtual reality (VR) to a two-week ‘geriatrics’ elective. Learning was enhanced by player autonomy, engagement, safety, applicability, choices, multiple perspectives and moral reasoning opportunities. Discussion Digital programmes should be visually appealing, interactive with opportunities for practice and timely appropriate feedback.

Abstract Background Sexual risk-taking and struggles in managing romantic relationships may put young women with Attention Deficit Hyperactivity Disorder (ADHD) at risk of sexually transmitted diseases, unplanned pregnancies, and low relational satisfaction. To gain understanding of sexual behaviors and intimate relationships, this study aimed to identify and describe health care professionals’ (HCPs) perceptions and experiences of sexual and reproductive health (SRH) in young women with ADHD. Methods Qualitative interviews were performed with 16 HCPs. Data was analyzed using reflexive thematic analysis. Results Analysis resulted in the themes Struggling to meet expectations, Sexual risk-taking, and Complex romantic relationships. HCPs’ perceptions and experiences indicated that some women were afraid to be judged in clinical meetings when not living up to perceived expectations of sexual behaviors. Lack of impulse control was interpreted by HCPs to result in risk-taking behaviors leading to both negative and positive sexual experiences. Difficulties in assessing intentions of sexual partners were further perceived by HCPs to sometimes lead to sexual regrets or sexual victimization. The HCPs had experience of women wishing for romantic relationships but described these as being complicated by previous experiences, low self-esteem and conflict. ADHD medication and self-knowledge were perceived by HCPs to facilitate the women’s relationship quality. Conclusions This study highlights that, from the perspective of HCPs, self-stigmatization and hesitation to raise issues concerning sexuality with HCPs may pose risks for young women with ADHD. It provides insight into sexual risk-taking behaviors, showing the link to regretted sex and sexual victimization. The study concludes that there is a need for HCPs to understand the influence of stigma concerning ADHD and female sexuality as well as how symptoms and outcomes of living with ADHD may impact SRH in order to promote healthy behaviors and relationships in young women.

Abstract Background The 2022 Ebola Virus Disease (EVD) outbreak occurred at a time when Uganda was still battling the social and psychological challenges of the COVID-19 pandemic; placing health care professionals (HCPs) at a much higher risk of developing psychological distress. Psychological distress among HCPs can cause decreased workplace productivity and ineffective management of their patients. The current study aimed to investigate and understand psychological distress among HCPS in Mbarara city in Southwestern Uganda following the 2022 EVD outbreak. Method We enrolled 200 HCPs through convenient sampling from one private and one public health facility in Mbarara city in Southwestern Uganda, in a cross-sectional convergent parallel mixed method approach where qualitative and quantitative data were collected concurrently. Quantitative data, utilizing the Kessler Psychological Distress (K10) Scale, provided us with a quantitative measure of the prevalence of psychological distress among HCPs, and were analyzed using STATA version 16. Qualitative data, on the other hand, offered deeper insights into the nature, perceptions, and contextual factors influencing this distress, and were analyzed using emergent theme analysis. Results The prevalence of psychological distress was 59.5% and it was higher among females (63.9%) compared to males (36.1%). HCPs vividly expressed distress and anxiety, with heightened suspicion that every patient might be an EVD carrier, creating a pervasive sense of unsafety in the workplace. However, the outbreak had an educational affect where concerns about the announcement of another EVD outbreak were diverse, with HCPs expressing anxiety, despair, and dissatisfaction with the country’s management of potential outbreaks. Conclusion High levels of psychological distress were experienced by HCPs in Southwestern Uganda as a result of the 2022 EVD pandemic. HCPs express a wide range of feelings, such as dread, anxiety, despair, pessimism, and discontent with the way the outbreaks are handled throughout the nation. We recommend implementation of comprehensive psychosocial support programs tailored to the unique needs of HCPs, including counseling services, stress management workshops, and peer support networks.

Abstract Background Mindfulness-based interventions (MBIs) appear to be effective for improving the mental health of healthcare professionals (HCPs). However, the effectiveness of MBIs on extreme psychological trauma caused by the coronavirus disease 2019 (COVID-19) pandemic is largely unknown. The aim of this paper was to systematically review empirical studies of MBIs for HCPs carried out during the COVID-19 pandemic, to evaluate them and their effectiveness in different areas of mental health. Methods The electronic databases searched were Web of Science, Scopus, PubMed, and PsycINFO. The date when each database was last searched was September 15, 2023. Randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and non-randomized non-controlled trials (NRNCTs) focused on MBIs for health care staff who were working in healthcare centers during the COVID-19 pandemic were included. All of them employed standardized measures of mental health. The review followed the best practices and reported using PRISMA guidelines. A data collection form, adapted from the Cochrane handbook for systematic reviews of interventions, was used to extract and synthesize the results. The methods used to assess the risk of bias in the included studies were the Cochrane Risk of Bias Tool and the ROBINS-I Tool. Results Twenty-eight studies were included in the systematic review. Overall, the methodological quality of the studies was moderate. The results showed the effectiveness of MBIs in improving levels of stress, mindfulness, and mental well-being. However, no conclusive results were found regarding the effectiveness of MBIs in improving the levels of burnout, anxiety, depression, sleep quality, and resilience of HCPs. Conclusions The MBIs for HCPs carried out during the COVID-19 pandemic have mainly contributed to improving stress, mindfulness, and mental well-being at a time of serious health emergency. However, more robust studies at a methodological level would have been desirable. Systematic review registration PROSPERO CRD42021267621

Abstract Background Dementia is a major global public health challenge, and with the growing elderly population, its prevalence is expected to increase in the coming years. In Sweden, municipalities are responsible for providing special housing for the elderly (SÄBO), which offers services and care for older individuals needing specific support. SÄBO is both the person´s home and a care environment and workplace. Polypharmacy in patients with dementia is common and increases the risk of medication interactions. Involving clinical pharmacists in medication reviews has been shown to enhance medication safety and improve prescribing practices. However, the views of the standard care team involved in medication prescribing, administration, monitoring and documentation on integrating pharmacist services have received less attention. Thus, this study aims to explore how pharmacists’ contributions can enhance medication safety, improve patient care efficiency, and potentially alleviate the workload of general practitioners for people with dementia living in special housing. Methods This study has a descriptive qualitative study design using semi-structured interviews and qualitative content analysis. The study was conducted in a southern Swedish special housing and included nurses, assistant nurses, general practitioners (GPs), and a pharmacist. Due to the COVID-19 pandemic, interviews were conducted over the phone. The Swedish Ethical Review Authority approved the study. Results The analysis revealed three main categories, and eleven subcategories.: (1) Integrating multidisciplinary approaches for holistic dementia care, (2) Strengthening dementia care through effective medication management and (3) Advancing dementia care through pharmacist integration and role expansion. Nurses focused on non-pharmacological treatments, while GPs emphasized the importance of medication reviews in assessing the benefits and side-effects of prescribed medication. Pharmacists were valued for their reliable medication expertise, appreciated by GPs for saving time and providing recommendations prior to consultations with individuals with dementia and their next-of-kin. Although medication reviews were considered beneficial, there was skepticism about their ability to solve all medication-related problems associated with dementia care. Conclusions This study highlights the critical role pharmacists play in enhancing medication safety and patient care efficiency in special housing for individuals with dementia. Despite the value of their contributions, communication barriers within healthcare teams pose significant challenges. Recognising potential pharmacist role expansion is essential to alleviate the workload of GPs and ensure effective collaborative practices for better patient outcomes.

Abstract Background Huntington’s disease (HD) has substantial impact on patients and carers’ lives. Managing patients in the advanced phase of HD may be challenging to primary health care professionals. The aim of this study is to elicit health care professionals’ experiences of managing the challenges with patients with advanced HD in primary health care. Methods We did a qualitative study, collecting data from four focus group interviews with 22 primary health care professionals who had experience with caring for patients with HD in Norway. The data were analysed using a qualitative content analysis method, systematic text condensation. Results We found that health care professionals who care for patients with HD in primary health care experience challenges related to patients’ behaviour, family members and caregivers, professionals’ individual competency, and the organizational context. They conveyed that successful care and management of patients with advanced HD was dependent on individuals’ competency and “everyday tactics”, well-functioning teams, and leadership and organizational support. Conclusion In addition to individual competencies, including being personally suitable for the job, well-functioning primary care teams, and organization support and training is important for health care professionals’ ability to manage patients with advanced HD in primary health care.

Abstract Background Virtual reality (VR) training can enhance health professionals’ learning. However, there are ambiguous findings on the effectiveness of VR as an educational tool in mental health. We therefore reviewed the existing literature on the effectiveness of VR training on health professionals’ knowledge, skills, and attitudes in assessing and treating patients with mental health disorders. Methods We searched MEDLINE, PsycINFO (via Ovid), the Cochrane Library, ERIC, CINAHL (on EBSCOhost), Web of Science Core Collection, and the Scopus database for studies published from January 1985 to July 2023. We included all studies evaluating the effect of VR training interventions on attitudes, knowledge, and skills pertinent to the assessment and treatment of mental health disorders and published in English or Scandinavian languages. The quality of the evidence in randomized controlled trials was assessed with the Cochrane Risk of Bias Tool 2.0. For non-randomized studies, we assessed the quality of the studies with the ROBINS-I tool. Results Of 4170 unique records identified, eight studies were eligible. The four randomized controlled trials were assessed as having some concern or a high risk of overall bias. The four non-randomized studies were assessed as having a moderate to serious overall risk of bias. Of the eight included studies, four used a virtual standardized patient design to simulate training situations, two studies used interactive patient scenario training designs, while two studies used a virtual patient game design. The results suggest that VR training interventions can promote knowledge and skills acquisition. Conclusions The findings indicate that VR interventions can effectively train health care personnel to acquire knowledge and skills in the assessment and treatment of mental health disorders. However, study heterogeneity, prevalence of small sample sizes, and many studies with a high or serious risk of bias suggest an uncertain evidence base. Future research on the effectiveness of VR training should include assessment of immersive VR training designs and a focus on more robust studies with larger sample sizes. Trial registration This review was pre-registered in the Open Science Framework register with the ID-number Z8EDK.

Background The ongoing conflict in Syria has significantly affected the health care system, particularly in the realm of rheumatology. The purpose of this study is to assess the current state of rheumatic diseases in the northwestern region of Syria, where the health care infrastructure has been severely impacted.

Exploring Bereavement in Pediatric Nursing: A Systematic Review

AbstractObjective This study described the experiences and perceptions of how primary health care professionals (PHCPs) support patients with venous leg ulcers (VLUs) in self-care monitoring.Design A qualitative approach with reflexive thematic analysis was used, with 24 individual qualitative open interviews.Setting Primary health care clinics and community health care in four southern regions in Sweden.Subjects Registered nurses, district nurses and nurse assistants who had experience of caring for patients with VLUs. In total, 24 interviews were conducted with PHCPs in Sweden.Results PHCPs have a vital role in promoting patient independence and responsibility, identifying needs and adapting care strategies, while also recognising unmet needs in patients with VLUs.Conclusion PHCPs actively monitor patients’ self-care and establish caring relationships. They see a need for a structured primary health care work routine for ulcer management.

Abstract Aim Is upper quadrant neural tissue extensibility affected in asymptomatic health care professionals? Participants Ninety asymptomatic health care professionals of 26–60 years (30 surgeons, 30 dentists, 30 physiotherapist) were selected on the basis of inclusion and exclusion criteria. Methodology This was a cross-sectional type of observational study, and the data was collected by simple random sampling, in which various ULTT were performed on both upper extremities for median (ULTT1), radial (ULTT2), and ulnar (ULTT3) nerve. Elbow position was measured at first onset of discomfort perceived by participants (R1) and, secondly, when the firm resistance to movement was felt by the examiner (R2), by using universal goniometer. The test was considered positive if the symptoms arise before 60° of end elbow ROM. Results The results showed that there was reduced upper quadrant neural tissue extensibility in asymptomatic health care professionals. The median nerve was most affected, and the ulnar nerve was least affected. The prevalence rate of reduced neural extensibility was highest among dentists as compared to the surgeons and physiotherapists. High correlation was found between R1and R2 for all three ULTT (p-value = 0.000). Conclusion More than half, specifically 51.1%, of asymptomatic health care professionals had reduced extensibility of the neural tissues in their upper limbs. Therefore, early introduction of exercise will help in combating the occurrence of these nerve-related issues in further life.

Abstract Background Nonsuicidal self-injury (NSSI) is associated with stigma, and negative attitudes among healthcare professionals toward NSSI have been reported. A person-centered approach that focuses on how individuals with lived experience of NSSI perceive the treatment and care they receive is invaluable in reducing barriers to help-seeking and improving treatment and mental healthcare services. The aim of the current qualitative study was to explore the perceptions of young adults when they look back upon their experiences of psychiatric treatment for NSSI during adolescence. Methods Twenty-six individuals with lived experience of NSSI who were in contact with child and adolescent psychiatry during adolescence were interviewed. The interviews were analyzed using thematic analysis. Results Three main themes were developed: Changed perceptions in retrospect, The importance of a collaborative conceptualization and Lasting impression of the relationship. Participants’ perception of themselves as well as the treatment changed over time. The importance of a joint understanding of NSSI and an agreed-upon treatment focus was emphasized. The relationship to the mental health professionals, and experiences of how NSSI was communicated, were salient several years later. Conclusions Healthcare professionals need to communicate about NSSI in a respectful manner and include the perspective of the adolescent with lived experience of NSSI in a joint conceptualization of NSSI and treatment focus.

AbstractPurpose As reported in most European countries, the percentage of treated hypertensive patients achieving a well-controlled blood pressure (e.g. < 140/90 mmHg) is insufficient. This represents a major health concern particularly in countries with a high prevalence of cardiovascular events such as stroke. Therefore, there is a need to develop national programs to increase not only the awareness regarding elevated blood pressure but also the percentage of treated patients achieving recommended blood pressure targets. The present paper describes the new initiative of the Portuguese Society of Hypertension (PSH) to achieveat least 70% of controlled hypertensive patients, followed in primary care, in 2026.Materials and Methods The strategies used to improve blood pressure control are aimed at healthcare professionals and general population and include governmental and organizational interventions. To be able to analyze the control rate of HTN patients, and using BI-CSP reports (the Primary Care health unit platform), every six months, we will be addressing the proportion of HTN patients (age: 18-65 years) with BP < 140/90 mmHg and the proportion of HTN patients with at least one blood pressure recorded in the last semester.Conclusion With Mission 70/26, the PHS aims to improve awareness among all health professionals and community alike about the problem of uncontrolled HTN and its role in the consequent disability and high mortality rate from cardiovascular causes.

PurposeThe objective of this report is to provide longitudinal insights on the impact of a health professions exposure program for high school students of underrepresented backgrounds in medicine.ContextMedical students at the University of Chicago reviewed data from their chapter of the Health Profession Recruitment and Exposure Program (HPREP) from 2016–2021 to discover trends in enrollment. This data is documented in the context of the program's mission to increase awareness of health disparities, the success of prominent alumni, and recent community efforts post-COVID-19 pandemic.FindingsTwo hundred and ninety-nine high school students participated in the University of Chicago HPREP program between 2016 and 2021. Participants ranged in age from 12 to 18 years (mean = 16, SD = 1) and 74% (n = 222) were female students. Of 252 respondents, 58% (n = 147) identified as Black or African American, 31% (n = 77) identified as Latinx or of Hispanic origin, and 10% (n = 24) identified as another race or as bi-racial. Ten or fewer black male students participated in the program every year, including the 2020–2021 year in which 61 students participated.ConclusionsHPREP has played an important role in shaping the face of health care, especially in Chicago. The data suggests significant increases in the number of underrepresented minority women becoming physicians and serving Chicago communities in the next decade. Pathway programs for underrepresented students in medicine should be strategic in recruiting and educating future health professionals based on future workforce needs.

BackgroundPoor sleep quality is linked to physiological dysfunction, which increases the risk of obesity, cardiovascular disease, cognitive impairment, and other medical conditions. Despite the known health risks of sleep disturbances, literature is still scant regarding sleep quality and its associated factors among healthcare professionals in Ethiopia. Therefore, this study aimed to determine the prevalence of poor sleep quality and its associated factors among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital.MethodsAn institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A total of 418 healthcare professionals participated in the study. The study participants were chosen using the stratified random sampling method. Data were collected using a structured, self-administered questionnaire. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality of participants. Bi-variable and multivariable logistic regression models were used. p ≤ 0.05 was used to declare statistically significant variables.ResultsThe mean age of the study participants was 30.7 years (SD ± 6.3). The overall prevalence of poor sleep quality was 58.9% [95% CI (54.2, 63.6%)]. Being female [adjusted odds ratio (AOR) = 1.9, 95% CI (1.2, 2.9)], being a shift worker [AOR = 5.7, 95% CI (2.3, 14.3), not performing regular exercise [AOR = 2.08 (1.2–3.6)], being a khat chewer [AOR = 3.1, 95% CI (1.2, 7.6)], and having depressive symptoms [AOR = 2.6, 95% CI (1.3, 6.8)] were significantly associated with higher odds of having poor sleep quality.ConclusionThe prevalence of poor sleep quality among healthcare professionals was found to be high. As a result, we recommend that healthcare providers at the University of Gondar Comprehensive Specialized Hospital focus on early regular screening for sleep disturbances and pay special attention to shift work schedules and behaviors such as khat chewing, exercise, and depressive symptoms.

Introduction: Conirmatory factor analysis (CFA) is a statistical technique to verify the factor structure of a set of observed variables. Objective: The study was conducted with an objective to study the psychometric properties of DASS 21 scale by Conirmatory factor analysis. Method: This study used a Multi Method Design (Multiple approach Design), one was a cross sectional study of 228 participants and the other was a Solomon 4 group Design with total 64 participants. Four groups of health care professionals viz Allopathic doctors, Physiotherapists, Nursing professionals and Community Health Oficers (CHOs) were chosen for the study. Convenience sampling was done at two stages. Results: Conirmatory factor analysis was used to evaluate the construct validity of DASS 21 scale. The model was overidentiied as the estimated parameters were less than the number of observed variances and covariances. CMIN/DF (Chi square (minimum discrepancy function) /Degree of freedom) value was 2.021 which was < 5. Goodness of Fit Index (GFI) value (0.892) was near to .9. Root Mean square Residuals (RMR) and Root Mean Square Error of Approximation (RMSEA) value were 0.031 and 0.063, respectively which were less than 0.08. Average variance extracted (AVE) for the three constructs were less than the squared interconstruct correlation. Conclusion: DASS-21 scale demonstrated a good convergent validity, but in this study, discriminant validity was found to be poor as determined by average variance extracted in comparison to squared Interconstruct correlation.

Patientensicherheit ist eines der höchsten Ziele der Gesundheitsversorgung und seit dem Jahr 2022 zehntes nationales Gesundheitsziel in Deutschland. Versorgungsfehler tragen in großer Zahl zu vorübergehender oder dauerhafter Beeinträchtigung, verlängertem Krankenhausaufenthalt oder sogar zum Tod von Patientinnen bei. Obwohl das Thema seit der Veröffentlichung von „To err is human“ im Jahr 2000 in den USA auch in Deutschland große Beachtung erfährt, besteht weiterhin hoher Handlungsbedarf. Unerwünschte Ereignisse, die im Behandlungskontext ausgelöst werden, sind angesichts der Komplexität medizinischer Behandlungen und der Bandbreite patientenseitiger gesundheitlicher Vorbedingungen nicht vollständig verhinderbar. Strategien zur Verbesserung der Versorgungsqualität konzentrieren sich daher auf die Verhinderung vermeidbarer unerwünschter Ereignisse. Diese sind so definiert, dass sie bei Einhaltung aktueller medizinischer Standards nicht auftreten würden. Das Aktionsbündnis Patientensicherheit e. V. (APS), ein Zusammenschluss von Vertretungen von Gesundheitsberufen, -institutionen, Verbänden und Patientenorganisationen setzt sich seit seiner Gründung im Jahr 2005 für die Umsetzung von Strategien zur Vermeidung unerwünschter Ereignisse ein. Behandlungsfehler treten meist innerhalb komplexer und arbeitsteiliger Zusammenhänge auf. Vor diesem Hintergrund ist für das APS das wichtigste Instrument zur Verbesserung der Patientensicherheit das gemeinsame Lernen aus Fehlern [1]. Um dies zu ermöglichen und erfolgreich anzuwenden, muss offen kommuniziert werden.

Background The unexpected outbreak of the COVID-19 pandemic has led huge impact on health and safety of employees. Although now the epidemiological situation has improved, but it remains a challenge, especially in light of the emergence of new threats. The aim of the work is to present an epidemiological analysis of data on COVID-19 as an occupational disease in Poland. Material and Methods The analysis covered all cases of occupational diseases sent by state sanitary inspectors to the Central Register of Occupational Diseases. The years 2020–2022 and such available data as: age, gender, activities and territorial differentiation were analyzed. The data were presented as absolute numbers and incidence rates per 100 000 employed persons and for healthcare workers also per 100 000 persons authorized to practice. Results In the period 2020–2022 in Poland 7030 diseases recognized as occupational diseases were recorded, of which almost half were infectious diseases (47%). Among infectious diseases, dominated COVID-19 in number of 2059 cases. In this period 98.6% of all cases of COVID-19 were concentrated in the health care and social activities. According to workplaces, most diseases were caused by working in hospitals – 1825 cases (88.6% of all COVID-19 cases in the healthcare workers). Most cases concerned nurses – 1355 cases (65,8%) and doctors – 212 cases (10,3%). The incidence of COVID-19 in the group of physicians per 10 000 persons entitled to practice ranged from 2.6 in 2020 to 68.3 in 2022, while among nurses and midwives the rates were 7.9 and 194.9, respectively. Conclusions The COVID-19 pandemic changed the picture of occupational diseases in Poland. Therefore, it is very important to understand the key contributions of people working in environments where workers are at increased risk of contracting COVID-19 due to the nature of their work, and to promote the recognition of COVID-19 as an occupational disease. Med Pr Work Health Saf. 2023;74(6):479–86.

Abstract Background Forward with Dementia is a co-designed campaign to improve communication of dementia diagnosis and post-diagnostic support. Methods Webinars, a website, social and traditional media, and promotions through project partners were used to disseminate campaign messages to health and social care professionals (primary audience) and people with dementia and carers (secondary audience). The campaign ran between October 2021 and June 2022, with 3-months follow-up. The RE-AIM framework was used for process evaluation. Measurements included surveys and interviews, a log of activities (e.g. webinars, social media posts) and engagements (e.g. attendees, reactions to posts), and Google Analytics. Results There were 29,053 interactions with campaign activities. More than three-quarters of professionals (n = 63/81) thought webinars were very or extremely helpful. Professionals and people with dementia and carers reported that the website provided appropriate content, an approachable tone, and was easy to use. Following campaign engagement, professionals planned to (n = 77/80) or had modified (n = 29/44) how they communicated the diagnosis and/or provided post-diagnostic information and referrals. Qualitative data suggested that the campaign may have led to benefits for some people with dementia and carers. Conclusions Forward with Dementia was successful in terms of reach, appropriateness, adoption and maintenance for professionals, however flow-through impacts on people with dementia are not clear. Targeted campaigns can potentially change health professionals’ communication and support around chronic diseases such as dementia.

Background: Proton Pump Inhibitors (PPIs) are commonly prescribed drugs and their inadequate prescription can have adverse outcomes. Multiple factors are responsible for inappropriate use of PPIs including self-medication, less knowledge about PPIs in medical staff, and consumer-oriented advertising. Objective: To assess the knowledge and practices about PPI use among Physicians in Tharparkar District of Sindh province, Pakistan. Methods: This is a cross Sectional study that was done in the rural hospitals (Basic Health Unit, Rural Health Centre, Talukka, and District Hospital) in Tharparkar District Sindh. The study took place for 6 months from October 13, 2019, to April 12, 2020. All PMC licensed Physicians working in district Tharparkar for at least 6 months were consecutively enrolled. Knowledge questions comprised of questions about PPI and their indication and side effects while practice questions such as indication, route, and duration of action were asked. All participants were classified as having adequate knowledge and adequate practice based on the correct answer to each question. The study included PMC-licensed physicians with one-year internship/ house job experience and Physicians who had worked at district Tharparkar in a rural setting for at least 6 months. Physicians who did not give consent were excluded from the study. Results: Of 102 practitioners, the mean age of the participants was 39.57 ±9.14 years. The majority of the practitioners were males (n=82, 80.4%). Most of the practitioners (n=66, 65%) were working in district hospitals, 21 (19.6%) in rural health centers, and 15 (14.7%) in basic health units. Adequate knowledge was observed in 34 (33.3%) while adequate practice in 33 (32.4%) participants. Conclusion: The knowledge and practices about Proton Pump Inhibitor (PPI) use were found to be unsatisfactory among Physicians working at Tharparkar

Abstract Background Eldercare workers in nursing homes report high musculoskeletal disorders, stressful work, and sickness absence. Initiatives that can accommodate these issues are needed. Current studies point out that nature contact may offer a range of human health benefits, potentially promoting healthier work among eldercare workers. Therefore, this study aimed to investigate facilitators and barriers for using outdoor areas as part of the daily work among eldercare workers in Danish nursing homes. Methods In this multiple case study, we collected data from three nursing homes, conducting three semi-structured focus group interviews with eldercare workers and three individual interviews with nursing home managers. Furthermore, we conducted observations of the daily work and mappings of the nursing homes’ outdoor environments to gain in-depth knowledge of eldercare workers’ and managers’ perspectives on using outdoor areas in their daily work. The data was thematically analysed using ‘The Behaviour Change Wheel’ (BCW), more specifically the COM-B model, as a theoretical foundation for exploring facilitators and barriers for the use of outdoor areas. Results Frequently mentioned facilitators were facilities, traditions or repetitive events, positive experiences with residents (‘star moments’), and knowledge about the residents. Frequently mentioned barriers were insufficient staffing, hierarchy in the work tasks, professional identity, and lack of ideas. Conclusions The identified facilitators and barriers should be considered when designing initiatives for increased use of outdoor areas or activities of eldercare workers. Trial registration According to the Danish ethics committee (Law of committee, (komitéloven) paragraph 14, Sect. 2), qualitative interviews, which do not include human biological materials, do not need neither approval by ethical and scientific committee or informed consent (The Danish National Centre for Ethics).

Abstract Background Health care professionals play a central role in offering reproductive genetic carrier screening but face challenges when integrating the offer into practice. The aim of this study was to design, execute, and evaluate theory-informed implementation strategies to support health care professionals in offering carrier screening. Methods An exploratory multi-method approach was systematically employed based on the Theoretical Domain Framework (TDF). Implementation strategies were designed by aligning TDF barriers reported by health care professionals involved in a large carrier screening study, to behaviour change techniques combined with study genetic counsellors’ experiential knowledge. The strategies were trialled with a subset of health care professionals and evaluated against controls, using findings from questionnaires and interviews with healthcare professionals. The primary outcome measure was the number of couples who initiated enrolment. Results Health care professionals (n = 151) reported barriers in the TDF Domains of skills, e.g., lack of practice in offering screening, and challenges of environmental context and resources, e.g., lack of time, which informed the design of a skills video and a waiting room poster using the TDF-behaviour change technique linking tool. Following implementation, (Skills video n = 29 vs control n = 31 and Poster n = 46 vs control n = 34) TDF barrier scores decreased across all groups and little change was observed in the primary outcome measure. The skills video, though welcomed by health care professionals, was reportedly too long at seven minutes. The waiting room poster was seen as easily implementable. Conclusions As carrier screening moves towards mainstream healthcare, health care professionals report barriers to offering screening. To meet their needs, developing and testing experiential and theory-informed strategies that acknowledge contextual factors are essential.

Introduction. Scientific reasoning for improving the organisation of cancer prevention and the providing onco-dermatological care to the population in the conditions of the public health system development. Materials and methods. The article includes the method of system approach as well as bibliosemantic, epidemiological, medical and statistical, sociological, expert assessment, content analysis, structural and logical analysis, modelling methods. Sources of information are the data from scientific literature, the Center for Medical Statistics of the Ministry of Health Care of Ukraine, the National Cancer Registry of Ukraine, the sociological research among various groups of participants in providing healthcare services and strategic documents of the national and international levels. Results. Unfavourable trends in skin malignancies spread, an increase in their contribution to the burden of the disease and the imperfection of the organisation of skin cancer prevention and the onco-dermatological care to the population were revealed. According to the principles of the state policy and the recommendations of the international organisations the directions of improving the preventive, therapeutic and diagnostic services were reasoned out on the basis of the data from the scientific literature, epidemiological research, spread, locational, gender and age peculiarities of skin cancer among the population, risk factors for their development, estimating the health care resource support, scale and results of the activities, studies of the patients, doctors and health care professionals' opinions. The modern functional-organisational model of the prevention system and control of skin cancer in the conditions of the public health system development with the definition of its principles, structures and functions was reasoned and worked out. Conclusions. The practical implementation of the measures for improving the prevention organisation and therapeutic and diagnostic work to fight skin cancer and the developed functional and organisational model of the system of prevention and control of onco-dermatological pathology in conditions of the public health development will effectively prevent onco-dermatological diseases, reduce the burden of skin cancer, improve people’s health and health care performance indicators and contribute to the health care sustainable development and the population’s well-being.

Abstract Background In the spring of 2020, the Covid-19 outbreak sent a shock wave through the Swedish society and placed an extraordinary pressure on the health and social care system for older people. In the initial phase there were few guidelines for care providers to follow and staff in home care organisations often had to tackle challenges posed by the pandemic as they appeared. The aim of this study was to understand how the spread of Covid-19 was managed in organisations providing home care to older adults in different municipalities in Region Stockholm, and what actions were taken to minimise the spread of the disease among clients and staff. Method A descriptive qualitative study was performed based on eight interviews with managers of home care providers for older adults in three different municipalities in Region Stockholm.Three of the eight providers operate within an integrated care system. Data were analysed using conventional content analysis. Results Three themes were identified covering actions taken to handle the spread of the virus, feelings of insecurity and anxiety, and internal and external factors influencing how the pandemic was tackled. There was no single strategy followed by all municipalities or organisations, however, there were similarities between the organisations. One such example was the introduction of cohort care and the experience of lacking personal protective equipment. Providers in the integrated care system emphasized some advantages with their system that was seen as facilitators for minimising the risk of spreading the virus, like the joint meetings with managers from both health and social care and the close contact with healthcare professionals in relation to dissemination of hygiene instructions. Conclusion Social care workers providing home care to older persons are an important group in preventing dissemination of infectious diseases like Covid-19. For better readiness and preparedness for future pandemics, municipal home care services would need larger stocks of personal protective equipment, clear guidelines and more training on how to reduce dissemination of disease. Ways to achieve closer communication between health and social care providers should also be investigated.

Girmaw F, Adane E, Kassaw AT, Ashagrie G, Baye T. Clinicoecon Outcomes Res. 2023:593–606. At the author’s request, we, the Editors and Publisher of ClinicoEconomics and Outcomes Research, have retracted the following article. Following publication, the authors contacted the journal to explain that the published article was derived from the MSc thesis of the second author, Ejigayehu Adane. However, the authors now acknowledge the remaining four authors had no formal contribution to the study or the manuscript which was provided for publication. In addition, the corresponding author is unable to provide a copy of the original MSc thesis of the second author. To uphold the integrity of the research and adhere to ethical standards the authors requested to retract the article and we, the Editor and Publisher agreed with this decision. We have been informed in our decision-making by our editorial policies and COPE guidelines. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted”.

Abstract Background Functional neurological disorder (FND) is a common and often disabling condition. Limited access to services for FND poses challenges both for patients and their health care providers. This survey explored the attitudes, experiences, support needs and training needs of health care professionals (HCPs) who provide care to individuals with FND in Ireland. Methods A broad range of HCPs working with patients with FND in Ireland partook in an anonymous online 12‐item survey. Participants were recruited via professional bodies and snowball convenience sampling utilising social media and email invitation. Descriptive and inferential statistics were employed to analyze data. Results A total of 314 HCPs working in Ireland completed the survey. 80% were female and over half worked in their current role for more than 10 years. 75% of the sample encountered three or less individuals with FND per month. Identified service‐related challenges to effective patient care included insufficient clinic time, lack of confidence explaining the diagnosis, and the need for greater access to specialist support. Data revealed persisting negative attitudes toward FND patients among a proportion of respondents. The majority of respondents did not feel they received adequate education on FND, with the exception of neurologists, of whom 65% felt adequately trained. The majority of respondents (85%) also felt that people with FND did not have access to appropriate FND services in Ireland. Conclusion This study indicates that there is a significant need to improve FND education among HCPs in Ireland, in addition to developing appropriately resourced, integrated, multidisciplinary care pathways for the FND patient group.

Background: Coronavirus disease 2019 (COVID-19) pandemic raised an immediate demand for skilled workforce in hospitals. There is limited literature related to perspectives of trainers in this unprecedented situation. This study aimed to examine lived experience of trainers while delivering training to a large number of participants in a challenging situation with the fear of contracting the infection themselves. Methods: A qualitative, phenomenological research was conducted in a tertiary care training centre among 21 trainers who trained 8417 healthcare personnel. Data was collected through Google Forms, which consisted of open-ended questions. Thematic analysis was done using MAXQDA software. Three themes and nine subthemes related to the teaching–learning method, administrative support, and challenges faced by the trainers were extracted. Results: Participants included nurses, nursing tutors, resident doctors, and faculty from nursing and medical specialities. Classroom teaching strategies with demonstration, simulation & hands-on training, and even virtual demonstrations were favoured as the effective teaching methods and modes. Well-planned modules, availability of infrastructure and advanced supporting software facilitated training sessions. Hands-on skill assessment was favoured as the best evaluation method. Trainers also expressed various challenges faced in planning and executing the training. Conclusion: A meticulous planning of preparedness training based on the understanding level of participants and their scope of work led to feasible and fast large-scale capacity building of healthcare professionals during COVID-19 pandemic. Diverse educational methods, as per demand of situations, online training, and in-person hands-on techniques via simulation lead to more responsive delivery of training and learning than a single method.

Fentaw Girmaw,1 Ejigayehu Adane,2 Abebe Tarekegn Kassaw,1 Getachew Ashagrie,1 Tenaw Baye1 1Department of Pharmacy, College of Health Science, Woldia University, Woldia, Ethiopia; 2Department of Pharmacy, College of Health Science, Wollo University, Wollo, EthiopiaCorrespondence: Tenaw Baye, Email tenegnaw27@gmail.comBackground: Ethiopia introduced a social health insurance (SHI) scheme for the formal sector that will cost 3% of the monthly salary as a premium and provide universal health coverage. Since health care professionals (HCP) are the primary front-line service providers, their willingness to pay (WTP) for SHI may have a direct or indirect impact on how the programme is implemented. However, little is known about WTP for SHI among HCP.Objective: To assess WTP for SHI and associated factors among government employee HCP in the North Wollo Zone, Northeast Ethiopia.Methods: Using the contingent valuation method, a mixed approach and cross-sectional study design were applied. For the qualitative study design, in-depth interviews were performed with focal persons and officers of health insurance. Multistage systematic random sampling was used to select 636 healthcare professionals. Logistic regression analysis was used to determine independent predictors of WTP for SHI. Qualitative data were analyzed using thematic analysis.Results: A response rate of 92.45% was achieved among the 636 participants, with 588 healthcare professionals completing the interview. The majority (61.7%) of participants were willing to join and pay the suggested SHI premium. Participants’ WTP was significantly positively associated with the presence of under five years of children but their willingness to pay was significantly negatively associated with the female gender and increasing monthly salary. On the other hand, on the qualitative side, the amount of premium contribution, benefits package, and quality of service were the major factors affecting their WTP.Conclusion: The majority of healthcare professionals were willing to pay for the SHI scheme, almost as much as the premium set by the government. This suggests proof that healthcare financing reform is feasible, particularly for the implementation of the SHI system.Keywords: Ethiopia, health care professionals, social health insurance, willingness to pay

Background: Laboratory Information Systems like any other automated systems have been touted for their contribution in recognizing and minimizing diagnostic errors, supplementing the decision-making process and improving diagnostic outcomes Objectives: This study aimed to review LIS end users’ experiences using LIS and their attitude towards LIS, explore factors that affect LIS end users in a laboratory and locate connections between user issues and user variables if any. Methodology: A descriptive study was carried out to assess the personal and professional aspects experienced by LIS end users and to determine the usability of LIS. A purposive sampling methodology was used to interview all the laboratory personnel working at the department of Laboratory Medicine at the selected tertiary hospital. A five-point liker scale was used to find out the LIS end users’ experience. The System Usability Scale to ascertain the factors affecting usability and analyzing the associations between user issues and user variables (nine of them). Fisher’s Exact test was to analyse the responses to assess human factors and relations affecting the usability of LIS. Results: All the seventy respondents had a favourable response to the installation of LIS and viewed it as a valuable investment for the laboratory. Among the nine user variables, seven were found to have P ≤ 0.05 with issues affecting LIS end users in a laboratory setting, namely, gender, age, work experience using LIS, educational qualification, department within laboratory medicine, type of LIS training and job position, suggesting significant association. Conclusion: The LIS end users had a positive attitude towards LIS and acknowledged its role in the smooth functioning of the workflow in the laboratory.

The deficiency of medical care professionals is a very popular economic and social problem that's becoming an important issue for a lot of countries. This paper aims to give an overall review and analysis of research results about the existence and reasons for migration (circulation) of highly educated healthcare personnel in Serbia, Croatia and Slovenia. The research that has been done in June 2022 included 604 students from three higher education institutions in Serbia, Croatia and Slovenia. The results, of which we came, showed that brain circulation happens mostly from economically weaker countries to the more developed ones, while better life standards, an opportunity for better studies and getting more practical skills are the most frequent motives for healthcare students.

Abstract Background Families of children and adolescents with cancer strive to maintain routines and normalcy during the child’s treatment trajectory that requires frequent hospital visits. Intravenous chemotherapy at home can reduce time spent on the frequent hospital visits and mitigate disruption in daily life. Studies on home chemotherapy for children and adolescents with cancer are limited, as is knowledge of family and health care professionals’ needs, and knowledge required to inform adaptation or replication of interventions in other settings. The aim of this study was to develop and describe an evidence-based home chemotherapy intervention that is feasible and safe for children and adolescents and suitable for future feasibility testing. Methods The Medical Research Council’s guidance for developing complex interventions in health care and the framework of action developed by O’Cathain et al. was used as theoretical frameworks to structure the development process. A literature search, an ethnographic study, and interviews with clinical nurse specialists from adult cancer departments formed the evidence base. Educational learning theory to support and understand the intervention was identified. Stakeholder perspectives were explored in workshops with health care professionals and parent-adolescent interviews. Reporting was qualified using the GUIDED checklist. Results A stepwise educational program to teach parents how to administer low-dose chemotherapy (Ara-C) to their child at home and a simple and safe administration procedure were developed. Key uncertainties were identified, including barriers and facilitators impacting future testing, evaluation, and implementation. Causal assumptions and reasoning for how the intervention leads to short-term outcomes and long-term impact were clarified in a logic model. Conclusions The iterative and flexible framework allowed for integration of existing evidence and new data and was successfully applied to the development process. The detailed report on the development process of the home chemotherapy intervention can enhance adaptation or replication of the intervention to other settings and thereby mitigate family disruption and stress of frequent hospital visits for these treatments. The study has informed the next phase of the research project that aims to test the home chemotherapy intervention in a prospective single-arm feasibility study. Trial registration ClinicalTrials.gov ID: NCT05372536.

Abstract Background Postpartum depression is a risk factor for suicide and maltreatment of children, and its early detection and appropriate intervention are issues to be resolved. In Japan, local governments are working to detect postpartum depression early by conducting home visits to families with infants within 4 months postpartum, but home-visit professionals have faced new difficulties due to the coronavirus disease 2019 (COVID-19) pandemic that started in 2020. The purpose of this study was to clarify the difficulties experienced by health care professionals who perform home visits to screen for postpartum depression. Methods Focus-group interviews were conducted during the COVID-19 pandemic with health care professionals (n = 13) who make postpartum home visits to families with infants within 4 months. Data were analyzed using thematic analysis. Results Four main categories were identified that describe the difficulties experienced by health care professionals: “Lack of support for partners,” “Difficulty in talking face-to-face,” “Inability to offer family assistance,” and “Anxiety about being a source of infection.” Conclusions This study shed light on the difficulties faced by professionals in supporting mothers and children in the community during the COVID-19 pandemic. Although these difficulties were considered to have become apparent during the pandemic, the results may offer an important perspective for postpartum mental health support even after the pandemic ends. Accordingly, it may be necessary for these professionals to receive supported through multidisciplinary collaboration in order to improve postpartum care in the community.

Anna-Karin Edberg,1 Giusy Trogu,2 Alessandra Manattini,2 Agnieszka Renn-&Zdot;urek,3 Daria Maria Modrzejewska,3 El&zdot;bieta Barbara Wo&zacute;nicka,4 Silvia Popovici,5 Liliana Pintilie,6 Ingela Beck,1 Akvil&edot; Virbalien&edot;,7 Aurelija Šiurien&edot;7 1Kristianstad University, Kristianstad, Sweden; 2Anziani e non solo Societá Cooperativa Sociale, Carpi, Italy; 3University of Humanities and Economics, Lodz, Poland; 4Stefan Batory State University, Skierniewice, Poland; 5Asociatia Demetrius, Iasi, Romania; 6Executive Office of the Order of General Nurses, Midwives and Nurses in Romania, Iasi, Romania; 7Klaipeda State University of Applied Sciences, Klaipeda, LithuaniaCorrespondence: Anna-Karin Edberg, Faculty of Health Sciences, Kristianstad University, SE 291 88, Kristianstad, Sweden, Tel +46 44-250 39 75, Email anna-karin.edberg@hkr.seIntroduction: Health care professionals (HCPs) encounter different forms of loneliness in their work. It is essential that they have the courage, skills, and tools to deal with loneliness, in particular with existential loneliness (EL) which relates to meaning in life and the fundamentals of living and dying.Aim: The aim of this study was to investigate HCPs’ views on loneliness among older people and their understanding, perception, and professional experience of EL in older people.Materials and Methods: In all, 139 HCPs from five European countries participated in audio-recorded focus group and individual interviews. The transcribed materials were locally analyzed using a predefined template. The participating countries’ results were then translated, merged, and inductively analyzed using conventional content analysis.Results: Participants described different forms of loneliness – a negative form that is unwanted and causes suffering, and a positive form where solitude is desired and sought. The results showed that the HCPs’ knowledge and understanding of EL varied. The HCPs mainly related EL to different types of loss, eg loss of autonomy, independence, hope, and faith, and to concern alienation, guilt, regret and remorse, and concerns about the future.Discussion and Conclusions: The HCPs expressed a need to improve their sensitivity and self-confidence to engage in existential conversations. They also stated the need to increase their knowledge and understanding of aging, death, and dying. Based on these results, a training program aimed to increase knowledge and understanding of older people’s situation has been developed. The program includes practical training in conversations about emotional and existential aspects, based on recurrent reflections on the topics presented. The program is available at: www.aloneproject.eu.Keywords: older people, health care professionals, existential loneliness, qualitative, multicenter study

Introduction: Vaccine attitude can change disease progress, facilitate herald immunity among the community, and stop disease progression. According to the available data, there is no current curative treatment against the virus. The only way to stop the spread of infection is to develop the vaccine and accelerate the vaccine, as shown previously with the influenza pandemic. Objective: The study’s main goal was to investigate health care workers’ knowledge, attitude, and practice toward the coronavirus disease 2019 (COVID-19) vaccine in Dubai Health Authdority (DHA), United Arab Emirates (UAE). Methods: In April 2021, an anonymous cross-sectional comparative study measured the willingness and hesitancy to take the COVID-19 vaccine among health care providers in the primary health care sector at DHA. Results: In terms of COVID-19 vaccine knowledge, there was widespread agreement on the significance of the vaccine in preventing the transmission of illness (91.6%) and on the vaccine’s value for the public and community (95.6%). Furthermore, based on health care providers’ opinions, most individuals agreed to promote the COVID-19 vaccination in patients, family, and friends (92.7%), with just 6.9% doubtful. In actuality, 72.1 percent of those who got the vaccination received two doses, while 27.9% received just one dosage. In terms of vaccine type, Pfizer (72.7%), Sinopharm (23.8%), and AstraZeneca (3.6%) were the available vaccines during the study period. Discussion: The majority of participants agreed that the vaccine is essential for health care providers and the community (more than 90%), and they were willing to recommend it to their families (92.7%). They also agreed that the vaccine is necessary to prevent the spread of the disease (91 percent), boosting vaccine confidence. Conclusion: COVID-19 vaccine was widely accepted by Dubai’s health care workers. Several factors were identified as significant determinants of vaccine acceptance. UAE health care authorities can use the study’s findings to develop public health policies and implement campaigns to address concerns about the COVID-19 vaccine and other emerging infectious diseases.

Abstract Background The person-centred practice framework represents the cornerstone of a middle-range theory. Internationally, person-centredness has become an increasingly common topic. The measurement of the existence of a person-centred culture is complex and subtle. The Person-Centred Practice Inventory—Staff (PCPI-S) measures clinicians’ experience of a person-centred culture in their practice. The PCPI-S was developed in English. Therefore, the aims of this study were (1) to translate the PCPI-S into German and to cross-culturally adapt and test in the acute care setting (PCPI-S aG Swiss) and (2) to investigate the psychometric properties of the PCPI-S aG Swiss. Methods The two-phase investigation of this cross-sectional observational study followed the guidelines and principles of good practice for the process of translation and cross-cultural adaptation of self-reporting measures. Phase 1 involved an eight-step translation and cultural adaptation of the PCPI-S testing in an acute care setting. In Phase 2, psychometric retesting and statistical analysis based on a quantitative cross-sectional survey were undertaken. To evaluate the construct validity, a confirmatory factor analysis was implemented. Cronbach’s alpha was used to determine the internal consistency. Results A sample of 711 nurses working in a Swiss acute care setting participated in testing the PCPI-S aG Swiss. Confirmatory factor analysis indicated a good overall model fit, validating the strong theoretical framework, which underpins the PCPI-S aG Swiss. Cronbach’s alpha scores demonstrated excellent internal consistency. Conclusion The chosen procedure ensured cultural adaptation to the German-speaking part of Switzerland. The psychometric results were good to excellent and comparable with other translations of the instrument.

Abstract Background The global coronavirus disease 2019 pandemic put extreme pressure on healthcare systems worldwide, forcing a heavy workload on healthcare professionals. Frontline treatment and care for patients with coronavirus disease 2019 compelled healthcare professionals to rapidly adapt to new working conditions. This study explores the experiences of frontline healthcare professionals to learn more about how frontline work affects their learning and skills development but also interprofessional collaboration during a pandemic. Methods In-depth, one-to-one semi-structured interviews were conducted with 22 healthcare professionals. A broad interdisciplinary group, the participants were employed in public hospitals in four of Denmark’s five regions. Using a reflexive methodology for the data analysis allowed reflexive interpretation when interpreting subjects and interpreting the interpretation. Results The study identified two empirical themes: into the unknown and in the same boat, which we critically interpreted using learning theory and theory on interprofessionalism. The study found that the healthcare professionals moved from being experts in their own fields to being novices in the frontline of the pandemic, and then back to being experts based on interprofessional collaboration that included shared reflection. Working in the frontline was imbued with a unique atmosphere in which workers were equals and functioned interdependently, the barriers normally obstructing interprofessional collaboration set aside to focus on combating the pandemic. Conclusions This study reveals new insights regarding knowledge on frontline healthcare professionals in terms of learning and developing new skills, as well as the importance of interprofessional collaboration. The insights contributed to the understanding of the importance of shared reflection and how the development of expertise was a socially embedded process where discussions were possible without fear of being ridiculed and healthcare professionals were willing to share their knowledge.

AbstractObjective To be regularly physically active is of major importance for the health of people with metabolic risk factors. Many of these persons are insufficiently active and in need of support. This study aimed to explore barriers and facilitators perceived by health care professionals’ within Swedish primary care in their work to support persons with metabolic risk factors to increase their physical activity.Design A qualitative design with focus group discussions was used. The data were analysed using qualitative content analysis with a manifest, inductive approach.Setting Primary health care in five Swedish healthcare regions.Subjects Nine physiotherapists, ten physicians and five nurses participated in six digital focus group discussions including two to six participants.Results Barriers and facilitators to supporting persons with metabolic risk factors to increase their physical activity were found within four generic categories, where the barriers and facilitators related to each generic category: ‘Patient readiness for change’, ‘Supporting the process of change’, ‘The professional role’, and ‘The organisation of primary care’.Conclusion The findings suggests that barriers and facilitators for supporting patients with metabolic risk factors can be found at several levels within primary care, from individual patient and the health care professionals to the organisational level. In the primary care setting, this should be highlighted when implementing support to increase physical activity in people with metabolic risk factors.KEY POINTSHealth care professionals within primary care are in a position to support people with metabolic risk factors to increase their physical activity.Barriers and facilitators to support the patients should be addressed at several levels within primary care.The study highlights factors on multiple levels such as professional responsibility, organisational prioritisation and resources, and the challenge to motivate behaviour change.

Purpose The objective of this scoping review is to compile and examine characteristics and impacts of live music interventions on the health and wellbeing of children, families, and health care professionals in paediatric hospital care. Methods We searched four scientific databases for peer-reviewed publications of empirical studies of all study designs. The first author screened the publications, with spot-checks for eligibility by the second and third authors. Data extraction and quality assessment were made by the first author with support from the second and third. Additionally, the included studies were screened for quality appraisal. The analysis followed an inductive, interpretive approach for synthesis. Results Quantitative features were screened and compiled, and qualitative inductive analyses of findings were elaborated into categories connected to research questions. The reported impacts were thematized through emergent features of importance and prerequisites beneficial for successful interventions. Recurrent outcomes present themes of positive affect, copingand reduced hospitalization. Emotional regulation, play and participation, age, session design, adaptivity, and familiarity present benefits, barriers, and facilitators for outcomes. Conclusions Findings from collected empirical research display philosophy, practice, and relations as keys for characteristics, impacts, and implications of live music interventions in paediatric hospital care. The communicative aspects of music appear at the core of importance.

Objectives: Health care settings are ideal for addressing patients' smoking and quitting, but barriers may limit providers’ assistance with cessation, including lack of knowledge about newer devices being used by some smokers to quit (e.g., e-cigarettes). Cessation practices among nurse practitioners (NPs) and physician assistants (PAs) are also unknown. Study design: Cross-sectional. Methods: Participants (N = 459) were 151 oncologists, 150 primary care physicians (PCPs), 98 nurse practitioners (NPs), and 60 physician assistants (PAs) recruited from a national online panel who completed an online survey. Results: Four barriers were common across specialties: “patient doesn't want to quit, and it is their decision,” “smoking is not reason for patient's visit; must treat the immediate problem first,” “patient wants to quit on their own,” and “lack of effective methods available.” While a majority of oncologists (58%) were aware of free telephone counseling for cessation, only 29% of NPs were aware. Perceived knowledge of e-cigarettes was low. Greater comfort treating patients' smoking predicted greater frequency of engagement in 4 of 5 general cessation practices (βs = 0.15-0.26, all p ≤ .001). NPs and PAs more frequently asked patients about smoking and e-cigarette use compared to oncologists, but oncologists more frequently referred patients to effective quitting resources (e.g., quitlines). Conclusions: NPs and PAs may be uniquely positioned to provide cessation assistance, but providers need more education on currently available, effective cessation methods, and about e-cigarettes. Addressing patient resistance to offers of cessation services and improving clinical workflows to enhance cessation service provision should be investigated in future research.

BackgroundDepression is the major mental disorder that frequently co-occurs with other physical illnesses, although its detection at primary healthcare is limited. Thus, the purpose of this study is to evaluate health professionals’ knowledge and attitude toward depression and its related factors.ObjectiveTo assess knowledge and attitude of healthcare professionals toward people with depression at different health facilities of Ilu Aba Bor zone, Ethiopia, 2021.MethodsA cross-sectional study was carried out involving 404 primary healthcare professionals using a systematic random sampling technique in February 2021. Attitude was assessed using depression attitude questionnaires. Epi-data version 3.1 and SPSS version 26 was used for data entry and analysis. The p-values lower than 0.05 were deemed statistically significant.ResultIn the current study, 30.4% (95% CI; 25.86, 34.94) of the respondents have inadequate knowledge and 29.9% (95% CI; 25.4, 36.8) have negative attitude toward depression. A vast majority (77.7%) of healthcare professionals have never received any kind of training on mental health. Accordingly, contact with the person with mental illness and mental health training were significantly associated with inadequate knowledge. In addition, perceived cause of depression and mental health training were significantly associated with negative attitude.ConclusionAccording to this study, the magnitude of inadequate knowledge and negative attitude in the diagnosis and treatment of depression is comparably high. Therefore, primary healthcare settings should prioritize raising awareness, promoting positive attitudes, and improving detection and treatment of depression cases.

IntroductionThe COVID-19 pandemic has had a profoundly detrimental impact on the emotional wellbeing of health care workers. Numerous studies have shown that their rates of the various forms of work-related distress, which were already high before the pandemic, have worsened as the demands on health care workers intensified. Yet much less is known about the specific social processes that have generated these outcomes. This study adds to our collective knowledge by focusing on how one specific social process, the act of treating critically ill COVID-19 patients, contributed to emotional pain among health care workers.MethodsThis article draws from 40 interviews conducted with intensive care unit (ICU) staff in units that were overwhelmed with COVID-19 patients. The study participants were recruited from two suburban community hospitals in Massachusetts and the interviews were conducted between January and May 2021.ResultsThe results show that the uncertainty over how to treat critically ill COVID-19 patients, given the absence of standard protocols combined with ineffective treatments that led to an unprecedented number of deaths caused significant emotional pain, characterized by a visceral, embodied experience that signaled moral distress, emotional exhaustion, depersonalization, and burnout. Furthermore, ICU workers’ occupational identities were undermined as they confronted the limits of their own abilities and the limits of medicine more generally.DiscussionThe inability to save incurable COVID-19 patients while giving maximal care to such individuals caused health care workers in the ICU an immense amount of emotional pain, contributing to our understanding of the social processes that generated the well-documented increase in moral distress and related measures of work-related psychological distress. While recent studies of emotional socialization among health care workers have portrayed clinical empathy as a performed interactional strategy, the results here show empathy to be more than dramaturgical and, in this context, entailed considerable risk to workers’ emotional wellbeing.

BackgroundPathological Altruism and the concept of Helper Syndrome are comparable. We focused on Schmidbauer’s description because it provides a comprehensive and testable definition. Nevertheless, this concept of Helper Syndrome has not yet been empirically investigated in a sample of helping professionals.AimTo investigate whether nurses working with covid-19 patients are more likely to have Helper Syndrome compared with individuals from non-helper professions.MethodsThe online survey took place between April 2021 and February 2022, in urban and rural regions of Salzburg, during the time of the COVID-19 pandemic. Nurses (n = 447) and controls (n = 295) were compared regarding Helper Syndrome characteristics. To measure characteristics of Helper Syndrome the following questionnaires were used: WHO-Five (WHO-5), selected scales of the Personality, Style and Disorder Inventory (PSSI) and the Freiburg Personality Inventory-Revised (FPI-R), the Alcohol Use Disorders Identification Test (AUDIT). Insecure gender identity and self-assessment of having a Helper Syndrome was measured by a Likert scale.ResultsIn both groups, Helper Syndrome was detected (nurses 29.5%, controls 30.5%). Participants with Helper Syndrome showed significant differences in personality styles and traits, namely significantly higher scores for Foreboding-Schizotypical Personality Style, Spontaneous-Borderline Personality Style, Amiable-Histrionic Personality Style, Ambitious-Narcissistic Personality Style, Loyal-Dependent Personality Style, Helpful-Selfless Personality Style, Carefully-Obsessive Personality Style, Optimistic-Rhapsodic Personality Style, Social Orientation, Strain, Emotionality and lower well-being. The only difference between nurses and controls was that nurses were significantly less open aggressive.ConclusionFor the first time, we were able to demonstrate Schmidbauer’s concept of Helper Syndrome. According to our data, we found a subgroup of individuals similar to Schmidbauer’s description of Helper Syndrome, but this sample was independent of helping or non-helping profession. These individuals seem to be at higher risk for psychiatric disorders.

The outbreak of the COVID-19 pandemic exerted significant mental burden on healthcare workers (HCWs) operating in the frontline of the COVID-19 care as they experienced high levels of stress and burnout. The aim of this scoping review was to identify prevalence and factors associated with burnout among HCWs during the first year of the COVID-19 pandemic. A literature search was performed in PubMed, Web of Science, and CINAHL. Studies were selected based on the following inclusion criteria: cross-sectional, longitudinal, case-control, or qualitative analyses, published in peer-reviewed journals, between January 1, 2020 and February 28, 2021. Studies carried out on other occupations than healthcare workers or related to other pandemics than COVID-19 were excluded. Following the abstract screen, from 141 original papers identified, 69 articles were eventually selected. A large variation in the reported burnout prevalence among HCWs (4.3–90.4%) was observed. The main factors associated with increase/ decrease of burnout included: demographic characteristics (age, gender, education level, financial situation, family status, occupation), psychological condition (psychiatric diseases, stress, anxiety, depression, coping style), social factors (stigmatisation, family life), work organization (workload, working conditions, availability of staff and materials, support at work), and factors related with COVID-19 (fear of COVID-19, traumatic events, contact with patients with COVID-19, having been infected with COVID-19, infection of a colleague or a relative with COVID-19, higher number of deaths observed by nurses during the COVID-19 pandemic). The findings should be useful for policy makers and healthcare managers in developing programs preventing burnout during the current and future pandemics. Int J Occup Med Environ Health. Int J Occup Med Environ Health. 2023;36(1):21–58

Background: The tobacco epidemic is one of the biggest public health threats the world has ever faced. There are more than 4000 chemicals in tobacco smoke, of which at least 300 are known to be harmful. A 2015 survey in Italy revealed that 58% of cardiologists correctly indicated smoking as an addiction and 45% regularly advised their patients to stop smoking. Aims: The aim is to assess the knowledge of health care professionals (HCPs) related to tobacco cessation and its related activities. Materials and Methods: A descriptive, cross-sectional, pilot survey on HCPs-30 doctors and 30 nurses was chosen by convenient sampling at a selected tertiary care hospital in New Delhi. Tool: A semi-structured questionnaire contains items to assess knowledge of HCPs regarding tobacco cessation and its activities. Results: 96.3% of doctors and 76% of nurses were 'asked' their patients about their history of tobacco use, respectively. 86.7% of doctors and 70.1% of nurses 'advice' patients to stop tobacco use. 63.3% of doctors and 54.1% of nurses were interested in participating in tobacco cessation training. Conclusion: Most of the HCPs had given brief interventions by 5 'A's method. More tobacco cessation training would be suggested by health-care workers.

Sara Domínguez-Salas,1 Carmen Rodríguez-Domínguez,1 Ana Isabel Arcos-Romero,1 Regina Allande-Cussó,2 Juan Jesús García-Iglesias,3 Juan Gómez-Salgado3,4 1Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville, Spain; 2Department of Nursing, University of Seville, Seville, Spain; 3Department of Sociology, Social Work and Public Health, University of Huelva, Huelva, Spain; 4Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, EcuadorCorrespondence: Carmen Rodríguez-Domínguez, Department of Psychology, Universidad Loyola Andalucía, Avenida de las Universidades s/n, Dos Hermanas, Seville, 41007, Spain, Tel +34 955 641 600 (Ext. 2625), Email mcrodriguez@uloyola.esPurpose: The impact of the COVID-19 pandemic on the working, personal and health conditions of health professionals has been highlighted, although it is necessary to verify whether certain instruments used in research on this topic have sufficient psychometric support for their use. This need was the main motivation for undertaking the present study. We aimed to analyse the psychometric properties of the Utrecht Work Engagement Scale (UWES-9) in a sample of active health care workers during the pandemic.Patients and Methods: A cross-sectional study was conducted from March to August 2020 with 2326 active health care workers (78.7% women). The instruments that were applied included the UWES-9 scale, the Sense of Coherence scale (SOC-13), the Goldberg General Health Questionnaire (GHQ-12) and an item on self-perceived health.Results: The three-factor structure related to the correlation of pairs of errors presented the best fit. The reliability of the UWES-9 was highlighted by the adequate internal consistency of the items, the existence of invariance according to gender, and its convergent and discriminant validity.Conclusion: The findings of this work support the use of the UWES-9 to assess the work engagement of health personnel during the COVID-19 pandemic and identify it as an adequate measure of this psychological variable and the constructs that comprise it.Keywords: gender invariance, UWES-9, engagement, health care professionals, COVID-19, psychometric

Abstract Background By sharing patient stories, health care professionals (HCPs) may communicate their attitudes, values and beliefs about caring and treatment. Previous qualitative research has shown that HCPs usually associate paediatric palliative care (PPC) with death or dying and that they find the concept challenging to understand and difficult to implement. Attending to HCPs’ stories may provide a richer account of their understanding of PPC. Thus, the aim of this study was to explore PPC stories narrated by HCPs to gain increased insight into their understanding of what PPC entails. Methods This qualitative study collected data from four focus group interviews with 21 HCPs from different units in two Norwegian hospitals. Stories told by the HCPs to illustrate their comprehension of PPC were analysed following thematic analysis procedures. Results Four themes were identified illustrating what PPC meant to the participants: creating spaces for normality, providing tailored support for the family, careful preparations for saying goodbye and experiencing dilemmas and distress. The stories centred on family care, particularly relating to dramatic or affective situations when the death of a child was imminent. Conclusion The stories reflect how the HCPs view PPC as a specific field of health care that requires particular professional sensitivity, including good communication, collaboration and planning. Thus, the HCPs in this study demonstrated knowledge about the core qualities needed to succeed in PPC. However, similar to previous research, the stories illustrate that how HCPs speak about PPC is strongly associated with end-of-life care, and by that the HCPs do not capture the breadth of the PPC concept. The findings highlight the importance of increasing knowledge about the meaning and content of PPC among HCPs in order to maintain quality of life for all children with life-limiting or life-threatening conditions throughout their illness trajectory.

Rabia Latif,1 Nazish Rafique,1 Lubna Al Asoom,1 Ahmed A Alsunni,1 Ayad Mohammed Salem,1 Kholoud Al Ghamdi,1 Rasha AlNujaidi,2 Maha Alblaies,2 Sara Alali,2 Leyan Alotaibi,2 Nada Alghamdi2 1Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Rabia Latif, Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, PO Box: 1982, Dammam, 31441, Saudi Arabia, Tel +966 3 8577000 3335134, Email rlhussain@iau.edu.saObjective: COVID-19 is a public health emergency of international concern. There is still no definitive cure for this highly transmittable illness. Immunization and breaking the chain of infection is the only successful approach to mitigate its spread. Our study explored the adherence to COVID-19 preventive measures and its associating factors among Health Care Professionals (HCPs) working in Saudi Arabia.Methods: For this cross-sectional study, an online survey was conducted from December 01, 2020, to March 31, 2021, among 978 HCPs in Saudi Arabia. The self-administered questionnaire consisted of demographic information, COVID-19 preventive behaviors, knowledge, attitude, fear, and risk. Mann–Whitney U-test, Kruskal–Wallis one-way analysis, Spearman correlation, and binary logistic regression tests were used in data analysis.Results: Most of the HCPs were Saudi nationals (86.9%), females (63.1%), age group 20– 29 years (42.3%), Middle Eastern ethnicity (82.5%), and working in the government sector (80.8%). A 52.2% of the participants were compliant with COVID-19 preventive behavior. The most and the least compliant preventive behaviors were “wearing masks” (88.8% compliance) and “keeping social distancing” (60.7% compliance). Preventive behavior was significantly higher in HCPs having a) more knowledge of COVID-19 (U=104849; p 0.001); b) positive attitude (U=84402; p 0.001); c) higher fear (U=103138; p less than 0.001) and d) nursing profession (p 0.01). COVID-19 knowledge (p< 0.001), attitude (p< 0.001), and fear (p< 0.001) contributed significantly to the prediction of preventive behavior compliance. A unit increase in COVID-19 knowledge, attitude, and fear scores raised the odds of being compliant with preventive behavior by factors of 2.34, 1.87, and 1.53 respectively.Conclusion: About half of the study participants were compliant with COVID-19 preventive behavior. Preventive behavior is significantly higher among HCPs having more knowledge of COVID-19, more fear, a positive attitude, and the “nursing” profession. Having more knowledge, a positive attitude, and more fear of COVID-19 may increase the likelihood of being compliant with preventive behavior.Keywords: health care professionals, health personnel, COVID-19, prevention, behavior