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Background: Telehealth is in early stages in the Kingdom of Saudi Arabia (KSA). Identifying barriers to using telehealth is an essential step prior to its implementation; however, no theoretically based scales exist for the same purpose. Objective: To design a theory-based scale capable of measuring telehealth users’ perceptions of benefits, barriers, and social influence in the KSA. Methods: The Saudi Telehealth Acceptance Scale (STAS) was constructed based on the Unified Theory of Acceptance and Use of Technology and its content validity was determined by eight experts using the modified Delphi process. Only items with a content validity index score of ≥0.83 were chosen. Finally, the face validity of the questionnaire for healthcare professionals, which was in English, was determined by eight healthcare professionals, and for the patient version, which was in Arabic, by six patients. Results: Initially, 37 items were identified; however, after Round 1, 29 items remained and after Round 2, 24 items were included in the STAS for both healthcare professionals and patients. In the healthcare professionals scale, there were 7 performance expectancy (PE) items, 6 effort expectancy (EE) items, 3 social influence (SI) items, 4 facilitating conditions (FC) items, and 4 behavioral intention (BI) items, while in the scale for patients, there were 9 PE items, 4 EE items, 3 SI items, 4 FC items, and 4 BI items. Conclusions: The two new scales showed evidence of content and face validity. The significance of the two scales is that they were both designed in the context of the healthcare system in the KSA and could provide standardized data collection tools to measure the acceptance of telehealth among HCPs and patients.

The association was investigated between healthcare practitioners' actions of routinely identifying children of adults with mental illness by asking whether they have children under the age of 18 and practitioners' perspectives and practices regarding supporting parents and their children. The factors that contribute to practitioners' such routine identification were also determined. A cross-sectional nationwide survey was conducted using an anonymous self-report questionnaire among Japanese healthcare practitioners. The responses (84.7% were nurses) from 1138 participants were analysed. More than half of the participants (73.7%) routinely identified whether adults with mental illness had children. Participants who routinely identified children also provided more support to children and to the client regarding his or her parenting. Three factors were found to contribute to the participants' routine identification of children: (1) recognising 'difficulty with parenting' as a reason why support for children is necessary; (2) 'assessing parenting status when supporting a parent with a mental illness' and (3) realising that participants 'do not know how to provide support' as a reason why support for children is difficult. Providing education to practitioners regarding supporting children whose parents have a mental illness will help increase the routine identification of children in mental health services. [ABSTRACT FROM AUTHOR]

Background: Telehealth is in early stages in the Kingdom of Saudi Arabia (KSA). Identifying barriers to using telehealth is an essential step prior to its implementation; however, no theoretically based scales exist for the same purpose. Objective: To design a theory-based scale capable of measuring telehealth users' perceptions of benefits, barriers, and social influence in the KSA. Methods: The Saudi Telehealth Acceptance Scale (STAS) was constructed based on the Unified Theory of Acceptance and Use of Technology and its content validity was determined by eight experts using the modified Delphi process. Only items with a content validity index score of ≥0.83 were chosen. Finally, the face validity of the questionnaire for healthcare professionals, which was in English, was determined by eight healthcare professionals, and for the patient version, which was in Arabic, by six patients. Results: Initially, 37 items were identified; however, after Round 1, 29 items remained and after Round 2, 24 items were included in the STAS for both healthcare professionals and patients. In the healthcare professionals scale, there were 7 performance expectancy (PE) items, 6 effort expectancy (EE) items, 3 social influence (SI) items, 4 facilitating conditions (FC) items, and 4 behavioral intention (BI) items, while in the scale for patients, there were 9 PE items, 4 EE items, 3 SI items, 4 FC items, and 4 BI items. Conclusions: The two new scales showed evidence of content and face validity. The significance of the two scales is that they were both designed in the context of the healthcare system in the KSA and could provide standardized data collection tools to measure the acceptance of telehealth among HCPs and patients. [ABSTRACT FROM AUTHOR]

Healthcare systems in Europe are facing increasingly complex challenges that demand innovative solutions. Furthermore, public health is increasingly recognised as a productive factor which impacts the healthcare sector’s contribution to national economies. The out-migration of healthcare practitioners from Latvia is one of the most pressing problems in the health sector, which, in turn, negatively impacts the country’s economy. The outflow of healthcare practitioners to other EU countries has increased since 2004, the year which saw Latvia’s accession to the EU. This trend is a consequence of labour accumulation efficiency in the single market, and this article aims at conducting analyses of the main push factors governing healthcare practitioners’ emigration from Latvia and the impact of these factors on the healthcare sector. The complexity of this migration determines the use of an interdisciplinary as a methodological approach in the analysis of the main trends in the healthcare labour market. This approach can assist one in carrying out an assessment of the healthcare system’s losses as a result of the out-migration which has occurred thus far. Particular attention is paid to the training of resident doctors as a perspective trend in keeping healthcare professionals in the country. The legal mechanism for recovering public funding dedicated to residency programs has also been assessed. In conclusion, the article states that the mass emigration of healthcare practitioners from Latvia may jeopardise the efficient functioning of the country’s healthcare system.

Objective: To investigate the anxiety levels, sleep quality and potential risk factors of healthcare practitioners involved in the management of COVID-19 patients in a mobile cabin hospital, and further to assess the impact of progressive muscle relaxation (PMR) on their anxiety levels and sleep quality. Methods: We conducted a pre-post self-controlled trial. Healthcare practitioners meeting the inclusion criteria underwent daily 30-min PMR sessions for seven consecutive days. The Pittsburgh Sleep Quality Index (PSQI) and Hamilton Anxiety Scale (HAMA) were used to assess the anxiety and sleep quality of subjects pre- and post-intervention. Statistical analysis was performed using the Wilcoxon test, Mann-Whitney U test, Kruskal-Wallis H test, and Spearman rank correlation. Results: A total of 94 participants completed the study. No statistically significant differences in HAMA or PSQI total scores were observed between groups categorized based on demographic variables such as age, sex, and years of education (p > 0.05). The PSQI total score and its components (excluding sleep medication usage) exhibited a positive correlation with the HAMA total score and its psychological anxiety component (p < 0.05), and a correlation was observed between somatic anxiety manifestations and several components of the PSQI. The PSQI total scores before and after intervention were 10.0 (8.0, 13.0) and 8.0 (6.0, 9.0) respectively (p < 0.001); the HAMA total scores were 8.0 (5.0, 13.0) and 6.0 (4.0, 9.5) respectively (p < 0.001). The detection rates of poor sleep and anxiety states, along with their severity, significantly decreased post-intervention (p < 0.001). Conclusion: Healthcare practitioners experience prominent anxiety and sleep issues in the mobile cabin hospital. PMR can be an effective intervention for improving the anxiety and sleep quality of healthcare professionals during support periods in the mobile cabin hospital. However, trials with larger samples are necessitated to further affirm these preliminary findings. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a neurodegenerative disease with progressive in nature, presenting with symptoms such as gait impairments and postural instability that leads to fall with complications such as fractures, disability and mortality. Alarming demands on care by the healthcare practitioners increasing by time. However, there is no study published regarding association between knowledge, attitude and practice (KAP) of healthcare practitioners on fall prevention among PD population. Therefore, this study aims to provide a comprehensive overview of studies dealing with KAP of healthcare practitioners and fall prevention in PD. Methods: The studies published between year 2013 to February 2023 were evaluated.The search was conducted within international electronic databases. A scoping review was conducted using the Arksey and O'Malley framework. All journal articles that focused on the KAP of healthcare practitioners on fall prevention in PD patients were selected. In overall, 5 studies included in this review discussed about studies related to KAP of healthcare practitioners based on screening of result. There were no direct KAP study of healthcare practitioners on falls prevention among PD population. Conclusion: Paucity of literatures observed related to role of healthcare practitioners in falls prevention in PD population. [ABSTRACT FROM AUTHOR]

In Tunisia, self-medication is a common practice, and there is a continual rise in the prevalence of cardiovascular disease. Given the lack of data on the self-medication practices (SMPs) among cardiovascular patients in this area, the present study aimed to identify the prevalence and determinants of SMPs among cardiovascular patients in the city of Béja. A community-pharmacy-based survey was conducted among selected cardiovascular patients in Béja, Tunisia, from May 2021 to June 2021. Data were collected using a self-administered questionnaire provided by pharmacists during in-person surveys with patients. Descriptive statistics were used to summarize the data, while Fisher's exact test was used for categorical variables, with the significance level set at p < 0.05. The frequency of self-medication among the 150 respondents was 96%; 70.14% of participants reported that the primary reason why people engage in self-medication is the existence of an old prescription. The most prevalent conditions leading patients to self-medicate were headaches (100%), fever (83.33%), toothache (65.97%), and dry cough (47.92%). The most frequently self-administered drugs were paracetamol (100%), antibiotics (56.94%), and antitussives (47.92%). The results of our study indicate that SMPs among Tunisian cardiovascular patients have a high prevalence. With this in mind, healthcare practitioners should ask their patients about their self-medication practices and advise cardiovascular patients about the risks and benefits associated with this practice. [ABSTRACT FROM AUTHOR]

Background: Cancer is common and disproportionately impacts older adults. Moreover, cancer care of older adults is complex, and the current Canadian cancer care system struggles to address all of the dimensions. In this project, our goal was to understand the barriers and facilitators to caring for older adults with cancer from perspectives of healthcare professionals and cancer care allies, which included community groups, seniors’ centers, and other community-based supports. Methods: In collaboration with a patient advisory board, we conducted focus groups and interviews with multiple local healthcare professionals and cancer care allies in British Columbia, Canada. We used a descriptive qualitative approach and conducted a thematic analysis using NVivo software. Results: A total of 71 participants of various disciplines and cancer care allies participated. They identified both individual and system-level barriers. Priority system-level barriers for older adults included space and staffing constraints and disconnections within healthcare systems, and between healthcare practitioners and cancer care allies. Individual-level barriers relate to the complex health states of older adults, caregiver/support person needs, and the needs of an increasingly diverse population where English may not be a first or preferable language. Conclusions: This study identified key barriers and facilitators that demonstrate aligned priorities among a diverse group of healthcare practitioners and cancer care allies. In conjunction with perspectives from patients and caregivers, these findings will inform future improvements in cancer care. Namely, we emphasize the importance of connections among health systems and community networks, given the outpatient nature of cancer care and the needs of older adults. [ABSTRACT FROM AUTHOR]

Background: Low viral load suppression rates among older adolescents and young adults with HIV are a global challenge, including in Namibia. Healthcare providers struggle with managing these age groups due to their unique demographic characteristics. Monitoring viral load suppression is vital for evaluating antiretroviral treatment effectiveness, making it essential to identify and address existing gaps. Objectives: This study aimed to explore and describe healthcare practitioners’ understanding and experiences in managing older adolescents and younger adults living with HIV in seven high-burden districts of Namibia. Method: Qualitative descriptive phenomenological research was followed in this study. Healthcare practitioners directly managing older adolescents and younger adults living with HIV were purposively recruited. Telephonic individual interviews were conducted, and data saturation was achieved with the 29th participant. Colaizzi’s seven-step analysis was used to analyse the data. Results: Two themes emerged from the study: (1) healthcare practitioners’ knowledge of viral load management and (2) the strategies employed to manage high viral load in these age groups. These strategies included implementing differentiated service delivery, adopting interprofessional and Ubuntu approaches, psychosocial support, community engagement, enhancing adherence counselling, and support from implementing partners. Conclusion: The findings revealed inadequate knowledge among healthcare practitioners regarding viral load management, which negatively impacts the provision of quality care and an effective HIV response within the spirit of Ubuntu. Contribution: This study enhances healthcare practitioners’ capacity in viral load management and guides policy makers in supporting this unique population, thus improving their health outcomes.

Background: Effective communication between healthcare practitioners and patients in the emergency department (ED) is crucial for patient satisfaction and quality of care. This study explored patients' perspectives on communication with nurses and physicians in the ED. Methods: A cross-sectional study was conducted using a sample of 159 patients to assess the type of information relayed by nurses and doctors. The interview data were analyzed to examine nursing staff communication, physician communication, and communication difficulties. Results: Nurses were found to be less likely to inform patients about their results or disposition. While 81.2% of physicians introduced themselves to patients, only 51.6% stated their status level. Approximately 68.6% of subjects were offered analgesia or treatment, and 60% reported no communication difficulties with medical staff. Empathy was demonstrated by 54.2% of healthcare practitioners, and nearly 80% of patient encounters were conducted in understandable language. Conclusion: The study highlights the importance of effective communication in the ED, including empathy, information provision, and language barriers. To improve patient satisfaction and healthcare quality, medical organizations should develop comprehensive work plans, provide communication skills workshops, and enhance the ED work environment. Future research should focus on the perspectives of medical staff and explore communication in larger samples and various contexts. [SJEMed 2023; 4(2.000): 128-133]

Abstract Background Actors portraying simulated patients are widely used in communication skills training in healthcare, but debates persist over the authenticity of these interactions. However, healthcare professionals value simulation‐based training because of the opportunity to think and react in real time, which alternatives cannot provide. Objective To describe a method for the use of simulation which maximises authenticity by grounding training in real, observed, patterns of patient communication. Design Naturally occurring care interactions were video recorded and analysed using conversation analysis (CA) to identify communication patterns. We focused on sites of recurring interactional trouble as areas for training, and identified more and less effective ways of dealing with these. We used the CA findings to train actors portraying simulated patients, based on the observed interactional patterns. Settings and Participants Patients living with dementia and healthcare practitioners (HCPs) on two acute healthcare of the elderly wards in the English East Midlands. Outcome Measures One month later HCPs reported using the skills learned in clinical practice. Masked‐ratings of before and after simulated patient encounters confirmed these self‐reports in relation to one key area of training. Results The Conversation Analysis Based Simulation (CABS) method used in this setting showed positive results across a range of quantitative and qualitative outcome measures. What is significant for the transferability of the method is that qualitative feedback from trainees highlighted the ability of the method to not only illuminate their existing effective practices, but to understand why these were effective and be able to articulate them to others. Discussion/Conclusion While the CABS method was piloted in the dementia care setting described here, it has potential applicability across healthcare settings where simulated consultations are used in communication skills training. Grounding simulated interaction in the observed communication patterns of real patients is an important means of maximising authenticity. Patient and Public Contribution The VideOing to Improve dementia Communication Education (VOICE) intervention which piloted the CABS method was developed by a multidisciplinary team, including three carers of people with dementia. People living with dementia were involved in the rating of the before and after video simulation assessments.

Purpose: Dementia support workers (DSWs) are employed to improve the hospital care for patients living with dementia. An evaluation sought to understand the perspectives and experiences of DSWs and related healthcare practitioners within one health board, to identify any role ambiguity and inform future role development. Design/methodology/approach: Framework analysis was used to synthesise data from semi-structured interviews and focus groups with dementia support workers, and a wider group of related healthcare practitioners. Findings: Thirteen semi-structured interviews were conducted with DSWs. Two focus groups were held with DSWs (n = 2 and 4) and two with associated healthcare practitioners (n = 3 and 5). Participants described inconsistencies in the understanding and delivery of the DSW role. Role ambiguity was identified as a key theme. Originality/value: This paper offers insight into challenges experienced by DSWs and addresses factors that could help improve and support the DSW role, and potentially the experience of other staff, and patients/people living with dementia. Overall, this evaluation highlights both the value of the DSW role in supporting the needs of patients/people living with dementia and the potential for person-centred activities to be used as therapeutic interventions. [ABSTRACT FROM AUTHOR]

Introduction: Precision medicine (PM) has revolutionized treatments, particularly cancer. However, this treatment approach is in infancy stage in Pakistan. Therefore, it is important to explore and look into the level of knowledge, attitude and practice by healthcare practitioners (HCPs) especially physicians and pharmacists who are majorly involved in cancer-care. Methods: Mixed-method sequential exploratory design, comprising of qualitative and quantitative study was adopted. In qualitative phase semi-structured face-to-face interviews using purposive sampling were audio-recorded, transcribed verbatim and thematically analyzed until data saturation reached. Quantitative study was a cross-sectional survey based upon results from the first phase using convenience sampling technique. Data obtained was then statistically analyzed using SPSS v22. Results: In qualitative study the data saturation was reached at fourteen physicians and eleven pharmacists, who despite of having practice constrains and limited resources, possessed enough knowledge regarding PM for cancer treatment and were found to be enthusiastic and optimistic towards learning it. Out of 165 participants, 64.85% of HCPs showed moderate knowledge, 66.06% showed adequate attitude, and 60.60% practice adequately towards the implementation of PM in the country. No significant difference in knowledge, attitude, and practice was found among physicians and pharmacists during the quantitative phase. Conclusion: The findings clearly expressed the need for facilitating healthcare practitioners with better knowledge and improving their attitude to bring improvements and advancements in the practice of PM in Pakistan. Provision of financial support, diagnostic equipment, and manufacture of targets at the local level can ensure the best treatment opportunities for every population in Pakistan. [ABSTRACT FROM AUTHOR]

Healthcare practitioners face significant risks of workplace violence due to various reasons such as hospital congestion, miscommunication, and aggressive behaviours of patients and relatives. Exposure to workplace violence may disrupt the workflow process and compromise patient care in healthcare facilities, ultimately affecting job performance, reducing job satisfaction, and negatively affecting the physical and mental health of healthcare practitioners. This study aimed to review all the published studies conducted on the experiences of workplace violence among healthcare practitioners. This study is a systematic review of qualitative studies. Data were collected through online databases including ScienceDirect, PubMed, MEDLINE and JSTOR were searched from the year 2015--2021. The inclusion criteria were: qualitative methods and mixed methods of data collection and analysis; studies that were carried out among healthcare practitioners who have been experience on workplace violence; scope of the primary studies included experience of workplace violence; and published in English/Malay in academic journal between 2015 and 2021. A total of 15 papers were included in the final analysis. The overall quality of the included papers was high. Of the 15 papers, 12 studies fully met the CASP criteria. The results of the 15 included studies were organised into the thematic groups of: i) verbal violence as the common workplace violence; ii) perceived causes of workplace violence and iii) seeking help. Across different countries, verbal violence was the most common type of workplace violence reported by healthcare practitioners. This review also identified that a lack of information, failure to meet patient expectations, and delayed treatment were the main contributing factors to workplace violence. [ABSTRACT FROM AUTHOR]

Healthcare systems in Europe are facing increasingly complex challenges that demand innovative solutions. Furthermore, public health is increasingly recognised as a productive factor which impacts the healthcare sector's contribution to national economies. The outmigration of healthcare practitioners from Latvia is one of the most pressing problems in the health sector, which, in turn, negatively impacts the country's economy. The outflow of healthcare practitioners to other EU countries has increased since 2004, the year which saw Latvia's accession to the EU. This trend is a consequence of labour accumulation efficiency in the single market, and this article aims at conducting analyses of the main push factors governing healthcare practitioners' emigration from Latvia and the impact of these factors on the healthcare sector. The complexity of this migration determines the use of an interdisciplinary as a methodological approach in the analysis of the main trends in the healthcare labour market. This approach can assist one in carrying out an assessment of the healthcare system's losses as a result of the out-migration which has occurred thus far. Particular attention is paid to the training of resident doctors as a perspective trend in keeping healthcare professionals in the country. The legal mechanism for recovering public funding dedicated to residency programs has also been assessed. In conclusion, the article states that the mass emigration of healthcare practitioners from Latvia may jeopardise the efficient functioning of the country's healthcare system. [ABSTRACT FROM AUTHOR]

Background: Actors portraying simulated patients are widely used in communication skills training in healthcare, but debates persist over the authenticity of these interactions. However, healthcare professionals value simulation‐based training because of the opportunity to think and react in real time, which alternatives cannot provide. Objective: To describe a method for the use of simulation which maximises authenticity by grounding training in real, observed, patterns of patient communication. Design: Naturally occurring care interactions were video recorded and analysed using conversation analysis (CA) to identify communication patterns. We focused on sites of recurring interactional trouble as areas for training, and identified more and less effective ways of dealing with these. We used the CA findings to train actors portraying simulated patients, based on the observed interactional patterns. Settings and Participants: Patients living with dementia and healthcare practitioners (HCPs) on two acute healthcare of the elderly wards in the English East Midlands. Outcome Measures: One month later HCPs reported using the skills learned in clinical practice. Masked‐ratings of before and after simulated patient encounters confirmed these self‐reports in relation to one key area of training. Results: The Conversation Analysis Based Simulation (CABS) method used in this setting showed positive results across a range of quantitative and qualitative outcome measures. What is significant for the transferability of the method is that qualitative feedback from trainees highlighted the ability of the method to not only illuminate their existing effective practices, but to understand why these were effective and be able to articulate them to others. Discussion/Conclusion: While the CABS method was piloted in the dementia care setting described here, it has potential applicability across healthcare settings where simulated consultations are used in communication skills training. Grounding simulated interaction in the observed communication patterns of real patients is an important means of maximising authenticity. Patient and Public Contribution: The VideOing to Improve dementia Communication Education (VOICE) intervention which piloted the CABS method was developed by a multidisciplinary team, including three carers of people with dementia. People living with dementia were involved in the rating of the before and after video simulation assessments. [ABSTRACT FROM AUTHOR]

The patient’s privileges are a set of moral principles that direct how patients and medical staff interact with one another. Each patient has a right to evidence of their legal obligations and the healthcare provider’s duties. Respecting patient rights is an essential aspect of healthcare practices. The truth is that those who are ill are among society’s most helpless members. The medical profession consequently views improvements to patient rights as being of the highest significance. A patient’s rights are the set of moral principles that guide their engagement with medical personnel. Every single patient has an authorized right to knowledge about those rights as well as the duties of the healthcare practitioner. Aim: To assess the awareness regarding the patient rights and responsibilities among the patients in the tertiary care hospital. The objective is to assess the patient’s and family’s knowledge about the patient’s rights and to study how patients’ rights and ethics impact hospital employees. Materials and methods: A questionnaire-based cross-sectional study will be carried out among 349 patients visiting the tertiary care hospital. Expected Result: The expected result of the study will be to uncover a baseline level of awareness among patients and their families regarding patients’ rights when visiting hospitals. Through comprehensive assessments and surveys, will be determined that a considerable portion of patients may have limited knowledge about their rights in the healthcare setting. Also, it is expected that healthcare providers will become more attuned to the importance of upholding patients’ rights. This alignment with patients’ rights and ethical principles is anticipated to positively influence the overall organizational culture within hospitals, fostering an environment of respect, empathy, and patient empowerment.

Juan Bornman,1 Brenda Louw1,2 1Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, Gauteng, South Africa; 2Department Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, TN, USACorrespondence: Juan Bornman, Email Juan.bornman@up.ac.zaBackground: Contemporary healthcare practitioners require leadership skills for a variety of professional roles related to improved patient/client outcomes, heightened personal and professional development, as well as strengthened interprofessional collaboration and teamwork.Objective/Aim: The aim of this study is to systematically catalogue literature on leadership in healthcare practice and education to highlight the leadership characteristics and skills required by healthcare practitioners for collaborative interprofessional service delivery and the leadership development strategies found to be effective.Methods/Design: A rapid review was conducted. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) diagram shows that the 11 databases, yielded 465 records. A total of 147 records were removed during the initial screening phase. The remaining 318 records were uploaded onto Rayyan, an online collaborative review platform. Following abstract level screening, a further 236 records were removed with 82 records meeting the eligibility criteria at full text level, of which 42 were included in the data extraction. The Mixed Methods Appraisal Tool (MMAT) was used for quality appraisal.Results: Results showed variability in methodologies used, representing various healthcare disciplines with a range in population size (n = 6 to n = 537). Almost half of the results reported on new programs, with interprofessional collaboration and teamwork being the most frequently mentioned strategies. The training content, strategies used as well as the length of training varied. There were five outcomes which showed positive change, namely skills, knowledge, confidence, attitudes, and satisfaction.Conclusion: This rapid review provided an evidence-base, highlighted by qualitative, quantitative, and mixed methods research, which presents distinct opportunities for curriculum development by focusing on both content and the methods needed for leadership programs. Anchoring this evidence-base within a systematic search of the extant literature provides increased precision for curriculum development.Keywords: collaboration, healthcare practitioners, interprofessional healthcare, leadership development, strategies

Introduction In low-income countries the utilisation of sexual and reproductive health and rights (SRHR) services is influenced by healthcare practitioners’ knowledge, attitudes and practices. Despite awareness of the potential problems due to ingrained biases and prejudices, few approaches have been effective in changing practitioners’ knowledge, attitudes and practices concerning SRHR in low-income countries. Objectives 1) To assess whether participating in an SRHR international training programme (ITP) changed healthcare practitioners’ SRHR knowledge, SRHR attitudes and SRHR practices and 2) examine associations between trainees’ characteristics, their SRHR work environment and transfer of training. Methods A pre- and post-intervention study, involving 107 trainees from ten low-income countries, was conducted between 2017 and 2018. Paired samples t-test and independent samples t-test were used to assess differences between trainees’ pre- and post-training scores in self-rated SRHR knowledge, attitudes, knowledge seeking behaviour and practices. Linear regression models were used to examine association between trainees’ baseline characteristics and post-training attitudes and practices. Results Trainees’ self-rated scores for SRHR knowledge, attitudes and practices showed statistically significant improvement. Baseline high SRHR knowledge was positively associated with improvements in attitudes but not practices. High increases in scores on knowledge seeking behaviour were associated with higher practice scores. No statistically significant associations were found between scores that measured changes in SRHR knowledge, attitudes and practices. Conclusion The findings indicate that the ITP was effective in improving trainees’ self-rated scores for SRHR knowledge, attitudes and behaviours (practices). The strongest association was found between improvement in SRHR knowledge seeking behaviour and the improvement in SRHR practices. This suggests that behaviour intention may have a central role in promoting fair open-minded SRHR practices among healthcare practitioners in low-income countries.

This study aimed to evaluate the structural validity of the Universal Measures of Bias – Fat (UMB Fat) among Malaysian healthcare practitioners using Rasch analysis. Data from a cross-sectional survey of 268 public and private doctors and allied health practitioners in Peninsular Malaysia were used for this analysis. Using Rasch analysis, overall model fit and item fit of the summary UMB Fat and domain scores were examined, together with unidimensionality, response threshold ordering, internal consistency, measurement invariance, and item targeting. Data showed overall misfit to the Rasch model for both the summary UMB Fat score and domain scores. Whilst unidimensionality was observed for the domain scores, this was not evident for the summary score where multiple local dependencies were present. Disordered thresholds were observed for the response format, in which the majority improved with modification. Suboptimal targeting was also detected with an uneven distribution of items at the upper and lower end of the logit scale for the summary and domain scores. Despite this, excellent internal consistency reliability was observed (person separation index: 0.76–0.89), and no measurement invariance was detected. The Rasch model supports reporting of the UMB Fat domain scores but not the summary score. Several issues related to local dependencies and response format were identified that could benefit from refining the UMB Fat to improve measurement accuracy, particularly when used by healthcare practitioners in Asian countries. • Examine the structural validity of the UMB Fat in an Asian healthcare population. • The Rasch model supports reporting domain scores but not the summary UMB Fat score. • Issues with local dependencies and the response format need further re-evaluation. [ABSTRACT FROM AUTHOR]

Background: As reproductive genetic carrier screening (RGCS) becomes more widely accessible, ensuring uptake by primary healthcare professionals (HCPs) is essential to equitable service provision. This study aimed to identify and prioritise implementation strategies to reduce barriers and support HCPs to routinely offer RGCS in Australia. Methods: HCPs (n = 990) involved in a large national research study, offering couples-based RGCS, were surveyed at three time points: prior to offering RGCS through the study (Survey 1: Barriers); 8+ weeks after offering to their patients (Survey 2: Possible supports); and towards the end of the study (Survey 3: Prioritised supports). HCPs were from primary care (e.g. general practice, midwifery) and tertiary care (e.g. fertility, genetics) settings. Results were analysed via a novel approach of using behaviour change theory (Capability, Opportunity and Motivation – COM.B) to align theory to practice. Results: Survey 1 (n = 599) identified four barrier themes: time constraints, lack of HCP knowledge and skill, patient receptivity, and HCP's perceived value of RGCS. Survey 2 (n = 358) identified 31 supports that could facilitate HCPs offering RGCS. Survey 3 (n = 390) was analysed separately by speciality and clinic location. Prioritised supports for primary care HCPs were 'regular continuing professional development activities' and 'a comprehensive website to direct patients for information'. There was general accordance with the perceived importance of the supports, although some difference in relation to funding between professional groups and clinic locations. Conclusion: This study identified a range of supports acceptable to HCPs across specialties and geographic locations that policymakers may use to direct efforts to ensure the roll out of RGCS is equitable across Australia. As reproductive genetic carrier screening becomes more widely accessible, ensuring uptake by primary health care professionals (HCPs) is essential to equitable service provision. We surveyed HCPs offering reproductive genetic carrier screening and identified a range of priorities to address barriers to and support for routine offering of screening. Top supports included patient resources, funding, and ongoing education. Policymakers may use these findings to direct their future efforts. [ABSTRACT FROM AUTHOR]

This pilot study was designed to determine the conversational structure on Ebola Virus Disease (EVD), pattern of knowledge sharing and knowledge sharing behaviour of healthcare practitioners (HCP) on Medscape online network. The study was guided by Conversation Theory, and deployed a retrospective document/content analysis research design. Ninety-two comments from healthcare practitioners including 16 EVD newsposts out of 37 EVD news were randomly extracted from the network between 2014 and 2018. Extracted data were analysed using NVivo and Microsoft Excel applications. An EVD knowledge taxonomy was developed from the content mapping of EVD topics posted on the network. Results from the pilot study revealed that news on EVD were mostly on EVD outbreak management at the peak period of EVD outbreak in 2014. Also, the HCPs mostly engaged in knowledge sharing on issues relating to EVD risk. Findings revealed that the entire (37) newsposts were of interest to HCPs and they responded to 16 newsposts. There were three active and influential HCPs on the network. The novelty of this study stems from its focus on conversation patterns of HCP on online knowledge sharing using the variables of Conversation theory to examine their knowledge sharing behaviours. The outcome of the study could serve as a model for other studies on other trending viral diseases such as Coronavirus, Lassa Fever, Monkey pox, etc. This study thus recommends replicate analysis in the main study with a larger data set with further findings using network analysis and other statistical tools to examine the conversational structure on EVD and pattern of knowledge sharing among the HCPs. [ABSTRACT FROM AUTHOR]

Abstract Background Person-centred care is integral to high-quality health service provision, though concepts vary and the literature is complex. Validated instruments that measure person-centred practitioner skills, and behaviours within consultations, are needed for many reasons, including in training programmes. We aimed to provide a high-level synthesis of what was expected to be a large and diverse literature through a systematic review of existing reviews of validation studies a of instruments that measure person-centred practitioner skills and behaviours in consultations. The objectives were to undertake a critical appraisal of these reviews, and to summarise the available validated instruments and the evidence underpinning them. Methods A systematic search of Medline, EMBASE, PsycINFO and CINAHL was conducted in September 2020. Systematic reviews of validation studies of instruments measuring individual practitioner person-centred consultation skills or behaviours which report measurement properties were included. Review quality was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Details of the reviews, the included validation studies, and the instruments themselves are tabulated, including psychometric data, and a narrative overview of the reviews is provided. Results Four reviews were eligible for inclusion. These used different conceptualisations of person-centredness and targeted distinct, sometimes mutually exclusive, practitioners and settings. The four reviews included 68 unique validation studies examining 42 instruments, but with very few overlaps. The critical appraisal shows there is a need for improvements in the design of reviews in this area. The instruments included within these reviews have not been subject to extensive validation study. Discussion There are many instruments available which measure person-centred skills in healthcare practitioners and this study offers a guide to what is available to researchers and research users. The most relevant and promising instruments that have already been developed, or items within them, should be further studied rigorously. Validation study of existing material is needed, not the development of new measures.

In Tunisia, self-medication is a common practice, and there is a continual rise in the prevalence of cardiovascular disease. Given the lack of data on the self-medication practices (SMPs) among cardiovascular patients in this area, the present study aimed to identify the prevalence and determinants of SMPs among cardiovascular patients in the city of Béja. A community-pharmacy-based survey was conducted among selected cardiovascular patients in Béja, Tunisia, from May 2021 to June 2021. Data were collected using a self-administered questionnaire provided by pharmacists during in-person surveys with patients. Descriptive statistics were used to summarize the data, while Fisher’s exact test was used for categorical variables, with the significance level set at p < 0.05. The frequency of self-medication among the 150 respondents was 96%; 70.14% of participants reported that the primary reason why people engage in self-medication is the existence of an old prescription. The most prevalent conditions leading patients to self-medicate were headaches (100%), fever (83.33%), toothache (65.97%), and dry cough (47.92%). The most frequently self-administered drugs were paracetamol (100%), antibiotics (56.94%), and antitussives (47.92%). The results of our study indicate that SMPs among Tunisian cardiovascular patients have a high prevalence. With this in mind, healthcare practitioners should ask their patients about their self-medication practices and advise cardiovascular patients about the risks and benefits associated with this practice.

Background: Epidermolysis bullosa (EB) is a painful genodermatosis presenting with skin fragility and blisters. There is no cure; the prognosis is guarded and depends on the subtype of the disease. Managing these patients can be emotionally challenging for healthcare practitioners. Aim: To determine the perceptions, impact, and needs of healthcare practitioners (HCP) caring for patients and their families with EB. Setting: Nelson Mandela School of Medicine, Durban and Grey’s Hospital, Pietermaritzburg, KwaZulu-Natal. Methods: The study was guided by interpretative phenomenological analysis. Individual in-depth interviews were conducted with 10 healthcare practitioners. Guba’s trustworthiness framework was used to ensure rigour. Results: Six global themes were identified, each related primarily to the perceptions, impact, and needs of healthcare practitioners. The experiences and perceptions of healthcare practitioners were that caring for patients with an incurable disease such as EB could negatively impact healthcare practitioners. There were divergent views among the disciplines of HCPs regarding the extent of care in a resource-limited environment. This resulted in negative emotions, ethical concerns, and a need for continued medical education and the application of coping strategies. Healthcare practitioners observed that patients and their families were vulnerable, requiring comprehensive biopsychosocial care. Conclusion: Healthcare practitioners should be aware of their emotional challenges, seek support where necessary, and use effective coping strategies and self-care. Contribution: The concerns and needs of healthcare practitioners are highlighted and interventional strategies to assist healthcare practitioners are suggested which will ultimately improve patient care.

Background Snakebites cause significant morbidity and mortality in Uganda. Effective management of snakebites requires knowledge of the appropriate first aid measures, as well as knowledge of the appropriate antivenom to use, but little is known about familiarity with effective snakebite management techniques and associated factors among healthcare practitioners (HCPs) in Uganda. Methods In May 2022, we collected data on sociodemographic characteristics, knowledge of snakebite first aid, envenomation signs, diagnosis and antivenom administration among 311 HCPs from two snakebite high-incidence districts in Uganda using a semi-structured questionnaire. Results Of the 311 HCPs, 64.3% had ever treated snakebite cases, 87.1% were confident to provide supportive treatment, but only 9.6% had ever been trained on snakebite management. Overall, 22.8% of HCPs had high knowledge of snakebite management. Higher education (at least degree vs certificate; PR=2.21 95% CI 1.508 to 4.56), older age (30–45 vs <30 y; PR=1.97, 95% CI 1.22 to 3.21) and previous training (PR=1.82, 95% CI 1.08 to 3.05) were associated with high knowledge of snakebite diagnosis and management. Conclusions Overall, knowledge of snakebite management was limited. Training, level of education and age of the HCP all had an impact on knowledge. Deliberate efforts are required to increase HCPs' knowledge of snakebite case care in high-burden regions to manage incident cases. [ABSTRACT FROM AUTHOR]

This research initiates a comprehensive evaluation of safety awareness among emergency medical service (EMS) practitioners in Riyadh, Saudi Arabia, an area experiencing substantial academic and regulatory transformation. By employing the Safety Attitudes Questionnaire, the study explores safety awareness across various EMS domains, unveiling a significant consistency that is unaffected by the work environment, professional tenure, or gender. Importantly, there are no significant disparities in safety awareness between hospital-based EMS practitioners and their pre-hospital counterparts, regardless of their tenure or gender. The findings highlight a homogenous safety awareness landscape among Riyadh's EMS practitioners, suggesting strategies to sustain and strengthen patient safety culture irrespective of workspace, experience, or gender. This research not only presents these key findings but also advocates for sustainable resilience in healthcare delivery. It emphasizes the need for continued efforts to instill a culture of safety, underpinned by regular training and the adoption of swift response strategies, ensuring a sustainable approach to patient safety in times of crisis. [ABSTRACT FROM AUTHOR]

An educational intervention, based on qualitative evidence of racism in healthcare, is described. Using vignettes from a previous project, interviews were conducted to gather qualitative evidence of racism in healthcare settings from a wide range of healthcare staff in Sweden. From this interview material, case studies were devised that were subsequently presented to trainee healthcare professionals, in a seminar discussion. After the seminar, trainees responded to reflective questions. The order of work, as well as the materials used, are described. This intervention was successful in facilitating discussion about racism in an educational context, despite the difficult nature of these conversations for some participants. [ABSTRACT FROM AUTHOR]

Abstract Background Early intervention in cerebral palsy could improve motor outcome but is only possible following early identification of those affected. There is a need for training of healthcare professionals (HCPs) in early detection of atypical motor development. We developed a video-based e-learning course - Training in Early Detection for Early Intervention (TEDEI) - to address this need. We evaluated whether participation in the course improved knowledge and changed behaviour of HCPs. Methods Participants were 332 HCPs (38% physiotherapists, 35.8% occupational therapists), predominantly UK-based (83.7%). Analysis of training effects used mixed methods and followed Kirkpatrick’s model, first assessing “Reaction” through a feedback questionnaire involving Likert scale and free text responses (n = 141). “Learning” was assessed through multiple choice questions (MCQs): all 332 HCPs completed a pre-course quiz of 6 MCQs followed by the course, then a 16 item post-course quiz including the 6 pre-course questions. “Behaviour” was assessed through in-depth qualitative interviewing of 23 participants. Results “Reaction”: TEDEI was found to be effective, engaging and well structured. “Learning”: Scores improved significantly between the pre-course and post-course quiz, median improvement 1/6 (z = 5.30, p

Background: Person-centred care is integral to high-quality health service provision, though concepts vary and the literature is complex. Validated instruments that measure person-centred practitioner skills, and behaviours within consultations, are needed for many reasons, including in training programmes. We aimed to provide a high-level synthesis of what was expected to be a large and diverse literature through a systematic review of existing reviews of validation studies a of instruments that measure person-centred practitioner skills and behaviours in consultations. The objectives were to undertake a critical appraisal of these reviews, and to summarise the available validated instruments and the evidence underpinning them. Methods: A systematic search of Medline, EMBASE, PsycINFO and CINAHL was conducted in September 2020. Systematic reviews of validation studies of instruments measuring individual practitioner person-centred consultation skills or behaviours which report measurement properties were included. Review quality was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Details of the reviews, the included validation studies, and the instruments themselves are tabulated, including psychometric data, and a narrative overview of the reviews is provided. Results: Four reviews were eligible for inclusion. These used different conceptualisations of person-centredness and targeted distinct, sometimes mutually exclusive, practitioners and settings. The four reviews included 68 unique validation studies examining 42 instruments, but with very few overlaps. The critical appraisal shows there is a need for improvements in the design of reviews in this area. The instruments included within these reviews have not been subject to extensive validation study. Discussion: There are many instruments available which measure person-centred skills in healthcare practitioners and this study offers a guide to what is available to researchers and research users. The most relevant and promising instruments that have already been developed, or items within them, should be further studied rigorously. Validation study of existing material is needed, not the development of new measures. [ABSTRACT FROM AUTHOR]

Background: Metacognition is the process of awareness of the way in which we think. Healthcare practitioners are intrinsically required to make complex and demanding decisions daily—and just as with non-healthcare-related industries, they are susceptible to human error. Human factors (HF) can have catastrophic implications and the use of metacognition is a well-regarded tool to aid decision-making. Objective: This systematic review aimed to determine how metacognition and human factors influence decision-making in healthcare practitioners. Methods: the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine (AMED) Database, Dentistry & Oral Sciences Source, MEDLINE, SPORTDiscus, APA PsycArticles Psychology & Behavioral Sciences Collection and APA PsychInfo were searched for eligible qualitative studies. The search was carried out in December 2021. Results: Six studies met the inclusion criteria for the current review. Twenty main themes and twenty-eight subthemes were categorised into twenty-one descriptive themes. These were synthesised into fourteen analytical themes, four of which were determined to be recurrent and one of which held significant implications for clinical practice: (1) Cognitive bias identification; (2) Systematic approach; (3) Holistic approach and creative thinking; (4) Identifying uncertainty; and (5) Drawbacks. Conclusions: This review found that metacognition improves decision-making in healthcare practitioners through cognitive bias identification, facilitation of systematic approaches, holistic approaches, and creative thinking. However, consideration should be made to its limitations. Further research is required to fully understand the findings in relation to specific practice areas and their clinical implications. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused disruptions to cancer care by delaying diagnoses and treatment, presenting challenges and uncertainties for both patients and physicians. We conducted a nationwide online survey to investigate the effects of the pandemic and capture modifications, prompted by pandemic-related control measures, on cervical cancer screening-related activities from mid-March to mid-August 2020, across Canada. Methods: The survey consisted of 61 questions related to the continuum of care in cervical cancer screening and treatment: appointment scheduling, tests, colposcopy, follow-up, treatment of pre-cancerous lesions/cancer, and telemedicine. We piloted the survey with 21 Canadian experts in cervical cancer prevention and care. We partnered with the Society of Canadian Colposcopists, Society of Gynecologic Oncology of Canada, Canadian Association of Pathologists, and Society of Obstetricians and Gynecologists of Canada, which distributed the survey to their members via email. We reached out to family physicians and nurse practitioners via MDBriefCase. The survey was also posted on McGill Channels (Department of Family Medicine News and Events) and social media platforms. The data were analyzed descriptively. Results: Unique responses were collected from 510 participants (November 16, 2020, to February 28, 2021), representing 418 fully and 92 partially completed surveys. Responses were from Ontario (41.0%), British Columbia (21.0%), and Alberta (12.8%), and mostly comprised family physicians/general practitioners (43.7%), and gynecologist/obstetrician professionals (21.6%). Cancelled screening appointments were mainly reported by family physicians/general practitioners (28.3%), followed by gynecologist/obstetrician professionals (19.8%), and primarily occurred in private clinics (30.5%). Decreases in the number of screening Pap tests and colposcopy procedures were consistently observed across Canadian provinces. About 90% reported that their practice/institution adopted telemedicine to communicate with patients. Conclusions: The area most severely impacted by the pandemic was appointment scheduling, with an important level of cancellations reported. Survey results may inform resumptions of various fronts in cervical cancer screening and management. Funding: The present work was supported by the Canadian Institutes of Health Research (operating grant COVID-19 May 2020 Rapid Research Funding Opportunity VR5-172666 Rapid Research competition and foundation grant 143347 to Eduardo L Franco). Eliya Farah and Rami Ali each received an MSc stipend from the Department of Oncology, McGill University.

Abstract Background Issues of medication adherence, multimorbidity, increased hospitalisation risk and negative impact upon quality of life have led to the management of polypharmacy becoming a national priority. Clinical guidelines advise a patient-centred approach, involving shared decision-making and multidisciplinary team working. However, there have been limited educational initiatives to improve healthcare practitioners’ management of polypharmacy and stopping inappropriate medicines. This study aimed to evaluate the impact of a polypharmacy Action Learning Sets (ALS) tool across five areas: i. healthcare practitioners’ confidence and perceptions of stopping medicines; ii. knowledge and information sources around stopping medicines; iii. perception of patients and stopping medicines; iv. perception of colleagues and stopping medicines and v. perception of the role of institutional factors in stopping medicines. Methods The ALS tool was delivered to a multi-disciplinary group of healthcare practitioners: GPs [n = 24] and pharmacy professionals [n = 9]. A pre-post survey with 28 closed statements across five domains relating to the study aims [n = 32] and a post evaluation feedback survey with 4 open-ended questions [n = 33] were completed. Paired pre-post ALS responses [n = 32] were analysed using the Wilcoxon signed-rank test. Qualitative responses were analysed using a simplified version of the constant comparative method. Results The ALS tool showed significant improvement in 14 of 28 statements in the pre-post survey across the five domains. Qualitative themes (QT) from the post evaluation feedback survey include: i. awareness and management of polypharmacy; ii. opportunity to share experiences; iii. usefulness of ALS as a learning tool and iv. equipping with tools and information. Synthesised themes (ST) from analysis of pre-post survey data and post evaluation feedback survey data include: i. awareness, confidence and management of inappropriate polypharmacy, ii. equipping with knowledge, information, tools and resources and iii. decision-making and discussion about stopping medicines with colleagues in different settings. Conclusions This evaluation contributes to developing understanding of the role of educational initiatives in improving inappropriate polypharmacy, demonstrating the effectiveness of the ALS tool in improving healthcare practitioners’ awareness, confidence and perceptions in stopping inappropriate medicines. Further evaluation is required to examine impact of the ALS tool in different localities as well as longer-term impact.

Background: Early intervention in cerebral palsy could improve motor outcome but is only possible following early identification of those affected. There is a need for training of healthcare professionals (HCPs) in early detection of atypical motor development. We developed a video-based e-learning course - Training in Early Detection for Early Intervention (TEDEI) - to address this need. We evaluated whether participation in the course improved knowledge and changed behaviour of HCPs. Methods: Participants were 332 HCPs (38% physiotherapists, 35.8% occupational therapists), predominantly UK-based (83.7%). Analysis of training effects used mixed methods and followed Kirkpatrick's model, first assessing "Reaction" through a feedback questionnaire involving Likert scale and free text responses (n = 141). "Learning" was assessed through multiple choice questions (MCQs): all 332 HCPs completed a pre-course quiz of 6 MCQs followed by the course, then a 16 item post-course quiz including the 6 pre-course questions. "Behaviour" was assessed through in-depth qualitative interviewing of 23 participants. Results: "Reaction": TEDEI was found to be effective, engaging and well structured. "Learning": Scores improved significantly between the pre-course and post-course quiz, median improvement 1/6 (z = 5.30, p < 0.001). HCPs also reported a perceived improvement in their knowledge, confidence and ability. "Behaviour": HCPs could see how TEDEI would improve their clinical practice through having an assessment framework, ways of working better with parents, and developing observational skills useful for tele-health assessments. Conclusion: Our brief e-learning course on early detection for early intervention was viewed positively, improved knowledge and showed potential for positive changes in practice. Kirkpatrick's model provided a useful framework for undertaking this evaluation. [ABSTRACT FROM AUTHOR]

In low-income countries the utilisation of sexual and reproductive health and rights (SRHR) services is influenced by healthcare practitioners' knowledge, attitudes and practices. Despite awareness of the potential problems due to ingrained biases and prejudices, few approaches have been effective in changing practitioners' knowledge, attitudes and practices concerning SRHR in low-income countries. 1) To assess whether participating in an SRHR international training programme (ITP) changed healthcare practitioners' SRHR knowledge, SRHR attitudes and SRHR practices and 2) examine associations between trainees' characteristics, their SRHR work environment and transfer of training. A pre- and post-intervention study, involving 107 trainees from ten low-income countries, was conducted between 2017 and 2018. Paired samples t-test and independent samples t-test were used to assess differences between trainees' pre- and post-training scores in self-rated SRHR knowledge, attitudes, knowledge seeking behaviour and practices. Linear regression models were used to examine association between trainees' baseline characteristics and post-training attitudes and practices. Trainees' self-rated scores for SRHR knowledge, attitudes and practices showed statistically significant improvement. Baseline high SRHR knowledge was positively associated with improvements in attitudes but not practices. High increases in scores on knowledge seeking behaviour were associated with higher practice scores. No statistically significant associations were found between scores that measured changes in SRHR knowledge, attitudes and practices. The findings indicate that the ITP was effective in improving trainees' self-rated scores for SRHR knowledge, attitudes and behaviours (practices). The strongest association was found between improvement in SRHR knowledge seeking behaviour and the improvement in SRHR practices. This suggests that behaviour intention may have a central role in promoting fair open-minded SRHR practices among healthcare practitioners in low-income countries. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the safety climate among and between health practitioners in Saudi Arabia by identifying speaking up behavior and speaking up about the related climate. METHODOLOGY: A cross-sectional study was conducted among 135 physicians and 434 nurses in Saudi public hospitals using the Speaking Up about Patient Safety Questionnaire to assess various speaking up dimensions. Study questionnaires were completed from May to June 2019. The research purpose and confidentiality and anonymity assurance were provided at the beginning of the questionnaire. The individuals' participation was regarded as informed consent. RESULTS: A total of 569 physicians and nurses participated. Both professions perceived concerns regarding patient safety, and nurses kept silent more yet reported a higher likelihood of speaking up than physicians. Psychological protection for speaking up was equal for both professions, but nurses reported the environment as encouraging, and physicians were more resigned. CONCLUSION: The findings of this study support further investment into research to design interventions and improve patient safety by enhancing speaking up behavior and speaking up climate through recognizing and eliminating the barriers in healthcare settings. Despite ongoing improvement efforts, the current findings highlighted that safety is yet to be fully established. [ABSTRACT FROM AUTHOR]

Abstract Background Pharmaceutical compounding ensures access of individuals with specific requirements to individualized therapy. However, there is an inconsistency of compounded medication quality. Therefore, advancing the rational use of compounded medication is essential for patient safety and medication effectiveness. Objective The presented study was aimed to investigate the healthcare practitioners’ knowledge, perception, and practice of extemporaneous compounding and its contribution to the prevalence of antimicrobial resistance. Method A descriptive cross-sectional survey using a structured questionnaire was conducted. The study participants were 300 healthcare practitioners working in Jimma University Medical Center, hospital pharmacies, and community pharmacies in Jimma and Mettu Town, Southwest Ethiopia. Results Most respondents were pharmacists (62.7%) and first-degree holders (48.3%). The majority of them had experience in administering (57.7%), preparing (38%), prescribing (21%), and repackaging and labeling (14%) compounded medications. Commonly they request compounded medications when prepackaged products (77.7%) and needed dosage regimens (72.3%) were not available in the market. However, most of them believed that compounded medications might lack quality (49%) and had poor patient compliance (40.7%). Moreover, they fear that inappropriate preparation processes (75%) and under-dose administration (59%) of compounded medication might contribute to the development and prevalence of antimicrobial resistance. Conclusion Most healthcare practitioners practice rational use of compounded medications and strongly agree that inappropriate compounding of antimicrobials contributes to antimicrobial resistance development.

Users show a growing interest in expanding the implementation of digital tools as a support of technical and management issues in healthcare. This medical care has focused on telemedicine but does not include the recognition of needs as an important part of patient-centred healthcare. Nurses interact with patients at critical times in their life journeys, including birth and death, which are historical events linked with religious beliefs. Furthermore, large migration flows have led to multicultural societies in which religion and spirituality are experienced in distinct ways by different people. Finally, most healthcare professionals lack the proper skills to handle the spiritual needs of their patients, especially for core and digital competences. This article shows the results of qualitative research applying as a research tool an open-ended questionnaire, which allows detecting the educational needs for nurses' interventions aimed at providing spiritual support to their patients using digital tools. The results obtained reveal that nurses need education and training on fundamental spiritual concepts and digital competencies to meet the multiple demands of their patients' spiritual needs. Finally, we present an open digital educational proposal for the development of competencies for nurses and other health professionals to provide spiritual care with the support of digital tools. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to determine patient satisfaction with the following pharmacist-led services for inpatients in tertiary care hospitals. Methods Studies were identified from different databases from 2012 to 2020. A total of 1910 articles were identified using the search strategies out of which 1153 were rejected based on the review of titles and abstracts. The search criteria were the roles of inpatient pharmacists and patient satisfaction with inpatient pharmacy services. Multiple keywords were used such as 'patient satisfaction'/'inpatient pharmacist'/'pharmacist hospital services'/'clinical pharmacist roles'. The quality of each study was measured using the mixed methods appraisal tool, and the same was used to evaluate the risk of bias as well. Key findings A total of 11 cross-sectional studies were included in the evidence synthesis of this meta-analysis. Three studies tested the satisfaction of patients with inpatient counselling with a sample size of n = 742. The odd ratio (OR) was 215.33 (141.77 to 327.05) [95% confidence interval (CI)] showed a significant patient satisfaction (P = 0.00001) with the pharmacist's inpatient counselling (I 2 = 0%). Studies showed a statistically significant satisfaction of patients with discharge counselling P < 0.00001 and OR 55.74 (35.93 to 86.49) and heterogeneity I 2 = 0%. In a total of five studies, the healthcare professional (HCP) satisfaction with pharmacist services was reported, and satisfied and unsatisfied HCPs were n = 801 and n = 362, respectively. Results showed high satisfaction (P < 0.00001) and OR 4.62 (95% CI, 3.89 to 5.48). Conclusion This meta-analysis concluded that clinical pharmacist services in an inpatient setting have a significant impact on increasing patient satisfaction with their treatment. The clinical pharmacist services are not very well implemented and are limited in some hospitals, but patients who have received these services were highly satisfied and expected to receive them more often. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate healthcare practitioners' perceptions of electronic health record (EHR) systems and their effectiveness in supporting clinical decision-making in Tanzanian Primary Healthcare (PHC) facilities., Design/methodology/approach: A mixed-methods approach was employed, combining quantitative data from structured questionnaires and qualitative insights from open-ended responses. The study was conducted in the Dodoma region of Tanzania, focusing on a diverse representation of PHC facilities, including district hospitals, health centres and dispensaries. Data were analysed using multiple linear regression for quantitative data, and thematic analysis was applied to qualitative responses., Findings: The results revealed that while EHR systems are widely used in Tanzanian PHC facilities, their impact on clinical decision-making remains limited. Only a moderate portion of practitioners perceived EHR systems as effective in decision support, and frequent system use was negatively correlated with user satisfaction. Challenges such as inadequate training and support, system crashes, slow performance and poor usability and integration into clinical workflows were significant barriers to effectively utilising EHR systems., Originality/value: This study contributes to the limited literature on EHR system implementation in low-resource settings, specifically Tanzania, by focusing on decision-support features within EHR systems. The findings offer valuable insights for healthcare policymakers, system designers and practitioners to optimise EHR implementation and improve healthcare outcomes in resource-constrained environments., (© Emerald Publishing Limited.)