Knowledge levels and attitudes of health care professionals toward patients with hepatitis C infection

AIM:To study knowledge levels and attitudes of health care providers toward patients with hepatitis C virus infection in Guilan,a northern province of Iran.METHODS:This cross-sectional study was performed on 239 health care professionals from the Razi Hospital,including doctors,nurses,and operating room technicians.The questionnaires consisted of questions on demographic characteristics,knowledge levels,and attitudes toward hepatitis C patients.The questionnaire was tested in a pilot study and validated by Cronbach' s alpha coefficient.Data were analyzed using SPSS16 software.RESULTS:The mean ± SD knowledge score was 17.43 ± 2.65(from a total of 22).51.9% of the participants achieved scores higher than the mean.There was a significant relationship between knowledge score and age(P = 0.001),gender(P = 0.0001),occupational history(P = 0.0001),and educational history(P = 0.027).There was also a significant relationship between attitude level and age(P = 0.002),gender(P = 0.0001),occupational history(P = 0.0001),and educational history(P = 0.035).Physicians were significantly more knowledgeable and showed more positive attitudes.There was a positive correlation between knowledge and attitude scores(P = 0.02).CONCLUSION:Discriminatory attitudes are common among health care providers toward hepatitis C patients.It is therefore necessary to improve their knowledge level and attitude toward this disease.

Cross-Sectional Survey on Complementary and Alternative Medicine Awareness among Health Care Professionals and Students Using CHBQ Questionnaire in a Balkan Country

Objective： To conduct a study on attitudes, knowledge, and use of complementary and altemative medicine （CAM） therapies in Serbia. Available data about CAM therapies in the region are scarce, opinions lacking from health sector. Balkan region countries had a delay in issuing national policies on CAM therapies. Methods： The questionnaire used was based on previously validated CAM Health Belief Questionnaire （CHBQ）, formulated as 5-item Likert type scale, adjusted for local environment. Health care students and professionals were evaluated. The questionnaire comprehended 10 closed questions on attitudes, knowledge and use of CAM therapies. This survey was conducted in eight cities of Serbia, January 2010-July 2011. A total of 797 participants was included. The second group of participants was 145 healthcare professionals （50 academic staff, 64 clinical staff, 19 pharmacists, 6 other clinical branch specialists and 6 nurses）. Data were collected by an interview. Examinees could acquire maximum of 70 points, 35 representing neutral attitude. Restdts： Students of dentistry （54.65 ± 6.07） were better informed on CAM therapies than medicine students （50.26 ± 7.92）. Pharmacy students （51.16 ± 7.10） accepted low-scientific CAM. Pharmacists scored better than university professors （55.12±6.55 vs. 50.29± 9.50）. Primary health care professionals had better awareness than pharmacists in dispensing pharmacies. Both groups of participants preferred use of vitamins over any other CAM therapy. Conclusion： These pioneering efforts in the region exposed weaknesses in CAM attitudes of current and future health care professionals. Nevertheless, awareness on alternative medicine treatment choices is growing among Balkan prescribers. Supportive legal framework would facilitate dissemination of CAM medical practices.

Attitudes of Healthcare Professionals towards Mental Illness: A Survey Study in Ras Al Khaimah

Background: Negative and stigmatizing attitudes and behaviours towards people with mental health problems have the potential to lead to a lack of access to care, under-treatment, social marginalization, and can undermine the relationship between the patient and provider. The study aimed to measure attitude of healthcare professionals towards mental illness. Methods: Across sectional descriptive study was conducted over one month from April to May 2019 at Ras Al khaimah medical and health Science University and affiliated health care facilities. Mental Illness Clinicians’ Attitudes Scale version 4 Questionnaire was used to collect data from participants after obtaining their informed consent with assured confidentiality. Results: The study included 113 health care professionals. The mean score of attitude of health care professionals towards mental illness was 57.8 ± 10.8 out of 96. Negative attitudes were reported about the dangerousness, respect and suspicion over recovery of people with mental health problems, interactions with them in clinical practice, and fear of disclosure to colleagues or friends about mental health problems and confidence in capabilities of assessing mental health problems in primary care. The significant positive attitude was found among participants who were university faculty than those who worked in hospitals and Primary care centres (P = 0.04). Health care professionals who were university faculty and have reported more than 10 years of experience as health professionals reported significantly higher mean scores (P < 0.05). Neither age nor gender, or nationality appeared to be related to overall attitudinal responses towards mental illness. Conclusion: Educational programs might be useful to raise awareness towards the stigmatizing attitudes towards mental health and mental illnesses.

Understanding Health Care Professional-Patient Interactions in Multiple Sclerosis: A Systematic Review and Thematic Synthesis

Aim: To examine the experiences of health care professional (HCP)-patient interactions in Multiple Sclerosis (MS), identifying factors that can influence these interactions. Methods: A three-stage systematic review and thematic synthesis of qualitative and quantitative research was undertaken. Stage 1: the systematic literature search;Stage 2: methodological appraisal of the qualitative papers;Stage 3: thematic synthesis of all qualitative papers and the integration of quantitative findings into the synthesis. Results: Forty-nine qualitative studies were identified. This included 1014 individuals with MS (244 male, 755 female and 15 unknown) and 106 carers and 86 HCPs. Seventeen quantitative studies were identified which included 7680 (2008 male, 5812 females, and 40 unknown) participants as well as 224 carers. Two themes are discussed: 1) The expectations, experiences and perceptions of interactions with HCPs, and 2) The factors that influenced interactions and relationships. Discussion: There is need for improvement in the content and provision of information to patients with MS from HCPs. Specific strategies are suggested and implications for patients and health care providers are considered.

COVID-19 pandemic in the intensive care unit:Psychological implications and interventions,a systematic review

BACKGROUND The coronavirus disease 2019(COVID-19) pandemic produced changes in intensive care units(ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff;this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles,upon which we commented.RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.

Transition care in inflammatory bowel disease: A needs assessment survey of Quebec gastroenterologists and allied nurses

To determine the tools needed and problems encountered during the transition of inflammatory bowel disease (IBD) patients from pediatric to adult gastroenterologists (GIs) in Québec, Canada. METHODSWe conducted a needs assessment survey of Quebec health care professionals (HCPs). The survey was handed out to 136 Québec HCPs at a local conference in 2013. Additionally, it was emailed to any other HCPs in Quebec involved in caring for IBD patients. The completed surveys were compiled to derive descriptive data. Further specific subgroup analysis was then conducted. RESULTSAmong the conference attendees and individuals emailed 77 (28.2%) completed the questionnaire. Respondents included adult GIs (61.3%), pediatric GIs (20.8%) and IBD nurses (18.3%). The majority of respondents believed that a standardized structure is important for a successful transition. Adult and pediatric GIs equally felt that patients were inadequately prepared for the transition (P = 0.6). There were significant differences between adult and pediatric GIs when it came to resource availability (55.6% vs 90.9%, P = 0.002) and perceived need of a formal transition clinic (21.7% vs 68.8%, P = 0.0006). Both transition program and medical summaries were identified as the most valuable tools to improve transition. CONCLUSIONAs described in previous studies, our survey reinforces the importance of a transition program, education for young adult IBD patients and the need to improve communication between adult and pediatric GIs.

The Hermeneutic Circle Helps to Accumulate Knowledge and Understanding： An Empirical Example of Public Health Nurses＇ Experiences of Supporting Multiple-birth Families

In phenomenological research, the reduction is a complex reflective attentiveness required for phenomenological understanding. A literature review revealed that little research has been done on health care professionals working with multiple-birth families. Van Manen＇s method has been variously used in nursing science. The aim of this article is to describe the hermeneutic circle and the method of reduction, providing an empirical example of the experiences of public health nurses working with multiple-birth families. The data consisted of open interviews （n = 38） with three participant groups--parents of twins, nurses, and family care workers--written output from them and the researcher＇s notes. The phenomena of the lifeworld of multiple-birth families as described by nurses can be expressed as： ＂recognizing the strain＂, ＂targeting special needs＂, and ＂lightening the load of daily life＂. Reduction enables in-depth phenomenological hermeneutic research, helping to see the research stages both as parts and as a whole and the hermeneutic circle that accumulates understanding. Social and health care professionals need to listen more to parents＇ voices to better understand the needs and situation of multiple-birth families. More education and training is needed to empower parents of twins. This article can stimulate discussion on phenomenology, hermeneutic research and reduction.

The Effects of Information and Communication Technology on Health Service Delivery at Tafo Government Hospital

This study sought to find out the effects of Information and Communication Technology (ICT) on health service delivery at Tafo Government Hospital. A descriptive survey design was used. Data were collected through the use of semi-structured questionnaire and administered to 50 respondents where stratified random sampling technique was used by ranking position as strata. Data were analyzed using descriptive statistics. From the findings, 56% of the respondents overwhelmingly agreed to the fact that the applications of ICT provide quicker medical diagnoses, reduced workload among users, improvement in patients’ waiting time and information accessibility. Nonetheless, 72% bemoaned lack of ICT infrastructure, poor ICT network concerns coupled with that insufficient knowledge on the use of ICT could impede the impact of ICT in quality service delivery. This could be deduced from the findings that ICT improves collaboration and clinical decision support in facilitating clinical work flow integration among nurses and other medical professionals. Moreover, the findings above affirm the fact that without electricity, ICT infrastructure, insufficient skills and technical knowledge in dealing with ICT innovations, it is impossible to successfully adopt ICT resources in health care delivery. The above findings show that the majority of healthcare professional generally had a positive attitude towards ICT prospects as they rated their skill as fairly well. The study recommends that the Ministry of Health plays a supporting role by investing in health care ICT.

Management of hepatitis B and C in special population

Chronic viral hepatitis is one of the leading causes of cirrhosis worldwide.Chronic hepatitis B is more common in the Asia-Pacific region due to the larger population and lower screening availability.Hepatitis C predominates in the west due to injection drug abuse.The discovery of(oral)direct-acting antiviral agents(DAAs)has changed the landscape of chronic hepatitis C(CHC)management.Nucleos(t)ide analogs(NUCs)have also changed the approach to the treatment of chronic hepatitis B(CHB).Oral NUCs and DAAs have excellent efficacy and patient acceptance as well as a lower risk of resistance.However,certain populations have no robust data and safety and efficacy of such oral drugs is still evolving.In this review,we provide an overview of the management of CHB and CHC in special populations,such as those with chronic kidney disease,pregnant women,healthcare workers,and those undergoing chemo-or immunosuppressive therapy.

Physicians’Perspectives of Informed Consent for Medical Procedures:A Qualitative Interview Study

This work is based on an on-going research on medical informed consent in Papua New Guinea(PNG)with 19 doctors from hospitals,health care centers and private medical establishments in the National Capital District and Central Province who voluntarily participated in the study.The authors conducted an examination of doctors’understanding of informed consent for medical procedures through a qualitative interview study and we describe our findings.We saw a need to involved patients in decision-making about their care,ethical imperative and concerns about litigation and their complaints highlighted the issue of informed consent.In order for the patients to make an informed decision about medical procedure,the doctors involved in the proposed treatment should conduct the informed consent discussion.The discussion should include the treatment,the risks and benefits of treatment,and alternative therapies with associated risks and benefits.We studied doctors’perspectives of gaining informed consent for routine medical procedures.We used qualitative study methods using structured interviews selected by purposive sampling.The data collected were entered into a data base and were analyzed thematically.The discussion is based on review of legal decisions,commentaries and our personal experience in studying medical malpractice cases.We have utilized case reports and several informative writings that have appeared in the world literature,as well as selections from vast amounts of material available in USA,UK,Australia,India and PNG.The current informed consent processes do not appear to be ideal for many doctors in PNG.In particular,there are inhibiting factors that affect patients from making medical informed decisions,doctors find time not enough to run discussions on informed consent,Department of Health does not have a standard informed consent form,patients complain about no consent form,and they have not signed consent forms.These are but some issues that affect patients when trying to make informed decisions.We say that informed consent process flows from the relationship between doctor and patient,however when this does not occur,serious legal and ethical consequences may result.This report is not intended to be specific advice on any private legal matter.

Protection of Childhood in Greece

The early childhood care is important not only for individual Greek children and families but also for Greek society at large. Furthermore, it needs to be secured that the burden of labour and the raising of child is not only a woman＇s duty. There is a broad recognition that a strategy for developing early childhood services and childcare to support mother＇s labour force participation is in the public interest and should be the primary scope of the national health and social care policy. The inadequate organization of the child welfare system has adverse effects on the well-being, and function of the family. Only the improvement of the expected protection can lead to social politics that will give a chance to mother and child to live in conditions fitting human value and dignity. Herein, we presented the regulations and services along with health care professionals that refer to the protection of child in Greece.

Awareness Status of Chronic Disabling Neurological Diseases among Elderly Veterans

Background：The awareness,treatment and prevention of chronic diseases are generally poor among the elderly population of China,whereas the prevention and control of chronic diseases in elderly veteran communities have been ongoing for more than 30 years.Therefore,investigating the awareness status of chronic disabling neurological diseases （CDND） and common chronic diseases （CCD） among elderly veterans may provide references for related programs among the elderly in the general population.Methods：A cross-sectional survey was conducted among veterans ≥60 years old in veteran communities in Beijing.The awareness of preventive strategies against dementia,Alzheimer＆#39;s disease （AD）,Parkinson＆#39;s disease （PD）,sleep disorders,cerebrovascular disease （CVD） and CCD such as hypertension,and the approaches used to access this information,including media,word of mouth （verbal communication among the elderly） and health care professionals,were investigated via face-to-face interviews.Results：The awareness rates for CCD and CVD were approximately 100%,but that forAD was the lowest at 〈10%.The awareness rates for sleep disorders,PD and dementia,were 51.0-89.4%.Media was the most commonly selected mode of communication by which veterans acquired knowledge about CCD and CVD.Media was used by approximately 80% of veterans.Both health care professionals and word of mouth were used by approximately 50% of veterans.With respect to the source of information about CDND excluding AD,the rates of the use of health care professionals,word of mouth and media were 10.6-28.2%,56.5-76.5%,and approximately 50%,respectively.Conclusions：The awareness of CDND among elderly veterans was significantly lower than that of CCD.More information about CDND should be disseminated by health care professionals.Appropriate guidance will promote the rapid and extensive dissemination of information about the prevention of CDND by media and word-of-mouth peer education.