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Background: The academic clinician-educator (CE) often has a career spanning 40 or more years. Retirement represents the last stage of one's professional identity. Planning for retirement can be both exciting and challenging. Although it would seem reasonable that there would be research addressing the transition to retirement that incorporates guidance on important decisions or pathways to retirement with outcomes related to satisfaction, adjustment, or fulfillment in retirement, in fact, there is minimal such research. As CEs, the recently retired authors have drawn on our experiences in pediatrics as the foundation for our inquiry. The authors suggest that retirement decisions and needs differ in academic health center (AHC) faculty from those in health-care private practice. As an example, we suggest that CEs in all specialties, and likely other senior faculty in the health sciences, may have unique opportunities in retirement to enrich their institutions and their specialty organizations. The gaps we have encountered and our experiences in the retirement process have resulted in this paper, in which we encourage research that will inform more substantial, timely, and practical advice going forward. Methods: Our exploration of retirement from AHC careers includes two foci: (1) A review of relevant literature on retirement issues the CE, AHC, and national educator organizations might consider important in this transition process; and (2) the description of a theoretical framework known as Conservation of Resources Theory simply to help organize perspectives on the losses, gains, or conservation of tangible and intangible resources to weigh in the planning and transition process. Results: Several considerations relevant to retirement planning, both specific to academic faculty retirement in the health sciences and to retirement planning more broadly, emerged from our literature exploration. However, there were virtually no studies addressing these considerations, both personal and professional, accompanied by tracking their impact on satisfaction or well-being once in retirement. Discussion: Emerging from our examination of literature and our experiences in transitioning to retirement are a number of questions deserving of further study, likely in longitudinal, comparative or more broadly in global inquiries, in the effort to develop models to guide the retiring academic CE. Over the next decade, there will be so many faculty members considering or negotiating retirement that there is an urgent need to develop and study models that both inform this process and monitor outcomes in terms of satisfaction with the retirement years. [ABSTRACT FROM AUTHOR]

Purpose: End-of-life (EOL) care is a vulnerable period in an individual’s life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient’s wishes. The aims of our study were to assess HPs’ knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care. Methods: We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections: knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index. Results: Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers. Conclusion: Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area. [ABSTRACT FROM AUTHOR]

Background: Patient Reported Outcomes Measures (PROMs) are being used increasingly to measure health problems in stroke clinical practice. However, the implementation of these PROMs in routine stroke care is still in its infancy. To understand the value of PROMs used in ischemic stroke care, we explored the patients' experience with PROMs and with the consultation at routine post-discharge follow-up after stroke. Methods: In this prospective mixed methods study, patients with ischemic stroke completed an evaluation questionnaire about the use of PROMs and about their consultation in two Dutch hospitals. Additionally, telephone interviews were held to gain in-depth information about their experience with PROMs. Results: In total, 63 patients completed the evaluation questionnaire of which 10 patients were also interviewed. Most patients (82.2–96.6%) found completing the PROMs to be feasible and relevant. Half the patients (49.2–51.6%) considered the PROMs useful for the consultation and most patients (87.3–96.8%) reported the consultation as a positive experience. Completing the PROMs provided 51.6% of the patients with insight into their stroke-related problems. Almost 75% of the patients found the PROMs useful in giving the healthcare provider greater insight, and 60% reported discussing the PROM results during the consultation. Interviewed patients reported the added value of PROMs, particularly when arranging further care, in gaining a broader insight into the problems, and in ensuring all important topics were discussed during the consultation. Conclusions: Completing PROMs appears to be feasible for patients with stroke attending post-discharge consultation; the vast majority of patients experienced added value for themselves or the healthcare provider. We recommend that healthcare providers discuss the PROM results with their patients to improve the value of PROMs for the patient. This could also improve the willingness to complete PROMs in the future. [ABSTRACT FROM AUTHOR]

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Background: The FROM-16 is a generic family quality of life (QoL) instrument that measures the QoL impact of patients' disease on their family members/partners. The study aimed to assess the responsiveness of FROM-16 to change and determine Minimal Important Change (MIC). Methods: Responsiveness and MIC for FROM-16 were assessed prospectively with patients and their family members recruited from outpatient departments of the University Hospital Wales and University Hospital Llandough, Cardiff, United Kingdom. Patients completed the EQ-5D-3L and a global severity question (GSQ) online at baseline and at 3-month follow-up. Family members completed FROM-16 at baseline and a Global Rating of Change (GRC) in addition to FROM-16 at follow-up. Responsiveness was assessed using the distribution-based (effect size-ES, standardized response mean -SRM) and anchor-based (area under the receiver operating characteristics curve ROC-AUC) approaches and by testing hypotheses on expected correlation strength between FROM-16 change score and patient assessment tools (GSQ and EQ-5D). Cohen's criteria were used for assessing ES. The AUC ≥ 0.7 was considered a good measure of responsiveness. MIC was calculated using anchor-based (ROC analysis and adjusted predictive modelling) and distribution methods based on standard deviation (SD) and standard error of the measurement (SEM). Results: Eighty-three patients with 15 different health conditions and their relatives completed baseline and follow-up questionnaires and were included in the responsiveness analysis. The mean FROM-16 change over 3 months = 1.43 (SD = 4.98). The mean patient EQ-5D change over 3 months = −0.059 (SD = 0.14). The responsiveness analysis showed that the FROM-16 was responsive to change (ES = 0.2, SRM = 0.3; p < 0.01). The ES and SRM of FROM-16 change score ranged from small (ES = 0.2; SRM = 0.3) for the distribution-based method to large (ES = 0.8, SRM = 0.85) for anchor-based methods. The AUC value was above 0.7, indicating good responsiveness. There was a significant positive correlation between the FROM-16 change scores and the patient's disease severity change scores (p < 0.001). The MIC analysis was based on data from 100 family members of 100 patients. The MIC value of 4 was suggested for FROM-16. Conclusions: The results of this study confirm the longitudinal validity of FROM-16 which refers to the degree to which an instrument is able to measure change in the construct to be measured. The results yield a MIC value of 4 for FROM-16. These psychometric attributes of the FROM-16 instrument are useful in both clinical research as well as clinical practice. [ABSTRACT FROM AUTHOR]

Background: Family, the child's first environment, shapes their psycho-emotional balance. The literature links adolescent anxiety to family relationships, interactions, and dynamics. The self-esteem of adolescents appears to protect their mental health. Goal: This study examines whether family cohesion and adaptability affect adolescent anxiety symptoms. It also examines whether teen self-esteem mediates this relationship. Method: This cross-sectional, descriptive study included 166 Attica youth aged 12–18 from schools and educational units. The adolescents completed Olson's FACES-III cohesion and adaptability scale, Spielberger's STAI-C, Rosenberg's self-esteem scale, and a socio-demographic questionnaire. Results: Family cohesion, but not adaptability, was negatively correlated with state (rho = −0.25, p = 0.001) and trait (rho = −0.46, p < 0.001) anxiety in the adolescents. Teenagers from extreme families with the lowest cohesion and adaptability had higher trait anxiety (x2(2) = 6.91, p = 0.032) than those from moderately balanced/balanced families. Self-esteem mediated the relationship between the family cohesion functioning and adolescent's state anxiety (p = 0.005) and trait anxiety (p = 0.011). Conclusions: The findings show that family dysfunction negatively impacts adolescent anxiety, as well as their self-esteem, which protects mental balance. [ABSTRACT FROM AUTHOR]

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics. [ABSTRACT FROM AUTHOR]

Background: Ensuring patient safety is of paramount importance in healthcare services. Sleep disorders not only have detrimental effects on the health of healthcare students but also significantly impair their performance, leading to an increased risk of medication errors. These errors can pose a grave threat to the safety and well-being of patients. It is crucial to address and mitigate sleep disorders among internship healthcare students to safeguard the quality of care and minimize potential patient harm. Objectives: This study aimed to investigate the predictors of Patient Safety Competency (PSC) based on the sleep quality of internship healthcare students. Methods: A study was conducted on 331 students from the Ardabil School of Nursing and Midwifery at Ardabil University of Medical Sciences in northwest Iran from August to December 2022. The participants were selected by stratified random sampling. Data were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Health Professional Education in Patient Safety Survey (H-PEPSS). The collected data were analyzed using SPSS software version 22.0. Person correlation coefficients were used to examine the relationship between PSC level, its dimensions, and sleep quality, while multiple linear regression was conducted to identify the predictors of PSC. Results: The competency of nurses in patient safety was average in both classroom and clinical settings. However, their ability to work as a team with other healthcare professionals scored the lowest. In addition, the quality of sleep was found to be a predictor of patient safety competency among healthcare students during their internships. Conclusions: It is important to note that healthcare students tend to have moderate patient safety competence (PSC), which is positively correlated with their sleep quality. Therefore, it is vital to identify the key factors that directly affect PSC. This would enable nursing and midwifery faculty administrators to take preventive measures to enhance patient safety competence in both classroom and clinical settings. Additionally, organizing educational workshops that engage students and improve their sleep quality could improve patient care. Practical courses are recommended for health professionals and students in clinical settings to enhance patient safety competencies. Additionally, student internships should receive hands-on training to improve teamwork and rest conditions. [ABSTRACT FROM AUTHOR]

Background: This study investigated the online information-seeking behaviours of breast cancer patients at Jordan University Hospital, focusing on their dissatisfaction with available online health resources and its impact on their well-being and anxiety levels. Methods: Employing descriptive phenomenology and convenience sampling, we conducted five Skype-based focus groups with 4-6 breast cancer survivors each, from March to July 2020. Data analysis was performed using NVivo, following Braun and Clark's inductive thematic analysis framework. Results: The thematic analysis revealed critical insights into survivors' interactions with online cancer resources, identifying key subthemes such as the quality of online information, cyberchondriasis, health literacy and search strategies, the distress caused by counterproductive searches, and the tendency to avoid internet searches. Conclusion: The study underscores the challenges breast cancer survivors face in accessing online health information, especially in Arabic. It highlights the need to improve the quality and accessibility of these resources. Enhancing the cultural relevance of online materials and educating patients on effective information evaluation are crucial. These measures can significantly boost health literacy, mitigate anxiety, and provide better support for breast cancer survivors. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICUs) are often too noisy, exceeding 70–80 dBA, which can have negative effects on staff. The corresponding recommendation of the World Health Organization (average sound pressure level below 35 dBA) is often not achieved. To date there is a lack of intervention studies examining the extent to which unit-based noise management in ICUs contributes to a reduction in noise exposure for the staff. The study therefore aims to provide answers to 1) how unit-based noise management sustainably reduces the subjective noise exposure among staff, and 2) how this intervention affects other noise-related topics. Methods: We performed a monocentric prospective longitudinal study with three measurement points in a German university hospital in three ICUs. We collected data from different healthcare professionals and other professional groups between October 2021 and August 2022 using an online questionnaire. Data were analyzed using descriptive and inference statistics. Results: A total of n = 179 participants took part in the surveys. The majority of participants were nurses or pediatric nurses. Most participants worked more than 75% full-time equivalent. Staff on the three ICUs reported high levels of noise exposure. No significant changes in noise exposure over time were observed. Participants were already aware of the topic and believed that a behavior change could positively influence the noise environment. Conclusions: This study provides an initial insight into how a unit-based noise management could contribute to a reduction in the subjective noise exposure among staff in ICUs. The results of this study highlight the importance of this topic. Future studies should aim to research aspects of adherence and their facilitators or barriers, which promote the sustained implementation of noise-reducing measures by staff. Trial registration: German Clinical Trials Register (DRKS): DRKS00025835; Date of registration: 12.08.2021. [ABSTRACT FROM AUTHOR]

Developing an anesthesia module in the operating room is one of the significant steps toward the implementation of electronic medical records (EMR) in health care centers. This study aimed to develop and evaluate the web based-anesthesia module of an electronic medical record Sciences, in the operating room of the Namazi Medical Training Center of Shiraz University of Medical Iran. This developmental and applied study was conducted in steps including determining the functional and non-functional requirements, designing and implementing the anesthesia module, and usability evaluation. 3 anesthesiologists, 3 anesthesiologist assistants, and 12 anesthetist nurses were included in the study as a research community. React.js, Node.js programming language to program this module, Mongo dB database, and Windows server for data management and USE standard questionnaire were used. In the anesthesia module, software quality features were determined as functional requirements and non-functional requirements included 286 data elements in 25 categories (demographic information, surgery information, laboratory results, patient graphs, consults, consent letter, physical examinations, medication history, family disease records, social record, past medical history, type of anesthesia, anesthesia induction method, airway management, monitoring, anesthesia chart, blood and fluids, blood gases, tourniquets and warmers, accessories, positions, neuromuscular reversal, transfer the patient from the operating room, complications of anesthesia and, seal/ signature). Also, after implementing the anesthesia module, results of the usability evaluation showed that 69.1% of the users agreed with the use of this module in the operating room and considered it user-friendly. [ABSTRACT FROM AUTHOR]

Background: The chiropractic profession in the United States (US) has a long history of intra-professional discourse surrounding ideology and beliefs. Large-scale efforts have evaluated 3 distinctive subgroups of US chiropractors focused on these areas of practice: spine/neuromusculoskeletal, primary care, and vertebral subluxation. To our knowledge, there have not been any prior studies exploring the factors associated with these ideology and belief characteristics of these subgroups. The purpose of this study was to explore, describe, and characterize the association of US chiropractors' ideology, beliefs, and practice patterns with: 1) chiropractic degree program of graduation, 2) years since completion of chiropractic degree, and 3) US geographic region of primary practice. Methods: This was a secondary analysis of a cross-sectional survey of a random sample of US licensed chiropractors (n = 8975). A 10% random sample was extracted from each of the 50 states and District of Columbia chiropractic regulatory board lists. The survey was conducted between March 2018-January 2020. The survey instrument consisted of 7 items that were developed to elicit these differentiating ideologies, beliefs, and practice patterns: 1) clinical examination/assessment, 2) health conditions treated, 3) role of chiropractors in the healthcare system, 4) the impact of chiropractic adjustments [spinal manipulation] in treating patients with cancer, 5) vaccination attitudes, 6) detection of subluxation on x-ray, and 7) x-ray utilization rates. Multinomial regression was used to analyze associations between these 7 ideology and practice characteristic items from the survey (dependent variables) and the 3 demographic items listed above (independent variables). Results: Data from 3538 respondents (74.6% male) were collected with an overall response rate of 39.4%. Patterns of responses to the 7 survey items for ideologies, beliefs, and practice characteristics were significantly different based on chiropractic degree program of graduation, years since completion of chiropractic degree, and geographic region of primary practice. Conclusions: Among US chiropractors, chiropractic program of graduation, years since completion of chiropractic degree, and geographic region of primary practice are associated with variations in clinical ideology, beliefs, and practice patterns. The wide variation and inconsistent beliefs of US chiropractors could result in public confusion and impede interprofessional integration. [ABSTRACT FROM AUTHOR]

Introduction: Prevention of acquired immune deficiency syndrome (AIDS) requires proper awareness and attitude towards the disease, and ways of transmission and prevention. This study aimed to investigate the awareness and attitude of students at Kurdistan University of Medical Sciences and University of Kurdistan towards AIDS in 2020. Material and methods: This was cross-sectional, descriptive-analytical study. The study population was students at Kurdistan University of Medical Sciences (MUK) and University of Kurdistan (UOK) in 2020. 369 students were selected based on relative sampling. Data collection tool was international AIDS questionnaire (IAQ). Independent t-test and analysis of variance were applied for analysis. Results: The total IAQ score among students of MUK (75.38 ± 7.66) was higher than that of UOK students (71.17 ± 8.52) (p = 0.023). Although the total score in men (74.04 ± 8.14) was slightly higher than women (72.71 ± 8.50), there was no significant difference (p = 0.13). The difference in the scores of students living in single house with students living with their parents (p = 0.002) and students living in dormitories (p = 0.006) was statistically significant. The average score of undergraduates was the lowest, and doctorates the highest (p = 0.035). Conclusions: In light of the need to increase the awareness of ways of AIDS transmission, and appropriate attitudes towards people living with HIV/AIDS, with a focus on non-medical students, schemes should be designed and implemented to raise awareness and attitudes among people. [ABSTRACT FROM AUTHOR]

Although biomedical research requires cooperation with a large number of donors, its success also depends on the input of healthcare professionals who play a crucial role in promoting biomedical research and influencing an individual's decision to donate one's biospecimens that are left over after a medical procedure. This work was aimed at investigating the correlation between medical and healthcare students' willingness to donate a biospecimen, the type of tissues to be donated, and the type of biomedical research to be conducted. A population survey among medical and healthcare students enrolled at the Poznan University of Medical Sciences was conducted on their attitudes toward the donation of human biological material for research purposes. A total of 1500 students responded and completed the survey. The questionnaire used multiple-choice closed-ended questions designed to explore medical and healthcare students' preferences for sharing particular types of tissues and donating to a particular type of biomedical research. It asked three questions: 1. Which type of tissue would people be willing to donate for research purposes? 2. Which organs would they be willing to donate after death? 3. What type of research would they be willing to donate to? While future healthcare professionals' beliefs regarding certain types of tissues and research can influence their willingness to donate for research purposes, many students tend to think about the body and biomedical research in terms of clusters. Consequently, their willingness to donate certain tissues for a particular type of research can affect their decision to donate other tissues. Our data suggest that cluster thinking with regard to donation can be a predictor of people's readiness to participate in the collection and management of biospecimens. [ABSTRACT FROM AUTHOR]

Introduction: The quality of care and patient satisfaction is closely linked with dignity, which is a crucial component of therapy and care. However, there is very little study on dignity in the context of mental health care. Planning for ongoing patient care might benefit from an understanding of the notion of dignity by exploring the experiences of patients, caregivers and companions of patients who have a history of hospitalization in mental health institutions. To retain patients' dignity while they were being treated in mental wards, this study sought to understand the experiences of patients, caregivers and companions of patients. Materials and Methods: This investigation was qualitative. Semistructured interviews and focus groups were utilized to collect the data. The purposeful sampling method was employed for participant recruitment, which continued until data saturation. Two focus group discussions and 27 interviews were conducted. Participants included 8 patients, 2 patients' family members (companions), 3 psychologists, 4 nurses and 11 psychiatrists. Two focus group discussions were held with seven family members or companions of patients. Thematic analysis was used for data analysis. Results: The primary theme that emerged was the infringement of patients' dignity, through negative guardianship, dehumanization and violations of their rights. Subthemes included dehumanization, worthlessness and namelessness, patient rights violations and stripping patients of authority. Conclusion: Our results suggest that, regardless of the severity of the illness, the nature of psychiatric illness significantly compromises patients' dignity. Mental health practitioners, due to their sense of guardianship, may unintentionally treat patients with mental health disorders, thus compromising the patient's dignity. Patient or Public Contribution: The research team's experiences as a psychiatrist, doctor and nurse informed the study's objectives. Nurses and psychiatrists who work in the healthcare industry designed and conducted the study. The primary authors, who are healthcare providers, collected and analysed the required data. Furthermore, the entire study team contributed to the writing of the manuscript. Study participants were involved in the data collection and analysis. [ABSTRACT FROM AUTHOR]

Background: Patient-centeredness is a core element in healthcare. However, there is a gap between the understanding of this term by healthcare professionals, and patients' capability, self-efficacy, and willingness to take part in medical decisions. We aim to expose standpoints toward "patient centeredness" among junior medical managers (JMM), as they bridge between policy strategies and patients. We try to reveal cultural differences by comparing the views of the majority and the minority subpopulations of Israel (Arabic and Hebrew speakers). Methods: A cross-sectional survey among JMM studying for an advanced degree in health-system management at three academic training colleges in Israel was conducted in February–March 2022. The respondents completed a structured questionnaire comprising four sections: a) perceptions of trust, accountability, insurance coverage, and economic status; b) perceptions regarding decision-making mechanisms; c) preferences toward achieving equity, and d) demographic details. Results: A total of 192 respondents were included in the study—50% Hebrew speakers and 50% Arabic speakers. No differences were found between Arabic and Hebrew speakers regarding perception of trust, accountability, insurance coverage, and economic status. JMM from both subpopulations believed that patients' gender and age do not influence physicians' attitudes but Arabic-speaking respondents perceived that healthcare professionals prefer educated patients or those with supportive families. All respondents believed that patients would like to be more involved in medical decisions; yet Arabic-speakers perceived patients as tending to rely on physicians' recommendations while Hebrew speakers believed that patients wish to lead the medical decision by themselves. Conclusions: Patient-centeredness strategy needs to be implemented bottom-up as well as top-down, in a transparent nationwide manner. JMM are key actors in carrying out this strategy because they realize policy guidelines in the context of social disparities, enabling them to achieve a friendly personalized dialogue with their patients. We believe that empowering these JMM may create a ripple effect, yielding a bottom-up perception of equity and initiating change. [ABSTRACT FROM AUTHOR]

Although an increased usage and development of 3D technologies is observed in healthcare over the last decades, full integration of these technologies remains challenging. The goal of this project is to qualitatively explore challenges, pearls, and pitfalls of AR/VR/3D printing applications usage in the medical field of a university medical center. Two rounds of face-to-face interviews were conducted using a semi-structured protocol. First an explorative round was held, interviewing medical specialists (8), PhD students (7), 3D technology specialists (5), and university teachers (3). In the second round, twenty employees in high executive functions of relevant departments were interviewed on seven statements that resulted from the first interviewing round. Data analysis was performed using direct content analyses. The first interviewing round resulted in challenges and opportunities in 3D technology usage that were grouped in 5 themes: aims of using AR/VR/3D printing (1), data acquisition (2), data management plans (3), software packages and segmentation tools (4), and output data and reaching end-user (5). The second interviewing round resulted in an overview of ideas and insights on centralization of knowledge, improving implementation of 3D technology in daily healthcare, reimbursement of 3D technologies, recommendations for further studies, and requirement of using certified software. An overview of challenges and opportunities of 3D technologies in healthcare was provided. Well-designed studies on clinical effectiveness, implementation and cost-effectiveness are warranted for further implementation into the clinical setting. [ABSTRACT FROM AUTHOR]

Context: Empathy and self-esteem are essential in delivering quality health care, particularly for women in labor and giving birth. Aims: The aim of this study was to determine the empathy quotient and self-esteem of the second-year and final-year medical and nursing students and labor room staff. Settings and Design: This cross-sectional study was conducted at a teaching hospital in southern India between September and December 2021. Materials and Methods: The inclusion criteria for the study were (i) nursing or medical students currently in their second or final year and (ii) obstetrician or nursing officer or intern currently posted in the labor room. Empathy quotient and self-esteem were measured using the Cambridge Behavioral Scale and Rosenberg's Self-Esteem Scale, respectively. Statistical Analysis Used: The scale scores were summarized as mean (standard deviation), percentages, and 95% confidence intervals. The association between empathy quotient, self-esteem, age, gender, designation, and experience duration was analyzed. We performed multivariable analysis using binary logistic regression. P <0.05 was considered statistically significant. Results: Of the 400 participants included in the study, 36.8% (42.7% - medical, 26.2% - nursing personnel) had lower than average empathy quotient scores, and 13.3% (18.4% - medical, 4.1% - nursing personnel) had low self-esteem. Self-esteem had a statistically significant, independent effect on empathy quotient, as noted in the multivariable analysis among medical and nursing personnel. There was a significant difference between empathy quotient and self-esteem scores in medical and nursing personnel across various designations (P < 0.05). Conclusion: A third of the participants had empathy quotient ratings that were below average, and one-eighth of participants had low self-esteem. Self-esteem and empathy quotient are interdependent; hence has to addressed together. The empathy quotient and self-esteem vary across different designations emphasising the need to take measures to nurture it. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the level of knowledge, positive intentions, and attitudes regarding breastfeeding among university students. A validated questionnaire collected data from 236 students of the Faculty of Dental Medicine and Health Osijek about breastfeeding intentions, attitudes, and knowledge. Descriptive methods were used to present the students' results in terms of their intentions, attitudes, and knowledge. For each question included in the questionnaire, the maximum possible and maximum achieved numbers of points were calculated, as well as the percentage of points achieved in relation to the maximum possible number. Correlations between the results on individual scales of the questionnaire and the total results of the questionnaire are shown by Spearman's correlation coefficient. Questionnaire answers that were least in line with professional recommendations were selected and analyzed. We found that the areas that should be given special attention in the education of students are: the intention of breastfeeding for more than a year; the use of breaks for breastfeeding in the workplace; attitudes and knowledge about the quality of breast milk in relation to substitutes; attitudes about breastfeeding in public places and breastfeeding for more than two years; and the feeling of maternity and breastfeeding (compared to bottle feeding). The relationship between the results was considered in terms of intentions, attitudes, and knowledge in relation to the overall results of the questionnaire, and the authors' thoughts on the reasons behind the poorer results achieved for certain questions were presented. [ABSTRACT FROM AUTHOR]

Background: Resilience, a person's ability to adapt to adverse events, is associated with positive outcomes, especially in the field of healthcare. Research into the effects of the COVID-19 pandemic may help to understand and combat the long-term mental health burden for trainees in health care. Objective: This cross-sectional study aimed to assess the impact of the pandemic on health profession students' educational experiences, determine the association between their self-reported resilience and psychological distress and assess group differences between students from different graduate health profession programs in an academic medical center. Methods: Graduate health profession students completed a 44-question online survey and the 10-item Connor Davidson Resilience Scale (CD-RISC-10) during the COVID-19 pandemic period between January-March 2021. We used descriptive statistics, independent samples t test, Related-samples Wilcoxon signed rank test, Pearson correlations test and Analysis of variance (ANOVA) to analyze the data. Results: Majority of respondents reported that COVID-19 had a negative impact on their education and caused a reduction in educational opportunities (76.6% and 73% respectively). Majority also reported feeling burned out, lonely/isolated, or frustrated by COVID-19 restrictions (70.0%, 67.4%, and 61.8% respectively). Students reported increased use of both avoidant and adaptive coping strategies during the pandemic. Higher resilience scores were associated with higher self-reported stress, fewer burnout symptoms, and better overall well-being. Conclusion: The COVID-19 pandemic significantly affected students in graduate health profession programs. Instructional quality, educational opportunities, institutional trust, peer socialization, and personal health and wellbeing were perceived to be negatively impacted. Students may require additional support and resources from their training programs to mitigate these concerns. Future studies should evaluate the long-term impact of the COVID-19 pandemic among pandemic-era graduate health profession students. [ABSTRACT FROM AUTHOR]

Background: Simulation and role-playing are the most commonly used experiential teaching methods in nursing education. The purpose of the study was to describe the impact of geriatric role-play workshops on the knowledge and skills of nursing students. We set one hypothesis: Students believe that learning through experiential role-play improves their professional competencies. Methods: We conducted a descriptive quantitative study, collecting the data with a questionnaire. The study included 266 first-year nursing students who underwent 10 h of role-playing workshops in geriatric nursing in 2021. The questionnaire was compiled for the purpose of the present study, and its' internal consistency was 0.844 (n = 27). We used descriptive and correlation statistical analysis. Results: Respondents were convinced that they gained and consolidated knowledge and connected theory with practice through role-playing. They especially emphasized the abilities they acquired to communicate in a group, engage in constructive reflection, be more sensitive to one's own emotions, and feel empathy. Conclusions: Respondents understand the use of the role-play method as an effective form of learning in geriatric nursing. They are convinced that they will be able to use the experience when working with an elderly patient in a clinical setting. [ABSTRACT FROM AUTHOR]

Objective: To determine the degree of psychological stress in undergraduate dental students & explore related gender variation. Methods: 100 5th-year dental students at Al-Rafidain University College (RUC), Iraq, participated in the study by completing The Modified Dental Environment Stress Questionnaire (DES). Results: The primary sources of stress were found to be Completing the clinical requirement, the Atmosphere created by the clinical supervisors, Full working day, Patients being late or not showing up for their appointments, Difficulty in learning precision manual skills required for clinical and laboratory work, examination, and grades & fear of unemployment. The highest score source was (patients being late or not showing), followed by (examination and grades). Regarding gender differences, the (Full working day) was the highest stressor item for the male student's team, while female students chose (Atmosphere created by clinical supervisors) as their top stressor. Conclusion: The highest perceived sources of stress reported by students should be further explored by longitudinal studies, and strategies to minimize the resulting stress should be developed and implemented since psychological stress in study years of dentistry predicts occupational stress later. [ABSTRACT FROM AUTHOR]

Aim: This study determined the prevalence and key determinants of burnout among nurses and midwives in Kumasi, Ghana. Design: Hospital‐based cross‐sectional study. Method: A questionnaire was used to obtain data from 391 nurses and midwives at a tertiary hospital in Kumasi, Ghana using simple random sampling. Results: About 84.4% of the participants were females. The majority of the study participants experienced low burnout for all dimensions (58% in emotional exhaustion, 55.5% poor personal accomplishment and 38.3% depersonalization). Multiple regression analysis revealed that high emotional exhaustion was independently predicted by post‐graduate education (β = 6.42, p =.003), lack of support from management (β = 2.07, p =.024), dislike for leadership style, (β = 3.54, p <.001) and inadequate number of staff (β = 2.93, p =.005). Age (β = 0.35, p =.004), lack of support from management (β = 1.60, p =.012), and inadequate number of staff (β = 1.49, p =.034) independently predicted high depersonalisation. Female sex (β = 4.36, p <.001) and years of practice (β = −0.26, p <.001) independently predicted low personal accomplishment. [ABSTRACT FROM AUTHOR]

Adequate health literacy is essential to navigate the healthcare system and has a major role in peri-operative care and outcomes. Minimal information exists regarding surgeons' understanding of health literacy, clinical implications, and awareness of universal measures of support. This study assessed Canadian surgeons' perceptions of patients' health literacy and their knowledge of available supportive resources. We conducted a cross-sectional study using an electronic survey distributed to surgeons at academic institutions. Data collected included sociodemographics, health literacy knowledge, and practice surrounding the use of supportive measures. Across four Canadian academic institutions (University of Toronto, McMaster University, University of Alberta, and University of Calgary), 35 surgeons from various surgical specialties, including general, plastic, and orthopedic surgery, completed the survey. Approximately 74% of surgeons reported familiarity with the concept "health literacy", but they used general impressions to estimate their patients' health literacy levels. Surgeons' perceptions were that patients who had proficient health literacy represented 50% or less of their practice. However, knowledge of supportive tools for measuring patient health literacy was variable. Surgeons familiar with health literacy spent significantly more time (>15 minutes) counselling patients (38%, p=0.02) and used language at a 10th grade level or less (92%, p=0.04). Common supportive measures included using simple, non-medical terms (97%, n=34), repetition (83%, n=29), and drawing pictures/diagrams (83%, n=29). This study highlights the importance of surgeon awareness of health literacy and how improved awareness may guide patient-surgeon interactions and improve the quality of care. [ABSTRACT FROM AUTHOR]

Background: Healthcare systems may be resilient and adaptive, but they are not fit for purpose in their current state. Increasing threats to health system sustainability have underscored the need to move towards a learning health system in which research and data are used routinely in clinical practice to facilitate system improvement. This study aimed to establish which elements of the learning health system were being realised within a university-based general practice and determine acceptability from staff to embrace further the transition towards a learning health system. Methods: Semi-structured interviews were conducted with practice staff, including clinical and administrative staff, to determine the current state of the learning health system in the practice. An embedded researcher was placed within the general practice on a part-time basis to investigate the learning health system model. Interviews were transcribed and thematically analysed based on the National Academy of Medicine's framework of learning health systems. Results: In total, 32 (91%) practice staff were interviewed, comprising general practitioners (n = 15), nurses (n = 3), administrative staff (n = 13), and a psychologist (n = 1). Participants indicated that the practice was operating with several characteristics of a learning health system (e.g., emphasising science and informatics; focusing on patient-clinician partnerships; applying incentives; supporting a continuous learning culture; and establishing structures and governance for learning). These measures were supported by the university-based setting, and resultant culture of learning. Nevertheless, there were areas of the practice where the learning health system could be strengthened, specifically relating to the use of patient data and informatics. Staff generally expressed willingness to engage with the process of strengthening the learning health system within their practice. Conclusion: Although the idea of a learning health system has been gaining traction in recent years, there are comparatively few empirical studies presented in the literature. This research presents a case study of a general practice that is operating as a learning health system and highlights the utility of using the learning health system framework. [ABSTRACT FROM AUTHOR]

Managing type 1 diabetes involves coordinating complex daily behaviors that may rely on the cognitive abilities of people with diabetes (PWD) and spouses, especially as couples collaborate surrounding diabetes care. The aims of the study were to examine whether 1) the cognitive abilities of PWD and their spouses predicted lower A1C, 2) collaborating with a spouse with higher cognitive abilities was especially beneficial for PWD with lower cognitive abilities, and 3) the benefit of the cognitive abilities of PWD and their spouse occurred through better self-care. Couples (n = 199) were recruited with one member diagnosed with type 1 diabetes (PWD 52% female sex, average age 46.81 years, average duration of diabetes 27 years; spouses 48% female sex; average age 46.40 years). PWD and spouses completed fluid (trail making tests from the Delis-Kaplan Executive Function System) and crystallized (information subtest from the Wechsler Adult Intelligence Scale—4th Edition) ability tests. PWD rated their spouse's collaboration in diabetes and reported self-care behaviors through surveys. A1C was assessed as a measure of blood glucose through a blood assay. Multiple regressions revealed that spouses' crystallized ability was the only statistically significant predictor, with higher values associated with lower A1C (t = −2.17, P <0.05). The interaction of crystallized ability of PWD × spouse crystallized ability × collaboration indicated that PWD with lower ability tended to benefit more when they collaborated with a spouse who scored higher in ability (t = −2.21, P <0.05). Mediational analyses indicated that spouses' crystallized ability was associated with lower A1C through better self-care behaviors of PWD (B = 0.03, SE = 0.01, P <0.01). We conclude that PWD benefit from the cognitive abilities of their spouses through better self-care behaviors that are important for maintaining lower A1C across adulthood. [ABSTRACT FROM AUTHOR]

Background. During the coronavirus disease 2019 (COVID-19) pandemic, most hospitals have faced a heavy load of patients. In this situation, it is very important to consider the resilience and endurance of medical staff, as well as to identify and investigate the relevant factors which can increase their resilience. Objectives. The aim of this study was to identify the factors affecting the resilience of hospital medical staff during the COVID-19 pandemic. Material and methods. The present study is a qualitative study using a semi-structured interview. Participants included doctors, nurses, clinicians and managers working in tertiary referral hospitals during the COVID-19 pandemic. Interviews were conducted as needed until data saturation was reached using the purposive sampling method. A total number of 20 people, including 6 physicians, 2 hospital managers, 7 nurses, 1 radiologist, 3 laboratory technicians and 1 clinical psychologist, were interviewed in 7 educational hospitals of the Kerman Province. Results. After data analysis and coding, 127 initial codes were identified. By reviewing the codes, 127 initial codes were merged by the research team, and 23 codes in 6 main categories, including Personal Factors (7 codes), Family-Related Factors (2 codes), Community Related Factors (2 codes), Virus-Related Factors (2 codes), Organisational Factors (7 codes) and Economical Factors (3 codes) were extracted. Conclusions. Paying attention to the identified factors on the maintenance of medical human resources in the form of the “Surge Capacity Programme” can increase the resilience of medical staff. Such measures pave the way for a better response to other threats similar to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background. Primary health care physicians are at high risk of burnout. In addition, with the current conditions, they can have an effort-reward imbalance. However, studies on this topic concerning public primary health care (Puskesmas) physicians in Indonesia are still limited. Objectives. To assess whether the effort-reward imbalance among Puskesmas physicians is associated with two main burnout dimensions: emotional exhaustion and depersonalisation. Material and methods. This cross-sectional study surveyed physicians working in Puskesmas in Indonesia using the short version of the Effort-Reward Imbalance Questionnaire and Maslach Burnout Inventory-Human Services Survey questionnaires. Results. Of 226 physicians, 45.6% perceived high effort and low reward. A perceived effort-reward imbalance was higher among those working more than 40 hours weekly in work shifts and in urban areas. Significant predictors of emotional exhaustion included effortreward ratio (β = 0.426; p < 0.001), overcommitment (β = 0.393; p < 0.001) and working period at Puskesmas (β = - 0.122; p = 0.038). Predictors of depersonalisation include effort-reward ratio (β = 0.257; p -= 0.001), overcommitment (β = 0.170; p = 0.024), and night shift (β = 0.134; p -= 0.042). Conclusions. The effort-reward imbalance is significantly associated with emotional exhaustion and depersonalization. Therefore, it is important to set up the maximum working hours, balanced shift work arrangements, and standardized rewards for Puskesmas physicians. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The effect of the arrival day of the week, arrival time of the day, or discharge time of the day on emergency department (ED) patient experience (PE) scores has not been well studied. We performed a retrospective analysis of ED patients between July 1st, 2018 through March 31st, 2021. We recorded demographics, PE scores, arrival day, arrival and discharge times, and total ED and perceived ED times. We performed univariate and multivariable analyses. We sent 49,849 surveys and received back 2423 that we included in our study. The responding patients' median age was 52, with a majority of female gender (62%) and white race (57%). The average arrival time was 1:40 PM, and the average discharge time 2:38 PM. The average total ED time was 261 minutes, while the average perceived ED time was 540 minutes. We found a statistical association between worse PE scores and longer actual ED time but not longer perceived time. A later arrival time was significantly associated with worse PE scores on 4 out of 6 domains of the PE questionnaire. The discharge time and the day of the week were not significantly associated with PE scores. Conclusion: Actual longer ED time was significantly associated with worse PE scores, but not perceived time. Later arrival time was associated with worse PE scores, but not later discharge time. The arrival day of the week was not statistically associated with differences in PE. Further studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Introduction: Emergency department (ED) healthcare workers in Pakistan during the COVID-19 pandemic are facing an acute rise in mental illnesses. In this study, the authors aim to assess the frequency of anxiety and depression among healthcare workers in the ED. Methods: A cross-sectional online google form-based survey was conducted in the ED of Aga Khan University Hospital, Karachi, Pakistan between July and August 2020. The Hospital Anxiety and Depression (HAD) scale was used for mental illness assessment among ED healthcare workers. Descriptive analysis of grading as per the Likert scale is done through frequencies, means, and standard deviations. Categorical variables were expressed as frequency (%). Mann–Whitney U test was used to compare scores of various groups and sub-groups and the Chi-square test was used to assess the association of depression and anxiety categories among the groups. Results: In the ED, 127 healthcare workers (physicians and nurses) were included in this survey. The median depression score was 8 (IQR 6–10) with 21% (27) falling under depression and 39% (50) under borderline depression. The median anxiety score was 9 (IQR 7–12) with 33% (42) having abnormal, and 38% (48) having borderline anxiety. Healthcare workers working for > 45 h per week have odds of 3.62 [1.374–9.549] of developing depression compared to anxiety with a p-value of 0.009. Similarly, nurses and medical officers develop depression with odds of 2.18 [1.016–4.686] p-value 0.045 and 5.18 [0.197–1.02] p-value 0.002, respectively. Conclusion: ED healthcare workers during the COVID-19 pandemic suffered high levels of anxiety and depression, which is a matter of concern. Comprehensive support and training of ED healthcare workers are needed to promote physical and mental well-being and to develop guidelines that should be used during situations that can affect the mental health of healthcare workers. [ABSTRACT FROM AUTHOR]

Background: End-stage renal disease (ESRD) is a major chronic illness worldwide, and Taiwan reports one of the highest incidence rates of ESRD with 529 cases per million population (pmp). A number of patients with ESRD patients might require lifelong hemodialysis (HD) or peritoneal dialyses (PD). Due to the progression of dialysis, patients are likely to experience other chronic comorbidities, anxiety and depression, frequent hospitalizations, and higher rates of mortality compared to patients with other types of chronic illnesses. As a result, dialysis patients are prone to experience advance care planning (ACP) needs, such as whether they withdraw from receiving dialysis while approaching their end-of-life (EOL). Yet, existing studies have shown that dialysis patients seldom receive timely consultation regarding ACP and there are limited studies examining ACP amongst Taiwan HD patients. Purpose: The purpose of this study was to examine ACP awareness, contemplation, self-efficacy and readiness; and factors influencing ACP readiness. Design: This cross-sectional descriptive study with convenience sampling was conducted in the out-patient HD unit at a regional teaching hospital in southern Taiwan. A total of 143 ESRD patients undergoing HD treatments were recruited. A 55-item ACP engagement survey containing the subscales of awareness, contemplation, self-efficacy, and readiness was employed. The data were analyzed with t-tests, one-way ANOVAs, Pearson's correlations and multiple regressions. Results: The results of our investigation revealed that approximately half of the participants (n = 67, 46.9%) were not informed of ACP. Although they reported considering their EOL, medical decisions and desired care, they demonstrated significantly low self-efficacy in discussing ACP (t= -5.272, p < 0.001). HD duration influenced all four ACP subscales; religious beliefs significantly influenced ACP-self-efficacy and readiness; and marital status, education, and primary decision-maker status significantly influenced ACP-readiness. The predictors of ACP-readiness were high self-efficacy and being the primary decision-maker (Adjusted R2 61%). Conclusion: Most of the HD patients in this study had low ACP-awareness, contemplation, self-efficacy, and readiness, and most had not completed any ACP-related advance directives (AD). Healthcare professionals should proactively provide HD patients with ACP-related information and answer patients' and medical decision-makers' questions in a timely manner, thereby improving the quality of EOL care. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The COVID-19 pandemic and the consequent restrictive measures may be related to increased stress and anxiety and to changes in daily behaviors. Children with type 1 diabetes (T1D) are a vulnerable group due to their difficulties in achieving glycemic control and to their medical and psychological comorbidities. The purpose of the current study was to the investigate the changes on emotional and behavioral parameters in children with T1D due to the Coronavirus crisis. A total of 152 children and adolescents, aged 5–18, were studied: 114 (62 boys) with T1D and 38 (19 boys) healthy volunteers (HV) (controls). The study was performed at the Diabetes Center, Aghia Sofia Children's Hospital, during the first national lockdown in Greece. The CRISIS questionnaire was completed by parents/caregivers. The data were collected in May 2020 and referred to two time-points: three months prior (before the pandemic), and the past two weeks. During the lockdown, it was observed significant aggravation in the "Emotion/Worries (EW)" symptoms in both groups (logEW-before vs. logEW-during the crisis, T1D: 2.66 ± 0.23 vs. 3.00 ± 0.21, p < 0.001 and HV: 2.62 ± 0.16 vs. 2.83 ± 0.18, p < 0.001). Deterioration of "ΕW" was recorded for 93.0% of those with T1D and 92.1% of the HV. "EW" during the lockdown were affected by: previous psychological condition, COVID-related concerns, and "Life Changes due to the COVID-19 crisis in the past two weeks (LC)". Deterioration was observed in the "daily behaviors" and "use of digital media" for all of the children. The crisis and the associated restrictions negatively affected both the lifestyle parameters and the behavioral and emotional variables of the children with T1D. [ABSTRACT FROM AUTHOR]

Background: Action on social determinants of health (SDH) in primary health care settings is constrained by practitioners, organizational, and contextual factors. The aim of this study is to identify barriers and enablers for addressing SDH in clinical settings in Saudi Arabia, taking into consideration the influence of local cultural and social norms, to improve care and support for marginalized and underserved patients. Methods: We conducted a qualitative study involving individual in-depth interviews with a sample of 17 primary health care physicians purposefully selected based on the inclusion criteria, as well as a focus group with four social workers, all recruited from King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia. All interviews were audio-recorded, translated from Arabic to English, transcribed verbatim, and analyzed using thematic analysis following a deductive-inductive approach. Results: According to study participants, financial burdens, challenges in familial dynamics, mental health issues and aging population difficulties were common social problems in Saudi primary health care. Action on SDH in primary care was hindered by 1) lack of physician knowledge or training; 2) organizational barriers including time constraints, patient referral/follow up; 3) patient cultural norms and 4) lack of awareness of physician's role in managing SDH. Enablers to more socially accountable care suggested by participants includes: 1) more education and training on addressing SDH in clinical care; 2) organizational innovations to streamline identification of SDH during patient encounters (e.g. case finding questionnaire completed in waiting room); 3) better interprofessional coordination and clarification of roles (e.g. when to refer to social work, what support is provided by physicians); 4) identifying opportunities for broader advocacy to improve living conditions for marginalized groups. Conclusion: Enabling more socially accountable care requires a multipronged approach including leadership from the Ministry of Health, hospital administrations and medical schools. In particular, there is a need for: 1) training physicians to help patients in navigating social challenges; 2) improving clinical/administrative interprofessional teams, 3) mobilizing local communities in addressing social challenges; and 4) advocating for intersectoral action to prevent health inequities before they become more complex issues presenting to clinical care. [ABSTRACT FROM AUTHOR]

Background: Patient safety culture is a critical element in promoting safety and improving the quality of patient care. To enhance this culture, evaluation of the present culture is necessary. This study aims to investigate the dimensions of patient safety culture from the perspective of the staff of Saveh teaching hospitals, Saveh City, Iran. Methods: This descriptive cross-sectional study was performed in two hospitals affiliated with Saveh University of Medical Sciences in 2019. The research sample consisted of 196 medical staff selected through the proportional stratified sampling method. The study data were collected through the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire and analyzed by the independent t-test and Mann-Whitney test in SPSS software v. 21. The level of significance was set as P<0.05. Results: Among the 12 dimensions of the questionnaire, intra-organizational teamwork, by taking 76% of the total score (4.12±0.28), was desirable and considered the best dimension. However, teamwork among organizational units, by taking 36.6% of the total score (2.92±0.83), was in the poorest condition. There was a significant relationship between gender and patient safety culture, and women were more responsive to patient safety than men (P<0.05). Conclusion: According to the study findings, improving patient safety culture and intercommunication between hospital units is necessary. It is recommended to provide a more intimate environment for communication between hospital personnel. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cuidarte is the property of Universidad de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Previous research on the fears and anxieties of expectant mothers has focused mostly on their fears about giving birth rather than parenting. This study aims to describe mothers' fears and concerns about parenthood during pregnancy and to examine the similarities and differences in the perspectives of primiparous and multiparous mothers. The qualitative research for this study was conducted in three postpartum units in Finland and focused on the responses to an open-ended question about parenting fears and concerns that was part of a questionnaire given to 250 mothers after they had given birth. The responses from the 128 mothers who answered this question were subject to inductive content analysis. Fears and concerns on parenthood included worries about coping with the future and everyday life with their new baby, the psychological burden of parenthood, their maternal resources and self-efficacy, meeting their baby's needs, their baby's health, concerns about their relationship with their partner and financial issues. Primiparous and multiparous mothers shared many of the same concerns, but some differences emerged. The findings contribute an interesting perspective to the social debate about declining birth rates and their psychosocial causes. Further studies are needed to examine the fears and concerns of younger adults, and even teens, about parenthood. [ABSTRACT FROM AUTHOR]

Background: The availability of palliative care facilities for children vary considerably among the European member states. In Romania, a country where health expenditure is among the lowest in Europe, palliative care has been mainly provided by charitable organizations. Despite the high number of children needing palliative care, there is scant literature and research available on paediatric palliative care in Romania. The study explores the viewpoints of various paediatric oncology providers with regard to paediatric palliative care provision in Romania. Methods: Four mixed focus groups were conducted at four university-affiliated paediatric oncology centres located in three distinct Romanian regions (Bucuresti-llfov, Nord-Est and Nord-Vest). The focus groups were analyzed using thematic coding. Results: For many healthcare professionals, emotional burden inherent to the profession; unhealthy work-life balance and understaffing were among the biggest barriers to the successful integration of pediatric palliative care. The lack of staff was attributed to a shortage of financial resources, and to the persisting cultural stigma surrounding palliative care and oncology. Also political turmoil was identified as an important obstacle to palliative care implementation. Conclusion: Significant barriers persist limiting the broader implementation of pediatric palliative care in Romania. In order to render palliative care in pediatric oncology more sustainable, more attention should be paid to the mental health care of healthcare professionals working in this field, to the development of mobile palliative care services and to the emigration of skilled medical staff. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to elucidate the unique challenges faced by pediatric emergency medicine (PEM) physicians from racial/ethnic groups underrepresented in medicine (URiM). Methods: This study is a subanalysis of data from 18 URiM faculty from a sample of 51 semistructured key informant interviews with PEM faculty in the top NIH‐funded pediatric departments and highest‐volume pediatric EDs in the country. Faculty are from eight hospitals representing a spectrum of geographic locations including the northeastern, midwestern, western, and southern regions of the country. Results: Of 18 study participants, the majority were Black (72.2%) and female (83.3%). Three main thematic categories were identified: challenges related to race, support systems, and suggested strategies to improve diversity and inclusion in PEM. A common race‐related experience was microaggressions from colleagues and patients. Additionally, when attempting to lead and assert themselves, URiM women in particular were perceived as "angry" and "intimidating" in a way that non‐URiM peers were not. As a result of these negative experiences, participants described the need to go above and beyond to prove themselves. Such pressure produced stress and feelings of isolation. Participants combatted these stressors through resilience strategies such as formal mentorship and peer and family support. Participants indicated the need to increase diversity and create more inclusive work environments, which would benefit both URiM physician wellness and the diverse patients they serve. Conclusion: Those URiM in PEM face subtle racial discrimination at an institutional, peer, and patient level. The stress caused by this discrimination may further contribute to physician burnout in PEM. While URiMs adopt individual resilience strategies, their unique challenges suggest the need for departmental and institutional efforts to promote greater diversity and inclusion for physician wellness, retention, and quality patient care. [ABSTRACT FROM AUTHOR]

Objectives: Understanding vaccine intentions and attitudes of health professionals is critical as the Pfizer-BioNTech and the Moderna COVID19 vaccines are being administered throughout the United States. This study estimates the level of vaccine hesitancy at a health sciences center in West Texas prior to the distribution of the vaccines. Methods: An analytical cross-sectional study was performed via anonymous Qualtrics survey administered to approximately 4500 faculty, staff, postdoctoral research associates/medical residents, and employees at a multi-campus health sciences university in the United States. Respondents were asked demographic questions and intention to receive the vaccine. Factors associated with the intention to receive a vaccine were determined using logistic regression analysis. Results: A total sample of 2258 subjects were evaluated (50.0% response rate). Among all respondents, 64.6% reported that they would probably or definitely receive the COVID-19 vaccine. Men had higher levels of intention to receive the vaccine (OR = 2.11, 95% CI 1.64-2.71); respondents who indicated yearly influenza vaccines are necessary were also more likely to receive the vaccine (OR = 6.04, 95% CI 4.70-7.75). Eighty-three percent of faculty and 56% of the staff reported intention to receive the vaccine. Respondents who had previously tested positive for COVID-19 reported more interest in receiving the vaccine (58.5% yes vs 41.5% no). Conclusion: In this study, the intention to receive the COVID-19 vaccination at a United States health sciences center falls below the necessary herd immunity estimates. Public health initiatives must be developed to decrease vaccine hesitancy, especially among health professionals. [ABSTRACT FROM AUTHOR]