Perceptions Of Digital Medical Education Among Post Graduate Medical Students: Mixed Method Survey In Covid 19 Situation

Background:Digital health literacy and digital skills should become prerequisite competencies for health professionals to facilitate the implementation and leverage the potential of digital technologies to improve health. The primary objective of our study was to investigate perceptions of medical students on the role of online teaching in facilitating medical education during the COVID-19 pandemic. Material And Methods:A cross-sectional study wasconducted at the national level using both offline and online (mixed) survey for a period of 3 months (Dec -Feb2020) with a self-administered questionnaire devised on the basis of a literature search “on current online teaching methods following the Covid-19 pandemic situation”among the Post Graduate medical students. Result:Our Study response s consisted of post graduate medical students (n=398) across Indiaamong them 29.9% agreed to that online teaching is helpful during covid-19 situation. Some of the barriers includeexperience, mode of accessing, tools used, internet facilities, availability of Audio-visual aids, user friendlinessof soft-ware. Conclusion:During Covid -19 pandemic online lectures provided a sustainable method of teaching-learning.Some of the facilitators in our study include web learning teaching mode, feasibility of class timing, easy grabbing of information, able to answer during online exam or class.

Knowledge, Practice And Perceived Barrier Of Pressure Ulcer Prevention Among Nurses In A Public Hospital In Selangor

@#Pressure Ulcers (PUs) are a significant health problem for hospitalized patients associated with the leading cause of morbidity and mortality. Each year, more than 2.5 million patients suffer from PUs, and about 60,000 people died due to complications of PUs globally. Although PUs brings devastating consequences, fortunately, it can be prevented. The prevention of PUs represents a marker of quality of care and safety of a health-care organization. PUs prevention indeed needs multidisciplinary collaboration management; however, nurses' role is more significant as they are the frontline in providing patient care. This study aimed to assess knowledge, practice, and perceived barriers of PUs prevention among nurses in a Public Hospital in Selangor. A descriptive and cross-sectional study was used to obtain the data. A purposive sample of 220 nurses had been recruited from ICU, CCU, medical, surgical, and orthopedic wards at Public Hospital in Selangor. Data were obtained from self-administered questionnaires. The result was analyzed using the IBM Statistical Packages for Social Science (SPSS) Window Version 23. This study revealed that the respondents had adequate knowledge (95.0%) and good practice (96.8%) of PUs prevention. Heavy workload and inadequate staff were mostly cited as the barrier of PUs prevention. In overall, the respondents' knowledge and practice were good; however, deficits in a particular area of knowledge and practice of PUs prevention still exist. The hospital and nursing department should organize continuous education programs and in-house training in related field to optimized nurses’ knowledge and practice regarding pressure ulcer prevention and management.

Assessment of hand hygiene practices among health care providers in a government tertiary care hospital

Background: Hand hygiene practices either by hand rub by disinfectant or hand washing by soap and water are very important for preventing Health care-associated infections (HCAIs). WHO have devised guidelines for hand rub and hand wash and advocated “My five moments for hand hygiene” as the approach for appropriate performance, teaching and evaluation of hand hygiene. The objective of this study is to observe hand hygiene practices, among health care providers in a tertiary care govt. hospital and document facilities available at the point of patient care for hand hygiene practices.Methods: A cross sectional observation study was conducted in 8 departments of a Government Tertiary care Hospital for observation of hand hygiene practices as Per WHO Guideline on “5 Moment of Care”. Total of 600 observations were made and one Health care provider was observed once at a point of time. Data Entry was done in MS excel and was analysed in Open Epi software.Results: Among 600 moments observed, 354 (59%) moments were those where hand hygiene practices were missed by HCPs. Among various HCPs 63% Doctors, 62% Nurses, 52% Medical students and 59% nursing students missed the hand hygiene practices. Lack of antimicrobial soap, alcohol based agents, sterile towel and hand drier were perceived barriers for hand hygiene Practices.Conclusions: There lies a huge gap in practice of hand hygiene among all cadres of health care providers. The study is able to identify the lack of infrastructure which can be improved to promote hand hygiene in wards.

Knowledge, Attitude And Perceived Barriers Towards Child Adoption Among Infertile Couples In A Selected Infertilty Clinic In Bhubaneswar

A correlational descriptive study was conducted to assess the knowledge, attitude and perceived barriers towards child adoption among infertile couples in a selected infertility clinic in Bhubaneswar. A total of 200 samples were taken using total enumerative sampling. Self– structured socio– demographic performa, knowledge questionnaire, attiude likert scale and perceived barriers likert scale was used to assess the level of knowledge, attitude and perceived barriers among the infertile couples towards child adoption. The data was analyzed by using SPSS version 20.0 (Statistical Package for the Social Science). The knowledge score of the infertile couples reveals that 63% husband have moderate knowledge while 53% wife have low knowledge, attitude score of the infertile couples reveals that 84% husbands and 82% wife have neutral attitude and perceived barriers score of the infertile couples reveals that 91% husband and 88% wife have moderate perceived barriers and financial barriers was seen as the chiefcause for the couples to adopt the child. The relation between knowledge and attitude of husband and wife showed a positive correlation with r value .238 and .296 and p value0.001 and 0.0001 respectively. There was no correlation between attitude and perceived barriers of the infertile couples and there is a negative correlation between between perceived barriers and knowledge of the infertile couples with r value was –.20 and –.16 with p value 0.004 and 0.02 respectively. The infertile couples need to be aware regarding the various aspects of child adoption so that they could choose this as an alternative to fulfil their parenthood.

Physicians' knowledge, perceived barriers, and practices regarding cancer pain management: a cross-sectional study from Palestine

Background: Pain continues to be a prevalent yet undertreated problem among cancer patients. Achieving adequate control of cancer pain is influenced by physicians' knowledge and practices, which have been found to be inadequate by many studies. In this study, we aimed to examine knowledge and practices, as well as perceived barriers relating to the management of cancer pain among Palestinian physicians. Methods: This cross-sectional study took place at eight hospitals in the northern West Bank in Palestine. A questionnaire was developed and distributed to physicians who were responsible for the care of cancer patients. The questionnaire assessed knowledge, perceived barriers, assessment practices, pain documentation, and delaying processes relating to cancer pain management (CPM). Results: In total, we analysed 109 questionnaires. The mean age of the participants was 32.3 ± 7.0 years and 73.4% had less than 10 years of professional experience. After analysing the data, we found physicians' knowledge to be inadequate, with a mean knowledge score of 6.2 ± 1.9 out of 14. The barriers that were perceived by the highest percentages of physicians to affect CPM were inadequate pain assessment (89%), insufficient experience (79.8%), and insufficient knowledge (76.1%), all of which are staff-related. However, 65% reported assessing pain on every round and 70% asked about all items related to the nature of pain. Finally, obtaining opioids from the pharmacy was the most recognized delaying step in CPM. Conclusions: Despite reporting good practices, physicians showed substantial knowledge deficits regarding CPM. Besides, many barriers appear to impede effective CPM. Therefore, appropriate educational programmes and policy changes are recommended in order to improve professional performance as well as patient care (AU)

Barreras percibidas en los servicios comunitarios y de salud por los adultos mayores / Barriers perceived by older adults in the community and health services

Introducción: Cuba, en la actualidad, se ubica entre los más envejecidos poblacionalmente de América Latina y el Caribe. Objetivo: Identificar las barreras percibidas en los servicios comunitarios y de salud por adultos mayores. Métodos: Investigación de tipo cualitativo-descriptivo realizada en el área de salud del Policlínico Wilfredo Santana, en el municipio Habana del Este. Participaron 526 sujetos con quienes se organizaron grupos focales y entrevistas semiestructuradas, dirigidas a los adultos mayores, médicos, líderes formales y expertos. La información obtenida se sometió a un análisis de contenido temático. Resultados: Las categorías, conceptos y proposiciones permitieron identificar barreras para la vida cotidiana de los adultos mayores estudiados mientras que los médicos y líderes de la comunidad expresaron dificultades técnicas y laborales. Conclusiones: Los adultos mayores estudiados percibieron barreras como la inestabilidad en los servicios en la atención primaria de salud, dificultades para el acceso a los servicios públicos o su ausencia en la comunidad y otros aspectos como la no adecuación de los diseños arquitectónicos a las características de la ancianidad, las limitadas opciones recreativas, las afectaciones económicas y la indisciplina social en general. Los médicos y líderes de la comunidad identificaron como barreras la sobrecarga y el exceso de trabajo burocrático y la falta de preparación específica para la atención de este grupo poblacional(AU)

Introduction: Cuba is currently one of the oldest nations in Latin America and the Caribbean. Objective: To determine the barriers perceived by older adults in the community and health services. Methods: Qualitative-descriptive research study conducted in Wilfredo Santana polyclinics located in Habana del Este municipality. The participants amounted to 526 who were organized in focal groups and semi-structured interviews were made to older adults, physicians, formal community leaders and experts. The collected information was subjected to a thematic content analysis. Results: The different categories, concepts and suggestions allowed identifying the barriers to the daily life of the studied older adults whereas physicians and community leaders stated the existing technical and working difficulties. Conclusions: The studied older adults perceive barriers such as unstable primary health care services; difficulties to get access to public services or their absence within the community; the inadequate architectural designs for the elderly characteristics, limited recreational options, economic problems and social indiscipline in general. The physicians and the community leaders consider overload and excessive red tape as well as lack of specific preparation to take care of this population sector as perceived barriers(AU)

Investigating predictors of the 641 elders' willingness to enroll in nursing homes in Shanghai / 上海交通大学学报（医学版）

Objective · To survey the willingness to enroll in nursing homes among the elders in Shanghai and explore its predictors. Methods · A field survey was performed to collect data from 641 elders aged 60 years old and above in six community health centers in Shanghai. Sociodemographic variables, willingness to use nursing home, perceived barriers and perceived benefits were measured. Results · The questionnaire is with good structural validity and good intrinsic reliability. KMO index, P value of Bartlett's test of sphericity, and the range of Cronbach's α coefficients were 0.862, 0.000,and 0.739-0.824, respectively. Among the respondents, 46% were willing to enroll in a nursing home in this survey. Age had significant influence on their willingness (P=0.045). After adjusting for age, the multivariate Logistic regression analysis showed that shame (OR=0.76, 95% CI=0.62-0.94), adaptability (OR=0.61, 95% CI=0.50-0.74) and perceived benefits (OR=1.63, 95% CI=1.32-2.03) were related to willingness (P<0.05).Conclusion · Elders in Shanghai have a relatively high level of willingness to enroll in nursing homes, especially the elders aged from 60 to 69. Shame and adaptability of elders, and the services provided by nursing homes were the predictors of the elders' willingness.

Barreras percibidas, beneficios, autoeficacia y nivel de actividad física de los adolescentes / Perceived barriers, benefits, self-efficacy and level of physical activity of adolescents

El objetivo de esta investigación fue determinar la correlación entre las barreras percibidas, beneficios, autoeficacia y el nivel de actividad física de los adolescentes; para tales efectos se desarrolló un estudio descriptivo correlacional de corte transversal en 108 adolescentes de un colegio púbico de Bucaramanga. Los instrumentos de recolección de datos fueron el EBBS (Exercise Benefits/Barriers Scale) y la versión larga del IPAQ (International Questionnaire of Physical Activity). Los datos fueron analizados a través del paquete estadístico SPSS. Se encontró una mayor percepción de beneficios en los adolescentes de género masculino; en ambos géneros las barreras fueron percibidas bajas; en el género femenino la autoeficacia fue percibida más alta; y el nivel de actividad física fue reportado bajo. En el análisis bivariado se reportaron correlaciones bajas y negativas en todas las dimensiones. Por lo tanto, en esta investigación se comprobó la hipótesis nula respecto a que no hubo relación entre las variables de estudio.

The objective was to determine the correlation between perceived barriers, benefits, self-efficacy and the level of physical activity of adolescents; For that purpose, a cross-sectional correlational descriptive study was developed in 108 adolescents of a pubic school in Bucaramanga. The instruments of data collection were the EBBS (Exercise Benefits / Barriers Scale) and the long version of IPAQ (International Questionnaire of Physical Activity). The data were analyzed through the statistical package SPSS. We found a greater perception of benefits in male adolescents; In both genders the barriers were perceived as low; In the female gender self-efficacy was perceived higher; And the level of physical activity was reported under. In the bivariate analysis low and negative correlations were reported in all dimensions. Therefore, in this investigation we verified the null hypothesis regarding that there was no relation between the study variables.

Mediating Effects of Perceived Barriers on the Relationship between Depression and Diabetes Management Self-efficacy in Type 2 Diabetes Patients

BACKGROUND: Diabetes mellitus is a life threatening disease that one out of ten Korean adults aged over 30 has it. Depression of diabetes patients affects the perception on their health negatively and self-management inefficiently, and then leads to a failure in blood sugar control. Therefore, it is necessary to investigate the relationships among depression, perceived barriers and self-efficacy on diabetes management in depth. METHODS: This descriptive study was undertaken to identify the mediating effects of perceived barriers on the relationship between depression and self-efficacy on diabetes management among type 2 diabetes patients. 173 patients with type 2 diabetes were recruited from an out-patient clinic of Y university hospital. Data were collected from June 26 to July 18, 2014 using a structured self-report questionnaire, and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, multiple regressions, and Sobel test. RESULTS: Among173 participants, 12.1% were classified as depressed group. Self-efficacy on diabetes management was found to be significantly associated with education level and the presence of complications. Depression and perceived barriers were positively related to each other, but both were negatively related to self-efficacy on diabetes management. In addition, perceived barriers were found to mediate the relationship between depression and diabetes management self-efficacy. CONCLUSIONS: Strategic nursing interventions based on considerations of the relationship between perceived barriers and self-efficacy on diabetes management need to be provided for type 2 diabetes patients with depression.

Stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake and related psychosocial factors

BACKGROUND/OBJECTIVES: Understanding individual's intention, action and maintenance to increase fruit and vegetable intake is an initial step in designing nutrition or health promotion programs. This study aimed to determine stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake, self-efficacy, perceived benefits and perceived barriers. SUBJECTS/METHODS: This cross-sectional study was conducted among 348 public university staff in Universiti Putra Malaysia. A pre-tested self-administered questionnaire and two days 24-hour diet recall were used. RESULTS: Half of the respondents (50%) were in preparation stage, followed by 43% in action/maintenance, 7% in pre-contemplation/contemplation stages. Respondents in action/maintenance stages had significantly higher self-efficacy (F = 9.17, P < 0.001) and perceived benefits (F = 5.07, P < 0.01) while respondents in pre-contemplation/contemplation and preparation stages had significantly higher perceived barriers (F = 4.83, P < 0.05). Perceived benefits tend to outweigh perceived barriers pre-ceding to taking action. Self-efficacy is important in motivating individuals to increase fruit and vegetable intake as self-efficacy and perceived barriers crossed over between preparation and action/maintenance. Respondents in action/maintenance stages had the highest adjusted mean serving of fruit and vegetable intake (F = 4.52, P < 0.05) but the intake did not meet recommendation. CONCLUSION: Intervention strategies should emphasize on increasing perceived benefits and building self-efficacy by providing knowledge and skills to consume a diet high in fruits and vegetables in order to promote healthy changes in having high fruit and vegetable intake.

Nível de atividade física e barreiras percebidas para a prática de atividades físicas entre policiais militares / Level of physical activity and perceived barriers to practice physical activities among military police / Nivel de actividad física y barreras percibidas para la práctica de actividades físicas entre los policía militares

O estudo descreveu o nível de atividade física e as barreiras percebidas para a prática de atividades físicas em uma amostra de 316 policiais militares de Feira de Santana, Bahia. Houve 37% de indivíduos insuficientemente ativos, sem diferença significante entre os sexos e a idade. Entre as barreiras percebidas para a prática de atividade física destacaram-se: compromissos familiares (39,2%), jornada de trabalho (36,7%), falta de equipamento (30,4%), ambiente inseguro (26,9%), falta de companhia (25,6%), tarefas domésticas (20,6%) e falta de recursos financeiros (20,3%). A prevalência de policiais insuficientemente ativos foi maior entre os que percebem barreiras pessoais, ajustado pelo sexo, idade e pelas barreiras ambientais, sociais e financeiras (RP: 1,5; IC95%: 1,00-2,26).

This research describes levels of physical activity and perceived barriers to physical activities of military police in Feira de Santana, Bahia. This is a cross sectional study, with a sample of 316 subjects. The results showed that in regard to physical activity, 37% of the military police are inactive, no significant difference related to gender and age. Among perceived barriers to practice physical activity stood out: family commitments (39.2%), the workday (36.7%), lack of equipment (30.4%), unsafe environment (26.9%), lack of company (25.6%), housework (20.6%) and lack of financial resources (20.3%). The prevalence of inactive police was higher among those who perceived personal barriers, adjusted by gender, age, and by environmental, social and financial barriers (OR: 1.5; CI95%: 1.00-2.26).

El objetivo del estudio fue describir el nivel de actividad física y barreras percibidas a practicar actividades físicas en una muestra de 316 policía militar de Feira de Santana, Bahia. Hubo 37% de los oficiales de policía con el nivel de actividad física insuficiente, pero ninguna diferencia significativa entre los sexos y la edad. Entre las barreras percibidas para la práctica de actividad física se situó: compromisos com la familia (39.2%), la jornada laboral (36.7%), falta de equipo (30.4%), entorno inseguro (26.9%), carencia de la compañía (25.6%), tarefas del hogar (20.6%) y la falta de recursos financieros (20.3%). La prevalencia actividad física insuficiente fue mayor entre los que se dan cuenta de las barreras personales, ajustadas por sexo, edad y por barreras ambientales, sociales y financieras (RP: 1.5; IC95%: 1.00-2.26).

Relationship of dietary self-efficacy and illness beliefs, perceived benefits and perceived barriers for the reduction of sodium intake in the elderly

The purpose of this study was to examine the relationship of dietary self-efficacy and illness beliefs, perceived benefits, and perceived barriers for the reduction of sodium intake in the elderly. A cross-sectional study was performed on 252 elderly people, aged 65 yrs and above, living in Daejeon Metropolitan city and Jecheon city, Chungbuk from March 21 to March 30, 2011. Dietary self-efficacy of three factors (resisting relapse, reducing salt and behavioral skills), perceived benefits and barriers, accurate and inaccurate illness beliefs were measured by 5 or 4 point Likert scale. With the increasing education level of the elderly, dietary self-efficacy, and accurate illness belief score increased and perceived barrier score decreased. Perceived benefits score was higher in the subject living alone compared to those living with siblings or spouses. Among three factors of dietary self-efficacy, reducing salt was scored highest and behavioral skills scored lowest in the elderly. Recording meal diary and reading labels for salt content in the items of behavioral skills showed lower score than other items. Accurate illness beliefs and perceived benefits were more scored than inaccurate illness beliefs and perceived barriers respectively in the subjects. The subjects with higher accurate illness beliefs, lower inaccurate illness beliefs, higher perceived benefits, and lower perceived barriers for the reduction of sodium intake showed higher dietary self-efficacy. In summary, accurate illness beliefs and perceived benefits positively correlated with dietary self-efficacy for the reduction of sodium intake in the elderly, whereas inaccurate illness beliefs and perceived barriers are negatively correlated.

Knowledge, Self-Efficacy, and Perceived Barriers on the Low-Iodine Diet among Thyroid Cancer Patients Preparing for Radioactive Iodine Therapy

The purposes of the study were to assess knowledge, self-efficacy, and perceived barriers on a low-iodine diet among thyroid cancer patients and to identify strategies for nutrition education. A self-administered questionnaire was developed based on a review of literature and pilot-tested. A total of 121 female thyroid cancer patients participated in a survey and 117 responses were used for data analysis. An average knowledge score of the thyroid cancer patients was 4.5 point (available score: 0-10 point). Majority of the respondents knew that seaweeds such as lavers, brown seaweeds, and sea tangles contain large amount of iodine. However they mistook the low iodine diet as a low salt diet and were not aware of foods and seasonings that are allowed on the low iodine diet. While self-efficacy related to consuming various fruits and vegetables, to choosing potatoes and sweet potatoes for snacks, and restricting consumption of eggs, milk and milk products, and processed foods was rated highly, self-efficacy for preparing foods without using sea salts was rated low. The self-efficacy score increased as their interest on the dietary life and perceived cooking skills were greater. Most perceived barriers toward practicing the low iodine diet were related to preparation of the low iodine menus. As their interest in the dietary life and cooking and perceived cooking skills were greater, the patients perceived barriers on practicing the low iodine diet less. While the patients showed higher self-efficacy and lower barrier perception on selecting foods low in iodine and restricting food high in iodine, they showed lower self-efficacy and higher barrier perceptions on preparing low iodine meals. Clinical dietitians should recognize the gap between what the patients should know and what they really know and identify strategies on how to improve self-efficacy and reduce perceived barriers on the low iodine diet. Recent literature and the findings of the study reveal that incorporating cooking classes into nutrition education for thyroid patients is effective to enhance self-efficacy and to reduce perceived barriers on the low iodine diet.

Analyses on the Factors Associated with Dietary Behavior Regarding Colon Cancer Risk

A case-control study was conducted in order to examine dietary behavioral factors associated with colorectal cancer risks. Data were collected from 128 cases with either colorectal cancer or large bowl adenomatous polyps and 129 controls regarding stages of dietary behavioral change, perceived barrier, self efficacy, nutrition knowledge, social support and food availability as well as body mass index and overall dietary quality. Cases showed less desirable behaviors with respect to fat reduction and vegetable intake compared with controls based on the analyses of the stages of dietary change. After adjustment of relevant covariates (age, gender and smoking), significant trends of increasing risk with higher level emerged for perceived barriers resulted from environmental conditions (OR = 1.6 - 2.0) and self-efficacy (OR = 2.2 - 2.3). No such relationships were found for nutrition knowledge and social support. The risk of colorectal cancer was associated with the kinds of foods available at home showing a borderline protective relation with milk (OR = 0.6) and respective significant and borderline direct associations for fresh meat (OR = 2.1) and soft drinks (OR = 0.6 when reversely scored). Within-group analyses presented best predictors of overall dietary quality as food availability for the case and self-efficacy and social support for the control. The findings of this study suggested a need for focusing on motivational and reinforcing factors in the development of nutrition education programs for colorectal cancer prevention.