Professional Quality of Life (ProQOL) of Health Care Providers in Manipur, India

Introduction: Professional Quality of Life (ProQOL) relates to comfort and satisfaction in a profession. Health care providers are exposed to great level of stress and traumatic events in their job. This study aimed at de-termining the ProQOL of health care providers in Bishnupur district. Methodology: A cross sectional study was conducted among health care providers of Bishnupur district, Ma-nipur during 24 January- 24 February 2021. The participants were 153 healthcare providers from district hospital, CHCs and PHCs using a convenience method. The instrument for collecting data consisted of “Profes-sional Quality of Life Measure version 5(ProQOL-5)” questionnaire. Chi square test and Pearson’s r correlation was used for analysis. Results: Mean age of the participants was 37.54 + 9.1 years. The mean values for the domain compassion sat-isfaction (CS), secondary traumatic stress (STS), burnout (BO) was 36.7 + 5.2, 23.2+ 4.5 and 23.3 + 5.6 respec-tively. BO and STS were positively correlated. There was no significant association between other domains. Participants who had night shifts had more BO level compared to others. Conclusion: Majority of the participants had moderate CS and STS. Those having prolonged duty hours expe-rienced more burnout compared to others.

Evaluating a wellness intervention including micro-practices for healthcare professionals before and during COVID-19 / Evaluando una intervención de bienestar con micro prácticas para profesionalesde la salud antes y durante el COVID-19

Abstract Objective: To describe, with a mixed design study, healthcare professionals' pre-post descriptive measures of quality of life (subjective wellness) and prolonged fatigue, as well as an improvement in overall wellness and satisfaction regarding micro-practices as a result of participation in a wellness intervention before and during COVID-19. Material and Methods: This study had a mixed design involving two independent groups of healthcare professionals participating in a wellness intervention with micro-practices before and during COVID-19. The intervention contained multimodal presentations with animated cartoon stories, comics, storytelling, readings, breathing, mindfulness and visualization exercises, adapted from second-order factors in the Indivisible Self model. Pre-post descriptive measures of quality of life (subjective wellness), prolonged fatigue, as well as improvement in overall wellness and satisfaction regarding micro-practices were collected. Results: Attending to either wellness interventions before or during COVID-19 had a positive and, in some cases significant, effect on important indicators of quality-of-life and prolonged fatigue among healthcare professionals. A qualitative analysis indicated a subjective improvement in overall wellness and satisfaction regarding the use of micropractices included in the wellness interventions, regardless of whether these were presented in person or virtually. Most participants subjectively indicated that they improved in the targeted indicators, especially achievement of better wellness. Conclusions: During ordinary and extraordinary circumstances, healthcare professionals require specific interventions that act primarily to provide them with strategies that can improve physical, emotional, and spiritual health. Use of micro-practices in multimodal workshops to improve healthcare practitioner wellness is a successful tool for learning or remembering the importance of pausing during daily clinical activities and refocusing their energy.

Resumen Objetivo: Describir, con un estudio de diseño mixto, la medición descriptiva pre-post sobre la calidad de vida (bienestar subjetivo) y la fatiga prolongada entre profesionales de salud, así como su mejora en el bienestar general y satisfacción respecto al uso de micro-prácticas como resultado de participar en una intervención de bienestar antes y durante COVID-19. Material y métodos: Este estudio tuvo un diseño mixto en el que participaron dos grupos independientes de profesionales del sector salud en una intervención de bienestar con micro-prácticas antes y durante el COVID-19. La intervención consistió en presentaciones multimodales con historias con dibujos animados, cómics, narración de cuentos, lecturas, ejercicios de respiración, mindfulness y visualización, adaptados a partir de los factores de segundo orden del modelo del Yo Indivisible. Se recolectaron medidas descriptivas pre-post de calidad de vida (bienestar subjetivo), fatiga prolongada, así como su mejora en el bienestar general y la satisfacción con respecto a las micro-prácticas. Resultados: La asistencia a cualquiera de las intervenciones para el bienestar antes o durante la COVID-19 tuvo un efecto positivo y, en algunos casos, significativo, sobre importantes indicadores de calidad de vida y fatiga prolongada entre los profesionales del ámbito de la salud. El análisis cualitativo indicó una mejoría subjetiva en cuanto a su bienestar general y satisfacción con respecto al uso de las micro-prácticas incluidas en las intervenciones de bienestar, independientemente de si éstas se presentaron en persona o virtualmente. La mayoría de los participantes indicaron subjetivamente que habían mejorado en los indicadores enfocados, especialmente el logro de un mayor bienestar. Conclusiones: Durante circunstancias ordinarias y extraordinarias, los profesionales de la salud requieren intervenciones específicas que actúen principalmente para proporcionarles estrategias que puedan mejorar la salud física, emocional y espiritual. El uso de microprácticas en talleres multimodales para mejorar el bienestar de los profesionales es una herramienta exitosa para aprender o recordar la importancia que tiene hacer una pausa durante las actividades clínicas diarias y reenfocar su energía.

Perceptions and factors contributing to medication errors amongst the health-care providers in a tertiary care hospital

Background: The use of drugs in the medical field (health care) to reduce the illness process and suffering in the patients is very common. The drugs used should not harm or introduce a new ailment in the patients, which will indirectly increase the burden to the patient, relatives, and also to the society in many ways. Aims and Objectives: The primary objective of the study is to assess the awareness about medication errors among various healthcare professionals – doctors, nurses, and pharmacist, also to spread the awareness on avoiding these medication error and suggest remedies to minimize these errors after analyzing the data. Materials and Methods: This is a descriptive study undertaken after ethical committee approval and conducted by self-reported questionnaires in health-care providers. The participants are grouped into three groups as: Group A: Postgraduates of clinical departments; Group B: Nurses in intensive care unit, casualty and OT; and Group C: Pharmacists. The responses are analyzed using SPSS 17 software. Results: The study shows all the three groups that are equally involved in the mediation errors in different levels of health administration starting from selection of drugs, prescription writing, dispensing of medicine, and also administration of drugs to the patients. Conclusion: Many issues are involved in medication errors done by the health-care providers in different levels of care giving which should be corrected and minimized using latest technologies, reducing the overworking, conducting the lectures, seminars regularly will reduce the occurrence of the incidence, and suffering in such patients.

A study of knowledge, attitude and practices regarding biomedical waste management among health care providers in a tertiary care Institute in Punjab

The biomedical waste, if not properly managed, can harm the surrounding environment, cause various infections and injuries to the healthcare workers, patients, their attendants. Methods: This cross-sectional study was conducted to assess the knowledge, attitude and practices among different cadres of health care providers in a tertiary care institute. Expecting that 50% of the study population had precise knowledge about the rules and legislation of biomedical waste management, with an allowable error of 10%, at 95% confidence interval, and accounting for the finite population correction for 1700 participants, a minimum sample size of 426 was taken. Data analysis was done by using Microsoft excel and SPSS. Results: Out of 426 subjects, 138 (32.4%) were nurses, 35 (8.2%) were lab technicians and 253 (59.4%) were housekeeping staff. Knowledge, attitude and practices regarding biomedical waste management and handling were significantly (p<0.05) higher among the nurses as compared to other health care providers. Conclusions: Knowledge, attitude and practices regarding the collection, segregation, rules, and disposal of biomedical waste management was more among nursing staff compared to other health care workers. Hence, emphasis on adequate training is required among other health care workers for the safe handling and disposal of biomedical waste management.

Informal Healthcare Providers of Abortion Services among Three Scheduled Tribes of Jharkhand

Background: There is a dominant role of informal healthcare providers (IHPs) in the current cultural and sociological context of tribal communities. They outnumber formal health‑care providers, thus bridging the gap between existing and nonexisting public health facilities despite not having formal training or accreditation. Objectives: The study examines the role, relevance, and extent of abortion services provided by IHPs‑ in Jharkhand among three Scheduled Tribe groups. Materials and Methods: Based on in‑depth interviews with 15 IHPs and 42 married women among three Scheduled Tribe groups in three districts of Jharkhand, a qualitative study was conducted. Interview guidelines addressed reasons for preferring IHP services, their scope of practice, dissemination, and quality of services. Results: The majority of women seeking abortions used traditional contraceptives, which often resulted in unwanted pregnancies. The economic, cultural, social, access to services, and confidence factors encouraged women to seek abortion services from IHPs. There were differences in the nature of access to abortion services among tribal groups. The Chero and Korwa tribes continued to rely heavily on simpler life technologies that shaped their beliefs and practices regarding reproduction. The Ho tribe, however, preferred to use the formal health‑care system since they were close to a more complex society. Conclusion: IHP plays a significant role in the social structure of Tribes, demonstrating their marginalization in access to formal health‑care services. Eventually, they replaced traditional healers with their function as physicians.

Mental Health of Doctors Who Treat Patients with covid-19 in Mexico City: An Anthropological Investigation / La salud mental de los médicos que atienden covid-19 en la Ciudad de México: una investigación antropológica / A saúde mental dos médicos que tratam a covid-19 na Cidade do México: uma investigação antropológica

Introduction: The objective of this article was to explore, from an anthropological perspective, the social representations that doctors who treat covid-19 in specialized hospitals in Mexico City have, regarding the relationship between their professional performance and the deterioration of their mental health; as well as their social representations of the existing institutional resources to provide them mental health attention and their care-seeking and self-care strategies. Materials and Methods: For this, a quali-tative investigation was carried out with semi-structured interviews with 35 doctors who treat covid-19. Results: From the points of view of the doctors, various sociocultural and structural causes of mental illness related to their professional performance are documented and analyzed, as well as their repre-sentations about the inadequacy and/or ineffectiveness of the institution, group, or individual resources to provide them mental health attention; and some allopathic and non-biomedical forms of care-seeking and self-care. Conclusions: Recommendations are made to address the etiologies of the disease analyzed in a culturally and structurally appropriate way to the context of the pandemic.

Introducción: el objetivo de este artículo es explorar, desde una perspectiva antropológica, las representaciones sociales de los médicos que atienden covid-19 en hospitales especializados de la Ciudad de México, respecto a la relación entre su desempeño profesional y el deterioro de su salud mental, así como de los recursos institucionales existentes para atenderla y sus estrategias de búsqueda de atención y de autoatención. Materiales y métodos: para ello, se realizó una investigación cualitativa con entrevistas semiestructuradas a 35 médicos que atienden covid-19. Resultados: a partir de sus puntos de vista se documentan y analizan diversas causas socioculturales y estructurales del padecimiento mental relacionado con su desempeño profesional, así como sus representaciones sobre la inadecuación o ineficacia de los recursos institucionales, grupales o individuales, para atenderlo y algunas modalidades de búsqueda de atención y autoatención alopáticas y no biomédicas. Conclusiones: se realizan recomendaciones para abordar institucionalmente las etiologías del padecimiento reportadas por los entrevistados de una forma cultural y estructuralmente adecuada al contexto de la pandemia.

Introdução: O objetivo deste artigo é explorar, a partir de uma perspectiva antropológica, as represen-tações sociais que os médicos que tratam a covid-19 em hospitais especializados na Cidade do México, têm sobre a relação entre seu desempenho profissional e a deterioração de sua saúde mental; bem como os recursos institucionais existentes para cuidar da saúde mental e as estratégias de busca de cuidado e autocuidado. Materiais e métodos: Para isso, foi realizada uma pesquisa qualitativa com entrevistas semiestruturadas com 35 médicos que tratam da covid-19. Resultados: Do ponto de vista dos médicos, são documentadas e analisadas diversas causas socioculturais e estruturais do adoecimento mental relacio-nadas à sua atuação profissional, bem como suas representações sobre a inadequação e/ou ineficiência dos recursos institucionais, grupais ou individuais, disponíveis para atendê-los e algumas modalidades de busca de cuidado e autocuidado alopáticos e não biomédicos. Conclusões: São feitas recomendações para abordar institucionalmente as etiologias da doença relatadas pelos entrevistados de forma cultural e estruturalmente adequada no contexto da pandemia.

Barreras para la atención de las conductas suicidas en Ciudad de México: experiencias del personal de salud en el primer nivel de atención / Barriers to Care of Suicidal Behavior in Mexico City: Health Personnel Experiences at the First Level of Care / Barreiras para a atenção das condutas suicidas na Cidade do México: experiências dos profissionais de saúde na atenção básica

Resumen Objetivo: Identificar las barreras que existen para la atención de las conductas suicidas, desde la perspectiva de las/los profesionales de la salud mental del primer nivel de atención de la Ciudad de México. Metodología: Estudio cualitativo exploratorio, basado en 35 entrevistas semiestructuradas, dirigidas a personal de salud de dos unidades de salud mental de referencia nacional. El análisis de la información se hizo mediante el Framework Analysis. Resultados: Las/los participantes consideraron que las conductas suicidas no han sido definidas como una prioridad dentro de los trastornos de salud mental. La ausencia de políticas públicas, la sobrecarga de trabajo, la falta de seguimiento a las/los pacientes, entre otras, fueron identificadas como barreras para una atención adecuada y oportuna. Conclusiones: Los programas de prevención de las conductas suicidas deben tomar en cuenta el contexto socioeconómico de la población y las características de los servicios de salud, así como las necesidades de las personas prestadoras de servicios de salud. Se requiere ampliar el entrenamiento profesional y mejorar el sistema de referencia y contrarreferencia entre los distintos niveles de atención.

Abstract Objective: To identify the existing barriers to the care of suicidal behavior from the perspective of mental health professionals at the first level of care in Mexico City. Methodology: Qualitative exploratory study based on 35 semi-structured interviews conducted on health personnel from two national reference mental health facilities. The data were analyzed with Framework Analysis. Results: The participants considered that suicidal behavior has not been prioritized among mental health disorders. The absence of public policies, work overload, lack of patient follow-up, among others, were identified as barriers to adequate and timely care. Conclusions: Suicidal behavior prevention programs should consider the socioeconomic context of the population, the characteristics of health services, and the needs of health care providers. Professional training should be enhanced, and the referral and counter-referral system across levels of care should be improved.

Resumo Objetivo: Identificar as barreiras existentes para a atenção das condutas suicidas, desde a perspectiva dos profissionais de saúde mental de atenção básica da Cidade do México. Metodologia: Estudo qualitativo exploratório, baseado em 35 entrevistas semiestruturadas, dirigidas a profissionais de saúde de duas unidades de saúde mental de referência nacional. A análise da informação foi feita através do Framework Analysis. Resultados: Os participantes consideraram que as condutas suicidas não têm sido definidas como uma prioridade dentro dos transtornos de saúde mental. A ausência de políticas públicas, a sobrecarga de trabalho, a falta de seguimento aos pacientes, entre outras, foram identificadas como barreiras para uma atenção adequada e oportuna. Conclusões: Os programas de prevenção das condutas suicidas devem considerar o contexto socioeconômico da população e as características dos serviços de saúde, além das necessidades dos profissionais de saúde. É necessário ampliar o treinamento profissional e melhorar o sistema de referência e contrarreferência entre os diferentes níveis de atenção.

Consultório na Rua: experiências e sentimentos vivenciados pelos profissionais na assistência em saúde / Street Office: experiences and feelings experienced by health care professionals

2021.176470Introdução: o Consultório na Rua é uma estratégia da Atenção Básica no Sistema Único de Saúde (SUS), que tem como finalidade promover o cuidado às pessoas em situação de rua, sendo o serviço de referência sanitária para esta população. Através de ações que permitam a construção do vínculo de confiança, os profissionais promovem cuidado e assistência de saúde às demandas dos usuários. Objetivo: descrever as experiências, histórias e sentimentos vivenciados pelos profissionais do Consultório na Rua de Maceió-AL. Métodos: trata-se de estudo descritivo-exploratório, com abordagem qualitativa, realizado com 13 profissionais do Consultório na Rua de Maceió, cuja produção de dados ocorreu no período de outubro a dezembro de 2018, através da técnica da entrevista semiestruturada e dos registros em diário de campo. Os dados foram analisados pela técnica da Análise de Conteúdo, na modalidade temática, e discutidos à luz da literatura sobre a temática do Consultório na Rua. Resultados: a partir das entrevistas com os profissionais emergiram as seguintes temáticas: 1) experiências únicas; 2) histórias que marcam; e 3) sentimentos que transformam. Conclusão: pode-se concluir que o Consultório na Rua se mostra como um trabalho que gera ricas experiências e sentimentos para os profissionais, e que permite que os profissionais conheçam as histórias de vida dessa população ao mesmo tempo em que são afetados nesse processo. (AU)

Introduction: The Street Office is a Primary Care strategy in the Unified Health System (SUS), which aims to promote care for homeless people, being the health reference service for this population. Through actions that allow the construction of the bond of trust, professionals promote health care and care to the users' demands. Objective: Describing the experiences, stories and feelings experienced by the professionals of the Street Office of Maceió-AL. Methods: This is a descriptive-exploratory study with a qualitative approach, conducted with 13 professionals from the Street Office of Maceió, whose data production occurred from October to December 2018, through the semi-structured interview technique and records in a field diary. The data were analyzed by the content analysis technique, in the thematic modality, and discussed in the light of the literature on the theme of the Street Office. Results: From the interviews with the professionals emerged the following themes: 1) unique experiences; 2) stories that mark; and 3) feelings that transform. Conclusion: It can be concluded that the Street Office is shown as a work that generates rich experiences and feelings for professionals, allowing professionals to know the life histories of this population while they are affected in this process. (AU)

Buenas prácticas en la atención prenatal a adolescentes embarazadas: perspectivas de profesionales de la salud / Good prenatal care practices in teenage pregnancy from the perspective of healthcare professionals / Boas práticas no atendimento pré-natal para adolescentes grávidas: perspectivas de profissionais da saúde

Objetivo: sistematizar buenas prácticas de atención prenatal en un servicio de referencia para adolescentes embarazadas en Campinas, São Paulo, Brasil, desde la perspectiva de profesionales de la salud. Materiales y métodos: estudio cualitativo desarrollado entre junio y julio de 2017, se emplearon entrevistas semiestructuradas y se realizó un grupo focal con 10 profesionales de la salud que prestaban atención a adolescentes embarazadas en una unidad hospitalaria del sistema público de la región de Campinas, São Paulo, Brasil. Los datos fueron examinados mediante la técnica de análisis de contenido temático de donde surgieron nuevas categorías de análisis. Se hizo validación a través de triangulación de los resultados. Se identificó la aplicabilidad teórica y práctica de los principales hallazgos. Resultados: fueron elaboradas tres categorías emergentes del discurso de los profesionales y de las evidencias en la literatura: 1) análisis integral de las adolescentes en situación de embarazo; 2) experiencias profesionales en la atención a las adolescentes embarazadas que evidencian calidad en el servicio; 3) fortalezas y oportunidades del servicio con posibilidades de replicación como modelo asistencial. Son consideradas buenas prácticas durante el cuidado prenatal aquellas que priorizan la atención integral a las adolescentes embarazadas; estas son coordinadas por un equipo multidisciplinario, y consiguen tener un abordaje multidimensional, sobre todo, valorando la complejidad que supone la maternidad en la adolescencia. Conclusión: dentro de los servicios de salud sexual y reproductiva es recomendable el desarrollo de estrategias educativas, el fortalecimiento de la atención en grupos y la inclusión de la red de apoyo de las adolescentes en la atención, con el fin de favorecer una experiencia positiva durante el cuidado prenatal cuando el proceso de volverse madre acontece durante la adolescencia.

Objective: To systematize good prenatal care practices in a referral center for pregnant teenagers in Campinas, São Paulo, Brazil, from the perspective of healthcare professionals. Material and methods: Qualitative study conducted between June and July 2017 using semi-structured interviews and a focus group with 10 healthcare professionals providing care to pregnant teenagers in a public hospital in the region of Campinas, São Paulo, Brazil. Data were examined using the thematic content analysis technique, which gave rise to new analytical categories. Triangulation of the results was used for validation. The theoretical and practical applicability of the main findings was identified. Results: The study looked into three categories arising from the discourse of the professionals and the evidence found in the literature: 1) comprehensive analysis of pregnant teenagers; 2) professional experiences related to the care of pregnant teenagers reflecting service quality; and 3) strengths and improvement opportunities potentially replicable as a care model. Good practices in prenatal care are those which prioritize comprehensive care for pregnant teenagers, are coordinated by a multidisciplinary team and result in a multidimensional approach, valuing the complexity of motherhood in the teenage years. Conclusion: It is advisable to develop education strategies, strengthen group care and involve the teenager's support network as part of sexual and reproductive health services in order to promote a positive experience during prenatal care when the process of becoming a mother takes place during adolescence.

Objetivo: Sistematizar as boas práticas de atenção pré-natal em um serviço de referência para adolescentes grávidas em Campinas, São Paulo/Brasil desde a perspectiva dos professionais da saúde. Materiais e métodos: Estudo qualitativo desenvolvido entre junho e julho de 2017. Empregaram-se entrevistas semiestruturadas e grupo focal com 10 profissionais da saúde que prestavam atendimento à adolescentes grávidas em uma unidade hospitalar da rede pública da região de Campinas, São Paulo/Brasil. Os dados foram analisados por meio da técnica de análise de conteúdo temática onde surgiram as categorias de análise. Realizou-se validação através de triangulação dos resultados e foi identificada a aplicabilidade teórica e prática dos principais achados. Resultados: Foram elaboradas três categorias emergentes do discurso dos professionais e das evidências na literatura: 1) análise compreensiva das adolescentes em situação de gravidez; 2) vivências profissionais no cuidado de adolescentes grávidas que mostram a qualidade no atendimento; 3) potencialidades e oportunidades do serviço com possibilidades de replicação como modelo assistencial. No atendimento pré-natal, são consideradas como boas práticas aquelas que priorizam a atenção integral à gestante adolescente; as que são coordenadas por uma equipe multidisciplinar e conseguem ter uma abordagem multidimensional, sobretudo, avaliando a complexidade que supõe a maternidade durante a adolescência. Conclusões: Dentro dos serviços de saúde sexual e reprodutiva, é recomendável o desenvolvimento de estratégias educativas, o fortalecimento da atenção em grupos e a inclusão da rede de apoio das adolescentes na atenção para favorecer uma experiência positiva durante o cuidado pré-natal levando em consideração o processo de tornar-se mãe durante a adolescência.

Stigmatizing attitudes toward people living with HIV/AIDS (PLWHA) among primary health care providers in Kinta District, Perak

@#Background: Stigmatizing attitudes expressed by health care providers prevent some members of at-risk populations from accessing human immunodeficiency virus (HIV) screening and care. This attitude contributes to the continuity of the infection dissemination within our community, which gives an impact on the healthcare service and the curtailment of the global HIV/acquired immunodeficiency syndrome (AIDS) pandemic. Objective: This study was conducted to identify stigmatizing attitudes toward people living with HIV/AIDS (PLWHA) and their determinants among primary health care providers in Kinta District, Perak. Methodology: A cross-sectional study was conducted in 36 primary care clinics in Kinta District, Perak. Using stratified random sampling, 365 primary health care providers were recruited into the study. A validated self-administered questionnaire was used to obtain sociodemographic data as well as information on the healthcare experiences of healthcare providers, their knowledge of HIV/AIDS, and attitudes toward PLWHA. Determinants were identified using multiple linear regression. Results: More than half of the respondents (54.1%) had never provided care to HIV/AIDS patients. A minority (29.9%) had received training on HIV/AIDS. This study shows that doctors (Coef.= -9.50, 95% CI: -18.93, -0.07, p= 0.048), respondents with HIV-positive relatives, (Coef.= -5.61, 95% CI: -10.57, -0.65, p= 0.027), those who had provided care to HIV/AIDS patients (Coef.= -2.38, 95% CI: -4.31, -0.45, p= 0.016), and those with a higher knowledge score on HIV/AIDS (Coef.= -0.86, 95% CI: -1.59, -0.13, p= 0.021) were less likely to show stigmatizing attitudes toward PLWHA. Conclusion: The issue of stigmatizing attitudes toward PLWHA among primary health care providers needs to be addressed. This study finds that knowledge, profession, experiences with caring for PLWHA, gender, and having HIV-positive relatives are significant predictors of stigmatizing attitudes toward PLWHA among primary health care providers in Kinta District, Perak. Interventional programs to improve knowledge and awareness, as well as decrease stigma toward PLWHA, should be implemented among all health care providers, especially those who have no opportunity to provide direct care.

Barriers to Effective HIV Testing Services and Strategies for Its Promotion at the Primary Health Care Facilities in Ibadan, Nigeria

Background:HIV testing services (HTS) act as a critical entry point to HIV care, treatment and prevention services, and offer the opportunity for specially-trained health care providers to encourage avoidance of high risk sexual behaviour among both HIV negative andHIV-positive individuals. However,there aresome challenges that can hinder effective delivery ofHIV Counseling and Testingservices by health care providers. This studywastherefore designed to investigate barriers to effective HIV testing services and strategies for its promotion at the primary health care facilities in Ibadan.Methods: This descriptive cross-sectional study was carried out among health care providers in primary health care facilities in five local government areas in Ibadan metropolis, Nigeria. A 4-stage sampling techniques was used to select 19 respondents and interviewed using key informan interview guide. Interviews were transcribed verbatim. Spot check of transcripts wereconducted to ensure completeness of the transcription. Thedata were sorted, categorized, and analyzed using a qualitative data analysis computer software package (NVivo). Results: All the respondents interviewed reported that,there were pre and post-tests counseling including HIV testing services in their facilities. Some respondents added there were laboratory services and linkages to other care and support services for those tested positive to HIV. However, most of the respondents reported insufficient consumables, insufficient staff, no privacy, lack of infrastructures as barriers to effective HIV testing services. Many of the respondents recommended community sensitization, more provision for consumables, drugs and kits as strategies for promoting HIV testing services. Conclusion: This study revealed that the primary health centres have pre-test and post-test HIV counseling services but insufficient consumables and staff were the major barriers to HIV testing services in this study. Itis therefore necessary for government to make provision for consumables and more personnel to boost the activities of the health facilities.

Tourniquet application in snake bite: are we aware?

Background: To assess the use of tourniquets as mentioned in National Snake Bite Management Protocol among peripheral health care providers.Methods: This was a prospective cross-sectional study conducted in a tertiary care institute between June 2016 to June 2017. A total of 36 patients of snake bite referred from peripheral health facility were enrolled in the study and were evaluated for : date and time of bite, site of bite, weather snake was seen, type of envenomation, first aid given in Govt facility/alternative practitioner, tourniquet applied/not applied, anti snake venom given/not given as first aid and outcome.Results: The mean age of the study population was 39 years (17.38) range 18 years to 75 years. 18 patients were male and 18 were female. 30 (83.3%) patients had site of bite over the extremities’. The venom was hemotoxic in 12 (33.3%) patients and neurotoxic 21 (58.3%). 30 (83.3%) patients  received first aid in the Government health facility  manned by qualified in healthcare practitioner and 6 (16.7%) were treated by traditional healers. 29 (80.6%) patients had a tight tourniquet tied to the site of the bite when seen in emergency department of institute. None of the patients had their limbs splinted. 31 (86.1%) patients had received anti snake venom (ASV) at the peripheral health facility. The mortality rate was 5.6% with only 2 deaths.Conclusions: The majority of peripheral health care providers both qualified and unqualified use tourniquets in patients suffering with snake bite. The peripheral health care providers are not aware of importance of limb splinting and immobilisation. Though the rate of instilling ASV is good, the health care providers in the peripheral institutes should be made aware of recommendations of national snake bite management protocol with regard to use of tourniquets and limb splitting in snake bite patients.

Needs And Utilization Of Drug-Information Resources Of Healthcare Providers In An Academic Tertiary Care Center

Objective: To investigate the drug-related information needs of healthcare providers (HCPs), their utilization of drug information resources as well as the main factors influencing the selection of resources. Methods: A total of 393 HCPs were conveniently selected and invited to complete a questionnaire. Stratified sampling was used for the three subpopulations of physicians, pharmacists, and nurses. The questionnaire was coded, validated, and analyzed using the Statistical Package for the Social Sciences (SAS version 9.2). Results: Of 450 HCPs approached, 393 completed the questionnaire (response rate 87%). Information related to drug dosage/administration, indications, and interactions is the most frequently required, 47%, 44%, and 34%, respectively. The majority of the sample perceived the Internet (69.47%) and electronic databases (67.43%) as “very useful.” Printed materials (46.56%) and Personal Digital Assistants (PDAs) (44.78%) or calling the pharmacy (43.26%) were also useful resources of information followed by using electronic books and journals (38.42%) and asking colleagues (32.32%). The majority (53.18%) described consulting a clinical pharmacist as “very useful.” However, 16% of the nurse group and 35% of the physician group were not aware of the existence of the Drug Information Center (DIC) and more than 8% of the participants consider calling the DIC about drug-related information “not useful”. Conclusion: Digital resources are used by HCPs more frequently than traditional resources, consulting a clinical pharmacist or calling the DIC. Providing reliable electronic resources and raising the awareness of HCPs regarding the role of a clinical pharmacist and DIC for patient-specific therapies should be instituted.

Human Immunodeficiency Virus: Attitudes and knowledge among health professionals in Santiago, Chile / Virus de Inmunodeficiencia Humana: actitudes y conocimientos de profesionales de salud en Santiago, Chile

Abstract Introduction: Nowadays there a significant increase of HIV cases is in Chile. It is imperative that health professionals have the necessary knowledge to provide adequate healthcare without stigmatizing people living with HIV/AIDS. Objective: Determine health professionals' HIV level of knowledge and their willingness to attend people living with this virus. Methods: This quantitative, cross-sectional study used an online selfadministered survey, that consisted on 15 questions. It evaluated the knowledge and attitudes in health professionals and technicians working in the West Metropolitan Health Centers in Santiago, Chile. Results: The response rate was 32.7% (n=235). 86.8% of participants said they felt safe doing medical procedures to people living with HIV, even though one out of ten said that they related the word fear with HIV; 52.4% were unaware of the clinical guidelines of the local Ministry of Health; and 42.7% incorrectly identified the use of double clinical gloves as a protective measure. Conclusions: The results of this study demonstrate that it is necessary to update and reinforce the knowledge about HIV and universal protective measures in health professionals..

Resumen Introducción: En Chile existe actualmente un aumento significativo de casos de VIH. Es imperativo que los profesionales de la salud tengamos el conocimiento necesario para poder atender adecuadamente y sin estigmatización a las personas que viven con VIH. Objetivos: Determinar nivel de conocimiento y disposición a atender a personas que viven con VIH. Métodos: Estudio transversal en el que se utilizó una encuesta online a profesionales y técnicos de salud que trabajaban en Centros Metropolitanos de Salud Occidente en Santiago, Chile. Resultados: La tasa de respuesta fue 32,7% (n=235). Los resultados mostraron que un 86,8% de los participantes se sentía seguro al realizar procedimientos médicos a personas que viven con VIH, esto a pesar de que uno de cada diez relacionaba la palabra VIH con miedo; 52,4% desconocía las pautas clínicas del Ministerio de Salud local; y el 42,7% identificó incorrectamente el uso de doble guante como medida de protección. Conclusiones: Los resultados de este estudio demuestran que es necesario actualizar y reforzar, en los profesionales y técnicos de la salud, el conocimiento sobre VIH y medidas de protección universales.

Adaptación y validación de la versión argentina de un instrumento para evaluar actividades de desarrollo profesional continuo / Adaptation and validation of the Argentine version of an instrument to assess continuing professional development activities

Introducción. Investigadores canadienses desarrollaron un cuestionario autoadministrado para indagar sobre la intención de los participantes de actividades de desarrollo profesional continuo (DPC) de transferir los conocimientos adquiridos en ámbitos áulicos a la práctica clínica. Su uso podría facilitar los procesos de mejora de la calidad en dichas actividades de DPC.Objetivo. Realizar la traducción y adaptación transcultural y validación del cuestionario REACTION (A theoRy-basEd instrument to assess the impACT of continuing profesional development activities on profesional behavIOr chaNge) para su uso en la Argentina, a partir de la versión original en inglés.Población y métodos. Se realizó la traducción y adaptación transcultural de los 12 ítems del instrumento, con un proceso de cinco pasos. La validez de constructo se exploró mediante el análisis factorial exploratorio, y la confiabilidad, a través del coeficiente de Cronbach y el coeficiente G.Resultados. La versión final del cuestionario se aplicó a una muestra de 133 médicos asistentes a 9 actividades presenciales de DPC de un hospital universitario de la Ciudad de Buenos Aires (edad promedio: 38 años; el 23,3 %, hombres; el 76 %, médicos de familia). El análisis factorial exploratorio arrojó 3 factores (influencia social, confianza en las capacidades propias y criterio ético). El coeficiente de Cronbach fue 0,82 y el coeficiente G fue 0,72.Conclusiones. Se realizó la adaptación y validación de la versión argentina del instrumento REACTION para evaluar el impacto del DPC enfocado en el entrenamiento de habilidades clínicas en la intención de los médicos de implementarlo en su práctica.

Introduction. Canadian researchers developed a self-administered questionnaire to ask participants of continuing professional development (CPD) activities about their intention to translate the knowledge acquired in the classroom into clinical practice. The questionnaire may facilitate quality improvement processes in such CPD activities.Objective. To translate, cross-culturally adapt and validate the original English REACTION questionnaire (A theoRy-basEd instrument to assess the impACT of continuing professional development activities on professional behavIOr chaNge) for its use in Argentina.Population and methods. The 12 questionnaire items were translated and cross-culturally adapted using a five-step process. The construct validity was assessed using an exploratory factor analysis, whereas reliability, with Cronbach's coefficient and the G coefficient.Results. The final questionnaire version was administered to a sample of 133 physicians who attended 9 CPD activities at a teaching hospital in the Autonomous City of Buenos Aires (average age: 38 years; 23.3 %, men; 76 %, family physicians). The exploratory factor analysis showed 3 factors (social influence, confidence in one's abilities, and ethical judgment). Cronbach's coefficient was 0.82 and the G coefficient, 0.72.Conclusions. The Argentine version of the REACTION questionnaire was adapted and validated to assess the impact of CPD centered on clinical skills training on physicians' intention to implement it in their practice

Acciones del personal de salud del área estomatológica en relación a la COVID-19 / Actions taken by dental care providers in relation to COVID-19

Introducción: El brote de la enfermedad del coronavirus 2019 (COVID-19) ha sido declarado emergencia de salud pública de importancia internacional. Los estomatólogos, entre el personal sanitario, son los más expuestos a la enfermedad porque su área de trabajo es la boca, sitio que se reconoce como el lugar a partir del cual se contagia la enfermedad. Objetivo: Esclarecer elementos relacionados con la COVID-19 y las medidas a tener en cuenta para la prevención del contagio del personal de salud del área estomatológica. Comentarios principales: No se ha descubierto un método único que cumpla con todos los requisitos con respecto a las infecciones asociadas a la atención médica. En el enfrentamiento a la COVID-19 cumplen un papel importante las precauciones estándares, o sea, medidas que se aplican a todos los pacientes, independientemente del diagnóstico o de si se conoce si tiene una infección o está colonizado por un agente. El SARS-CoV-2 es un virus envuelto, y esta característica lo hace más sensible a la acción de las sustancias desinfectantes. Consideraciones globales: La COVID-19 manifiesta síntomas no específicos. Los más comunes son fiebre, anorexia y tos seca. La transmisión probablemente ocurre a través de la propagación del virus en el aire y por contacto. Con la implementación de precauciones estándares entre las que se encuentran la higiene de las manos, uso de equipos de protección personal y el cuidado del medio ambiente, se puede disminuir la posibilidad del contagio y contribuir a controlar la diseminación. Es importante que los proveedores de atención médica, dentro de los que se encuentra el personal de salud del área estomatológica, y el público conozcan este nuevo virus para que las acciones coordinadas, oportunas y efectivas puedan ayudar a prevenir casos adicionales o malos resultados ante el enfrentamiento a esta pandemia(AU)

ABSTRACT Introduction: The outbreak of coronavirus disease 2019 (COVID-19) has been declared a worldwide public health emergency. Dentists are the health care providers most directly exposed to this condition, since their area of activity is the mouth, a location recognized as the site through which the disease is transmitted. Objective: Clarify some notions about COVID-19 and the measures to be taken to prevent transmission to dental care providers. Main remarks: A single method has not been discovered which meets all the requirements concerning infections associated to medical care. In the struggle against COVID-19 an important role is played by standard precautions, i.e. measures applied to all patients, irrespective of their diagnosis or whether they are known to have an infection or be colonized by a given agent. SARS-CoV-2 is an enveloped virus, a characteristic that makes it more sensitive to the action of disinfectants. General considerations: COVID-19 presents non-specific symptoms, the most common of which are fever, anorexia and dry coughing. Transmission probably occurs by the spread of the virus in the air and by direct contact. Implementation of standard precautions, among which are hand hygiene, the use of personal protection equipment and care for the environment, will lead to a reduction in the chances of contagion and will contribute to control the spread of the disease. It is important for medical care providers, among them dental care professionals, and the public at large to know about this new virus, so that coordinated, timely and effective actions may be taken which will help prevent the occurrence of new cases or bad results in the struggle against this pandemic(AU)

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.

Oral leukoplakia: Management protocol for primary health-care providers and family physicians

Oral cancer is very common in India. Most of the oral cancers develop on a potentially malignant (precancerous) lesion. Leukoplakia is the most common precancerous lesion in the oral cavity. The malignant transformation rate of oral leukoplakia is very high. There is no marker to distinguish those lesions that may transform to frank cancer from those that may not. Thus, early identification of oral leukoplakia and its proper treatment is important for best prognosis. This article highlights on the diagnosis and treatment protocol for oral leukoplakia.

Observational study to determine the pattern of distribution of stop - bang score in predicting OSA and its implication among female health care providers

Objective: To determine the pattern of distribution of STOP-Bang score in predicting OSA and its implication among female health care providers. Methods: In this study, we enrolled 100 female health care providers with age>20 years and excluded subjects on long term respiratory illness and with secondary cause of obesity. Detailed historyand clinical examination were done along withfilled STOP-Bang questionnaire. Results: We included 100 subjects, the mean age was 26.23 ± 1.74 years, mean BMI was 23.18+ 1.73. Our study results, Snoring, Tiredness and observed apnea were observed more than other parameters. In the study, the significance of snoring (8% with ‘p’ value 0.006), tiredness (52% with ‘p’ value 0.000) and observed apnea (17% with ‘p’ value 0.001) was statistically significant.The most common score on the STOP-Bang questionnaire was 1point (n = 42), followed by no points (n = 41). Subjects with low risk were 57; with high risk were 2 which were statistically significant. Conclusion: Snoring, tiredness and observed apnea play an important factor among females in STOP-Bang score which also was statistically significant.The STOP-Bang questionnaire performed adequately for OSA screening in female health care providersindicated that it could be used as an effective non-invasive screening tool for identifying subjects with high risk of OSA.

Simplified bronchiolitis severity score for health care providers

Background: Bronchiolitis is a viral lower respiratory infection of young infants. It requires monitoring by outpatient health care providers and rarely needs hospitalization. Scoring of severity in community helps in early referral. A simplified bronchiolitis scoring for rural health care providers with no facility for measurement of oxygen saturation (SpO2) and chest X-ray (CXR) is a long-felt need. This study proposes a simplified score.Methods: The proposed bronchiolitis severity score (PSS) has to be validated against the standard bronchiolitis severity score (SSS). The PSS was administered by a physician, nurse and researcher. The reliability was measured by the comportment of internal consistency and inter-observer agreement.Results: The physicians rating of severity by SSS and PSS was similar in 97% of cases. The internal consistency of 0.72 and the kappa index of 0.86 were obtained. The inter-rater agreements between physician, nurse, researcher was 0.94, 0.94 and 0.93 respectively.Conclusions: The PSS is reliable, valid and can be administered by nurses in peripheral health care settings.