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1.
J Psychiatr Res ; 180: 33-38, 2024 Sep 30.
Article in English | MEDLINE | ID: mdl-39368327

ABSTRACT

Given increasing emphasis on understanding the role of genes in the etiology of addictive disorders, the present study aimed to investigate the implications of genetic explanations of addiction for attitudes and beliefs about patients among addiction treatment providers. Participants were recruited from addiction-related professional organizations. The sample included professionals with medical backgrounds (n = 153) and with nonmedical backgrounds (n = 232). They viewed a description of a fictitious patient with either alcohol use disorder or gambling disorder, which was experimentally varied to indicate the presence or absence of a genetic cause. They completed measures of their genetic attributions for the patient's symptoms as well as their attitudes and beliefs about the patient. The presence of a genetic explanation increased genetic attribution ratings but did not significantly affect other measured variables. However, participants' genetic attributions for the patient's symptoms were associated with significantly lower ascriptions of blame to the patient and greater belief in the effectiveness of medication, but also with reduced confidence in the effectiveness of psychotherapy and with pessimism about the patient's prognosis. Geneticized, biomedical conceptualizations of addiction may have implications for treatment providers' attitudes toward patients.

2.
BMC Prim Care ; 25(1): 177, 2024 May 21.
Article in English | MEDLINE | ID: mdl-38773496

ABSTRACT

BACKGROUND: Advanced chronic kidney disease (ACKD) is associated with a high risk of adverse cardiovascular and renal events and has a significant impact on quality of life and life expectancy. Several studies have identified areas for improvement in their management in primary care. Some professional and environmental factors can act as key barriers to appropriate care. OBJECTIVE: To analyse attitudes, subjective norms, and perceived behavioural control among primary care professionals related to the implementation of an evidence-based approach for individuals with ACKD in primary care. METHODOLOGY: This was a qualitative study using an interpretative phenomenological approach based on the theory of planned behaviour. Two aspects of the evidence-based approach were explored: the implementation of clinical practice guidelines and the utilisation of electronic kidney disease records within the scope of this study. Primary care nurses and physicians participated in a previous pilot interview and five focus groups. Subsequently, a thematic analysis of the gathered data was conducted. FINDINGS: Thirty-three primary care professionals participated. The emerging themes included: experiences in the management of ACKD (highlighting a distinct profile of older, frail patients with comorbidities masking CKD and a CKD follow-up primarily focused on analytical monitoring and drug adjustment); factors in the professional environment influencing the use of scientific evidence (such as time constraints, excessive electronic health records, and unfamiliar reference guidelines); attitudes towards the application of recommendations on ACKD (recognising limitations of computer systems despite considering them as guidance); and capacities to implement evidence-based recommendations (acknowledging formative needs and challenges in coordinating care with nephrology services). CONCLUSIONS: Several psychological elements identified through the TBP hinder the adequate implementation of an evidence-based approach for individuals with CKD. Attitudes have been identified as factors modulating the use of standardised electronic records. Instead, subjective norms (influences from the professional environment) and perceived behavioral control (perception of capabilities) acted as barriers to the proper application of clinical practice guidelines and standardised records. IMPLICATIONS FOR PRACTICE: Strategies aimed at optimising the management of people with ACKD should focus not only on training but also on improving attitudes, organisational structures, IT systems and coordination between primary care and nephrology.


Subject(s)
Attitude of Health Personnel , Focus Groups , Qualitative Research , Renal Insufficiency, Chronic , Humans , Renal Insufficiency, Chronic/therapy , Renal Insufficiency, Chronic/psychology , Male , Female , Middle Aged , Primary Health Care , Adult , Practice Guidelines as Topic , Electronic Health Records , Nurses/psychology , Evidence-Based Medicine , Physicians/psychology
3.
J Adv Nurs ; 80(3): 1232-1240, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37864358

ABSTRACT

AIMS: To discuss the construction and use of vignettes as a novel approach in spiritual care research and education. DESIGN: Methods paper. METHODS: In this methods paper, the authors introduce the use of vignettes in spiritual care research and provide insight into the construction of vignettes. The vignette presented was part of a study of neurosurgical nurses' attitudes and responses to the spiritual needs of neuro-oncology patients. The development process, consisting of four steps, is explained in this paper. RESULTS: Using a vignette to explore nurses' attitudes towards spiritual care is an innovative way to understand what behaviours nurses consider appropriate in situations where the patient is seeking meaning and connection. Transparent description of the development process is crucial to ensure reproducibility. CONCLUSION: The use of theoretically constructed and validated vignettes in spiritual care research is new. Vignettes used in surveys have the potential to elicit nurses' responses to patients' search for meaning and connectedness. IMPLICATIONS: In order to investigate nurses' attitudes and behaviours towards patients' spiritual needs, carefully constructed and validated vignettes are valuable research tools. IMPACT: Vignettes have proven to be a valuable research tool in the social and health sciences. So far, their use as a survey instrument in spiritual care research has not been investigated. Therefore, this method paper introduces vignettes as a novel approach to spiritual care research. Our findings contribute to the further development of vignettes in nursing science, as there are similarities with case development and simulation training in nursing education. REPORTING METHOD: Reporting guideline is not applicable. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.


Subject(s)
Attitude of Health Personnel , Spiritual Therapies , Humans , Reproducibility of Results , Spirituality , Educational Status
4.
Brain Behav ; 12(10): e2767, 2022 10.
Article in English | MEDLINE | ID: mdl-36101902

ABSTRACT

OBJECTIVES: Mental health professionals are becoming increasingly involved in the process of employment rehabilitation of persons with psychiatric disabilities. However, few studies address the attitudes of these professionals toward the employability of those with mental illness. The aim of this research was to identify differences in the attitudes of medical and non-medical mental health professionals, as well as to detect any association between attitude scores and the type of professional. METHODS: A sample of 140 employees from public and third sector mental health organizations answered a questionnaire using a scale measuring their attitudes and views on the employability of people with psychiatric disabilities. The psychometric characteristics of the scale are provided together with the variations detected in the professionals' attitudes. RESULTS: This research shows that significant differences in the attitudes between medical and non-medical mental health employees exist and that there is a need for the implementation of educational programs that may help to improve the attitudes of medical professionals toward the employability of people with mental illness. CONCLUSION: This research indicates the importance of improving the professionals' attitudes to support people attempting to return to work.


Subject(s)
Mental Disorders , Mental Health , Attitude , Employment , Health Personnel , Humans , Surveys and Questionnaires
5.
Article in English | MEDLINE | ID: mdl-35897342

ABSTRACT

The aim of this research was to analyze how the need for psychological support of health workers (HCWs) influenced the beliefs, perceptions and attitudes towards their work during the COVID-19 pandemic and to predict the need of psychological assistance. A descriptive transversal study was conducted based on a self-administered questionnaire distributed to health professionals working in the Canary Islands, Spain. The data were analyzed using Pearson's chi-squared test and the linear trend test. The correlation test between ordinal and frequency variables was applied using Kendall's Tau B. Multiple logistic regression was used to predict dichotomous variables. The sample included 783 health professionals: 17.8% (n = 139) of them needed psychological or psychiatric support. Being redeployed to other services influenced the predisposition to request psychological help, and HCWs who required psychological support had more negative attitudes and perceptions towards their work. After five waves of COVID-19, these HCWs reported to be physically, psychologically and emotionally exhausted or even "burned out"; they did not feel supported by their institutions. The commitment of health personnel to fight against the COVID-19 pandemic decreased after the five waves, especially among professionals who required psychological support.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Health Personnel/psychology , Pandemics , SARS-CoV-2 , Attitude of Health Personnel , Burnout, Professional , Chi-Square Distribution , Humans , Linear Models , Psychosocial Support Systems , Spain/epidemiology , Surveys and Questionnaires
6.
Antimicrob Resist Infect Control ; 11(1): 92, 2022 06 28.
Article in English | MEDLINE | ID: mdl-35765093

ABSTRACT

BACKGROUND: Antimicrobial resistance (AMR) is a problem in residential aged care facilities (RACF). There is a gap in our understanding of how psychosocial barriers such as risk perceptions shape staff attitudes towards antimicrobial stewardship (AMS). We sought to ascertain the attitudinal domains that have been identified to be of importance to AMS in RACF and comment on how they have been measured empirically. Our aim was to consolidate what is known regarding staff attitudes and perceptions in order to inform future stewardship. METHOD: We searched PsycINFO, PsycARTICLES, CINAHL Plus, MEDLINE, PubMed, Web of Science, Cochrane, and Scopus databases for primary studies of healthcare workers attitudes to AMS in RACF (1990-February 2021). RESULTS: 14 Studies were included in the review, within which 10 domains were identified: attitudes towards antimicrobial prescribing; guidelines; educational interventions; self-confidence regarding clinical assessment and prescribing; awareness of AMR as a problem and stewardship as a priority; self-efficacy; perception of role; perception of risk; team culture and resident/family members expectations. 46 measures were developed across the 14 studies to measure the 10 domains. The variability in the attitudinal domains and how these domains were measured was large. Only 13% included psychometric data regarding reliability and/or internal consistency. CONCLUSIONS: Attitudes are generally defined as having three evaluative bases: cognitive, behavioural, and affective. Findings from the current review suggest that the measures commonly used to capture healthcare staff attitudes to AMS do not sufficiently capture affect; particularly with respect to staff's risk perceptions, perceptions of their role, and family members' expectations. Given that affective processes have been postulated to influence medical decision making, these findings highlight the importance of understanding how staff, especially nurses feel about implementing AMS strategies and other peoples' (e.g. residents and their families) perceptions of stewardship. It is expected that a more nuanced understanding of RACF nurses affective experiences when applying AMS, and their perceptions of the risks entailed, will help in reducing barriers to overprescribing antibiotics.


Subject(s)
Antimicrobial Stewardship , Aged , Anti-Bacterial Agents/therapeutic use , Attitude of Health Personnel , Humans , Long-Term Care , Reproducibility of Results
7.
Sci Prog ; 105(2): 368504221102798, 2022.
Article in English | MEDLINE | ID: mdl-35603882

ABSTRACT

Health personnel have faced highly adverse circumstances in the workplace since the beginning of the COVID-19 pandemic. Prolonged exposure to stressful situations at work is considered to affect the physical, psychological, and emotional health of these workers, as well as job performance. The objective of this study was to analyze the beliefs, attitudes, and feelings of health personnel from one Spanish region towards their work after five waves of the COVID-19 pandemic. A Cross-sectional descriptive study was carried out using an electronic questionnaire, adapted, and validated through the Delphi technique. A convenience sampling of 783 was recruited among health personnel from the Canary Islands during the fifth wave of the pandemic in September 2021. Bivariate analyzes have been performed by the Chi-square test accepting statistical significance (p 0.050). The 94.3% (n=738) of the respondents considered the pandemic to have highlighted the shortcomings of the Spanish health system. A clear level of exhaustion and/or a reduction in the level of commitment can be observed in these workers as the pandemic continues, as participants reported feeling both mentally and physically exhausted when finishing their shifts, and even "burned out by their work". This study highlights the resilience and vocation of healthcare professionals, who even considering the effects of the pandemic would choose the same profession. On the other hand, these professionals felt undervalued by their institutions, and almost one of every five, precised psychological support in some point during the health crisis.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cross-Sectional Studies , Emotions , Health Personnel/psychology , Humans , Pandemics , SARS-CoV-2 , Spain/epidemiology
8.
Nurs Ethics ; 29(3): 527-539, 2022 May.
Article in English | MEDLINE | ID: mdl-35142227

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic is impacting the delivery of healthcare worldwide, creating dilemmas related to the duty to care. Although understanding the ethical dilemmas about the duty to care among nurses is necessary to allow effective preparation, few studies have explored these concerns. AIM: This study aimed to identify the ethical dilemmas among clinical nurses in Spain and Chile. It primarily aimed to (1) identify nurses' agreement with the duty to care despite high risks for themselves and/or their families, (2) describe nurses' well-being and (3) describe the associations between well-being and the duty to care. RESEARCH DESIGN: Cross-sectional self-reported anonymous data were collected between May and June 2020 via electronic survey distribution (snowball sampling). ETHICAL CONSIDERATIONS: The Institutional Ethical Review Committees in both countries approved the study (CHUC_2020_33 and 27/2020). FINDINGS: In total, 345 clinical nurses answered the primary question about the duty to care for the sick. Although in the total sample 77.4% agreed they have a duty to care for the sick, significant differences were found between the Spanish and Chilean samples. Overall, 53.6% of the nurses reported low levels of well-being; however, among those reporting low well-being, statistically significant differences were found between Spanish and Chilean nurses as 19.4% and 37.8%, respectively, disagreed with the statement regarding the duty to care. DISCUSSION: Participants in both countries reported several ethical dilemmas, safety fears, consequent stress and low well-being. These results suggest that prompt actions are required to address nurses' ethical concerns, as they might affect their willingness to work and psychological well-being. CONCLUSION: Our findings shed light on the ethical dilemmas nurses are facing related to the duty to care. Not only has the coronavirus disease 2019 pandemic given rise to ethical challenges, but it has also affected nurses' well-being and willingness to work during a pandemic.


Subject(s)
COVID-19 , Nurses , Cross-Sectional Studies , Humans , Pandemics , Surveys and Questionnaires
9.
Midwifery ; 105: 103225, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34915446

ABSTRACT

OBJECTIVE: The growing prevalence of obesity is a concern for midwives. In Canada, the absence of regulatory standards, varying protocols and consultant preferences shape clinical decision making for the midwife and may lead to inconsistent practice. Our aim was to understand the barriers, enablers, and knowledge gaps that influenced experiences of midwives in Ontario, Canada when providing care to clients impacted by obesity. METHODS: Mixed methods design using a sequential, explanatory approach. Surveys conducted with midwives were administered using an online platform, followed by semi-structured interviews to understand the perspectives elicited in the survey in greater detail. Interviews were audio recorded and transcribed verbatim. Survey data were analyzed using descriptive statistics, and thematic analysis was used for generating codes, categories and themes from the interview data. RESULTS: 144 midwives completed the survey and 20 participated in an interview. The participants described their clinical management when caring for those with obesity which included considerations regarding additional tests/investigations, consultation and transfer of care, and place of birth. Up to 93% of surveyed midwives believed that clients with obesity were appropriate for midwifery-led care however there was less certainty about suitability as BMI increased to higher ranges such as > 45). The care management was influenced by beliefs and attitudes, knowledge, and system-level factors. Midwives experienced barriers such as inconsistent practices and role confusion, and felt ill equipped to care for pregnancies affected by obesity due to unclear guidelines. CONCLUSIONS: Overall, midwives believe clients with obesity are suitable for midwifery-led care due to its individualized, non-judgmental approach to care. Additional training for midwives and other obstetric care providers would be beneficial to help overcome barriers in providing effective care to pregnancies affected by obesity.


Subject(s)
Midwifery , Nurse Midwives , Attitude of Health Personnel , Female , Humans , Obesity/therapy , Ontario , Parturition , Pregnancy , Qualitative Research , Surveys and Questionnaires
11.
Zdr Varst ; 60(3): 152-157, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34249161

ABSTRACT

INTRODUCTION: The Safety Attitudes Questionnaire (SAQ) is among the most frequently cited tools for measuring safety culture in healthcare settings. Its ambulatory version was used in this study. The aim was to assess safety culture in out-of-hours (OOH) family medicine service and its variation across job positions, regions, and respondents' demographic characteristic. METHODS: A cross-sectional observational study was carried out targeting 358 health professionals working in the 29 largest Croatian healthcare centres providing out-of-hours family medicine service. The response rate was 51.7% (185 questionnaires). The questionnaire comprised 62 Likert items with 5 responses (fully disagree to fully agree). Scores of negatively worded items were reversed before analysis. Scores on the total scale and subscales were calculated as additive scores. The study included demographic data on gender, age, working experience, and job position. Repeated measurement analysis of variance was used to assess variation of Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV) sub-scales. RESULTS: Nurses assessed safety culture higher than did physicians and residents. Teamwork climate had higher scores than Ambulatory process of care and Organizational climate. Stress recognition and Perceptions of workload had the lowest overall scores. Variation across gender, age, working experience, and region was not statistically significant. CONCLUSIONS: SAQ-AV can be used to identify areas for improvement in patient safety at OOH GPs. There is a need to improve staffing and support for OOH GP residents. Further research is needed in order to gain better understanding of factors influencing observed variations among job positions.

12.
Scand J Prim Health Care ; 39(3): 322-331, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34128751

ABSTRACT

OBJECTIVE: To analyse and describe general practitioners' perceptions of the notion of a 'personal responsibility for health'. DESIGN: Interview study, phenomenographic analysis. SETTING: Swedish primary health care. SUBJECTS: General Practitioners (GPs). MAIN OUTCOME MEASURES: Using the phenomenographic method, the different views of the phenomenon (here: personal responsibility for health) were presented in an outcome space to illustrate the range of perceptions. RESULTS: The participants found the notion of personal responsibility for health relevant to their practice. There was a wide range of perceptions regarding the origins of this responsibility, which was seen as coming from within yourself; from your relationships to specific others; and/or from your relationship with the generalized other. Furthermore, the expressions of this responsibility were perceived as including owning your health problem; not offloading all responsibility onto the GP; taking active measures to keep and improve health; and/or accepting help in health. The GP was described as playing a key role in shaping and defining the patient's responsibility for his/her health. Some aspects of personal responsibility for health roused strong emotions in the participants, especially situations where the patient was seen as offloading all responsibility onto the GP. CONCLUSION: The notion of personal responsibility for health is relevant to GPs. However, it is open to a broad range of interpretations and modulated by the patient-physician interaction. This may make it unsuitable for usage in health care priority settings. More research is mandated to further investigate how physicians work with patient responsibility, and how this affects the patient-physician relationship and the physician's own well-being.Key PointsThe notion of personal responsibility for health has relevance for discussions about priority setting and person-centred care.This study, using a phenomenographic approach, investigated the views of Swedish GPs about the notion of personal responsibility for health.The participants found the notion relevant to their practice. They expressed a broad range of views of what a personal responsibility for health entails and how it arises. The GP was described as playing a key role in shaping and defining the patient's responsibilities for his/her health.The notion was emotionally charged to the participants, and when patients were seen as offloading all responsibility onto the GP this gave rise to frustration.


Subject(s)
General Practitioners , Attitude of Health Personnel , Female , Humans , Learning , Male , Physician-Patient Relations , Primary Health Care , Qualitative Research
13.
J Nurs Meas ; 29(2): 347-364, 2021 08 01.
Article in English | MEDLINE | ID: mdl-33795486

ABSTRACT

BACKGROUND AND PURPOSE: A new instrument was designed specifically to evaluate nurses' knowledge, attitude, and practice toward patients who use opioids. This study team developed and tested the psychometric properties of the Perception of Opioid Use Survey (POUS) instrument. METHODS: The instrument was tested among 306 nurses at a 183 bed acute care community hospital, with psychometric evaluation for validity, reliability, and exploratory factor analysis. RESULTS: Internal consistency results were Cronbach's alpha = .550 for the overall scale and each subscale: Self-Efficacy = .796, Attitudes = .744, Community Impact = .806, and Causative Factors = .763. CONCLUSIONS: Psychometric testing results support that the POUS is valid, reliable, and significantly correlated with theoretically selected variables.


Subject(s)
Analgesics, Opioid , Nursing Staff/psychology , Nursing Staff/statistics & numerical data , Psychometrics/standards , Substance Abuse Detection/psychology , Substance Abuse Detection/statistics & numerical data , Surveys and Questionnaires/standards , Adult , Attitude of Health Personnel , Factor Analysis, Statistical , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Reproducibility of Results
14.
J Subst Abuse Treat ; 115: 108033, 2020 08.
Article in English | MEDLINE | ID: mdl-32600620

ABSTRACT

BACKGROUND: How addiction treatment providers view different models of addiction has implications for workforce development and addiction treatment, however research exploring their views is limited. This study examined Australian, UK and US treatment providers': (1) levels of support for the psychosocial, disease model of addiction (DMA) and brain disease model of addiction (BDMA); and, (2) individual demographic characteristics that were associated with support for these models. METHODS: A total of 1438 treatment providers in Australia (n = 337), the UK (n = 165) and US (n = 936) completed an online survey. Support for the psychosocial and DMA were measured using the Short Understanding of Substance Abuse Scale (SUSS) (Humphreys et al., 1996) and BDMA support using a measure created by the authors. Hierarchical multiple linear regression analyses were used to analyze associations between treatment providers' demographic characteristics (i.e., previous addiction status, attended 12-step programmes, age, gender, education level) and level of support for each model. RESULTS: There were no significant differences in treatment providers' support for the psychosocial model between the three country groups. US participants had significantly higher levels of support for the DMA than the UK group, and the UK group was higher than the Australian group. US participants had significantly higher levels of support for the BDMA than Australian and UK participants. Regression analyses found that being younger in all three country groups and a higher level of education in the UK group was associated with greater psychosocial model support. A personal experience of addiction and 12-step programmes was associated with stronger support for the DMA, as was older age in the Australian and US treatment provider groups. In the US group, a personal experience of addiction and 12-step programmes was associated with support for the BDMA. CONCLUSION: Treatment providers from different backgrounds and in different countries vary in how they view the etiology of addiction. How differences in views about addiction impact service delivery and clients' experience of care remains an important topic for future research. Furthermore, policy makers should consider treatment providers' heterogenous views about addiction and the implications for service delivery and workforce policy development.


Subject(s)
Behavior, Addictive , Brain Diseases , Aged , Attitude of Health Personnel , Australia , Humans , United Kingdom
15.
Bioethics ; 34(3): 306-317, 2020 03.
Article in English | MEDLINE | ID: mdl-32100330

ABSTRACT

This paper is an analysis of the limits of family authority to refuse life saving treatment for a family member (in the Chinese medical context). Family consent has long been praised and practiced in many non-Western cultural settings such as China and Japan. In contrast, the controversy of family refusal remains less examined despite its prevalence in low-income and middle-income countries. In this paper, we investigate family refusal in medical emergencies through a combination of legal, empirical and ethical approaches, which is highly relevant to the ongoing discussion about the place of informed consent in non-Western cultures. We first provide an overview of the Chinese legislation concerning informed consent to show the significance of family values in the context of medical decision-making and demonstrate the lack of legal support to override family refusal. Next, we present the findings of a vignette question that investigated how 11,771 medical professionals and 2,944 patients in China responded to the family refusal of emergency treatment for an unconscious patient. In our analysis of these results, we employ ethical reasoning to question the legitimacy of family refusal of life-sustaining emergency treatment for temporarily incompetent patients. Last, we examine some practical obstacles encountered by medical professionals wishing to override family refusal to give context to the discussion.


Subject(s)
Decision Making , Emergency Treatment , Family , Social Values/ethnology , Treatment Refusal/ethics , Treatment Refusal/legislation & jurisprudence , China , Humans , Informed Consent/legislation & jurisprudence , Mental Competency/legislation & jurisprudence
16.
J Obstet Gynaecol Can ; 42(1): 16-24, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31787548

ABSTRACT

OBJECTIVE: This study aimed to explore the attitudes of obstetrics and gynaecology residents in Canada towards interventions that influence caesarean section rates. The study looked at residents' attitudes towards four guidelines that support vaginal and assisted delivery (vaginal birth after caesarean section, induction of labour, operative vaginal birth, and fetal health surveillance in labour) and towards Society of Obstetricians and Gynaecologists of Canada (SOGC) guidelines in general. The study also sought to investigate whether these attitudes vary by residency training location. METHODS: An online survey of obstetrics and gynaecology residents across Canada was conducted. Residents responded to statements derived from guidelines using a five-point attitudinal scale and to an optional long-answer question about how residency has prepared them to make decisions around interventions. Descriptive summary statistics are used to present the findings (Canadian Task Force Classification III). RESULTS: A total of 27% of residents completed the survey. The majority demonstrated attitudes congruent with guidelines and favourable towards SOGC guidelines in general. Residents attitudes were least favourable towards electronic fetal monitoring, with 67.4% of responses congruent with the guideline. Attitudes were most aligned with the operative vaginal birth guideline, with 87.9% of responses congruent with the guideline. This sample was underpowered to detect statistically significant differences among residency programs, although there was some variation in attitudes across programs, with the most congruent scoring program at 81.8% congruent responses and the lowest at 66.7%. CONCLUSION: Obstetrics and gynaecology residents in Canada have favourable attitudes towards interventions that support vaginal and assisted delivery. There was variability in observed attitudes across programs, although this was not statistically significant.


Subject(s)
Attitude of Health Personnel , Cesarean Section , Gynecology/education , Internship and Residency , Obstetrics/education , Practice Guidelines as Topic , Students, Medical , Adult , Canada , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pregnancy , Societies, Medical , Surveys and Questionnaires , Young Adult
17.
Eur J Clin Pharmacol ; 76(2): 285-290, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31732756

ABSTRACT

BACKGROUND: Many patients receive Z-drugs for hospital-associated sleep problems, in spite of well-known risks. The aim of this study was to learn more about the attractiveness of Z-drugs, seen from the doctors' and nurses' perspective. METHODS: Using a standardized questionnaire, doctors (63/116) and nurses (73/243) in a German general hospital were surveyed about the risks and benefits of Z-drugs, compared with benzodiazepines. RESULT: "Reduced time to get to sleep" was perceived by doctors (51%) and nurses (53%) to be a strong benefit of Z-drugs; "confusion" and "falls" were perceived by ca. 10% of doctors and ca. 15% of nurses to be a frequent problem. Compared with benzodiazepines, respondents more often answered "unable to judge" for Z-drugs; e.g. for doctors, 18% (benzodiazepines) vs. 45% (Z-drugs) were unable to judge "improved daytime functioning" and 12% (benzodiazepines) vs. 37% (Z-drugs) were unable to judge "falls." CONCLUSION: Z-drugs seem to be attractive because experiential knowledge overemphasizes their benefits and fails to take risks such as drug-related falls and confusion into account. Difficulties to judge a drug's risk-benefit ratio do not prevent doctors and nurses from using them. Interventions for reducing Z-drug usage should incorporate local quality assurance data about relevant patient risks.


Subject(s)
Benzodiazepines/administration & dosage , Hypnotics and Sedatives/administration & dosage , Nurses/statistics & numerical data , Physicians/statistics & numerical data , Attitude of Health Personnel , Benzodiazepines/adverse effects , Cross-Sectional Studies , Female , Germany , Hospitals , Humans , Hypnotics and Sedatives/adverse effects , Male , Sleep Wake Disorders/drug therapy , Surveys and Questionnaires
18.
Psychiatr Serv ; 71(4): 337-342, 2020 04 01.
Article in English | MEDLINE | ID: mdl-31847736

ABSTRACT

OBJECTIVE: The authors designed this project to identify barriers to using long-acting formulations of antipsychotics. METHODS: The authors used a focused ethnographic approach. Patients, psychiatrists, nurses, therapists and administrators were interviewed about barriers to use of long-acting injectable (LAI) antipsychotics at six facilities in New York State, as were representatives from insurance firms, a pharmaceutical company, and a national professional organization. Interviews were conducted and analyzed by a central team not affiliated with the institutions. RESULTS: Interviews were obtained with 23 patients, 16 psychiatrists, three nurses, 23 therapists, 14 administrators, four insurers, one representative from a pharmaceutical industry, and one representative from a national organization. Major barriers identified from the interviews included restricting discussions about LAI medication to only patients with nonadherence or repeated hospitalizations; inadequate education efforts with patients about LAI antipsychotics; inadequate support for patients making medication decisions; lack of communication within the treatment team about issues relevant to use of LAI formulations by patients; therapists' limited knowledge about LAI antipsychotics, which restricted their role in supporting patients making treatment decisions; psychiatrist concerns about the pharmacologic properties of LAI formulations; lack of clinic infrastructure to support LAI prescriptions; and payer concerns about whether the immediate costs of LAI administration would translate into later potential cost benefits. CONCLUSIONS: Effective shared decision making about use of LAI antipsychotics requires that patients receive accurate information and support for their decision making. The training needs and administrative support requirements of all team members should be considered to provide patients with the information and support required.


Subject(s)
Antipsychotic Agents/therapeutic use , Attitude of Health Personnel , Decision Making, Shared , Health Communication , Health Knowledge, Attitudes, Practice , Health Services Research/methods , Professional-Patient Relations , Schizophrenia/drug therapy , Adult , Delayed-Action Preparations , Humans , Injections , Qualitative Research
19.
Article in English | MEDLINE | ID: mdl-31710802

ABSTRACT

PURPOSE: Interprofessional education (IPE) is a concept that allows students from different health professions to learn with and from each other as they gain knowledge about their chosen professions and the professions of their colleagues. The purpose of this systematic review was to determine the effectiveness of IPE in the academic preparation of students of the health professions. METHODS: A search was conducted of the PubMed and CINAHL databases using the following eligibility criteria: IPE including students from 3 or more healthcare professions, IPE exposure within academic coursework, measurement of attitudes and/or perceptions as outcomes, and quantitative reporting of results. Articles were screened by title, abstract, and full text, and data were extracted. RESULTS: The search yielded 870 total articles. After screening, 7 articles remained for review. All studies reported a positive impact of IPE on the education of students of the health professions. CONCLUSION: Evidence showed that IPE activities were an effective tool for improving attitudes toward interdisciplinary teamwork, communication, shared problem-solving, and knowledge and skills in preparation for collaboration within interdisciplinary teams.


Subject(s)
Clinical Competence/standards , Health Occupations/education , Interprofessional Relations/ethics , Students, Health Occupations/psychology , Attitude of Health Personnel , Communication , Evaluation Studies as Topic , Humans , Interdisciplinary Communication , Knowledge , Problem Solving , Social Change , Students, Health Occupations/statistics & numerical data
20.
Int J Older People Nurs ; 14(4): e12268, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31486587

ABSTRACT

BACKGROUND: The ageing population is increasing, and negative attitudes towards older people are all too common and largely overlooked. However, little research has examined how ageist, prejudice, and discrimination, that often occur in healthcare settings, impact the community's perceptions of entering Residential Aged Care (RAC) in the future. In particular, studies have not investigated how contact with RAC influences individuals' attitudes towards RAC facilities, residents and staff. This study is the first to examine individuals' resistance towards living in RAC using the contact hypothesis, a theory of prejudice reduction. AIMS: To explore how positive or negative contact with RAC residents and staff impacts individuals' behavioural intentions towards entering RAC in the future. To examine whether perceptions of trust, independence and RAC staff mediate the relationship between contact and behavioural intentions towards entering RAC in the future. DESIGN: A cross-sectional survey design. METHOD: Data were collected via online surveys using contact (positive or negative), trust, independence, perceptions of RAC staff and resistance levels (mild refusal or extreme refusal) measures. Participants (n = 373) from Australia and USA were recruited using social media, word of mouth and Amazons Mechanical Turk. FINDINGS: Individuals who experienced negative contact with RAC residents and staff were more likely to report intense resistance to RAC, "I would rather die than enter RAC". Whereas, positive contact with RAC residents and staff was associated with reductions in the adverse appraisal of RAC staff; a diminished perception that individuals lost their independence, and an increased trust in RAC residents, facilities and staff. Participants from USA reported greater levels of resistance towards RAC in comparison with participants from Australia. This study demonstrates how interactions with RAC residents, facilities and staff are critical in shaping attitudes towards RAC. IMPLICATIONS FOR PRACTICE: It is recommended that the public are exposed to opportunities where they can experience positive contact with RAC. RAC facilities can promote interaction between the public and RAC residents through encouraging participation in community partnership programs/intergenerational programs.


Subject(s)
Adaptation, Psychological , Attitude , Homes for the Aged , Patient Admission , Adult , Aged , Aged, 80 and over , Australia , Cross-Sectional Studies , Cultural Characteristics , Female , Health Services for the Aged , Humans , Internet , Male , Middle Aged , Surveys and Questionnaires , United States , Young Adult
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