A Psychological Service Dedicated to Work-Related Stress: the Experience at Perugia General Hospital.

INTRODUCTION: The characteristics of the working environment significantly influence the mental well-being of workers, and the presence of unfavorable conditions in the workplace can have a negative impact on mental health. Healthcare professionals are particularly exposed to the risk of burnout and the development of psychiatric, and particularly affective, symptoms. This paper aims to describe the activity of a psychological support service dedicated to work-related stress at the General Hospital of Perugia, Italy. SUBJECTS AND METHODS: In June 2022, a free and anonymous psychological service dedicated to healthcare professionals was established at the Perugia General Hospital. The main objectives of the service were to promote overall well-being of workers, to provide psychological support, and to address professionals towards specific pathways to care. RESULTS: The activity of the service consisted of clinical consultations with psychiatrists and psychologists who also administered psychometric tools to better characterize the overall clinical picture. After the clinical evaluation process, healthcare professionals who accessed the service were addressed to specific pathways of care, when needed. The data collection carried out from June 2022 to April 2024 showed a total number of 139 accesses to the Service, with a majority of requests from women (80%) and mainly belonging to nursing staff (53%). CONCLUSIONS: Preliminary data from the psychological service dedicated to healthcare professionals confirms the high prevalence of work-related stress, especially in specific settings. In the near future, psychological support services are expected to identify work-related stress situations as soon possible, possibly contributing to the reduction of stigma and to the built of healthier working environments.

Ethical self-efficacy among healthcare professionals caring for people with dementia: a brief pre- and post-report on the CARE intervention.

BACKGROUND: Interventions targeting healthcare professionals' confidence in managing ethical issues in dementia care are limited despite documented positive effects of educational programs on staff knowledge and self-efficacy. However, inconsistencies in the literature regarding the impact of educational programs underscore the need for targeted interventions. The CARE intervention, specifically designed to enhance confidence in ethical decision-making, aims to address this gap. This study evaluates the effectiveness of the CARE intervention in enhancing the ethical self-efficacy of healthcare professionals caring for people with dementia, particularly those with initially low levels of self-efficacy. METHODS: Using a non-experimental pre-post evaluation design, the CARE intervention was administered to healthcare professionals (n = 86), measuring ethical self-efficacy pre-and post-intervention. We hypothesized significant differences in ethical self-efficacy mean scores pre- and post-intervention for all participants, particularly those with low pre-measurement scores, whom we expected to benefit most from the intervention. Statistical analysis included paired t-tests and Wilcoxon tests for the low pre-measurement subgroup analysis. RESULTS: While no significant change was observed in the entire sample, participants with low initial self-efficacy showed a statistically significant improvement post-intervention. CONCLUSIONS: The CARE intervention holds promise in improving ethical self-efficacy among healthcare professionals with initial low confidence levels. Targeted interventions are essential in addressing confidence gaps in managing ethical challenges in dementia care, with implications for professional well-being and quality of care. Further research should explore long-term effects and expand sample size to enhance generalizability and sustainability of findings.

Development and validation of an instrument to evaluate the perspective of using the electronic health record in a hospital setting.

BACKGROUND: Evaluating healthcare information systems, such as the Electronic Health Records (EHR), is both challenging and essential, especially in resource-limited countries. This study aims to psychometrically develop and validate an instrument (questionnaire) to assess the factors influencing the successful adoption of the EHR system by healthcare professionals in Moroccan university hospitals. METHODS: The questionnaire validation process occurred in two main stages. Initially, data collected from a pilot sample of 164 participants underwent analysis using exploratory factor analysis (EFA) to evaluate the validity and reliability of the retained factor structure. Subsequently, the validity of the overall measurement model was confirmed using confirmatory factor analysis (CFA) in a sample of 368 healthcare professionals. RESULTS: The structure of the modified HOT-fit model, comprising seven constructs (System Quality, Information Quality, Information technology Service Quality, User Satisfaction, Organization, Environment, and Clinical Performance), was confirmed through confirmatory factor analysis. Absolute, incremental, and parsimonious fit indices all indicated an appropriate level of acceptability, affirming the robustness of the measurement model. Additionally, the instrument demonstrated adequate reliability and convergent validity, with composite reliability values ranging from 0.75 to 0.89 and average variance extracted (AVE) values ranging from 0.51 to 0.63. Furthermore, the square roots of AVE values exceeded the correlations between different pairs of constructs, and the heterotrait-monotrait ratio of correlations (HTMT) was below 0.85, confirming suitable discriminant validity. CONCLUSIONS: The resulting instrument, due to its rigorous development and validation process, can serve as a reliable and valid tool for assessing the success of information technologies in similar contexts.

How to meet coping strategies and preferences of children during invasive medical procedures: perspectives of healthcare professionals.

Children with negative procedural experiences have an increased risk of fear and distress, with psychological consequences for subsequent procedures and future healthcare behaviors. Gaining control and feeling trust are important aspects for children to decrease fear. To enable professionals providing personal care during medical procedures, a systematic, evidence-based approach that supports children in expressing their preferences is needed. This study will gain insight into the experiences and needs of professionals involved in small invasive medical procedures to meet the coping strategies and preferences of children undergoing these procedures. A qualitative design was used to gain insight into professionals' perspectives. Data were collected through online focus groups with various professionals involved in medical procedures, such as anesthetists, laboratory staff, nurses, and pediatricians. Five interdisciplinary focus groups, with a total of 32 participants, were held. One overarching theme was revealed: "Balancing between different actors within the context of the hospital." Professionals reported they had to deal with different actors during a medical procedure: the child, the parent, the colleague, and themselves. Each actor had its own interests. They were aware of the child and parents' priority to gain control and feel trust. Nevertheless, they perceive organizational and personal aspects that hinder addressing these needs. CONCLUSION: To provide personalized care, professionals experience balancing between the needs and interests of diverse actors during medical procedures. The findings underscore the importance of a policy supporting HCPs in integrating patient-centered care into practice through practical tools and training initiatives such as scenario training. WHAT IS KNOWN: • Unresolved pain and stress arising from medical procedures can have significant short- and long-term impacts on children. Empowering children to gain control and fostering a sense of trust are crucial factors in reducing fear associated with medical procedures. • Children and parents expect to receive child-tailored care from professionals including respect for their own, unique needs, and boundaries. Professionals should build trustful relationships and provide appropriately tailored autonomy around medical procedures. WHAT IS NEW: • Healthcare professionals vary in their awareness of children's needs during a medical procedure. Beside this, the organizational dynamics of the hospital, along with the presence of actors such as the child, parent, colleague, and oneself, collectively influence the conduct of medical procedures. • Providing person-centered care during medical procedures can present challenges. The results highlight the significance of a policy to assist healthcare professionals in incorporating patient-centered care into their practice through practical tools and a culture of self-reflections regarding patient-centered values.

Does organisational myopia mediate the effect of occupational health and safety practices on the risk of occupational accidents in Turkish healthcare institutions?

Occupational health and safety (OHS) policies in healthcare institutions must be well managed, because healthcare practice involves many physical, biological, ergonomic, chemical, and psychosocial hazards that can affect the health of healthcare workers. In addition, their work performance may be affected by the so-called organisational myopia. In this context, the aim of our study was to determine how organisational myopia affects OHS practices in healthcare institutions and whether it increases the risk of occupational accidents. The study population consisted of a convenience sample of 420 healthcare professionals working throughout Turkey who completed a questionnaire addressing these three domains: organisational myopia, OHS practices, and risk of occupational accidents. Their responses were analysed with exploratory factor analysis, reliability analysis, and Spearman's correlation to assess the adequacy of measurement tools and identify relationships between variables, followed by mediation analysis. We found that OHS practices mitigate organisational myopia and the risk of occupational accidents. We also found no significant effect of organisational myopia on the risk of occupational accidents. Our findings underscore the importance of OHS practices in healthcare institutions and that organisational myopia should be evaluated in special contexts such as working time, experience, or routinisation.

Electronic health records model to improve the quality of patients' healthcare.

Background: Electronic health records (EHR) has been acknowledged for bringing down healthcare costs and enhancing hospital service standards. Aim: The aim of this study was to develop an EHR model to lower patient treatment costs and enhance healthcare quality in South African public healthcare. Methods: In this study, a cross-sectional quantitative methodology was used. The research data for this study were provided by medical healthcare professionals, at Dr. George Mukhari Academic Hospital (DGMAH). This included doctors, nurses, pharmacists, radiologists, and radiographers who completed a semi-structured questionnaire. Results: The final model's findings show that the use of EHR significantly improves information quality (IQ) and positively influences medical errors reduction (MER). Knowledge quality (KQ) has a positive significant impact on MER, whereas IQ has a considerable negative impact on MER. Furthermore, cost reduction in patient treatment (CRPT) has a positive significant influence on MER. Conclusion: Patients obtain better medical care when medical professionals have access to complete and accurate information. Medical errors can be reduced or even prevented with the use of EHRs, which can lead to better patient outcomes. Contribution: The quality of patient care at South African public hospitals and in other developing countries can be enhanced by using this framework as a guide to reduce treatment costs.

The Awareness of and Adherence to the Pregnancy Prevention Program for Oral Retinoids: A Questionnaire Survey in Denmark.

PURPOSE: We aimed to investigate the awareness of oral retinoid teratogenicity and the adherence to the pregnancy prevention program (PPP) related to oral retinoid use by physicians, pharmacists, and patients in Denmark. METHODS: As part of the multi-country survey, web-based questionnaires were distributed among Danish dermatologists, general practitioners, community pharmacists, and women of childbearing age, who were using or had used oral retinoids within the past 5 years. RESULTS: A total of 62 physicians, 96 pharmacists, and 50 oral retinoid using women responded; 95%, 100%, and 98%, respectively, were aware of the teratogenic risks of oral retinoids. For physicians, the most applied PPP measures were the usage of the patient (44%) and the healthcare professional (19%) guides, while the least applied measure was signing medication risk awareness form (3%). Among the pharmacists, the warning sign on the outer medication package was the most used measure (45%). Among the women, a majority (90%) had read the patient information leaflet included in the medication package and 72% discussed the use of contraception with their healthcare provider, while risk awareness forms and patient cards were seen by only few. CONCLUSIONS: In Denmark, physicians, pharmacists, and medicine users were aware about the teratogenic effects of oral retinoids. Adherence to pregnancy prevention measures varied, suggesting unwillingness to use the measures that require patients' signatures among physicians and a lack of awareness of pharmacy targeting measures. Accessibility of the latter measures need to be optimized to improve the safety of oral retinoid use.

'Pain free if I ever will be': lived experience of workers seeking care for pain attributed to musculoskeletal disorders.

BACKGROUND: Pain attributed to musculoskeletal disorders are a significant hinderance to work ability and economic growth, especially in developing countries. Quality of life and lived experience of workers with musculoskeletal disorders have not been explored enough to determine whether person-centred care is provided. There is a wealth of evidence for using the biomedical approach in the management of workers with musculoskeletal disorders, which has proved ineffective in reducing absenteeism and symptoms experienced by workers. The purpose of this study was to explore the lived experience of workers seeking care for musculoskeletal disorders and how their pain attitudes and beliefs influenced their experience. METHODS: A qualitative approach with thematic analysis was used. Purposive sampling was used to recruit six participants for semi-structured interviews. All participants were either experiencing pain attributed to a musculoskeletal disorder or had received care for a musculoskeletal disorder. RESULTS: Pain attitudes and beliefs of workers with a musculoskeletal disorder and healthcare professionals greatly influenced the care and recovery process of musculoskeletal disorders. There is a primary biomedical lens informing care of workers with musculoskeletal disorders received. Workers expect healthcare professionals to explore their concerns further, but the focus of care for most participants was their presenting complaint. There is also a need for the autonomy of workers to be preserved, and communication between healthcare professionals and workers with musculoskeletal disorders needs to improve. CONCLUSIONS: Many stakeholders are involved in the recovery process from musculoskeletal disorders. There is a need for a biopsychosocial informed practice to improve return-to-work (RTW) in workers with musculoskeletal disorders. Change is needed at all healthcare system levels to reduce the negative experiences of workers and maladaptive pain beliefs that is associated with persisting symptoms and extended absenteeism.

Peer-to-Peer Human Milk Sharing Through Social Media Groups: The Experiences of Women Donors and Recipients in Hong Kong.

AIM: To explore the lived experience of donors and recipients involved in peer-to-peer human milk donation. DESIGN: An exploratory descriptive qualitative study. METHOD: Semi-structured interviews were conducted between November 2022 and April 2023. A total of 50 women consisting of 34 donors and 16 recipients were recruited using purposive sampling from specific social media groups in Hong Kong that focus on breast milk donation and sharing. Data were analysed based on thematic analysis. RESULTS: Five key themes were identified in this study: Motivation; Milk sharing as a social act; Not a Norm; Recommendation to formal milk banks; and Formal donation as the preferred route. CONCLUSION: The findings indicate informal milk sharing is seen as an inferior alternative to formal milk donation systems. The establishment of formal milk banks is viewed as a way to address the shortcomings of informal sharing. IMPLICATIONS FOR THE PROFESSION: The findings have implications for the healthcare field, particularly in improving the experiences of those involved in informal milk sharing. The insights gained from the experiences of informal milk sharers can directly inform and enhance the services provided by formal milk banks. IMPACT: Given the growing prevalence of online informal milk sharing, healthcare professionals should enhance their understanding of this practice. However, the practice has remained understudied, particularly in Asian region. This study brings together the experiences of both milk donors and recipients, providing a comprehensive view on the phenomenon. REPORTING METHOD: The Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Investigating the influencing factors of evidence-based healthcare practice adoption.

BACKGROUND:  In healthcare facilities, evidence-based healthcare practice (EBHP) is becoming more widely acknowledged as a critical element of patient care delivery. An increasingly important component of EBHP is the implementation of electronic health records (EHRs). OBJECTIVES:  This study aims to investigate factors that influence EBHP adoption in public healthcare institutions in South Africa. METHOD:  Four hundred and fifty patients were self-administered to healthcare professionals at an academic public hospital in Gauteng and used in this study. A total of 300 responses were available for use in the final analysis following the data cleaning procedure. Utilising structural equation modelling (SEM), the collected data were analysed. RESULTS:  Perceived ease of use (PEOU) and perceived usefulness (PU) were found to be major variables in the adoption of EBHP along with technological, organisational and environmental factors. The technology context relative advantage (RELA) was shown to have a positive significant influence on the adoption of evidence-based healthcare practice by the PEOU and PU, with the environmental context government laws and regulations (GLRS) and organisational context organisational readiness (ORGR) coming in second and third, respectively. CONCLUSION:  Perceived ease of use, PU, ORGR, and GLRS are regarded as a vital variables in the implementation of EBHP in South African public hospitals.Contribution: The study's conclusions would be helpful to policymakers as they redefine nursing practice. Furthermore, the findings heighten the consciousness of healthcare practitioners regarding the significance of employing evidence-based practice while making decisions.

An evaluation of support to the second victims in Tshwane District Health Services, South Africa.

BACKGROUND:  Initiatives to reduce patient safety incidents (PSI) and support healthcare professionals who may experience psychological trauma as a result are becoming increasingly common. However, little is known about the quality of the support provided by Tshwane District Health Services. Therefore, it is necessary to assess their assistance for the second victims in order to evaluate their effectiveness. METHODS:  A cross-sectional study was conducted, and 319 healthcare professionals from six primary health care institutions were invited to participate in the study. The sociodemographic information, work experience, emotional support, familiarity with the concept of the 'second victim' and involvement with PSIs were collected. RESULTS:  The mean age was 39.8 years, ranging from 22 years to 66 years. The majority of participants were females (n = 249; 78.1%), nurses (n = 153; 49.2%), and those with 5-9 years of experience (n = 82; 25.8%). Most participants (n = 168; 52.7%) were aware of the possibilities of emotional support, while less than half (n = 142; 44.5%) were familiar with the term 'second victim'. The cumulative incidence of adverse events in the institutions was 19.4%, and the majority of second victims (n = 39; 62.9%) emotionally felt the need to speak with someone about it, preferably outside of the workplace. Less than 5% of individuals received support that was initiated by existing structures at their workplace. CONCLUSION:  Frameworks exist to assist second victims, although they are only known to some healthcare professionals. However, their current use in Tshwane health facilities is ineffective. After experiencing PSIs, second victims often rely on psychological assistance outside of the workplace.Contribution: Authorities need to determine the causes behind some healthcare professionals' lack of awareness regarding the support framework for second victims, as well as their growing tendency to rely on psychologists outside of the workplace, and corrective measures should be implemented.

Disrupted Candidacy: A Longitudinal Examination of the Constrained Healthcare-Access Journeys of National Health Service Workers in Scotland Seeking Supports for Long COVID Illness.

INTRODUCTION: Evidence examines how persons experiencing Long COVID (LC) struggle to secure healthcare for symptoms. However, few studies examine healthcare workers experiencing LC, nor the complex and multiple difficulties faced when seeking and receiving healthcare. METHODS: This study is based on two phases of longitudinally conducted qualitative interviews, 6 months apart, with National Health Service (NHS) workers experiencing LC, from different occupational roles at NHS locales in Scotland (first interviews, n = 50; second interviews, n = 44). RESULTS: Multiple factors restricted healthcare access, including worries about pressuring the NHS and concerns over LC being legitimised. When healthcare was sought, workers struggled to secure support, referrals and treatment. The following reasons were included: (1) context: the restrictive pandemic healthcare context; (2) illness climate: low GP knowledge surrounding LC and how this could be treated, trends for ascribing symptoms to other causes and reluctance to diagnose LC; (3) sense-making of LC: healthcare availability linked to occupational role identity. To visualise and examine healthcare barriers, candidacy theory is applied, drawing inferences between healthcare context, illness climate, sense-making and identities. CONCLUSION: NHS workers' complex journeys represent Disrupted Candidacy, intersecting challenges across candidacy domains, restricting the seeking and receiving of LC healthcare. Findings provide insights into why NHS workers resisted and withdrew from healthcare-seeking, and the barriers they faced when attempting to secure LC support. This study presents a pathway for future LC illness research to use a modified candidacy theory framework. PATIENT AND PUBLIC CONTRIBUTION: This research focuses on amplifying and learning from lived experiences, and the voices of NHS workers in Scotland experiencing LC. Interviews represent primary data for this study; thus, participants and their healthcare journeys are centred in this research and all aspects of production, reporting and output. Explicit discussions of stakeholder group involvement are highlighted in the methods section.

Assessing the Quality of Life of Healthcare Professionals in High-Stress Units at a Tertiary Health Centre in South-eastern Nigeria.

INTRODUCTION: Work serves as a fundamental pillar of human life, shaping both individual livelihoods and societal engagements. The intricacies of the work environment play a pivotal role in determining the Quality of Life (QoL), with increasing emphasis on creating conducive workspaces that enhance employee satisfaction and productivity. Healthcare professionals, in particular, face various factors that contribute to occupational stress and such stressors can adversely affect their health and diminish their QoL. OBJECTIVE: This study sought to assess the quality of life of healthcare professionals in the Intensive Care Units (ICUs) and other stressful units in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi. METHODOLOGY: A cross-sectional study was conducted involving 296 consenting participants after approval from the ethics and research committees at NAUTH, Nnewi. They were selected using a two-stage sampling approach. Data were collected with a structured self-administered questionnaire adopted from the World Health Organization Quality of Life scale (WHOQOL-BREF) and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. The level of significance was set at P < 0.05. RESULTS: The results showed the mean overall quality of life score was 74.62 ± 14.0, the mean score for the physical domain (59.15 ± 12.49), the psychological domain (70.16 ± 13.46), the social domain (65.82 ± 18.19), and the environmental domain (53.90 ± 15.49). The majority 268 (90.5%), of the respondents had good quality of life. The profession (X2 =12.44, p<.05), years of work experience (X2 = 25.85, p<.05), and income level (X2 = 19.56, p<.05), show a statistically significant association with quality of life. CONCLUSION: The result obtained from this study shows that the majority of the respondents report a good quality of life. Most respondents with poor quality of life were attributed to their profession, years of work experience and income.

INTRODUCTION: Le travail est un pilier fondamental de la vie humaine, qui façonne à la fois les moyens de subsistance individuels et les engagements sociétaux. Les subtilités de l'environnement de travail jouent un rôle essentiel dans la détermination de la qualité de vie (QoL), et l'accent est mis de plus en plus sur la création d'espaces de travail propices à l'amélioration de la satisfaction et de la productivité des employés. Les professionnels de la santé, en particulier, sont confrontés à divers facteurs qui contribuent au stress professionnel et ces facteurs de stress peuvent nuire à leur santé et diminuer leur qualité de vie. OBJECTIF: Cette étude visait à évaluer la qualité de vie des professionnels de la santé dans les unités de soins intensifs (USI) et autres unités stressantes du Nnamdi Azikiwe University Teaching Hospital (NAUTH) de Nnewi. MÉTHODOLOGIE: Une étude transversale a été menée auprès de 296 participants consentants, après approbation des comités d'éthique et de recherche du NAUTH, à Nnewi. Ils ont été sélectionnés à l'aide d'une méthode d'échantillonnage en deux étapes. Les données ont été recueillies à l'aide d'un questionnaire structuré auto-administré adopté à partir de l'échelle de qualité de vie de l'Organisation mondiale de la santé (WHOQOL-BREF) et analysées à l'aide du logiciel SPSS (Statistical Package for Social Sciences) version 25.0. Le niveau de signification a été fixé à P < 0,05. RÉSULTATS: Les résultats ont montré que le score global moyen de qualité de vie était de 74,62 ± 14,0, le score moyen pour le domainephysique (59,15 ± 12,49), le domaine psychologique (70,16 ± 13,46), le domaine social (65,82 ± 18,19) et le domaine environnemental (53,90 ±15,49). La majorité des 268 (90,5%) répondants avaient une bonne qualité de vie. La profession (X2 = 12,44, p<0,05), les années d'expérience professionnelle (X2 = 25,85, p<0,05) et le niveau de revenu (X2 = 19,56, p<0,05) présentent une association statistiquement significative avec la qualité de vie. CONCLUSION: Les résultats de cette étude montrent que la majorité des personnes interrogées déclarent avoir une bonne qualité de vie. La plupart des répondants ayant une mauvaise qualité de vie sont attribués à leur profession, au nombre d'années d'expérience professionnelle et à leur revenu. MOTS CLÉS: Qualité de vie (QoL) ; Professionnels de la santé ; Unités à haut niveau de stress ; Centre de santé ; Nigeria.

Positive vaccine beliefs linked to reduced mental stress in healthcare professionals during COVID-19: a retrospective study.

Background and aim: The COVID-19 pandemic has led to a significant adverse effect on the mental health of healthcare professionals. This study aims to assess the effects of the prolonged pandemic on burnout and mood disorders and to evaluate the influence of positive vaccination beliefs on these factors at a medical center during the extended COVID-19 pandemic. Methods: This retrospective study analyzed the results of an online questionnaire survey including burnout status and mood disorders from 2020 to 2022. The factors related to mood moderate/severe disorders and the impact of the positive vaccine belief were also explored. Results: The initial analysis revealed that healthcare professionals continued to experience significant levels of personal and work-related burnout, along with mood disorders. However, the scores and the percentage of moderate to severe burnout gradually decreased. Notably, the percentage of individuals with moderate to severe mood disorders also gradually declined (2020: 13.4%, 2021: 12.3%, 2022: 11.1%). The number of participants who need professional interventions decreased from 56.2% in 2020 to 45.9% in 2021, and 46% in 2022. Multivariate analysis revealed a positive vaccine belief was associated with a lower risk of moderate/severe mood disorders, with odd ratios (OR) and 95% confidence intervals (95% CI) of 0.38 (0.28 - 0.52) and 0.41 (0.30 - 0.52) in the 2021 and 2022 cohorts, respectively. Further investigation revealed that age over 50 was linked to a positive vaccine belief in 2021 and 2022. Within the 2022 cohort, working as nurses was identified as the independent factor associated with a less positive belief, with the OR and 95% CI of 0.49 (0.27 - 0.90). Conclusion: The findings of the present study suggest burnout and mood disorders are still significant during the pandemic. A positive vaccine belief may mitigate pandemic-related mental distress. Further interventions to enhance the belief combined with other supporting measures are important in a long fight against the pandemic.

Truth to Action: Lived Experiences of Indigenous Healthcare Professionals Redressing Indigenous-Specific Racism.

STUDY BACKGROUND: The experience of discrimination through stereotyping, profiling, and bias-informed care not only leads to poor access to healthcare services, but low retention rates of Indigenous health professionals (IHP). As health systems transformation evolves, a significant gap remains in supporting IHP to safely address racism, to be supported culturally to bring their authentic selves and voices to work, and to attend to one's own intellectual, physical, relational, cultural and spiritual wellness within a westernized model of care. PURPOSE: The aim of the study was to investigate the experiences of IHP working in mainstream healthcare in order to understand how their work environment impacts the delivery of cultural safe practices. What is reported in this manuscript, as an exercise in truth-telling, is findings about lived experiences of IHP working in one mainstream provincial healthcare region, and not the whole context and outcomes of the study. METHODS: Using Indigenous research methodologies, we embodied our Indigeneity into every facet of the research process. We facilitated three talking circles with participants grounded in a distinct cultural and ceremonial context following Secwepemc protocols. RESULTS: The collective voices of IHP revealed the following common experiences: confronting genocide; addressing Indigenous-specific racism; uprooting toxicity and inequities; and upholding Indigenous human rights while enhancing accountability of systems transformation. CONCLUSIONS: The experience of IHP working in health systems goes beyond mere individual employment obligations, its often about a families and communities advocacy for Indigenous rights, culturally safe working environments and access to dignified and respectful healthcare service. This study highlights the need for IHP to be actively involved in health system transformation to ensure the redesigning and restructuring of healthcare service delivery by and for Indigenous Peoples remains centered on Indigenous health and human rights.

Characteristics of a Successful Nurse Peer Champion in the Implementation of Innovative Digital Technologies in Hospitals: A Qualitative Study.

Objectives: Using the Motivational Theory of Role Modelling as a framework, this study explores which attributes nurses deem essential for an effective peer champion, particularly in digital transformation processes within hospitals. Methods: A qualitative study was conducted with semi-structured interviews. Transcripts were coded using a hybrid approach of inductive and deductive coding and analysed using thematic analysis. Results: Ten nurses from Germany participated. The attributes most often mentioned were competence, taking on responsibility, a positive and passionate attitude, transferring knowledge and supporting aspirants in applying it, and leadership skills. Four types of champions were identified: a pragmatic and structured champion, a passionate innovator, a social and outgoing team leader, and a calm and empathetic team leader. Conclusions: The findings largely align with the body of literature on peer champion characteristics in other populations and should therefore be used to guide peer champion application in hospitals to enhance effective implementation of innovations. Innovation: The identification of four unique champion types offers an innovative contribution to the field. Highlighting the unique requirements of nurses when implementing innovative technologies in healthcare, this study emphasises the importance of involving end-users in the design and implementation process of new technologies, a crucial step towards a more sustainable and user-centred digital health ecosystem.

Exploring the perspectives of healthcare professionals regarding artificial intelligence; acceptance and challenges.

OBJECTIVES: The main objective of the study was to explore the perspectives of healthcare professionals (HCPs) regarding artificial intelligence (AI) and to identify challenges in its incorporation in the healthcare sector of Pakistan. METHODS: A qualitative exploratory study design was adopted. The study was conducted from January 15th to February 29th, 2024, and HCPs (doctors, pharmacists and nurses) from two tertiary care teaching hospitals in southern Punjab, Pakistan were taken as the study population. The interviews were conducted with the help of a semi structured interview schema. A thematic approach was adopted to analyse the data. RESULTS: Out of 40 HCPs approached, 25 participated in the study with a response rate of 62%. The participants included in the study were doctors (14), pharmacists (6) and nurses (5). The participants had limited knowledge regarding AI and its basics. However, they showed positive perceptions about its incorporation. They believed that many of the problems faced by the healthcare sector of Pakistan can be minimized by AI incorporation. They believed that AI can boost up the efficiency of healthcare providers, reduce their workload, save time and minimize medical errors. Four main themes with multiple subthemes were identified: (1) Cognizance of AI, (2) Acceptability of AI among HCPs and training requirements for effective incorporation, (3) Merits and Demerits of AI, and (4) Challenges in incorporation of AI with proposed solutions. CONCLUSION: HCPs showed a willingness to embrace AI incorporation and believed that it may bring numerous benefits to the health system. Policymakers should take necessary steps to ensure AI incorporation in our healthcare sector.

A Burnt-Out Health: Stigma towards Mental Health Problems as a Predictor of Burnout in a Sample of Community Social Healthcare Professionals.

Burnout is a primary psychosocial risk factor in the workplace. Mental health stigma, which includes negative cognitions, emotions, and behaviors, also undermines the performance of social healthcare professionals. This study aimed to explore the levels of burnout in a sample of community social healthcare workers as well as its relationships with variables such as stigma towards mental health problems, professional skills, and job characteristics. An online assessment was conducted with 184 social healthcare professionals (75.5% female, mean age = 40.82 years, SD = 9.9). Medium levels of burnout and stigma and high levels of professional skills were observed. Multiple linear regression analyses revealed that stigma towards mental health problems and professional skills predicted emotional exhaustion (R2 = 0.153, F(4, 179) = 9.245, p < 0.001), depersonalization (R2 = 0.213, F(3, 180) = 17.540, p < 0.001), and personal accomplishment (R2 = 0.289, F(5, 178) = 15.87, p < 0.001). These findings suggest that social healthcare systems could benefit from taking care of the mental health of their workers by addressing burnout, tackling negative attitudes towards mental health problems, and providing professional skills training. This would help to make social healthcare systems more inclusive and of higher quality, thereby reducing health costs.

Global disparities in cancer supportive care: An international survey.

BACKGROUND: The global cancer burden is rising, particularly in low- and middle-income countries (LMIC), highlighting a critical research gap in understanding disparities in supportive care access. To address this, the Multinational Association of Supportive Care in Cancer (MASCC) Health Disparities Committee initiated a global survey to investigate and delineate these disparities. This study aims to explore and compare supportive care access disparities between LMIC and High-Income Countries (HIC). METHODS: An online cross-sectional survey was conducted among active members of MASCC. Members, representing diverse healthcare professions received email invitations. The survey, available for 3 weeks, comprised sections covering (1) sociodemographic information; (2) clinical service/practice-related disparities in their region/nation; (3) population groups facing disparities within their region or country. Chi-squared or Fisher's exact test for cross-sectional analyses, and a multivariable logistic regression model was employed for statistical analysis. RESULTS: A total of 218 active members participated, with one-quarter (26.6%) from LMIC and 18.4% ethnic minorities, timely cancer care (43.7%) and timely supportive care (45.0%) emerged as the most pressing disparities globally. Notably, participants from LMIC underscored cancer drug affordability (56.4%) and supportive care guideline implementation (56.4%) as critical issues. Economically disadvantaged populations were noted as more likely to face disparities by both LMIC and HIC (non-US-based) respondents, while US-based respondents identified racial/ethnic minorities as facing more disparities. CONCLUSION: This global survey reveals significant disparities in cancer supportive care between LMIC and HIC, with a particular emphasis on medication affordability and guideline implementation in LMIC. Addressing these disparities requires targeted intervention, considering specific regional priorities.

Experience of caregivers and healthcare professionals using a telemedicine programme in a paediatric palliative care unit.

BACKGROUND: Telemedicine is a means of providing efficient treatment for children with complex chronic conditions and/or subsidiary palliative paediatric care. AIM: To evaluate how satisfied families and healthcare professionals are with a telemedicine programme. METHODOLOGY: This is a qualitative study of narrative design. Ten interviews were conducted with family members and professionals who had been using telemedicine for a year. Sampling was intentional and a discourse and content analysis was conducted. RESULTS: Six thematic categories emerged from the analysis of the interviews: degree of satisfaction; usefulness; benefits according to patient needs and attention; technical and human difficulties; and implantation of the system and proposals for improvement. CONCLUSIONS: The study shows that telemedicine is a very useful complementary tool for healthcare professionals in a palliative care context. It is necessary to take into account the perception and needs of both families and healthcare professionals with regard to this tool since it can improve patient care.