Health, well-being, and burnout amongst Early Career Doctors in Nigeria.

BACKGROUND: Early Career Doctors (ECDs) in Nigeria are faced with many individual and systemic problems, which consequently adversely affect their health, well-being, patient care and safety. OBJECTIVE: This study, the second phase of the Challenges of Residency Training and Early Career Doctors in Nigeria (CHARTING II) Study, sought to examine the risk factors and contributors to the health, well-being and burnout amongst Nigerian ECDs. METHODS: This was a study of health, well-being and burnout amongst Nigerian ECDs. Outcome variables included burnout, depression, and anxiety, which were respectively assessed using the Copenhagen Burnout Inventory (CBI) and Oldenburg Burnout Inventory (OLBI), Patient Health Questionnaire (PHQ-9) depression scale, and Generalized Anxiety Disorder (GAD-7) scale. The quantitative data obtained was analysed using the IBM SPSS, version 24. Associations between categorical outcome and independent variables were assessed using chi square, with level of significance set at < 0.05. RESULTS: The mean body mass index (BMI), durations of smoking and alcohol consumption of the ECDs were 25.64 ± 4.43 kg/m2 (overweight range), 5.33 ± 5.65 years and 8.44 ± 6.43 years respectively. Less than a third (157, 26.9%) of the ECDs exercised regularly. The most common disease conditions affecting the ECDs were musculoskeletal (65/470, 13.8%) and cardiovascular diseases (39/548, 7.1%). Almost a third (192, 30.6%) of the ECDs reported experiencing anxiety. Male and lower cadre ECDs were more likely than female and higher cadre ECDs to report anxiety, burnout and depression. CONCLUSION: There is an urgent need to prioritize the health and well-being of Nigerian ECDs, so as to optimize patient care and improve Nigeria's healthcare indices.

Characteristics of Workplace Violence on Doctors and Nurses at the Accident and Emergency Department in a Southern State of Nigeria.

Background: Violence against healthcare workers is a menace ravaging the health sector and staff of the accident and emergency department are the worst affected. As a consequence, this violence puts health-care provision at risk and compromises the quality of care. This study aimed to determine the prevalence, type, sources and risk factors of violence against doctors and nurses in the emergency department. Methodology: This is a cross-sectional study conducted in March-April 2022 amongst doctors and nurses in the ED using a self- administered questionnaire on the staff. Result: There were 51 respondents in this study comprising 35.3% doctors and 64.7% nurses. Most (72.5%) of the respondents have been victims of workplace violence and 86.2% experienced verbal abuse. Patient relatives make up a majority (83.8%) of the perpetrators of the violence, with lack of communication (41.2%) making up the majority of the perceived reason for the assault. Most of the victims did not make any report about the incident (86.5%). There was a significant relationship between the occurrence of workplace violence and the category of healthcare professionals. Conclusion: Workplace violence is common in the accident and emergency department and nurses are the worst affected. Most victims do not report the incident. Hospital administrators and managers should put policies, deterrents and strategies, such as training on communication skills and an improved reporting system to prevent violence against healthcare workers.

Essential Emergency and Critical Care: A Priority for Health Systems Globally.

Critical illness is a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided, and the potential for reversibility. An estimated 45 million adults become critically ill each year. While some are treated in emergency departments or intensive care units, most are cared for in general hospital wards. We outline a priority for health systems globally: the first-tier care that all critically ill patients should receive in all parts of all hospitals: Essential Emergency and Critical Care. We describe its relation to other specialties and care and opportunities for implementation.

Healthcare Provider Advocacy for Primary Health Care Strengthening: A Call for Action.

Primary Health Care (PHC) is the backbone of health systems and a cornerstone of Universal Health Coverage. In 2018, political commitment to PHC, including a comprehensive approach based on essential care throughout the lifespan, integrated public health functions, and community empowerment was reaffirmed by international stakeholders in Astana. As recent events exposed weaknesses of health care systems worldwide, growing attention has been paid to strengthening PHC. While the role of care providers as health advocates has been recognized, they may lack skills, opportunities, and resources to actively engage in advocacy. Particularly for PHC providers, guidance and tools on how to advocate to strengthen PHC are scarce. In this article, we review priority policy areas for PHC strengthening with relevance for several settings and health care systems and propose approaches to empower PHC providers-physician, non-physician, or informal PHC providers-to advocate for strengthening PHC in their countries by individual or collective action. We provide initial ideas for a stepwise advocacy strategy and recommendations for practical advocacy activities. Our aim is to initiate further discussion on how to strengthen health care provider driven advocacy for PHC and to encourage advocates in the field to reflect on their opportunities for local, national, and global action.

Pattern and Outcome of Non-Incidental Injuries in Children: Reports from a Tertiary Hospital.

Domestic accidents and the resulting injuries are major global health concerns, especially when children are affected. Household accidents result in morbidity and mortality in children but are often neglected compared to the attention given to other childhood illnesses. This is a case series of 6 children involved in domestic accidents due to the caregivers' negligence. The patients presented at the Accident and Emergency Department of the University of Port Harcourt Teaching Hospital, Nigeria. Domestic accidents can result from falls from height leading to traumatic brain injury, which can be mild, moderate or severe. All the falls in this case series were preventable. Therefore, it is recommended that safety measures should be instituted at home and wherever children are to prevent any accident which can lead to physical injury and indirectly impact the parents, guardians and family.

A Cross-Sectional Survey of Doctors in Nigeria Regarding Local Infection Prevention and Control Procedures for Coronavirus Disease 2019 (COVID-19).

Background: Worldwide COVID-19-related mortalities have included healthcare workers in the frontline caring for COVID-19 infected patients. This necessitates the practice of infection prevention and control procedures to protect health professionals from contracting the virus at the workplace. We investigated the knowledge and practice of doctors working in Nigeria regarding infection prevention and control procedures in the workplace. Methodology: This is a cross-sectional study of doctors and dentists working in Nigeria using a semi-structured self-administered questionnaire adapted from the World Health Organization "Perception of health workers regarding local infection prevention and control procedures for the Coronavirus Disease 2019" tool. Data were analyzed using SPSS version 25. Results: 302 doctors participated in this survey. Most were female 195 (64.6%); 80.50% provided direct care to patients; 267 (88.4%) worked in hospitals with suspected or confirmed cases of COVID-19 while 179 (59.3) directly cared for patients with suspected or confirmed cases of COVID-19 infection. 137 (70.6%) had close contact with confirmed cases of COVID-19. Hand hygiene and gloves were the most common procedure/material available for the prevention of infections for the respondents in the healthcare settings, followed by other types of medical facemasks, N95 respirator masks, eye protection like goggles and disposable aprons. Conclusion: In 2020, during the period of the COVID-19 pandemic, doctors in Nigeria were knowledgeable about infection prevention procedures but do not have access to personal protective equipment.

Ethical Dilemma involving autonomy and COVID-19 testing

Background: In December 2019, an atypical form of pneumonia was discovered in Wuhan, China and it has spread to different parts of the world including Nigeria. Testing for the causative agent which is the severe acute respiratory distress syndrome coronavirus-2 is one of the strategies to contain the pandemic. For some reason, some patients with clinical symptoms suggestive of COVID-19 may refuse to be tested for the disease. Methodology: A review of studies conducted on COVID-19 testing and ethical dilemma associated with it was done using Google Scholar, PubMed and Cochrane reviews. Conclusion: Ethical dilemma exists in testing for COVID-19 as some patients may refuse testing even when it is necessary and they present with symptoms suggestive of COVID-19. The right to autonomy according to the principles of medical ethics is necessary for every medical consultation but may not be important in pandemics as the person becomes a health threat and harmful to the public.