Patient Safety Culture in 2 Public Hospitals in Vietnam: A Mixed Method Study.

BACKGROUND: Patient safety culture is an important measure in assessing the quality of care. There is a growing need to establish a patient safety culture in hospitals. This study explored the perception of health professionals on patient safety culture in 2 public hospitals in Hanoi, Vietnam. METHOD: A mixed-methods study with an online Hospital Survey on Patient Safety Culture (HSOPSC) and qualitative data collection was conducted in Hanoi. The HSOPSC was validated in Vietnam before using it. RESULTS: A total of 626 health professionals, including physicians and nurses, were involved in the survey, and 49 of them participated in in-depth interviews and focus group discussions. The average positive response of patient safety culture composites was high at 85.2% and varied from 49.4% to 97.9%. The strongest areas were teamwork within units (91.3%) and organizational learning/continuous improvement (88.4%), and the areas that needed improvement were staffing (49.4%) and nonpunitive response to error (53.1%). CONCLUSION: The centralized incident reporting, management with peer involvement on event reporting, and continuous quality improvement should be routinely embedded by hospital leaders down to unit managers and all staff.

Utility of portable functional near-infrared spectroscopy (fNIRS) in patients with bipolar and unipolar disorders: A comparison with healthy controls.

BACKGROUND: This study aimed to evaluate portable functional near-infrared spectroscopy (fNIRS) device as an adjunct diagnostic tool for bipolar and unipolar disorders while performing cognitive tasks. METHODS: 150 participants were divided into three groups including bipolar, unipolar disorder, and healthy controls (50:50:50), matched by age, gender, and family history of mood disorder. Hemodynamics in the frontal cortex were monitored by fNIRS during the Stroop Color-Word Test and Verbal Fluency Test. The GLM compared the differences in oxy-hemoglobin levels between the two groups. The Receiver Operating Characteristic (ROC) graph was generated for each neuroanatomical area. RESULTS: For people with BD group, the area under the ROC curve (AUC) for the left orbitofrontal cortex was maximal during the VFT [AUC = 0.727, 95%CI = 0.617-0.824]. The Youden's index reached a peak (0.40) at the optimal cut-point value (HbO2 cutoff <0.180 µmol/ml for BD) in which the sensitivity was 82 %; specificity was 58 %; PPV was 0.66; NPV was 0.76 and correct classification rate was 70 %. Regarding the UD group, during VFT, the highest value AUC [AUC = 0.822, 95%CI = 0.740-0.903] was recorded in the left dorsolateral prefrontal cortex with the optimal cut-off value (HbO2cutoff ≥0.163 µmol/ml for healthy controls; <0.163 for unipolar disorder), the sensitivity was 72 %; specificity was 82 %; PPV was 0.80; NPV was 0.75, correct classification rate was 77 %, and the Youden's index was 0.54. CONCLUSION: Assessing hemodynamics during VFT using portable fNIRS offers the potential as an adjunct diagnostic tool for mood disorders in low-resource environments.

Differentiating people with schizophrenia from healthy controls in a developing Country: An evaluation of portable functional near infrared spectroscopy (fNIRS) as an adjunct diagnostic tool.

Introduction: This study aimed to evaluate portable functional near-infrared spectroscopy (fNIRS) device as an adjunct diagnostic tool in Vietnam to assess hemodynamics when people with schizophrenia and healthy controls performed cognitive tasks. Methods: One hundred fifty-seven participants were divided into schizophrenia (n = 110) and healthy controls group (n = 47), which were recruited by match of age, and gender. Hemodynamic responses in the frontal cortex were monitored with a 48-channel portable device during the Stroop Color-Word Test (SCWT) and Verbal Fluency Test (VFT). General linear model compared the differences in oxyhemoglobin (HbO2) levels between the two groups. The Receiver Operating Characteristic (ROC) graph was generated for each neuroanatomical area. Results: People with schizophrenia did not show significant activation in the frontal lobe during the SCWT and VFT as compared to pre-task. During the VFT, the area under the ROC curve of the bilateral dorsolateral prefrontal cortex, bilateral orbitofrontal cortex, bilateral frontopolar prefrontal cortex, and bilateral ventrolateral prefrontal cortex were greater than 0.7 (p < 0.001). The area under the ROC curve (AUC) for the right orbitofrontal cortex was maximal during the VFT (AUC = 0.802, 95%CI = 0.731-0.872). The Youden's index reached a peak (0.57) at the optimal cut-point value (HbO2 cutoff <0.209 µmol/ml for schizophrenia) in which the sensitivity was 85%; specificity was 72%; positive predictive value (PPV) was 0.88; negative predictive value (NPV) was 0.68 and correct classification rate was 76%. Discussion: Assessing hemodynamics during VFT by portable fNIRS offers the potential as an adjunct diagnostic tool for schizophrenia in developing countries.