Health care workers' knowledge and perceptions on WHO hand hygiene guidelines, and the perceived barriers to compliance with hand hygiene in Cyprus.

BACKGROUND: Hand hygiene (HH) is recognized as an important measure to avoid the transmission of harmful germs, and assists significantly in preventing healthcare-associated infections. HH compliance among health care workers (HCWs) is a result of their knowledge and perceptions. AIM: To investigate the knowledge and perceptions of WHO hand hygiene guidelines among HCWs, and the perceived barriers to compliance with hand hygiene in a major public hospital in Cyprus. METHODS: A descriptive correlational study was conducted in September of 2019. The target population was all of the HCWs in Nicosia General Hospital (N = 1,386). The final sample consisted of 820 participants (119 physicians, 613 nurses, 27 physiotherapists, 59 ward assistants, 2 unidentified). This study used the HH knowledge and perception questionnaire that was developed by the WHO. RESULTS: The results revealed that the average percentage score for knowledge among our sample was 61%, and statistically significant differences were observed among HCWs with regard to certain questions. It was found that HCWs, in most of their responses, presented high percentages of correct answers regarding their perceptions on hand hygiene guidelines but several perceived barriers to compliance on HH guidelines were identified as well. CONCLUSIONS: Knowledge and perceptions of HH guidelines among HCWs were moderate and good respectively. In addition, several perceived barriers to compliance on HH recommendations were identified. HH education is recognized as an important tool for removing these barriers but the recommended HH strategy should be multi-modal and consider local resources, administrative support and barriers to compliance with HH.

Dentists' Mental Health: Challenges, Supports, and Promising Practices.

OBJECTIVES: The mental health of dentists, like all health professionals, is a growing concern. The objectives of this study were to identify the mental health challenges experienced by Canadian dentists and to describe the support needs and promising practices to better support them. METHODS: This study used a mixed-methods case study design to gather data from semistructured qualitative interviews and a survey for triangulation. RESULTS: Thirty-six dentists and 17 stakeholders participated in the interviews, and 397 dentists participated in the survey. The interview and survey data revealed that dentists have experienced several challenges personally, professionally, and socially. Around 44% of participating dentists experienced a wide range of mental health issues, including depression, anxiety, and posttraumatic stress disorder. Sex/gender shaped the mental health experiences of female dentists, who reported more stress related to caring responsibilities. They had a higher percentage of mental health issues (50%) than men (37%). Caretaking emerged as the main challenge in the social and personal domain, particularly for female dentists in both survey and interview findings. The dentists' role in practice was one of the most frequently reported professional challenges. While practice owners reported challenges with staff and practice management, associate dentists experienced difficulties with the lack of autonomy and conflicts with office managers and owners. Other challenges reported by participating dentists included patient care responsibilities, loneliness, and isolation. To address these challenges and their impact, dentists and stakeholders identified several support needs and promising practices, including increasing awareness about mental health issues, expanding existing mental health resources, incorporating mental health content in dental education, and encouraging engagement in organized dentistry, particularly for women. CONCLUSIONS: The impact of mental health challenges on dentists' career trajectory and productivity is an ongoing concern in Canada. Gender-specific strategies to support the mental health of dentists should be developed. KNOWLEDGE TRANSLATION STATEMENT: This study identified the mental health challenges of dentists in Canada to inform the development of interventions and strategies to promote the health and well-being of dentists and dental students. It also highlighted the need for clinicians, students, and individuals in leadership positions in institutions and professional organizations to recognize and consider the working conditions of dentists in various positions to avoid negative consequences on their mental health, reduce the attrition from the professional, and improve patient care outcomes.

Complementary and alternative medicine use among pregnant women attending antenatal clinic: a point to ponder.

OBJECTIVES: Complementary and Alternative Medicine (CAM) is a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional medicine. Pregnant women are vulnerable to adverse effects of medicines, especially during the first trimester. Though it is advised to avoid unnecessary intake of medicine during pregnancy, CAM use is widespread. METHODS: A cross-sectional questionnaire-based study was conducted on 120 pregnant women attending the antenatal clinic of a tertiary-care teaching hospital in Udaipur district of Southern Rajasthan, India. Women of age 18 years and above were surveyed between July 2022 to December 2023 by convenient sampling strategy and data were entered in a pretested and pre-validated questionnaire. The data were analyzed using descriptive statistics, the Chi-square test was applied to compare CAM use among different demographic categories and a p-value less than 0.05 was considered statistically significant. RESULTS: Out of 120 participants, 58 (48.33 %) were using CAM therapy. Out of 58 users, 44 (75.86 %) were using herbal & traditional medicines. Twenty (34.48 %) were using CAM for a healthy baby, 18 (31.03 %) for easy delivery and 17 (29.31 %) for boosting immunity. Forty (68.96 %) participants started CAM on the advice of a relative/friend. Fifty six (46.67 %) participants believe that CAM therapy cannot cause adverse effects on the in utero child, while 32 (26.67 %) believe that CAM and modern medicines don't interact. CONCLUSIONS: CAM use among pregnant women is substantial. There is a need to raise awareness among the healthcare professionals and pregnant women regarding possible adverse effects and drug-drug interactions with CAM use.

BYOD security behaviour and preferences among hospital clinicians - A qualitative study.

BACKGROUND/OBJECTIVE: The use of personal devices for work purposes (Bring-your-own-device) has increased in hospitals, as it facilitates productivity and mobility for clinicians. However, owing to increased risk of leaking patient information, and heavy reliance of patient data privacy on user actions, BYOD is a major challenge for hospitals. There has been a dearth of empirical research studying clinicians' BYOD security behaviour. Therefore, the study's aim was to attain subjective understanding of clinicians' attitudes and preferences towards protecting patient data on their devices through a qualitative study. METHODS: 14 semi-structured interviews were conducted among Australian hospital-based clinicians. A hybrid thematic analysis was conducted using the framework method to explore socio-technical themes pertaining to the clinicians' BYOD security behavioural practices. RESULTS: Limited use of secure tools like antivirus and passcodes, and inadequate separation of patient and personal data on BYOD devices was found. Key technology concerns included malware introduction into hospital network, inadvertent patient data sharing, and slow remote access. Hospitals lacked dedicated BYOD policies and training, resulting in unsafe practices. Participants also cited misalignment of BYOD policies with workflow needs, privacy maintenance challenges and fears of personal data breaches, while calling for improved communication between technical and clinical staff and a strong cybersecurity culture. CONCLUSION: This study provides a comprehensive understanding of BYOD related user behaviour and the usefulness of security controls used in time-sensitive and complex hospital environments. It can inform future policies or processes by advocating for secure and productive BYOD use.

Experiences of Health-Care Professionals Who Served the Migrant Workers During the COVID-19 Pandemic in Singapore and Its Impact on Morale: A Brief Report.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has caused psychological distress among health-care professionals (HCP) worldwide, suggesting that morale could also be affected. This warrants further investigation as HCPs' morale directly impacts delivery of quality care and work productivity. This study aims to explore the experiences of HCPs who served migrant workers in a local COVID-19 hotspot in Singapore and the impact on their morale. METHODS: Eleven volunteer HCPs from a regional hospital in Singapore who served migrant workers in a local COVID-19 hotspot were recruited. Semi-structured face-to-face interviews were conducted, and recordings were transcribed verbatim. Transcripts were analyzed using thematic analysis. Morale of HCPs was evaluated based on responses. RESULTS: Four main themes emerged: motivators, challenges, support, and leadership. Motivators or factors that drove HCPs to serve include varying personal reasons and a sense of duty to do good. Challenges faced by HCPs include a language barrier, keeping up with rapidly changing workflows, fear of contagion, and coping with emotions. Support and leadership were revealed to have boosted HCPs' morale. CONCLUSIONS: Peer and social support and effective leadership have potential protective effects on HCPs' morale against negative experiences faced during the COVID-19 pandemic.

Explainable machine learning framework to predict the risk of work-related neck and shoulder musculoskeletal disorders among healthcare professionals.

Objective: This study aims to develop risk prediction models for neck and shoulder musculoskeletal disorders among healthcare professionals. Methods: A stratified sampling method was employed to select employees from medical institutions in Nanning City, yielding 617 samples. The Boruta algorithm was used for feature selection, and various models, including Tree-Based Models, Single Hidden-Layer Neural Network Models (MLP), Elastic Net Models (ENet), and Support Vector Machines (SVM), were applied to predict the selected variables, utilizing SHAP algorithms for individual-level local explanations. Results: The SVM model excels in both Mean Absolute Error (MAE) and Root Mean Square Error (RMSE) and exhibits more stable performance when generalizing to unseen data. The Random Forest model exhibited relatively high overall performance on the training set. The MLP model emerges as the most consistent and accurate in predicting shoulder musculoskeletal disorders, while the SVM model shows strong fitting capabilities during the training phase, with occupational factors identified as the main contributors to WMSDs. Conclusion: This study successfully constructs work-related musculoskeletal disorder risk prediction models for healthcare professionals, enabling a quantitative analysis of the impact of occupational factors. This advancement is beneficial for future economical and convenient work-related musculoskeletal disorder screening in healthcare professions.

Post-COVID job Stressors and Their Predictive Role on Mental Health: A Cross-Sectional Analysis Between Physicians and Nurses.

Introduction: Health care providers face heightened stress and increased rates of anxiety and depression post-COVID-19. The pandemic, officially declared over in May 2023, continues to impact their wellbeing significantly, with ongoing mental health monitoring and tailored interventions crucial for support. Objectives: The aim of this study was to describe the frequency of job stressors in a sample of Spanish health care providers post-COVID and to explore potential differences between physicians and nurses, hypothesizing that while both professional categories could experience similar job stressors, some of them could have a differential impact on the mental health of each subgroup. Methods: This cross-sectional substudy is part of the MINDxYOU project. The data were collected from 191 health care providers from two regions in Spain. Participants completed the UNIPSICO test battery, used to assess job stressors, and questionnaires to evaluate perceived stress, depressive symptomatology, anxiety, and resilience. Descriptive analyses, bivariate correlations, and linear regression models were performed to compare the two professions that were the most representative of our sample: physicians (n = 82) and nurses (n = 54). Results: The most frequent job stressors were workload, lack of positive feedback, and inequity in social interactions. Physicians reported worse outcomes in terms of workload, autonomy, role conflicts, inequity in social interactions, and work-family balance compared to nurses. Mobbing, despite not being very frequent, significantly predicted different mental health outcomes for both physicians and nurses. Inequity in social interactions and job satisfaction were significant predictors of physicians' mental health, while role ambiguity, interpersonal conflicts, and career turnover intentions predicted nurses' mental health. Conclusion: As hypothesized, our findings highlight that certain job stressors (i.e., inequity in social interactions, conflicts in the workplace) might be affecting physicians' and nurses' mental health differently. Therefore, effective strategies addressing each subgroup's specific stressors would be necessary to prevent the development of burnout syndrome and other serious mental health conditions associated with occupational stress. These strategies would imply organizational changes in most cases.

Evaluation of the Continuing Education Training "Beratende für Digitale Gesundheitsversorgung" ("Consultant for Digital Healthcare"): Protocol for an Effectiveness Study.

BACKGROUND: The digital transformation in health care requires training nursing and health professionals in the digitally competent use of digital assistive technologies (DAT). The continuing education training "Beratende für digitale Gesundheitsversorgung" ("Consultant for Digital Healthcare") was developed to fill this gap. The effectiveness of the training program will be assessed in this study. OBJECTIVE: The primary objective is to record and measure the participants' learning success. We will assess whether the previously defined teaching intentions, learning objectives, competencies, and participants' expectations have been achieved and whether a transfer of learning occurred. The secondary objective is participant satisfaction and feasibility of the training. The tertiary objective is the successful transfer of DAT by participants in their institutions. METHODS: Approximately 65 nursing and health care professionals will participate in the pilot phase of the further training and evaluation process, which is planned in a mixed methods design in a nonsequential manner. The different methods will be combined in the interpretation of the results to achieve a synaptic view of the training program. We plan to conduct pre-post surveys in the form of participant self-assessments about dealing with DAT and content-related knowledge levels. Exploratory individual interviews will also be conducted to build theory, to examine whether and to what extent competence (cognition) has increased, and whether dealing (affect) with DAT has changed. Furthermore, an interim evaluation within the framework of the Teaching Analysis Poll (TAP) will occur. The knowledge thereby gained will be used to revise and adapt the modules for future courses. To assess the transfer success, the participants create a practical project, which is carried out within the training framework, observed by the lecturers, and subsequently evaluated and adapted. RESULTS: We expect that the learning objectives for the continuing education training will be met. The attendees are expected to increase their level of digital competence in different skills areas: (1) theoretical knowledge, (2) hands-on skills for planning the application and practical use of DAT, (3) reflective skills and applying ethical and legal considerations in their use, (4) applying all that in a structured process of technology implementation within their practical sphere of work. CONCLUSIONS: The aim of this study and appropriate further training program are to educate nursing and health care professionals in the use of DAT, thereby empowering them for a structured change process toward digitally aided care. This focus gives rise to the following research questions: First, how should further training programs be developed, and which focus is appropriate for addressee-appropriate learning goals, course structure, and general curriculum? Second, how should a training program with this specific content and area be evaluated? Third, what are the conditions to offer a continued program? INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/57860.

Social Networks as a Tool for Evidence-Based Health Education: Umbrella Review.

BACKGROUND: The number of people who access social networking sites continues to increase at an exponential rate. The use of technology is an essential skill for nursing professionals and its development represents a challenge in improving health education, promotion and care. The objective of this systematic review is to analyse the use of social networking sites by healthcare professionals as an intervention tool for evidence-based public health education. METHODS: The protocol of this umbrella review was registered in the International Prospective Register of Systematic Reviews (CRD42023407249). Searches were carried out in MEDLINE (PubMed), Web of Science, CINAHL, PsycINFO (EBSCOhost), and Cochrane Library of Systematic Reviews, in February 2023. A narrative synthesis of the results was conducted. RESULTS: 1896 articles were found, of which 15 reviews fulfilled the inclusion criteria. Social networks broadened the profession; they were YouTube, X (formerly Twitter), Facebook, and Instagram. The target population was mainly young professionals, and they came across different topic areas that addressed health education. CONCLUSIONS: It is important to have information backed by scientific evidence to make health decisions. Health professionals active on social networking sites have a unique opportunity to educate the public about health by sharing scientific evidence in an accessible and clear way, which helps to combat misinformation.

New wearable and portable EEG modalities in epilepsy: The views of hospital-based healthcare professionals.

BACKGROUND: Novel mobile and portable EEG solutions, designed for short and long-term monitoring of individuals with epilepsy have been developed in recent years but, they are underutilized, lacking full integration into clinical routine. Exploring the opinions of hospital-based healthcare professionals regarding their potential application, technical requirements and value would be crucial for future device development and increase their clinical application. PURPOSE: To evaluate professionals' opinions on novel EEG systems, focusing on their potential application in various clinical settings, professionals' interest in non-invasive solutions for ultra-long monitoring of people with epilepsy (PWE) and factors which could increase future use of novel EEG systems. MATERIALS AND METHODS: We conducted an online survey where Hospital-based professionals shared opinions on potential advantages, clinical value, and key features of novel wearable EEG systems in five different clinical settings. Additionally, insights were gathered on the need for future research and, the need for additional information about devices from companies and researchers. RESULTS: Respondents (n = 40) prioritized high performance, data quality, easy patient mobility, and comfort as crucial features for novel devices. Advantages were highlighted, including more natural settings, reduced application time, earlier epilepsy diagnosis, and decreased support requirements. Novel EEG devices were seen as valuable for epilepsy diagnosis, seizure monitoring, automatic seizure documentation, seizure alarms, and seizure forecasting. Interest in integrating these new systems into clinical practice was high, particularly for supervising drug-resistant epilepsy, reducing SUDEP, and detecting nocturnal seizures. Professionals emphasized the need for more research studies and highlighted the need for increased information from companies and researchers. CONCLUSIONS: Professionals underscore specific technical and practical features, along with potential clinical advantages and value of novel EEG devices that could drive their development. While interest in integrating these solutions in clinical practice exists, further validation studies and enhanced communication between researchers, companies, and clinicians are crucial for overcoming potential scepticism and facilitating widespread adoption.

Evaluating the Efficacy of ChatGPT as a Patient Education Tool in Prostate Cancer: Multimetric Assessment.

BACKGROUND: Artificial intelligence (AI) chatbots, such as ChatGPT, have made significant progress. These chatbots, particularly popular among health care professionals and patients, are transforming patient education and disease experience with personalized information. Accurate, timely patient education is crucial for informed decision-making, especially regarding prostate-specific antigen screening and treatment options. However, the accuracy and reliability of AI chatbots' medical information must be rigorously evaluated. Studies testing ChatGPT's knowledge of prostate cancer are emerging, but there is a need for ongoing evaluation to ensure the quality and safety of information provided to patients. OBJECTIVE: This study aims to evaluate the quality, accuracy, and readability of ChatGPT-4's responses to common prostate cancer questions posed by patients. METHODS: Overall, 8 questions were formulated with an inductive approach based on information topics in peer-reviewed literature and Google Trends data. Adapted versions of the Patient Education Materials Assessment Tool for AI (PEMAT-AI), Global Quality Score, and DISCERN-AI tools were used by 4 independent reviewers to assess the quality of the AI responses. The 8 AI outputs were judged by 7 expert urologists, using an assessment framework developed to assess accuracy, safety, appropriateness, actionability, and effectiveness. The AI responses' readability was assessed using established algorithms (Flesch Reading Ease score, Gunning Fog Index, Flesch-Kincaid Grade Level, The Coleman-Liau Index, and Simple Measure of Gobbledygook [SMOG] Index). A brief tool (Reference Assessment AI [REF-AI]) was developed to analyze the references provided by AI outputs, assessing for reference hallucination, relevance, and quality of references. RESULTS: The PEMAT-AI understandability score was very good (mean 79.44%, SD 10.44%), the DISCERN-AI rating was scored as "good" quality (mean 13.88, SD 0.93), and the Global Quality Score was high (mean 4.46/5, SD 0.50). Natural Language Assessment Tool for AI had pooled mean accuracy of 3.96 (SD 0.91), safety of 4.32 (SD 0.86), appropriateness of 4.45 (SD 0.81), actionability of 4.05 (SD 1.15), and effectiveness of 4.09 (SD 0.98). The readability algorithm consensus was "difficult to read" (Flesch Reading Ease score mean 45.97, SD 8.69; Gunning Fog Index mean 14.55, SD 4.79), averaging an 11th-grade reading level, equivalent to 15- to 17-year-olds (Flesch-Kincaid Grade Level mean 12.12, SD 4.34; The Coleman-Liau Index mean 12.75, SD 1.98; SMOG Index mean 11.06, SD 3.20). REF-AI identified 2 reference hallucinations, while the majority (28/30, 93%) of references appropriately supplemented the text. Most references (26/30, 86%) were from reputable government organizations, while a handful were direct citations from scientific literature. CONCLUSIONS: Our analysis found that ChatGPT-4 provides generally good responses to common prostate cancer queries, making it a potentially valuable tool for patient education in prostate cancer care. Objective quality assessment tools indicated that the natural language processing outputs were generally reliable and appropriate, but there is room for improvement.

Person-centred care in the context of higher education - a discourse analysis based on interviews with programme directors.

BACKGROUND: As person centred care (PCC) is being implemented globally, higher educational institutions (HEI) have begun to play a crucial part in enabling this transition. In Sweden, however, the delivery of PCC is inconsistently implemented in medicine, nursing, occupational therapy, and physiotherapy study programmes. This inconsistency is partly the result of a lack of a national strategy across HEI. Program directors are responsible for the PCC content of their programs, so their views influence how PCC is taught. Using interviews with programme directors in higher education, we aim to deepen the understanding of the preconditions needed to implement PCC by exploring discourses and identifying subject positions of how PCC is taught and learned. METHODS: We performed a discourse analysis based on interviews with program directors in the above-mentioned national study programmes. A discourse can be seen as a struggle over identity. The subject position - i.e., discourses designate positions for persons to occupy as subjects - guided our analysis and identification of the subject positions of the teacher and the student in teaching and learning PCC. RESULTS: This study unfolded in two main antagonistic aspects with respect to teaching and learning PCC, resulting in four subject positions for the teacher and four corresponding subject positions for the students. First, the teacher and student were given a subject position as change agents towards a more egalitarian healthcare and were assigned a subject position to cope with a practical reality they could not change. Second, the teacher and student were assigned a subject position that embodied profession-specific identities, navigating and valuing these boundaries. Simultaneously, both teachers and students assumed a subject position that required interprofessional interaction and co-creation for teaching and learning PCC. CONCLUSION: This study demonstrates the discursive tension surrounding the implementation of PCC in HEI, and the findings can serve as a basis for creating future relevant and high-quality learning activities. The process of negotiating diverse and co-existing perspectives as well as building interprofessional trust when incorporating PCC into higher education is essential and requires further exploration.

Knowledge, Attitude, and Practice of Materiovigilance Among Healthcare Professionals at a Tertiary Care Teaching Hospital.

Objective This study aimed to assess the knowledge, attitudes, and practices (KAP) of materiovigilance among healthcare professionals (HCPs) at a tertiary care teaching hospital in South Gujarat, India. Specifically, it sought to identify gaps in current understanding and reporting practices related to adverse events associated with medical devices. Introduction Materiovigilance, the systematic monitoring and assessment of adverse events related to medical devices, is crucial for ensuring patient safety and enhancing device performance. In India, the Materiovigilance Programme of India (MvPI) under the Ministry of Health and Family Welfare oversees the safe use of medical devices, integrating them with the pharmacovigilance framework. Despite these efforts, challenges persist in awareness, reporting practices, and the integration of materiovigilance among healthcare professionals. The knowledge, attitude, and practice (KAP) of these professionals are pivotal for effective adverse event reporting, but underreporting due to a lack of awareness, inadequate training, and perceived administrative burden remains a significant barrier. The study underscores the importance of training programs, improving reporting infrastructure, and fostering a safety culture within healthcare institutions to enhance the effectiveness of materiovigilance in India. Methodology An observational, cross-sectional study was conducted using a questionnaire-based approach. A total of 215 HCPs, including consultant doctors, resident doctors, and nursing staff, participated in the study. The questionnaire covered aspects of knowledge regarding the Materiovigilance Programme of India (MvPI), classification of medical devices, attitudes towards adverse event reporting, and actual reporting practices. Data collection was carried out electronically over the course of one month using Google Forms (Google LLC, Mountain View, California, United States). Results Among the participants, 135 (62.79%) correctly identified MvPI as the program for monitoring adverse events caused by medical devices. A majority of 188 (87.44%) understood that medical devices in India are classified based on a risk-based approach. Positive attitudes towards reporting adverse events were prevalent, with 202 (93.95%) acknowledging the potential for adverse events from medical devices and agreeing on the importance of reporting. However, a significant gap was noted between noticing adverse events (138 participants, 64.19%) and actual reporting (60 participants, 27.91%), indicating a need for improved reporting practices. Only 104 participants (48.37%) had participated in workshops or continuing medical education (CME) sessions on medical device safety. Conclusion The study reveals a strong foundation of knowledge and positive attitudes towards the materiovigilance among HCPs in South Gujarat. However, there is a notable discrepancy between awareness and actual reporting practices. To enhance the effectiveness of materiovigilance, interventions such as targeted educational programs and simplification of reporting procedures are recommended. These efforts are essential to ensure timely detection, reporting, and management of adverse events related to medical devices, thereby enhancing patient safety and overall healthcare quality.

Potential, Pitfalls, and Future Directions for Remote Monitoring of Chronic Respiratory Diseases: Multicenter Mixed Methods Study in Routine Cystic Fibrosis Care.

BACKGROUND: The current literature inadequately addresses the extent to which remote monitoring should be integrated into care models for chronic respiratory diseases (CRDs). OBJECTIVE: This study examined a remote monitoring program (RMP) in cystic fibrosis (CF) by exploring experiences, future perspectives, and use behavior over 3 years, with the aim of developing future directions for remote monitoring in CRDs. METHODS: This was a mixed methods, multicenter, observational study in 5 Dutch CF centers following a sequential explanatory design. Self-designed questionnaires using the technology acceptance model were sent out to people with CF who had a minimum of 12 months of experience with the RMP and local health care professionals (HCPs). Questionnaire outcomes were used to inform semistructured interviews with HCPs and people with CF. Qualitative findings were reported following the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. Anonymous data on use frequency of all people with CF were analyzed. RESULTS: Between the second quarter of 2020 and the end of 2022, a total of 608 people with CF were enrolled in the program, and a total of 9418 lung function tests and 2631 symptom surveys were conducted. In total, 65% (24/37) of HCPs and 89% (72/81) of people with CF responded to the questionnaire, and 7 HCPs and 12 people with CF participated in semistructured interviews. Both people with CF and HCPs were positive about remote monitoring in CF care and found the RMP a good addition to daily care (people with CF: 44/72, 61%; HCPs: 21/24, 88%). Benefits ranged from supporting individual patients to reducing health care consumption. The most valued monitoring tool was home spirometry by both people with CF (66/72, 92%) and HCPs (22/24, 92%). Downsides included the potential to lose sight of patients and negative psychosocial effects, as 17% (12/72) of people with CF experienced some form of stress due to the RMP. A large majority of people with CF (59/72, 82%) and HCPs (22/24, 92%) wanted to keep using the RMP in future, with 79% (19/24) of HCPs and 75% (54/72) of people with CF looking forward to more replacement of in-person care with digital care during periods of well-being. Future perspectives for the RMP were centered on creating hybrid care models, personalizing remote care, and balancing individual benefits with monitoring burden. CONCLUSIONS: Remote monitoring has considerable potential in supporting people with CF and HCPs within the CF care model. We identified 4 practice-based future directions for remote monitoring in CF and CRD care. The strategies, ranging from patient driven to prediction driven, can help clinicians, researchers, and policy makers navigate the rapidly changing digital health field, integrate remote monitoring into local care models, and align remote care with patient and clinician needs.

The Effectiveness of Medical Adherence Mobile Health Solutions for Individuals With Epilepsy: Protocol for a Systematic Review.

BACKGROUND: Epilepsy requires continuous management and treatment to optimize patient outcomes. The advancement of digital health has led to the development of various mobile health (mHealth) tools designed to enhance treatment adherence among individuals with epilepsy. These solutions offer crucial support through features such as reminders, educational resources, personalized feedback, assistance with managing costs, shared decision-making, and access to supportive communities. To design effective medication adherence mHealth solutions, it is essential to evaluate the effectiveness of existing mHealth tools, understand the unique circumstances of different patients, and identify the roles of health care professionals within the digital care pathway. Existing studies on epilepsy primarily focus on self-management, whereas the effectiveness and usability of medical adherence mHealth solutions often remain overlooked. Furthermore, the involvement of health care professionals in digital care pathways for epilepsy as well as the impact of adherence mHealth solutions on the patient experience have not been adequately explored. OBJECTIVE: This study aims to assess the effectiveness of current mHealth solutions designed to improve medical adherence among patients with epilepsy. Furthermore, the study will examine the experiences of patients using mHealth solutions for maintaining medical adherence in epilepsy care. Finally, this review intends to determine the roles of health care professionals within mHealth systems aimed at supporting adherence to medication among patients with epilepsy. METHODS: A systematic literature review has been selected as the appropriate method to address the research questions, adhering to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The inclusion and exclusion criteria have been carefully selected, and both qualitative and quantitative analyses will be used to analyze the results. The expected results will mainly focus on the comparison, classification, and analysis of the effectiveness of current medical adherence mHealth tools. Moreover, the patient experiences using available medical adherence mHealth tools for epilepsy will be assessed. Finally, the role of health care professionals in the epilepsy digital care pathway will be explored, with emphasis on medical adherence. RESULTS: The initial search, full-text screening, and data extraction have been carried out. Thirty-three papers were included in the final stage of the review. The study is expected to be completed by October 2024. CONCLUSIONS: To enhance the digital care pathway for epilepsy, a medical adherence mHealth solution should be personalized, manage medications, include an alarm system, track seizures, support consultations, and offer updated treatment plans. This study aims to understand how findings from the research questions can improve mHealth solutions for individuals with epilepsy. Insights from this research on the effectiveness of current mHealth adherence solutions will provide guidance for developing future mHealth systems, making them more efficient and effective in managing epilepsy. TRIAL REGISTRATION: PROSPERO CRD4202347400; https://tinyurl.com/48mfx22e. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55123.

Challenges and coping strategies for providing maternal health care services among health care professionals in rural health facilities in Wolaita Zone, Southern Ethiopia: a qualitative study.

BACKGROUND: Many factors can decrease job productivity and cause physical and psychological complications for health care professionals providing maternal care. Information on challenges and coping strategies among healthcare professionals providing maternal healthcare services in rural communities is crucial. However, there needs to be more studies, especially qualitative research, to explore challenges and coping strategies for providing maternal health care services in Ethiopia among health care professionals, particularly in the Wolaita zone. OBJECTIVE: To explore the challenges and coping strategies of professionals providing maternal health care in rural health facilities in Wolaita Zone, Southern Ethiopia, in 2023. METHOD: A phenomenological qualitative study design was applied from May 20 to June 20, 2023. The study was conducted in rural areas of the Wolaita Zone, southern Ethiopia. Healthcare professionals from rural areas were selected using purposive sampling, and in-depth interviews were conducted. A qualitative thematic analysis was employed to analyze the data. Field notes were read, recordings were listened to, and each participant's interview was written word for word and analyzed using ATLAS.ti 7 software. RESULT: Five main themes emerged from the data analysis. These themes included inadequate funding from the government, societal barriers to health and access to health care, professionals' personal life struggles, infrastructure related challenges and health system responsiveness, and coping strategies. Reporting to responsible bodies, teaching mothers about maternal health care services, and helping poor mothers from their pockets were listed among their coping strategies. CONCLUSION: Healthcare professionals have a crucial role in supporting women in delivering babies safely. This study revealed that they are working under challenging conditions. So, if women's lives matter, then this situation requires a call to action.

Advancing evidence-based practice through the Knowledge Translation Challenge: Nurses' important roles in research, implementation science and practice change.

AIM: To describe a knowledge translation capacity-building initiative and illustrate the roles of nurses in practice change using an exemplar case study. DESIGN: The report uses observational methods and reflection. METHODS: The Knowledge Translation Challenge program involves a multi-component intervention across several sites. The advisory committee invited eligible teams to attend capacity-building workshops. Implementation plans were developed, and successful teams receive funding for a 2 year period. Evaluation involved collecting data on program uptake and impact on practice change. Data has been collected from five cohorts. The exemplar case study employed an action-research framework. RESULTS: Four nurse-led teams have demonstrated successful implementation of their practice change. The case study on implementing a clinical toolkit for clozapine management further illustrates a thoughtful planning process, and implementation journey and learnings by a team of nurses. CONCLUSION: The Knowledge Translation Challenge program empowers nurses to use implementation science practices to enhance the quality and effectiveness of healthcare services. Success of this initiative serves as a model for addressing the persistent gap between knowledge and practice in clinical settings and the value of activating nurses to help close this gap. IMPLICATIONS: As the most trusted and numerous profession, it is vital that nurses contribute to efforts to translate research evidence into clinical practice. The Knowledge Translation Challenge program supports nurses to lead practice change. IMPACT: The Knowledge Translation Challenge program successfully equips nurses and other health care providers with the knowledge, skills and resources to implement practice improvements which enhance the quality and effectiveness of healthcare services and nursing practice. PATIENT OR PUBLIC CONTRIBUTION: The Knowledge Translation Challenge advisory committee has three patient-public partners that support teams to develop a patient-oriented approach for their projects by providing feedback on the implementation plans. Each team was also supported to include patient-public partners on their project.

The life threat in hematopoietic allogeneic stem cell transplantation - an interview and focus group study on health care professionals' perspectives.

Understanding healthcare professionals' (HCPs) experiences with patients undergoing hematopoietic allogeneic stem cell transplantation (allo-HSCT) is crucial, given its dual nature of offering a hope for cure which on the other hand is accompanied by a high risk for morbidity and mortality. Yet, how HCPs experience their patients' existential threats remains unexplored. Qualitative thematic content analysis was employed to comprehend these experiences. This involved conducting three focus groups and 11 individual in-depth interviews with nurses and hematologists. We found that HCPs struggled to balance curative goals and the therapy's risks, while attempting to maintain their patients' hopes. The unpredictability of patient trajectories and their suffering burdened HCPs. Despite occasional disagreements within the team, (inter-)professional exchanges remained a crucial ressource, especially in addressing the patients' potential life threat. Team meetings and palliative care specialist supervisions were emphasized as vital for managing these challenges. HCPs sought support in communicating with patients about death-related issues and managing the transition from a curative to a palliative goal of care. Our research underscores the need for targeted support for HCPs and lays a groundwork for addressing their challenges. Trial registration number DRKS00027290 (German Clinical Trials Register). Date of trial registration January 10th, 2022.

Measurement of compassion fatigue in animal health care professionals: a systematic review of available instruments and their content validity.

Introduction: Compassion fatigue (CF) refers to emotional or physical exhaustion and emotional reactions resulting from prolonged exposure to traumatic events, commonly experienced by professionals in caregiving roles. CF is prevalent among healthcare professionals, including those in animal care. Several Patient-Reported Outcome Measures (PROMs) were developed to measure CF, but their psychometric validity was not reviewed systematically. This study aims to identify and review the content validity of CF PROMs used in animal health care professionals. Methods: Literature was searched in PubMed, PsycINFO, and EMBASE (1973-2023). We included studies conducted in animal health care professionals, using a PROM to measure CF, reporting at least one psychometric property of this PROM, and published as original research. For each identified PROM, additional literature search was conducted to identify PROM development and content validation studies. Three independent reviewers evaluated the content validity of each PROM using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology and summarized the quality of evidence using a modified GRADE approach. The protocol was registered in PROSPERO (CRD42023433982) and results reported following PRISMA guidelines. Results: Initially, 1709 studies were identified. After a double screening, 17 eligible studies were included. CF was measured using six different PROMs or their modified versions. Only one PROM specifically targeted animal health care professionals: the ProQOL-5 Veterinary Medicine Version. This and three other original CF PROMs were reviewed. For all PROMs, the quality of content validity was rated as insufficient due to deficiencies in the concept and items elicitation, inadequate target population representation, and inadequate details on cognitive interview procedures. The overall evidence quality was rated as low due to a limited number of PROM validation studies, poor methodological and reporting quality, and indirect result. Discussion: There is a scarcity of studies examining CF within the target population, and the quality of evidence for content validity of the reviewed PROMs for CF measurement is currently low. CF definition and construct description in PROM development studies suffer from vagueness and seem inadequately reflected by the content of the reviewed PROMs. Further research with a robust methodology seems necessary to address the identified flows. Systematic review registration: Measurement of compassion fatigue in people working with animals: protocol for a systematic review. PROSPERO 2023 CRD42023433982. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023433982.

Effectiveness of Ultraviolet Radiation and Disinfectant Wipes in Reducing the Microbial Contamination of Mobile Phones in a Tertiary Care Hospital.

Background As mobile phones act as a potential source of microbial contamination, particularly in a hospital environment, the effectiveness of two most debated interventions namely ultraviolet radiation and disinfectant wipes in reducing the microbial contamination of mobile phones is compared. Objective To screen the mobile phones of healthcare personnel for the presence of microorganisms and to compare the effectiveness of ultraviolet radiation and disinfectant wipes in reducing microbial contamination. Methods and materials Pre-intervention and post-intervention swabs were collected before and after the use of each intervention respectively using 56 samples and cultured for growth in nutrient agar. Agar plates are subjected to quantitative analysis using bacterial colony count to reflect the efficacy of the specific intervention used. The data collected was entered in Microsoft Excel (Microsoft® Corp., Redmond, WA, USA) and analysis was done using standard statistical packages. Results While comparing the pre-intervention bacterial load with the post-intervention load, post-intervention bacterial contamination in terms of colony-forming units/CFU has drastically reduced after both interventions, which is validated by statistical significance. However, it was observed participants using disinfectant wipes as intervention had 2.07 times higher chance of having a low bacterial load which wasn't statistically significant. Conclusion Our study shows that with the use of any intervention from the above-mentioned interventions, bacterial load or bacterial contamination can be reduced significantly, thus pointing out that both ultraviolet radiation and disinfectant wipes are effective in reducing contamination of mobile phones. It was also found that male doctors have more bacterial load than females, which can be minimized by effectively changing behavioral habits.