Healthcare professionals' digital health competence profiles and associated factors: A cross-sectional study.

AIMS: To identify healthcare professionals' digital health competence profiles and explore associated factors to digital health competence in healthcare settings. DESIGN: A cross-sectional study. METHODS: Data were collected from 817 healthcare professionals from nine organizations with an electronic questionnaire by using Digital Health Competence instrument (42 items) and Aspects Associated with Digital Health instrument (15 items) between 1st March and 31st July 2022. K-means clustering was used to describe digital health competence profiles. Binary logistic regression analysis was used to explore associated factors. RESULTS: Analysis revealed three digital health competence profiles: A - high competence (n = 336), B - intermediate competence (n = 352) and C - low competence (n = 129). Between the profiles, digital health competence showed significant differences (p < .001). Recent graduation year, working in outpatient environments and leader or specialist position were associated with higher digital health competence. Organizational practices and the influence from colleagues improved competence in human-centred remote counselling, digital solutions as part of work, competence in utilizing and evaluating digital solutions and ethical competence. Support from management improved digital solutions as part of work and ethical competence. CONCLUSION: Nursing and allied health professionals working in other than outpatient environments should be specifically acknowledged when digital health competence development initiatives are designed and targeted. The positive influence from colleagues could be harnessed by enhancing their involvement in digital health competence development methods such as orientation, mentoring or coaching. Additionally, managers should take a stronger role in supporting different areas of digital health competence. IMPACT: This was the first study that explored healthcare professionals' digital health competence profiles and associated factors. The detection of healthcare professionals' digital health competence profiles guides the development of digital health education according to different needs in healthcare environments. REPORTING METHOD: The study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Adjuvant therapy for hormone receptor-positive breast cancer: Perspective from a survey on breast cancer physicians' acceptance of practice-changing data.

A cross-sectional online survey was conducted. A high proportion of the Chinese breast cancer (BC) physician respondents (n=77) would prescribe extended adjuvant endocrine therapy (AET) with aromatase inhibitors (AI) beyond 5 years for postmenopausal females with BC, especially those with higher risk. Respondents with ≥15 years of clinical experience were more likely to prescribe a longer duration of AET for low-risk patients. Half of the respondents considered intermittent letrozole as an acceptable option. Most respondents would prescribe adjuvant chemotherapy to genomic high-intermediate risk [Oncotype DX recurrence score (RS) 21-25] females aged ≤50 years regardless of the clinical risk classification.

[Correlation of patient satisfaction with nurses' time spent at the bedside: A prospective observational study]. / Zusammenhang der Patientenzufriedenheit mit der Anwesenheitszeit Pflegender am Patientenbett.

Correlation of patient satisfaction with nurses' time spent at the bedside: A prospective observational study Abstract. Background: Patient satisfaction is of high importance in quality assurance in many hospitals. The existing shortage of nursing staff and the resulting additional workload for individual nurses reduce the time available for patient care. Aim: The aim of this study is to explore a possible relationship of patient satisfaction with the time spent by nurses at the bedside and the influence of other influencing predictors. Methods: In this observational study, nursing attendance time was collected using attendance records which were verified by digital call light logs, and then evaluated using a linear regression model including patient satisfaction. Results: The nursing attendance time showed no significant influence on "patient satisfaction" (p = 0.155). The most important variables influencing "patient satisfaction" were: "no previous hospital experience" (p = 0.001), "importance of care" (p < 0.001) and "Gender" (form male) (p = 0.001). Conclusions: The time spent by nurses at the patient's bedside is not considered decisive enough to have a clear positive influence on patient satisfaction. Adaptations in nursing care are recommended, which enable a holistic relationship building and goal-oriented nursing care that favours patient satisfaction.

[Telemedicine: validation of a questionnaire to evaluate the experience of health professionalsTelemedicina: validação de um questionário para avaliar a experiência dos profissionais de saúde]. / Telemedicina: validación de un cuestionario para evaluar la experiencia de los profesionales de la salud.

Objective: This objective of this work is to develop and validate a questionnaire to evaluate health professionals' experience with telemedicine systems. Methods: Based on an abbreviated, locally validated Spanish-language version of the patient questionnaire developed by Parmanto et al., a group of experts developed a version to evaluate the experience of health professionals who provide telemedicine services. The psychometric behavior of the items was tested in an initial sample of 129 professionals, using exploratory factor analysis. The comprehensibility of the items was then assessed through cognitive interviews. Finally, in a new sample of 329 professionals, the construct validity of the questionnaire was evaluated by means of confirmatory factor analysis (CFA); its criteria of external validity were assessed by comparing the score with that of a summary question. Results: A 12-item questionnaire was obtained, with a two-factor structure and acceptable adjustment indicators documented through CFA. Reliability, convergent validity, and discriminant validity were appropriate. The criteria of external validity showed optimal results. Conclusions: The instrument obtained has adequate psychometric properties and will contribute to the objective evaluation of the experience of health professionals who perform telemedicine.

Objetivo: Desenvolver e validar um questionário para avaliar a experiência dos profissionais de saúde com os sistemas de telemedicina. Métodos: Com base na versão abreviada em espanhol ­ e validada localmente ­ do questionário para pacientes desenvolvido por Parmanto et al., um grupo de especialistas gerou uma versão de consenso para avaliar a experiência de profissionais de saúde que prestam serviços de telemedicina. O comportamento psicométrico dos itens foi testado em uma primeira amostra de 129 profissionais, por meio de análise fatorial exploratória. Em seguida, sua compreensibilidade foi avaliada por meio de entrevistas cognitivas. Por fim, em uma nova amostra de 329 profissionais, avaliou-se a validade de construto do questionário por meio de uma análise fatorial confirmatória (AFC), e sua validade de critério externo, mediante a avaliação de sua pontuação com a de uma pergunta resumo. Resultados: Obteve-se um questionário de 12 itens com estrutura de dois fatores, com indicadores de ajuste aceitáveis, documentados pela AFC. A confiabilidade, a validade convergente e a validade discriminante foram adequadas. A validade de critério externo apresentou ótimos resultados. Conclusões: O instrumento obtido possui propriedades psicométricas adequadas e contribuirá para a avaliação objetiva da experiência dos profissionais que realizam telemedicina.

Prevalence, severity, and risk factor of breakthrough infection after vaccination with either the Covaxin or the Covishield among healthcare workers: A nationwide cross-sectional study.

Background and Aims: The coronavirus disease-2019 (COVID-19) pandemic has grappled the entire globe since the beginning of 2020. In India, two vaccines were released in January 2021, the Covaxin® and the Covishield™. However, despite vaccination, many breakthrough infections were reported during the second wave in India. The present cross-sectional study aimed to find out prevalence, severity, and associated risk factors of breakthrough infection among healthcare workers (HCWs) vaccinated against COVID-19. Material and Methods: After ethical approval and CTRI registration, a validated questionnaire was circulated as Google form-based survey to HCWs across the nation through e-mail over 3 weeks. Biweekly reminders were sent to nonresponders till the desired sample size was attained, after which the survey was closed, and responses were charted. Data obtained from the responses were collated and analyzed. Results: A total of 1096 HCWs responded to the survey (54.8% response rate) and 23.36% had breakthrough infection. The severity of infection was more in the 30-50 years age group (P = 0.0170) and doctors belonging to clinical branches (P = 0.0005). The point estimate for effectiveness in preventing infection was significantly better with Covishield™ (78.5% vs. 72.4%) (P = 0.0260). Nearly all those who were infected after vaccination thought that vaccination decreased disease severity. Conclusion: Breakthrough COVID-19 infection still occurred after vaccination though the prevalence of severe infection was low. Covishield™ performed significantly better than Covaxin® in terms of preventing the disease. Clinical branches of medicine were found at a higher risk and younger HCWs or those with comorbidities had a higher severity of the disease.

Factors Influencing Georgia Legislators' Decision-Making on Nurse Practitioner Scope of Practice.

The state of Georgia faces challenges in providing access to care, largely due to rural hospital closures and physician shortages. Although nurse practitioners (NPs) could help address Georgia's urgent health care needs, the state remains restrictive with respect to NP scope of practice (SOP). This study examined factors that influence Georgia legislators' decision-making on NP SOP. In June 2016, after the January through March legislative session, a questionnaire was e-mailed to 49 state legislators on the Committees on Health and Human Services in Georgia's House of Representatives and Senate. The questionnaire was adapted from a legislative questionnaire previously used in research on state educational policy. Nine of 49 (18%) Georgia legislators responded. The majority of nine respondents were Republicans having served less than 15 years in the legislature. The number of respondents was approximately equal between Senate and House of Representatives. The respondents rated expert testimony and hearing from constituents as most likely to influence their decision-making on NP SOP. They reported that media and concerns about reelection were least likely to influence their decision-making about NP SOP. Therefore, nurses who aim to influence state policy should consider legislator preferences, such as speaking personally with constituents and receiving expert testimony. In-person communication could enhance interactions with legislators, potentially improving policy outcomes. Future research is necessary and should be conducted by NPs to determine the forms of communication and content in testimony most effective in influencing state lawmakers about NP SOP and examine if results vary by state political or other contexts.

Dialysis nurses' knowledge, attitude, practices, and self-efficacy regarding vascular access care: A multicenter cross-sectional survey in Singapore.

BACKGROUND: Dialysis nurses play a pivotal role in the management of vascular access (VA), physician-patient liaison, and patient education for hemodialysis patients. This multicenter study aims to review the dialysis nurses' knowledge, attitude, practice, and self-efficacy toward providing care for patients' VA. METHODS: A multi-centered study was conducted using a self-administered survey. Nurses from 47 Singapore dialysis centers (five hospital-based and 42 community-based) providing hemodialysis were invited to participate on a voluntary and anonymous basis from April to November 2022. The survey consists of nurses' knowledge on VA (10 items), attitude on VA care (six items), usual practices (seven items), and self-efficacy in VA cannulation and management (six items). The total scores for the knowledge, attitude, and self-efficacy components were 50, 30, and 30 respectively. The instrument has been validated in a pilot study. RESULTS: In total, five hundred sixteen dialysis nurses participated the survey. The mean (±SD) knowledge score of the participants toward VA care was 30.0 (±8.1) over a total score of 50. The means (±SD) of their attitude and self-efficacy scores were 24.4 (±4.1) and 24.2 (±3.1) over 30 respectively. The majority of the nurses (84.1% in hospital-based centers and 98.9% in community-based centers) conducted patient education in some aspects of VA care. The percentage of nurses indicated need for referral to access specialists due to various abnormalities varied significantly between the hospital-based and community-based settings. In the multivariable linear regression analysis, longer working experience was a significant factor for higher knowledge score (B = 0.26; p = 0.001), attitude score (B = 0.08; p = 0.01), and self-efficacy score (B = 0.34; p < 0.001). CONCLUSION: Dialysis nurses in Singapore have satisfactory knowledge, practice, and self-efficacy on VA care. The majority of them expressed positive opinions toward the VA-related training they received, new technologies, and communications. The identified knowledge and practice gaps could be incorporated into the future training programs.

Healthcare professionals' perceptions of patient safety in European emergency departments: a comparative analysis of survey results.

Patient safety is a significant concern worldwide. The Emergency Departments (EDs) are vulnerable to adverse events. Europe, with its diverse healthcare systems, differs in patient safety. This study aimed to identify safety challenges through a comparative analysis of healthcare professionals' perceptions of patient safety in European EDs. In early 2023, a validated questionnaire was distributed to European ED professionals, meeting specific response rate criteria. The questionnaire included five safety domains and additional questions about infection control and team morale, with 36 ordinal scale questions. Responses ranged in five levels from "Never" to "Always," and the scores were summed to calculate the total safety score (TSS). The study examined the impact of per capita healthcare expenditure on safety perceptions using descriptive statistics, correlation assessments and SPSS 17 used for the analysis. The analysis of 1048 valid responses from 24 European countries revealed significant variability in safety perceptions. Teamwork scored highest, signifying effective collaboration. Common safety issues included overcrowding, patient flow management, understaffing, limited training and facilities for mental illnesses. TSS showed correlation with team morale and infection control, but no correlation with per capita healthcare expenditure. This comparative study underlines the disparities in patient safety perceptions across European EDs. Each country displayed unique safety concerns. Safety perceptions did not align with per capita healthcare expenditure, indicating that addressing ED safety needs multifaceted strategies. Policymakers can leverage these findings to inform strategic planning, encouraging targeted interventions to enhance patient safety at both the national and European levels.

Nurses Response to the Physical and Psycho-Social Care Needs of Patients with COVID-19: A Mixed-Methods Study.

The COVID-19 pandemic heavily impacted nursing care. This study aimed to understand which nursing interventions were instrumental in responding to COVID-19 patients' needs by exploring the experiences of patients and nurses. In this mixed-method study with an explanatory sequential design, we involved nurses caring for COVID-19 patients in intensive and sub-intensive care units and patients. In the first phase, we collected data through a survey that assessed patients' needs from the perspective of nurses and patients, as well as patient satisfaction. In the second phase, qualitative data were collected through interviews with patients and nurses. In the third phase, we extracted quantitative data from patients' records. Our sample included 100 nurses, 59 patients, 15 patient records, and 31 interviews (15 patients, 16 nurses). The results from the first phase showed patients and nurses agreed on the most important difficulties: "breathing", "sleep/rest", and "communication". Nursing care was rated positively by 90% of the patients. In the second phase, four themes were identified through the patients' interviews: "my problems", "my emotions", "helpful factors", and "nursing care". Five themes were identified through the nurses' interviews: "the context", "nurses' experiences and emotions", "facilitators and barriers to patient care", "nursing care", and "the professional role". From the third phase, the analysis of the clinical documentation, it was not possible to understand the nursing care model used by the nurses. In conclusion, nurses adopted a reactive-adaptive approach, based on experience/knowledge, pursuing generalized objectives, and adapting their response to the clinical evolution. In difficult contexts, nursing care requires a constant competent technical-relational presence at the patient's bedside.

Physicians' Agreement on and Implementation of the 2019 European Alliance of Associations for Rheumatology Vaccination Guideline: An International Survey.

Objective: To evaluate the perspective of healthcare professionals towards the 2019 European Alliance of Associations for Rheumatology (EULAR) vaccination guideline in patients with autoimmune inflammatory rheumatic diseases (AIIRD). Methods: Healthcare professionals who care for patients with AIIRD were invited to participate in an online survey regarding their perspective on the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD. Level of agreement and implementation of the 6 overarching principles and 9 recommendations were rated on a 5-point Likert scale (1~5). Results: Survey responses of 371 healthcare professionals from Asia (42.2%) and North America (41.6%), Europe (13.8%), and other countries were analyzed. Only 16.3% of participants rated their familiarity with the 2019 EULAR guideline as 5/5 ("very well"). There was a high agreement (≥4/5 rating) with the overarching principles, except for the principles applying to live-attenuated vaccines. There was a high level of agreement with the recommendations regarding influenza and pneumococcal vaccinations; implementation of these recommendations was also high. Participants also reported a high level of agreement with the remaining recommendations but did not routinely implement these recommendations. Conclusion: The 2019 update of EULAR recommendations for the vaccination of adult patients with AIIRD is generally thought to be important by healthcare professionals, although implementation of adequate vaccination is often lacking. Better education of healthcare providers may be important to optimize the vaccination coverage for patients with AIIRD.

Reliability and validity of the Chinese version of the Self-Efficacy Perception Scale for Administrator Nurses.

Objectives: This study aimed to translate the Self-Efficacy Perception Scale of Administrator Nurses (SEPSAN) into Chinese and test its reliability and validity among nurse managers. Methods: A scale translation and cross-sectional validation study was conducted. The English version was translated for Chinese by the Brislin translation model included direct translation, back translation, integration, and cultural adjustment. A total of 382 nurse administrators were recruited from 20 general hospitals in five Chinese cities to assess the reliability and validity of the scale from April to May 2023. Validity assessments included content, structural, and convergent validity. Reliability was evaluated using Cronbach's α coefficient and test-retest reliability. Results: The item-content validity index (I-CVI) of the scale ranged from 0.86 to 1.00, and the average scale-level content validity index (S-CVI/Ave) for the overall scale was 0.98. The exploratory factor analysis indicated five dimensions (planning, organizing, commanding, coordinating, controlling, and inspecting) with 41 items. The cumulative variance contribution rate was 63.72%. Confirmatory factor analysis showed an acceptable fit. The general Cronbach's α coefficient was 0.95, and the test-retest reliability was 0.87. Conclusion: The Chinese version of SEPSAN showed satisfactory reliability and validity and thus can be used to assess the self-efficacy of nurse administrators in China.

Survey of physicians' and physiotherapists' ankle muscle strength assessment practices for safe return to sports after lateral ankle sprain: A short report.

BACKGROUND AND PURPOSE: Ankle muscle strength is an important criterion to consider and assess for return to play (RTP) after lateral ankle sprain (LAS). This study therefore focuses on the reported ankle muscle strength consideration for RTP by physicians and physiotherapists, both clinicians involved in RTP decisions, and how they assess it in daily practice. The primary aim is to compare reported clinical practice on ankle muscle strength evaluation between physicians and physiotherapists. Our secondary aims are: to assess the prevalence of use of qualitative versus quantitative assessment and; to determine if there are any differences in how clinicians with or without a Sports Medicine or Physiotherapy Education approach this assessment. METHODS: A survey on RTP criteria after LAS was completed by 109 physicians in a previous study. A number of 103 physiotherapists completed the same survey. A comparison between clinicians' answers was realized and additional questions on ankle muscle strength were analysed. RESULTS: Physiotherapists consider ankle strength for RTP more than physicians (p < 0.001). A large majority of physicians (93%) and physiotherapists (92%) reported assessing ankle strength manually and less than 10% use a dynamometer. Physicians and physiotherapists with Sports Medicine or Physiotherapy Education selected more quantitative assessment than those without (p < 0.001). DISCUSSION: Despite being recognized as an important criterion, ankle muscle strength is not always part of the RTP criteria after LAS in daily practice. The dynamometers are scarcely used by physicians and physiotherapists, whereas it could accurately quantify ankle strength deficits. Sports Medicine or Physiotherapy Education increases the use of quantitative ankle strength assessments by clinicians.

Frailty knowledge, training and barriers to frailty management: A national cross-sectional survey of health professionals in Australia.

OBJECTIVE(S): To understand Australian health professionals' perceptions of their knowledge and previous training about frailty, as well as barriers to frailty assessment and management in their practice. METHODS: A cross-sectional online survey was developed and distributed to health professionals (medical, nursing and allied health) engaged in clinical practice in Australia through convenience and snowball sampling techniques from March to May 2022. The survey consisted of five sections: frailty training and knowledge; confidence in recognising and managing adults with frailty; the importance and relevance of frailty; barriers to assessing and managing frailty in practice; and interest in further frailty training. Responses were analysed using descriptive statistics. RESULTS: The survey was taken by 736 health professionals. Less than half of respondents (44%, 321/733) reported receiving any training on frailty, with 14% (105/733) receiving training specifically focussed on frailty. Most respondents (78%, 556/712) reported 'good' or 'fair' understanding of frailty. The majority (64%, 448/694) reported being 'fairly' or 'somewhat' confident with identifying frailty. Almost all respondents (>90%) recognised frailty as having an important impact on outcomes and believed that there are beneficial interventions for frailty. Commonly reported barriers to frailty assessment in practice included 'lack of defined protocol for managing frailty' and 'lack of consensus about which frailty assessment tool to use'. Most respondents (88%, 521/595) were interested in receiving further education on frailty, with a high preference for online training. CONCLUSIONS: The findings suggest frailty is important to health professionals in Australia, and there is a need for and interest in further frailty education.

Satisfaction of Health Professionals Regarding the Short Binasal Prong Used as a Non-Invasive Ventilation Interface in Neonatology.

Purpose: To evaluate the health professionals' satisfaction regarding the short binasal prong used in Neonatal Intensive Care Units (NICU), evaluate the difficulties related to its use, and present possible improvements in the design of this device. Patients and Methods: Observational, cross-sectional study with prospective data collection carried out in the NICU of a public hospital in southern Brazil. This research was presented into two stages. In the first stage, the Quebec User Evaluation of Satisfaction with Assistive Technology was applied with 90 health professionals to evaluate the satisfaction regarding the short binasal prong. In the second stage, the health professional's experiences and difficulties in using the binasal prongs in 14 newborns (NBs) that required non-invasive ventilation was collected. The short binasal prongs used was the Fanem® brand and the CPAP circuit was Gabisa Medical International (GMI®). Finally, improvements and recommendations were presented to optimize the device's design. Results: The mean score of the health professionals' satisfaction with short binasal prongs was 3.8 ± 0.6. Ease of adjustment (3.27) and dimensions (3.62) variables had the worst scores. The main difficulties pointed out by health professionals were: circuit disconnection (57.1%), the size of the prong did not correspond to NBs' anatomical characteristics (35.7%), air leakage (21.4%), and difficulty in fixing and positioning the prong in the NB (14.28%). The improvements suggested were: appropriate prong sizes based on the anatomical characteristics of the NBs; adjustable distance between insertion and base catheters; manufactured with malleable material, however not easily foldable; curved and adjustable insertion catheters and functional system of tracheas' connection. Conclusion: The dissatisfaction of health professionals with the dimensions and prongs adjustments and the difficulties faced in clinical practice indicate the need for improvements in these interfaces. The recommendations presented in this study may contribute to optimizing the design of the binasal prong in the future.

Operating room nurse's awareness and implementation status of the prevention of patient's intraoperative acquired pressure injuries: design and validation of a questionnaire.

Aim: To compile the awareness and implementation status of patients with intraoperative acquired pressure injuries prevention by operating room nurses and to test its reliability and validity. Design: This is an equipment development research based on recommendations for developing a reliable and valid questionnaire. Methods: The research was carried out in two phases from February to November 2022. Through a panel discussion, expert consultation, and literature review, the questionnaire for operating room nurses on the current status of awareness and implementation of the prevention of intraoperative acquired pressure injuries was preliminarily formulated. The formal questionnaire was developed through validity analysis, reliability analysis and item analysis, and reliability and validity tests were conducted. Moreover, according to the questionnaire survey results, confirmatory factor analysis was carried out to construct the structural equation model. Results: The initial questionnaire consisted of five dimensions with 48 items, which was finalized to five dimensions with 38 items after reliability and validity testing and analysis. The five dimensions included implementation of intraoperative acquired pressure injuries prevention, intraoperative acquired pressure injuries preventing cognitive conditions, preoperative intraoperative acquired pressure injuries preventing cognitive conditions, basic knowledge of pressure injuries, and implementation of intraoperative acquired pressure injuries prevention in special patients. Cronbach's α of the overall questionnaire was 0.969 while that of each dimension was 0.846-0.959. The KMO value of structural validity was 0.945 (P < 0.001), and the contribution rate of cumulative variance was 70.694%. The fitting of confirmatory factor analysis was found to be generally ideal: χ2/df = 2.382, RMR = 0.027, TLI = 0.894, RMSEA = 0.072, IFI = 0.905, CFI = 0.904. Conclusions: The study and design of the questionnaire for operating room nurses on the current status of awareness and implementation of the prevention of intraoperative acquired pressure injuries are scientific and rational, providing a scientific basis for the standardized reform of hospitals and the optimization of the intraoperative acquired pressure injuries management system of the operating room.

Burnout, Depression, Anxiety, and Stress Among Resident Physicians 18 Months Into the COVID-19 Pandemic: A Cross-Sectional Study.

Introduction: Burnout among resident physicians has been an area of concern that predates the COVID-19 pandemic. With the significant turmoil during the pandemic, this study examined resident physicians' burnout, depression, anxiety, and stress as well as the benefits of engaging in activities related to wellness, mindfulness, or mental wellbeing. Methods: A cross-sectional survey of 298 residents from 13 residency programs sponsored by the University of Kansas School of Medicine-Wichita was conducted in October and November 2021. A 31-item questionnaire measured levels of burnout, depression, anxiety, and stress. A mixed method approach was used to collect, analyze, and interpret the data. Descriptive statistics, one-way ANOVA/Kruskal-Wallis tests, adjusted odds ratios (aOR), and immersion-crystallization methods were used to analyze the data. Results: There was a 52% response rate, with 65.8% (n = 102) of the respondents reporting manifestations of burnout. Those who reported at least one manifestation of burnout experienced a higher level of emotional exhaustion (aOR = 6.73; 95% CI, 2.66-16.99; p < 0.01), depression (aOR = 1.21; 95% CI, 1.04-1.41; p = 0.01), anxiety (aOR = 1.14; 95% CI, 1.00-1.30; p = 0.04), and stress (aOR = 1.36; 95% CI, 1.13-1.64; p < 0.01). Some wellness activities that respondents engaged in included regular physical activities, meditation and yoga, support from family and friends, religious activities, time away from work, and counseling sessions. Conclusions: The findings suggested that the COVID-19 pandemic poses a significant rate of burnout and other negative mental health effects on resident physicians. Appropriate wellness and mental health support initiatives are needed to help resident physicians thrive in the health care environment.

Qualitative healthcare worker survey: Retrospective cross-sectional case study on COVID-19 in the African context.

Background: Despite the presence of COVID-19 epidemiologic data in Africa, there are gaps in the understanding of healthcare workers' concerns and fears early in the pandemic. Methods: A retrospective cross-sectional multi-country pan-African qualitative survey case study on the perceived effects of the COVID-19 pandemic on healthcare workers in the continent focused specifically on personal safety and misinformation. The survey was distributed to 13 countries via snowball sampling of practitioners between April 22 and May 15, 2020. The survey solicited free-form answers, resulting in a large spectrum of responses. Qualitative analysis included open and axial coding methods for thematic emergence. Results: A total of 489 analyzable responses were recorded. The majority of respondents (n = 273, 57%) highlighted personal safety concerns including lack of resources and training to prevent infection (33%); fear of infection and transmission (24%); lack of public awareness and compliance with regulations (12%); governmental concerns (9%) and economic insecurity (11%) amongst others. 328 respondents (67%) reported having heard misinformation about COVID-19. Responses included misinformation regarding origin of the virus (11%), false modes of transmission (6%), differential effect for specific groups (30%), unproven cures (35%), and disbelief in existence (11%). Responses for misinformation and fears revealed categorical associations between certain countries. Conclusion: Addressing fears and concerns of frontline healthcare workers facilitates their essential role in combating community misinformation, and further understanding could provide essential insight to institutions and governments to direct resource allotment and community education.

[Pattern of opinions of young physicians in gynecology and obstetrics in northern Germany]. / Stimmungsbild des ärztlichen Nachwuchses in der Frauenheilkunde und Geburtshilfe in Norddeutschland: Eine umfassende Bestandsaufnahme ausbildender Kliniken im Bereich der Norddeutschen Gesellschaft für Gynäkologie und Geburtshilfe mit Charakterisierung des ärztlichen Nachwuchses und einer praxisorientierten Herangehensweise in Vorbereitung auf die Generation Z.

Background: The new generation of physicians has disruptive effects and also does not stop at the discipline of obstetrics and gynecology. The discourse is still focused on Generation Y (1980-1994). In order to offer a constructive working environment to the new generation, time is pressing. It is important to be aware of their requirements for such an environment. Objective: Determination of the pattern of opinions of the next generation of physicians in gynecology and obstetrics and then to derive aspects relevant to the practice, taking the future dominant Generation Z (1995-2009) into account. Methods: A descriptive cross-sectional survey of junior physicians in gynecology and obstetrics at training hospitals was conducted from January to October 2021. A total of 81 questions on 6 topics were answered online. Results: A total of 122 questionnaires (n = 122) were evaluated. Of these 28% (n = 33) rated the workload as very high and 56% (n = 67) as high. Two thirds (n = 81) worked 40-59 h per week, 67% (n = 80) put the share of delegable activities at > 25%, 88% (n = 105) spent 25-75% of daily work time on documentation, 92% (n = 109) would like to have regular senior or chief physician visits. Of the participants 81% (n = 95) rated continuing education as less than good. For 32% (n = 38) there was a balanced relation between health and profession, 25% (n = 29) rated working conditions as family friendly and 88% (n = 102) would be willing to change employers if dissatisfaction persisted. Conclusion: The next generation of physicians is dominated by demands for further training, part-time work, a sense of purpose, compatibility of family and career, appreciation and self-care. Solution concepts to meet these demands would be available.

Barriers to nurse-patient communication in primary healthcare centers in Bahrain: Patient perspective.

Objectives: Effective and efficient communication is a core element in healthcare systems, especially between healthcare providers and patients. This study aimed to identify communication barriers between nurses and patients in primary healthcare centers in Bahrain. Methods: This is a cross-sectional study conducted across primary healthcare centers in Bahrain. Four hundred and two patients were recruited using convenience sampling. A self-administered questionnaire comprising 29 items on communication barriers was used. Results: A total of 402 patients consented to participate. The majority of participants reported the following statements had large effects on communication: "shortage in the number of nurses compared to the large number of patients" (254/401, 63.3%), "lack of desire of nurse to communicate with patients" (246/402, 61.2%), and "negative attitude of the nurse toward the patient" (238/401, 59.4%). Further, "difference in language between nurses and patients," "lack of self-confidence by nurses," and "nurses overwhelmed by work" were ranked as top three statements with a significant influence on communication between nurses and patients. Conclusions: Communication between healthcare providers and patients is pivotal for an optimal healthcare service. Based on the findings of this study and the literature, we recommend formal training of health care workers in improving communication skills and including this not only in medical curriculum but also in the form of continuing medical education (CMEs).

Burnout, Depression, Anxiety, and Stress Among Family Physicians in Kansas: 18 Months into the COVID-19 Pandemic.

INTRODUCTION: Given the significant turmoil during the COVID-19 pandemic, the authors evaluated burnout and other types of emotional distress experienced by family physicians in Kansas during the second year of the pandemic. The authors compared findings of this study to a similar study conducted 3 months into the pandemic. METHODS: A cross-sectional online survey of 272 actively practicing family physicians in Kansas was conducted from September 15 to October 18, 2021. A 34-item questionnaire was used to measure the physicians' levels of burnout, personal depression, anxiety, and stress. A mixed method approach was used to collect, analyze, and interpret the data. Descriptive statistics, Mann-Whitney U test/independent samples t-test, χ2, adjusted odds ratio, and immersion-crystallization methods were used to analyze the data. RESULTS: The response rate was 48.9% (n = 133). In aggregate, 69.2% of respondents reported at least 1 manifestation of professional burnout in 2021 compared with 50.4% in 2020; P ≤ .01). The 2021 respondents were at higher odds of experiencing burnout compared with 2020 respondents (aOR = 1.86; 95% CI, 1.00 to 3.57; P = .046). The respondents who reported at least 1 manifestation of professional burnout were more likely to screen positive for depression (aOR = 1.87; 95% CI, 1.31-2.66; P ≤ .01), report higher levels of anxiety (aOR = 1.53; 95% CI, 1.04-2.24; P = .013), and higher levels of stress (aOR = 1.39; 95% CI, 1.17-1.66; P ≤ .001). CONCLUSION: As the COVID-19 pandemic continued, there are significant and worsening rates of professional burnout and other forms of emotional distress among family physicians. These findings suggest timely need for appropriate psychological supports.