Using a Novel Gameplay Intervention to Target Intrusive Memories After Work-Related Trauma: Iterative Qualitative Analysis of Intensive Care Unit Staff Experiences.

BACKGROUND: Many intensive care unit (ICU) staff experience intrusive memories following work-related traumatic events, which can lead to long-term mental health outcomes and impact work functioning. There is a need for interventions that target intrusive memories in this population; however, factors such as mental health stigma and difficulty in fitting interventions into busy schedules can pose barriers. The Brief Gameplay Intervention For National Health Service Intensive Care Unit Staff Affected By COVID-19 Trauma (GAINS) study tested a brief, digital imagery-competing task intervention (including computer gameplay) with the aim of reducing the recurrence of intrusive memories, which holds promise for overcoming some of these barriers. OBJECTIVE: This substudy aims to explore barriers and facilitators to the uptake and practical use of the intervention by ICU staff, along with its acceptability, and iteratively explore the impact of intervention optimizations to further refine the intervention. METHODS: The GAINS study is a randomized controlled trial comparing access to a brief digital imagery-competing task intervention for 4 weeks with usual care followed by delayed access to the intervention. The participants were ICU staff who worked during the COVID-19 pandemic and experienced intrusive memories. All participants were sent a questionnaire at 4 weeks to gather data about intervention acceptability. Nested within the randomized controlled trial, a subset of 16 participants was interviewed, and data were analyzed using thematic analysis drawing from a framework approach. RESULTS: Both quantitative and qualitative data indicated high acceptability of the intervention. Intervention use data show that, on average, staff were able to target approximately 73% (3.64/4.88) of their intrusive memories and engaged with the Tetris component for the full 20 minutes per session. Overall, on the acceptability questionnaire, staff found the intervention easy to use, helpful, and highly acceptable. The interviews generated four themes: approach to the intervention, positives of the intervention, negatives of the intervention, and improvements and optimizations. Findings highlighted barriers that ICU staff experienced: stigma, feeling weak for seeking help, not wanting colleagues to know they were struggling, and skepticism. However, they provided suggestions on how barriers could be overcome and discussed the advantages of the intervention when compared with other treatments. Although participants described many positive aspects of the intervention, such as being easy to use, enjoyable, and leading to a reduction in the frequency or intensity of intrusive memories, they also raised practical issues for implementation. CONCLUSIONS: The intervention has the potential to overcome stigma and reduce the frequency of intrusive memories after traumatic events among ICU staff. Further refinement is needed to improve the adoption and reach of this intervention. A limitation is that we could not interview the National Health Service staff who were unable or unwilling to take part in the trial.

Implementing integrative therapies in adult critical care: Barriers and strategies.

BACKGROUND: Critically ill patients experience intense physical and psychological stressors in the intensive care unit (ICU). More than half of ICU survivors report overwhelming mental health symptoms after ICU discharge, such as post-traumatic stress symptoms, anxiety, and depression. Relaxation-inducing integrative therapies such as guided imagery, massage, therapeutic touch, music therapy, and spirituality-based healing practices have the potential to promote comfort and relaxation and improve patient outcomes. OBJECTIVES: The aim of this study was to explore the attitudes of healthcare professionals towards the implementation of relaxation-inducing integrative therapies in critical care, barriers to implementation, and potential strategies to overcome them. METHODS: We conducted seven focus group interviews with 23 critical care clinicians (70% nurses, 17% allied health professionals, 13% physicians). Interviews were audiotaped and transcribed verbatim. Data were thematically analysed using an inductive content analysis approach. FINDINGS: Results reveal a constant interplay between mostly positive personal attitudes towards implementation of integrative therapies and the perceived culture and priorities of the unit. The main benefits for critically ill patients as perceived by participants were promotion of comfort, sleep, and coping, increase of trust, and decrease of pain and stress. As for barriers, dominant themes were a perceived lack of evidence, cost, and time constraints and the fear of loss of professional credibility. Participants related nurses' education and training, family involvement, and leadership were seen as main strategies for implementation. CONCLUSIONS: The dominant ICU culture needs to be considered when implementing integrative therapies. Education, access to evidence, and role modelling are proposed as means to shift the ICU culture towards utilisation of integrative therapies in critical care.

Evaluation of the impact of leadership development on nurses and midwives underpinned by transformational learning theory: a corpus-informed analysis.

PURPOSE: The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT). DESIGN/METHODOLOGY/APPROACH: A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants' responses to the question "please tell us about the impact of your overall experience", which culminated in a combined corpus of 75,053 words. FINDINGS: Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact. RESEARCH LIMITATIONS/IMPLICATIONS: This in-depth qualitative evaluation of participants' feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice. ORIGINALITY/VALUE: Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments.

O planeamento da conferência familiar em cuidados paliativos: perceção dos profissionais de saúde / Family conference planning in palliative care: health professionals' perceptions

Atualmente, defrontar o fim de vida e o sofrimento, parece continuar a ser algo difícil. Os profissionais de saúde, nomeadamente os enfermeiros, devem cuidar de forma holística também na fase final de vida evitando o sofrimento. Cuidar da pessoa em fim de vida e família exige a participação ativa e competência do enfermeiro, no sentido de satisfazer as suas necessidades, privilegiando o direito de morrer com dignidade e o direito de receber bons cuidados, fundamentada no imperativo do respeito pela vida. Este relatório surge no âmbito do Estágio de Natureza Profissional, do Curso de Mestrado em Enfermagem à Pessoa em Situação Paliativa, e procura descrever de forma crítica e reflexiva todo o processo de aprendizagem e desenvolvimento de competências especializadas nesta área de intervenção em Enfermagem. Para o desenvolvimento de competências procuramos reunir o máximo de experiências e basear a prática clínica em evidência científica, envolvendo as dimensões da prestação de cuidados à pessoa e família em situação paliativa, da formação, da gestão e da investigação. Nesse sentido, o Estágio de Natureza Profissional desenrolou-se numa Unidade de Cuidados Paliativos, no qual emergiu a problemática de investigação sobre o planeamento da conferência familiar em cuidados paliativos na perceção dos profissionais de saúde. A pertinência do estudo de investigação decorreu do facto das conferências familiares em cuidados paliativos serem de extrema importância para todos os intervenientes no processo de doença, uma vez que, o planeamento da conferência familiar, surge essencialmente para a prestação de cuidados e apoio à família. Neste sentido tendo em conta o objetivo de investigação, optamos por uma scoping review, em que os resultados evidenciaram que o planeamento é fundamental para a realização das Conferências Familiares, de modo a permitir a sistematização e tratamento da informação. Os profissionais de saúde consideram como fundamental realizar a conferência familiar. Da experiência de estágio, salienta-se o desenvolvimento de competências e habilidades especializadas fundamentais para cuidar da pessoa em situação paliativa e família. Permitiu-nos ainda constatar o papel preponderante do enfermeiro especialista na formação profissional para o aprofundamento de competências, num contínuo de aprendizagem ao longo da vida, refletir sobre as práticas e sobre a importância da interação com a equipa multidisciplinar e a família. Percebemos que emerge a necessidade de oferecer a máxima qualidade à pessoa em fim de vida e família para a qual os cuidados paliativos são uma resposta mais adequada.

Currently, facing the end of life and suffering seems to continue to be something difficult. Health professionals, namely nurses, should also provide holistic care at the end-of-life stage, thus avoiding suffering. Caring for an end-of-life person and family requires the active participation and competence of nurses, in order to meet their needs, emphasising the right to die with dignity and the right to receive good care, based on the imperative respect for life. This report arises within the scope of the Professional Internship of the Master's Degree in Palliative Care Nursing and seeks to describe the entire learning process and development of specialised skills critically and reflectively in this area of Nursing intervention. In order to develop competencies, we seek to gather as many experiences as possible and base clinical practice on scientific evidence, regarding the extents of providing care to the person and family in a palliative situation, training, management, and research. On that note, the Internship of Professional Nature took place in a Palliative Care Unit, in which emerged the research issue concerning the planning of the family conference in palliative care in the perception of health professionals. The relevance of this research study was due to the fact that family conferences in palliative care are extremely important to all participants in the disease process, since family conference planning is essentially aimed at providing care and support to the family. To this effect, considering the research objective, we opted for a scoping review, upon which the results showed that planning is essential for the implementation of Family Conferences, so as to allow the systematisation and process of information. Health professionals consider it essential to hold the family conference. From the internship experience, the development of competencies and specialized skills fundamental to the palliative patient and family's care is highlighted. It has also allowed us to ascertain the preponderant role of the specialist nurse in professional training for the deepening of skills, in a lifelong learning constant, to reflect on the practices and on the importance of interaction with the multidisciplinary team and the family. We became aware that the need to offer the highest quality to the person at the end of life and the family emerges, for which palliative care is a more appropriate response.

Characteristics and impacts of live music interventions on health and wellbeing for children, families, and health care professionals in paediatric hospitals: a scoping review.

PURPOSE: The objective of this scoping review is to compile and examine characteristics and impacts of live music interventions on the health and wellbeing of children, families, and health care professionals in paediatric hospital care. METHODS: We searched four scientific databases for peer-reviewed publications of empirical studies of all study designs. The first author screened the publications, with spot-checks for eligibility by the second and third authors. Data extraction and quality assessment were made by the first author with support from the second and third. Additionally, the included studies were screened for quality appraisal. The analysis followed an inductive, interpretive approach for synthesis. RESULTS: Quantitative features were screened and compiled, and qualitative inductive analyses of findings were elaborated into categories connected to research questions. The reported impacts were thematized through emergent features of importance and prerequisites beneficial for successful interventions. Recurrent outcomes present themes of positive affect, copingand reduced hospitalization. Emotional regulation, play and participation, age, session design, adaptivity, and familiarity present benefits, barriers, and facilitators for outcomes. CONCLUSIONS: Findings from collected empirical research display philosophy, practice, and relations as keys for characteristics, impacts, and implications of live music interventions in paediatric hospital care. The communicative aspects of music appear at the core of importance.

Efficacy of pranayama in preventing COVID-19 in exposed healthcare professionals: A quasi-randomized clinical trial.

BACKGROUND: The global outbreak of COVID-19 has created a challenging situation, especially for the frontline Health Care Professionals (HCPs), who are routinely exposed and thus are at a higher risk of infection. Pranayama, a component of Yoga, is known to improve immune function and reduce infection. However, no clinical trial on the efficacy of Pranayama in preventing COVID-19 has yet been conducted. AIM AND OBJECTIVE: This quasi-randomized clinical trial assessed the efficacy of Pranayama in preventing COVID-19 infection in HCPs routinely exposed to COVID-19. METHODOLOGY: The study was conducted at 5 different COVID-19 hospitals, India in year 2020. The inclusion criteria were being an HCP exposed to COVID-19 patients and being negative on antibody tests. 280 HCPs were recruited sequential and assigned to intervention and control groups. Of these, 250 HCPs completed the study. The intervention was twice daily practice, for 28 days, of specially designed Pranayama modules under the online supervision of Yoga instructors. The HCPs in the control group were advised to continue their normal daily routine, but no pranayama sessions. Participants who developed symptoms suggestive of COVID-19 were subjected to Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) or Point of Care Rapid Antigen Test (RAT) for confirmation of the diagnosis. All the participants were tested for antibodies to COVID-19 on 28th day of the intervention to detect any asymptomatic infection. RESULTS: The intervention (123) and control (127) groups had comparable demographics and baseline characteristics. At end of 28 days of intervention, nine participants in the control group and one in the intervention group developed COVID-19 (P-value: 0.01, Odds Ratio: 0.107, 95% CI: 0.86; Risk Ratio: 0.11, 95% CI: 0.89). CONCLUSION: The intervention of twice daily practice of the Pranayama module for 28 days in HCPs might have made a noteworthy contribution and may have helped in preventing COVID-19 infection.

Professionals' experiences of supporting two-mother families in antenatal and child health care in Sweden.

BACKGROUND: In Sweden, antenatal and child health care are offered free of charge to all expectant and new parents. Professionals in antenatal and child health care play an important role in supporting parents. Previous research shows that same-sex mothers face heteronormative assumptions and insufficient support during their transition to parenthood. OBJECTIVE: To explore professionals' experiences of supporting two-mother families in antenatal and child health care. METHOD: A qualitative method with focus group discussions was used. An interview guide was followed, and the discussions were held online. The data was analysed according to inductive content analysis. SETTINGS AND PARTICIPANTS: The participants were midwives (n = 8) and nurses (n = 5) in antenatal and child health care from different parts of Sweden. Participants were recruited through the coordinating midwives and child health care nurses in the different regions. FINDINGS: One main category was identified: Striving to be open-minded in supporting same-sex mothers. Health care professionals described meeting well-prepared mothers, with an equal commitment between each other, and mothers on guard against heteronormative views. Professionals provided support through empowerment by creating a safe environment and aiming at providing equal support to all parents or tailored support to same-sex mothers. Mothers described handling challenges, as a balancing act to acknowledge both mothers. Struggling with documents and communication and a lack of information were other challenges to be handled. Professionals reflected on their own professional competence and expressed that knowledge acquired through education, experience and personal interest all contributed to their competence. CONCLUSIONS: Forms and documentation need to be updated to be gender neutral to be including to a variety of family constelleations. Health care professionals need time to reflect on norms and challenges to better support both mothers in a two-mother family.

Patient Safety Culture and Spiritual Health in the Operating Room: An Iranian Exploratory Qualitative Study.

The concept of patient safety and spiritual health are considered essential components of health care systems and form the main pillars of quality care in many health care organizations. This study aims to explain the culture of patient safety and spiritual health in the operating room from the perspectives of operating room physicians and nurses. This qualitative study was of qualitative conventional content analysis type using purposive sampling. Data were collected using semi-structured interviews. Graneheim and Landman (2004) methods were used to analyze the data. To analyze the data of this research, 5 main themes including continuous and dynamic training and upgrading of safety skills, attention to spirituality, conscientiousness and work commitment, effective communication and teamwork, equipping human and logistical resources based on the principle of care, accurate recognition of instructions and error control were obtained. According to the findings, a proper understanding of patient safety culture can improve patient safety culture and increase the quality of services provided to patients.

Perception of Patients with Cancer Enquiring About Adjuvant Therapy with Cannabis Medicine for Palliation of Symptoms: An Interview Study among Danish Health Care Professionals.

Background: A medicinal cannabis pilot program was launched in Denmark in 2018 to support patients as countermeasure against self-medication by use of cannabis products from the illicit market. The aim was to facilitate patient access to adjuvate therapy using medicinal cannabis under the guidance of physicians. Objective: The aim of this interview study was to elucidate how health care professionals (HCPs) perceive cancer patients enquiring about cannabis medicine (CM), including medicinal cannabis and cannabis-based medicine, for adjuvant palliative therapy. Design: The program used semistructured qualitative research interviews with thematic analysis. Setting/Participants: Fifty HCPs took part in the study with 10 informants in each of the following 5 groups: oncologists, palliative care specialists, general practitioners, registered nurses in oncology, and in palliative care. Results: The informants reported that optional CM as adjuvant therapy was only discussed when initiated by the patient or relatives. Reluctance by HCPs to enter into a dialogue about CM with their patients was mainly explained by the lack of clinical evidence for the use of CM in palliative care of patients with cancer. None of the oncologists had ever prescribed CM, while three palliative care specialists and two general practitioners had issued prescriptions on rare occasions. Conclusion: HCPs involved in cancer treatment and palliative care are in general reluctant to discuss optional adjuvant CM therapy with their patients. The Danish health care authorities need to address this barrier to ensure that patients eligible for CM therapy are given this option as intended by the launch of the national pilot program.

Exploring Human-Data Interaction in Clinical Decision-making Using Scenarios: Co-design Study.

BACKGROUND: When caring for patients with chronic conditions such as chronic obstructive pulmonary disease (COPD), health care professionals (HCPs) rely on multiple data sources to make decisions. Collating and visualizing these data, for example, on clinical dashboards, holds the potential to support timely and informed decision-making. Most studies on data-supported decision-making (DSDM) technologies for health care have focused on their technical feasibility or quantitative effectiveness. Although these studies are an important contribution to the literature, they do not further our limited understanding of how HCPs engage with these technologies and how they can be designed to support specific contexts of use. To advance our knowledge in this area, we must work with HCPs to explore this space and the real-world complexities of health care work and service structures. OBJECTIVE: This study aimed to qualitatively explore how DSDM technologies could support HCPs in their decision-making regarding COPD care. We created a scenario-based research tool called Respire, which visualizes HCPs' data needs about their patients with COPD and services. We used Respire with HCPs to uncover rich and nuanced findings about human-data interaction in this context, focusing on the real-world challenges that HCPs face when carrying out their work and making decisions. METHODS: We engaged 9 respiratory HCPs from 2 collaborating health care organizations to design Respire. We then used Respire as a tool to investigate human-data interaction in the context of decision-making about COPD care. The study followed a co-design approach that had 3 stages and spanned 2 years. The first stage involved 5 workshops with HCPs to identify data interaction scenarios that would support their work. The second stage involved creating Respire, an interactive scenario-based web app that visualizes HCPs' data needs, incorporating feedback from HCPs. The final stage involved 11 one-to-one sessions with HCPs to use Respire, focusing on how they envisaged that it could support their work and decisions about care. RESULTS: We found that HCPs trust data differently depending on where it came from and who recorded it, sporadic and subjective data generated by patients have value but create challenges for decision-making, and HCPs require support in interpreting and responding to new data and its use cases. CONCLUSIONS: Our study uncovered important lessons for the design of DSDM technologies to support health care contexts. We show that although DSDM technologies have the potential to support patient care and health care delivery, important sociotechnical and human-data interaction challenges influence the design and deployment of these technologies. Exploring these considerations during the design process can ensure that DSDM technologies are designed with a holistic view of how decision-making and engagement with data occur in health care contexts.

Transition experiences of internationally qualified health care professionals: A narrative scoping review.

BACKGROUND: The migration of health care professionals exposes the individual to a variety of challenges as they adjust to the host country's workforce system. While there is a growing body of literature on the individual transition stage of internationally qualified health care professionals, little is known about the overall process and how each stage interacts with the others. AIM: To examine what is known about factors impacting transition experiences of internationally qualified health care professionals at various stages from pre- to post-arrival in their new country. DESIGN: Scoping review incorporating narrative synthesis was conducted. DATA SOURCES: A range of databases were searched, including CINAHL, Medline, Scopus, and ProQuest, as well as reference lists. REVIEW METHODS: The adapted framework methodology described by the Joanna Briggs Institute informed this review. The review included qualitative and quantitative primary peer-reviewed research studies focusing on transition experiences of internationally qualified health care professionals. Included studies were analysed and synthesised using a three-step narrative synthesis. RESULTS: A total of 48 studies were included in the review from nursing, medicine, dentistry, physiotherapy, occupational therapy, and midwifery, with the majority from nursing. The majority of the internationally qualified health care professionals migrated from Philippine, India, and South Africa to the US, UK, Canada, and Australia. Four themes emerged from the review: misguided migration (pre-arrival), a shocking reality (early arrival), challenging accreditation and orientation (registration), and multidimensional work challenge (post-registration). Identified issues impacting the transition experience of internationally qualified health care professionals across different disciplines and nations were generally similar. CONCLUSIONS: Misinformation resulted in unexpected realities upon arrival in destination countries, ineffective accreditation procedures during registration and inadequate support in destination countries led to workplace challenges. With ongoing recruitment of international health care workers, a holistic approach that considers the various stages of transition is necessary to assist in establishing new identities and integrating into the destination country's workforce. This includes informing internationally qualified health professionals accurately about professional and cultural expectations in host countries prior to migration, implementing culturally specific training upon arrival in the destination country, developing and implementing effective accreditation and registration policies, and providing structured mentorship and support following employment.

A pilot survey of clinicians' experiences, attitudes, and interests in hypnosis.

Growing evidence supports the use of clinical hypnosis for medical and mental health applications. Most health care professionals lack training in hypnosis, and this may impact their readiness to recommend it. This study examined experiences, attitudes, and interests in hypnosis among health care professionals from a variety of disciplines. Thirty-seven health care professionals completed an online survey prior to attending a talk on hypnosis. Half of survey respondents were physicians or nurses. Most reported no training in hypnosis (70.3%), but half had previously experienced hypnosis. Participants displayed an understanding of common myths and misconceptions regarding hypnosis and felt hypnosis could be useful in health care settings. Despite this, the majority indicated they are rarely or never asked about hypnosis by their patients. A significant majority of survey participants believed individuals providing hypnosis should have both training and certification.

Nursing Student Perceptions and Attitudes Toward Patients With Cancer After Education and Mentoring: Integrative Review.

BACKGROUND: Knowledge about nursing student attitudes toward patients with cancer after an educational intervention and mentoring support is limited. This review examined the literature on this topic. OBJECTIVE: This integrative review aims to explore the literature on the experiences of students who participate in an oncology elective or educational course on cancer and their attitudes toward cancer. METHODS: A comprehensive search was conducted using PubMed, CINAHL, and MEDLINE databases. Each study was systematically assessed. An evidence table was completed to identify the key aspects of each study that was reviewed. RESULTS: There is insufficient information on the impact of nursing student education on the attitudes and skills of nursing students caring for patients with cancer. An integrative review was completed on the impact of education and mentoring for nursing students on cancer care, which yielded 10 studies that were reviewed. These studies indicate that educational intervention and mentoring improve the confidence and ability of nursing students to care for patients with cancer. CONCLUSIONS: Student nurses need to be armed with knowledge, skills, and positive attitudes while caring for patients with cancer. Nursing students perform best when they have accurate information, positive role models, and mentoring by experienced oncology professionals, to support proficiency in caring for patients with cancer. The lack of knowledge of nursing students in the areas of cancer care, treatment, and patient support requires additional education and research to promote expertise and positive attitudes toward cancer and treating patients with cancer. This will support nursing students' ability to care for patients with cancer as well as develop future educational interventions to shape nursing student attitude and knowledge. This integrative review also identifies the positive impact on the attitudes of other health care professionals who have received training or education on cancer.

A Swiss Health Care Professionals' Perspective on the Meaning of Interprofessional Collaboration in Health Care of People with MS-A Focus Group Study.

Multiple sclerosis (MS) is a chronic, inflammatory autoimmune disease of the central nervous system mainly of adults ranging from 20 to 45 years of age. The risk of developing MS is 50% higher in women than in men. Most people with MS (PwMS) experience a spectrum of symptoms such as spasticity, continence dysfunctions, fatigue, or neurobehavioral manifestations. Due to the complexity of MS and the variety of patient-centered needs, a comprehensive approach of interprofessional collaboration (IPC) of multiple health care professionals (HCP) is necessary. The aim of this qualitative study was to explore the meaning of IPC in the comprehensive care of PwMS from a HCP perspective. Focus groups (FG) with HCP were conducted, recorded, and transcribed verbatim. The sample contained HCP from three MS clinics in different phases of care and rehabilitation. Four main categories emerged: (a) experience with IPC, (b) relevant aspects for IPC in patients' treatment, (c) differences in in- and outpatient settings, and (d) influence of patient perspective. IPC plays a crucial role in HCP perspective when treating PwMS, which can benefit from an IPC therapeutic approach because HCP work together in a patient-centered way. The inpatient setting of HCP strongly supports the implementation of IPC. This prerequisite does not exist in outpatient settings.

Mapping the Psychosocialcultural Aspects of Healthcare Professionals' Information Security Practices: Systematic Mapping Study.

BACKGROUND: Data breaches in health care are on the rise, emphasizing the need for a holistic approach to mitigation efforts. OBJECTIVE: The purpose of this study was to develop a comprehensive framework for modeling and analyzing health care professionals' information security practices related to their individual characteristics, such as their psychological, social, and cultural traits. METHODS: The study area was a hospital setting under an ongoing project called the Healthcare Security Practice Analysis, Modeling, and Incentivization (HSPAMI) project. A literature review was conducted for relevant theories and information security practices. The theories and security practices were used to develop an ontology and a comprehensive framework consisting of psychological, social, cultural, and demographic variables. RESULTS: In the review, a number of psychological, social, and cultural theories were identified, including the health belief model, protection motivation theory, theory of planned behavior, and social control theory, in addition to some social demographic variables, to form a comprehensive set of health care professionals' characteristics. Furthermore, an ontology was developed from these theories to systematically organize the concepts. The framework, called the psychosociocultural (PSC) framework, was then developed from the various combined psychological and sociocultural attributes of the ontology. The Human Aspect of Information Security Questionnaire was adopted as a comprehensive tool for gathering staff security practices as mediating variables in the framework. CONCLUSIONS: Data breaches occur often in health care today. This frequency has been attributed to the lack of experience of health care professionals in information security, the lack of development of conscious care security practices, and the lack of motivation to incentivize health care professionals. The frequent data breaches in health care threaten the mutual trust between health care professionals and patients, which implicitly impacts the quality of the health care service. The modeling and analysis of health care professionals' security practices can be conducted with the PSC framework by combining methods of statistical survey, observations, and interviews in relation to PSC variables, such as perceptions (perceived benefits, perceived threats, and perceived barriers) or psychological traits, social factors, cultural factors, and social demographics.

The influence of psychosocial factors on the intention to incorporate complementary and integrative medicine into psychiatric clinical practices.

Complementary and integrative medicine (CIM) can be of great support to individuals suffering from psychiatric conditions; however, it is still rarely incorporated into clinical practice. OBJECTIVE: To examine the influences of psychosocial and sociodemographic factors on health-care professionals' intention to use CIM in their psychiatric clinical practice. METHOD: One-hundred-and-five participants completed a questionnaire developed from an adapted version of Triandis' Theory of Interpersonal Behavior (TIB). Intentions to use CIM (yes or no) were analyzed using logistic regression models. RESULTS: The multivariate model retained three main factors: affect, perceived social norms, and conditions facilitating CIM. These predicted health-care professionals' intention to use CIM with an AUC = 94.7%. RESULTS: underlined that positive affective attitudes towards CIM, feeling that CIM was congruent with professional and institutional goals, and having sufficient skills in CIM were essential to ensuring that health-care professionals would integrate CIM into their clinical practice.

Improving access to healthcare for paediatric sickle cell disease patients: a qualitative study on healthcare professionals' views.

BACKGROUND: In well-resourced countries, comprehensive care programs have increased life expectancy of patients with sickle cell disease, with almost all infants surviving into adulthood. However, families affected by sickle cell disease are more likely to be economically disenfranchised because of their racial or ethnic minority status. As every individual child has the right to the highest attainable standard of health under the United Nations Convention on the Rights of the Child, it is essential to identify both barriers and facilitators with regard to the delivery of adequate healthcare. Optimal healthcare accessibility will improve healthcare outcomes for children with sickle cell disease and their families. Healthcare professionals in the field of sickle cell care have first-hand experience of the barriers that patients encounter when it comes to effective care. We therefore hypothesised that these medical professionals have a clear picture of what is necessary to overcome these barriers and which facilitators will be most feasible. Therefore, this study aims to map best practises and lessons learnt in order to attain more optimal healthcare accessibility for paediatric patients with sickle cell disease and their families. METHODS: Healthcare professionals working with young patients with sickle cell disease were recruited for semi-structured interviews. An interview guide was used to ensure the four healthcare accessibility dimensions were covered. The interviews were transcribed and coded. Based on field notes, initial codes were generated, to collate data (both barriers and solutions) to main themes (such as "transportation", or "telecommunication"). Through ongoing thematic analysis, definitive themes were formulated and best practices were reported as recommendations. Quotations were selected to highlight or illustrate the themes and link the reported results to the empirical data. RESULTS: In 2019, 22 healthcare professionals from five different university hospitals in the Netherlands were interviewed. Participants included (paediatric) haematologists, nurses and allied health professionals. Six themes emerged, all associated with best practices on topics related to the improvement of healthcare accessibility for children with sickle cell disease and their families. Firstly, the full reimbursement of invisible costs made by caregivers. Secondly, clustering of healthcare appointments on the same day to help patients seeing all required specialists without having to visit the hospital frequently. Thirdly, organisation of care according to shared care principles to deliver specialised services as close as possible to the patient's home without compromising quality. Fourthly, optimising verbal and written communication methods with special consideration for families with language barriers, low literacy skills, or both. Fifthly, improving the use of eHealth services tailored to users' health literacy skills, including accessible mobile telephone contact between healthcare professionals and caregivers of children with sickle cell disease. Finally, increasing knowledge and interest in sickle cell disease among key stakeholders and the public to ensure that preventive and acute healthcare measures are understood and safeguarded in all settings. CONCLUSION: This qualitative study describes the views of healthcare professionals on overcoming barriers of healthcare accessibility that arise from the intersecting vulnerabilities faced by patients with sickle cell disease and their families. The recommendations gathered in this report provide high-income countries with a practical resource to meet their obligations towards individual children under the United Nations Convention on the Rights of the Child.

Mindfulness in primary care healthcare and teaching professionals and its relationship with stress at work: a multicentric cross-sectional study.

BACKGROUND: Work stress is a common problem among the health personnel of the Spanish National Health System. The objective of this paper is to assess the state of mindfulness among Spanish primary care providers and to evaluate its potential relationship with work stress and basic labor and sociodemographic characteristics. METHODS: Cross-sectional, multi-centric study. Primary care nurses, teachers, teaching collaborators and residents assigned to six Spanish Family Medicine/Family and Community Care Departments were invited to participate (n = 475). A template was designed in Google Forms, including sociodemographic and work-related variables. The state of mindfulness was measured with the Five Facet Mindfulness Questionnaire (FFMQ), while work-related stress was measured using an ordinal scale ranging from 0 to 10 points. Descriptive and inferential statistical analyses were carried out, as well as bivariate and multivariate statistics. RESULTS: The mean age of participants was 40,14 ± 13.12 (range:23-65 years); 66.9% were women, 42.5% internal medicine residents, 29.3% family physicians, and 20.2% nurses. More than half (54.5%) knew about mindfulness, with 24.0% have received training on it, and 22.5% were usual practitioners. The average level of mindfulness was 127.18 ± 15.45 (range: 89-177). The average score of stress at work was 6.00 ± 2.44; 49.9% (range: 0-10). 49.9% of participants scored 7 or more on the stress at work scale. There was an inverse correlation between the levels of mindfulness (FFMQ total score) and work-related stress (Spearman's r = - 0.155, p = 0.003). Significant relationships between the mindfulness practice and the level of mindfulness (F = 29.80, p < 0.001), as well as between the mindfulness practice and the level of work-related stress (F = 9.68, p = 0.042), were also found. CONCLUSIONS: Levels of mindfulness in primary care health providers were in line with those levels observed in other groups of health professionals. Half of all of the primary care providers suffered from a high degree of stress. Although weak, inverse relationships were observed between levels of mindfulness and stress at work, with lower values of stress at work among those who practiced mindfulness. TRIAL REGISTRATION: NCT03629457 .

Concerns of Health Care Professionals Managing non-COVID Patients during The COVID-19 Pandemic: A Descriptive Cross- Sectional Study.

CONTEXT: The coronavirus pandemic has put an unprecedented burden on the health-care workers who are the cornerstone of the work system, preparing to mitigate its effects. Due to the lack of protective equipments, guidelines for managing patients, or proper training and education regarding the same, health care professionals (HCPs) working in non-COVID areas may face even greater problems than those working in COVID areas of a hospital. Our aim was to find out the concerns of HCPs working in non-COVID areas. SUBJECTS AND METHODS: After obtaining institutional ethics approval, a descriptive cross-sectional study was planned. An online Google-based questionnaire was rolled out to all doctors through various social media platforms who were dealing with COVID-negative patients. RESULTS: We received a total of 110 responses. 84.5% of participants were concerned about the risk of infection to self and family, 67.3% were concerned by the disruption of their daily activities. 56.4% of HCPs were disturbed by the lack of any concrete protocol for patient management. Less staff availability, delay in discharging duties toward their patients, and increased workload were other concerns. More than half of the doctors received N-95 masks whenever required and were trained in donning and doffing of Personal protective equipment. Sixty-eight percemt of our respondents labeled their current quality of life as stressful. CONCLUSION: It is the need of the hour to develop a comprehensive strategy focussing on the above challenges that HCPs working in non-COVID areas are facing. This will go a long way in not only providing holistic care to the patients but also in controlling this pandemic.

Concerns of Health-care Professionals Managing COVID Patients under Institutional Isolation during COVID-19 Pandemic in India: A Descriptive Cross-sectional Study.

OBJECTIVE: Health-care professionals (HCPs) are the frontline warriors in the time of this uncertain and unpredictable crisis of COVID. They face many challenges while caring for these patients, yet they are expected to cope with it and deliver their duties for the betterment of humankind. Our primary aim was to identify and assess the concerns of HCPs working in COVID area in a tertiary institutional isolation center. METHODOLOGY: An online Google-based questionnaire survey was distributed through various social media platforms after approval of the institutional review board to a total of 100 HCPs who were treating and managing COVID-positive patients. RESULTS: Of 100 responses, 72% were concerned about the risk of infection to self and family, while 46% reported disruption of their daily activities at a personal level. At the institutional level, 17% were concerned about inadequate personal protective equipment-related challenges. 20% had inadequate knowledge and training about COVID. 16% of participants were anxious all the time, 11% feared all the time, and 12% had stress all the time while treating COVID patients. Connectedness and communication with family and friends, word of appreciation, music, and TV were few strategies to cope up with these challenges. CONCLUSION: There is a need to identify and address the concerns and challenges faced by HCPs and to develop a comprehensive strategy and guideline to provide a holistic care and to ensure their security in the workplace.