Underreporting of work-related low back pain among registered nurses: A mixed method study.

BACKGROUND: Identifying and addressing work-related health problems early is crucial, but workers often perceive barriers in reporting these to management. This study aimed to investigate the factors associated with nurses' reporting of work-related low back pain to their managers and explored the reasons why nurses with patient handling injuries did not report them. METHODS: This study is a concurrent mixed-method analysis of data from two statewide cross-sectional surveys of California registered nurses conducted in 2013 and 2016. The reporting of work-related low back pain to management (n = 288) was examined for associations with individual, occupational, and organizational factors. For qualitative analysis, the reasons for not reporting patient handling injuries were explored using open-ended responses (n = 42). RESULTS: Reporting was associated with BIPOC (Black, Indigenous, and People of Color) men (adjusted odds ratio [AOR]: 1.31, 95% confidence interval [CI]: 1.07-1.59) compared to non-Hispanic White women; being a non-US educated nurse (AOR: 0.90, 95% CI: 0.80-1.01); experiencing greater low back pain (AOR: 1.07, 95% CI: 1.02-1.12); missing work (AOR: 1.38, 95% CI: 1.21-2.62); perceiving high physical workload (AOR: 0.89, 95% CI: 0.81-0.98); perceiving high people-oriented culture (AOR: 1.14, 95% CI: 1.04-1.25); and perceiving high ergonomic practices (AOR: 0.89, 95% CI: 0.81-0.98). Identified themes on the reasons for not reporting injuries included organizational-culture attitudes toward work-related injuries and injury characteristics of musculoskeletal disorders. CONCLUSIONS: The findings indicate a need for management to remove structural barriers and improve organizational practices, and for a culture that promotes trust and open communication between workers and management.

Detecting underreport in real-world assessment contexts: The utility of multiple-scale indicators / Detectar la minimización de síntomas en contextos de evaluación reales. La utilidad de indicadores de escalas múltiples

Underreport of symptoms and personality characteristics is a relevant problem for psychological assessment. Nevertheless, most of the studies in this field use simulation designs. This study aims at comparing underreport prevalence in real world samples of different contexts, using single-scale and multiple scale underreport indicators from the Minnesota Multiphasic Personality Inventory–2 (MMPI-2) to identify the best one and assess its implications on the clinical scales scores. Using a Differential Prevalence Group design, 1438 participants were assessed with the MMPI-2, grouped in three samples from two non-clinical contexts (community and organizational) and one clinical context. The organizational sample had the highest prevalence of underreporting. Overall, multiple scale indicator LKS ≥ T65 performed better at distinguishing these samples. Analysis of variance revealed that LKS ≥ T65 was also the only indicator in which participants doing underreport consistently varied from honest re-sponders in the clinical scales scores, while also having lower probability of producing both type I and II errors. The existence of underreport has clear implication on the clinical scales results. The multiple scale indicator is the most robust and should be used in the detection of underreporting. This is a relevant implication for psychological assessment in different contexts, mainly in the organizational context.(AU)

La minimización de síntomas es un problema relevante para la evaluación psicológica. La mayoría de los estudios utilizan diseños de simulación. Este estudio tiene como objetivo comparar la prevalencia de la minimización de síntomas y sus implicaciones, utilizando indicadores de escala única y de escala múltiple del Inventario Multifásico de Personalidad de Minnesota-2 (MMPI-2) en muestras reales. Utilizando un diseño de Grupo de Prevalencia Diferencial se evaluaron 1438 participantes, agrupados en tres muestras: dos no clínicas (comunitario y organizacional) y una muestra clínica. La muestra organizacional tuvo la mayor prevalencia de minimización de síntomas. En general, el indicador de escala múltiple LKS ≥ T65 proporcionó los mejores resultados. El análisis de la varianza reveló que el LKS ≥ T65 era también el único indicador de diferenciación, en las escalas clínicas, de los participantes que realizaban o no la minimización de síntomas, a la vez que tenía una menor probabilidad de producir errores tipo I y II. La presencia de minimización tiene una clara implicación en las puntuaciones clínicas. El indicador de escalas múltiples es el más robusto en la detección de la minimización de síntomas y es relevante para la evaluación en diferentes contextos, principalmente en lo organizacional.(AU)

Are Patients with Schizophrenia Reliably Reporting their Cannabis Use? An African Cross-sectional Study.

BACKGROUND: Most studies of the prevalence of cannabis use among patients with schizophrenia used a self-report as declared by the patient himself. We hypothesize that patients with schizophrenia did not tell the truth and might underreport their use for many reasons to be discussed later. Indeed, the under-report of cannabis use among these patients can affect the effectiveness of their treatment. AIMS: To assess the degree of agreement between the prevalence values obtained from patients' reports and the results of the toxicological tests. METHODS: A cross-sectional study was carried out on 403 patients with schizophrenia. A sociodemographic, psychiatric history and illicit drug use profile was performed for each patient. We assessed the patients with the Positive and Negative Syndrome Scale (PANSS), Calgary Depression score (CDSS), Barratt Impulsiveness Score (BIS-10) and Medication Adherence Rating Scale (MARS). The consumption of cannabis used was confirmed with MINI International Neuropsychiatric Interview (MINI-DSM IV) and using toxicological analysis. RESULTS: Among the 403 patients who consented to give their urine samples, 49.1% (198/403) tested positive for cannabis, and 41.41% (82/198) underreported their use. The sensitivity and specificity of the questionnaire were 0.58 and 0.74. Based on the comparison between sociodemographic and psychiatric history data of patients who self-report and underreport their cannabis use, no significant difference was observed except for the duration of cannabis use and the score on the medication adherence scale. Moreover, it was found that impulsivity, PANSS score, CDSS score, and the type of schizophrenia are not involved in predicting the underreporting of cannabis use. CONCLUSION: The rate of patients who under-report cannabis use is important. Therefore, toxicological analysis is becoming relevant for identifying drug use among schizophrenic patients and in the addictive comorbidity research field.

Under-Reporting of Known HIV-Positive Status Among People Living with HIV: A Systematic Review and Meta-analysis.

Monitoring progress towards the UNAIDS 'first 90' target requires accurate estimates of levels of diagnosis among people living with HIV (PLHIV), which is often estimated using self-report. We conducted a systematic review and meta-analysis quantifying under-reporting of known HIV-positive status using objective knowledge proxies. Databases were searched for studies providing self-reported and biological/clinical markers of prior knowledge of HIV-positive status among PLHIV. Random-effects models were used to derive pooled estimates of levels of under-reporting. Thirty-two estimates from 26 studies were included (41,465 PLHIV). The pooled proportion under-reporting known HIV-positive status was 20% (95% confidence interval 13-26%, I2 = 99%). In sub-group analysis, under-reporting was higher among men who have sex with men (32%, number of estimates [Ne] = 10) compared to the general population (9%, Ne = 10) and among Black (18%, Ne = 5) than non-Black (3%, Ne = 3) individuals. Supplementing self-reported data with biological/clinical proxies may improve the validity of the 'first 90' estimates.

Underevaluation of fractures by self-report: an analysis from the FRISBEE cohort.

We assessed the rate of non-reported fractures in the FRISBEE cohort. Over a median follow-up period of 9.2 years, we registered 992 fractures. The global percentage of non-reported fractures was 21.3%. Underreporting of fracture event might influence any model of fracture risk prediction. INTRODUCTION: Most fracture cohort studies rely on participant self-report of fracture event. This approach may lead to fracture underreporting. The purpose of the study was to assess the rate of non-reported fractures in a well-characterized population-based cohort of 3560 postmenopausal women, aged 60-85 years, included in the Fracture Risk Brussels Epidemiological Enquiry (FRISBEE) study. METHODS: Incident low-traumatic or non-traumatic fractures were registered annually during phone calls. In 2018, we reviewed the medical files of 67.9% of our study participants and identified non-reported fractures ("false negatives fractures (FN)"). We also evaluated whether the rate of FN was influenced by baseline patients' characteristics and fracture risk factors. Generalized estimating equation (GEE) was used to calculate odds ratio (OR) and 95% CI. RESULTS: Over a median follow-up period of 9.2 years, we registered 992 fractures (781 by self-report, confirmed by a radiological report and 211 unreported). The global false negative rate for all fractures was 21.3%, including 22% for MOFs (major osteoporotic fractures), 13.1% for other major fractures, and 25.8% for minor fractures. The rate of non-reported fractures varied by fracture site: for MOFs, it was 2.7% (n = 2/73) at the hip, 5.3% at the proximal humerus (n = 5/94), 7.1% at the wrist (n = 11/154), and 46.5% at the spine (n = 100/215). For "other major" fractures, the highest rate of false negatives fractures was found at the pelvic bone (21%, n = 13/62), followed by the elbow (17.9%, n = 5/28), long bones (10.5%, n = 2/19), ankle (6.2%, n = 4/65), and knee (5.9%, n = 1/17). Older subjects (OR 1.7; 95% CI, 1.2-2.4; P = 0.003), subjects with early non-substituted menopause (OR 1.8; 95% CI, 1.0-3.3; P = 0.04), with a lower education level (OR 1.5; 95%CI, 1.1-2.2; P = 0.01), and those under drug therapy for osteoporosis (OR 1.5; 95% CI, 1.0-2.2; P = 0.05) were associated with a higher rate of FN. CONCLUSIONS: In conclusion, underreporting of a substantial proportion of fracture events will influence any model of fracture risk prediction and induce bias when estimating the associations between candidate risk factors and incident fractures.

Not recognized enough: The effects and associations of trauma and intellectual disability in severely mentally ill outpatients.

BACKGROUND: Little is known about the association between trauma and intellectual disability in SMI patients. AIM: To establish the prevalence of trauma and its association with intellectual functioning in SMI outpatients. METHODS: A cross-sectional study was conducted in two mental health trusts in the Netherlands. We used the Trauma Screening Questionnaire (TSQ) to screen for trauma and PTSD, and the Screener for Intelligence and Learning disabilities (SCIL) for suspected MID/BIF. Chi-square and t-tests were used to test differences in outcome over patient characteristics. Post-hoc analysis was used to investigate gender differences between patients with and without MID/BIF on trauma and sexual trauma. RESULTS: Any trauma was found in 86% of 570 patients and 42% were suspected for PTSD. The SCIL suggested that 40% had Borderline Intellectual Functioning (BIF), half of whom were suspected of having Mild Intellectual Disability (MID). These patients had more traumatic experiences (1.89 in BIF, 1.75 in MID, against 1.41 in SCIL-negative patients). Female MID/BIF patients (61%) had experienced significantly more sexual abuse than male MID/BIF patients (23%). CONCLUSIONS: Significantly more SMI outpatients who screened positive for MID/BIF reported having experienced traumatic events than those who screened negative. Rates of all trauma categories were significantly higher in the screen-positive group, who were also more likely to have PTSD. Sexual abuse occurred more in all females but the SCIL positive women are even more often victim. Clinical practice has to pay more attention to all of these issues, especially when they occur together in a single patient.

The Relationship between Free Press and Under-Reporting of Non-Fatal Occupational Injuries with Data from Representative National Indicators, 2015: Focusing on the Lethality Rate of Occupational Injuries among 39 Countries.

The epidemiology of occupational injuries is reported worldwide, but suspicions of under-reporting prevail, probably associated with free press. We examined the association between freedom of the press and lethality rate of occupational injuries based on the most comprehensive International Labour Organization database on labour statistics (ILOSTAT) among 39 countries. The occupational injury indices, national indicators, and information on freedom of the press in 2015 were sourced from ILOSTAT, World Bank open data, World Health Organization and Freedom House. The lethality rate was the number of fatal occupational injuries per 10,000 total occupational injuries. The relationship among fatal and total occupation injury rates, lethality rate, and national statistics were analysed using Spearman's rank correlation coefficients. Multivariable linear regression models with bootstrap estimation to manage non-normality determined freedom of the press associated with lethality rate. Freedom of the press was significantly correlated with fatal and total occupational injury rate and lethality rate of occupational injuries. Adjusting for national indicators, only freedom of the press was associated with lethality rate per 10,000 occupational injuries in the report of ILOSTAT. The lethality rate of occupational injury reported by each country might not reflect the actual lethality, but under-reported nonfatal occupational injuries, probably relating to freedom of the press.

Phosphatidylethanol confirmed alcohol use among ART-naïve HIV-infected persons who denied consumption in rural Uganda.

Under-reporting of alcohol use by HIV-infected patients could adversely impact clinical care. This study examined factors associated with under-reporting of alcohol consumption by patients who denied alcohol use in clinical and research settings using an alcohol biomarker. We enrolled ART-naïve, HIV-infected adults at Mbarara Hospital HIV clinic in Uganda. We conducted baseline interviews on alcohol use, demographics, Spirituality and Religiosity Index (SRI), health and functional status; and tested for breath alcohol content and collected blood for phosphatidylethanol (PEth), a sensitive and specific biomarker of alcohol use. We determined PEth status among participants who denied alcohol consumption to clinic counselors (Group 1, n = 104), and those who denied alcohol use on their research interview (Group 2, n = 198). A positive PEth was defined as ≥8 ng/ml. Multiple logistic regression models were used to examine whether testing PEth-positive varied by demographics, literacy, spirituality, socially desirable reporting and physical health status. Results showed that, among the 104 participants in Group 1, 28.8% were PEth-positive. The odds of being PEth-positive were higher for those reporting prior unhealthy drinking (adjusted odds ratio (AOR): 4.7, 95% confidence interval (CI): 1.8, 12.5). No other factors were statistically significant. Among the 198 participants in Group 2, 13.1% were PEth-positive. The odds of being PEth-positive were higher for those reporting past unhealthy drinking (AOR: 4.6, 95% CI: 1.8, 12.2), the Catholics (AOR: 3.8, 95% CI: 1.3, 11.0) compared to Protestants and lower for the literate participants (AOR: 0.3, 95% CI: 0.1, 0.8). We concluded that under-reporting of alcohol use to HIV clinic staff was substantial, but it was lower in a research setting that conducted testing for breath alcohol and PEth. A report of past unhealthy drinking may highlight current alcohol use among deniers. Strategies to improve alcohol self-report are needed within HIV care settings in Uganda.

El síndrome coronario agudo y otros diagnósticos provocan subregistro del infarto agudo del miocardio en el Hospital México, Costa Rica / Coronary syndrome and other diagnosis result in under reporting of acute myocardial infarction in the Mexico Hospital, Costa Rica

Justificación: el infarto agudo del miocardio es un problema mayor de salud pública. Es necesario verificar su adecuado registro en Costa Rica para atender eficientemente su problemática. Materiales y métodos: estudio descriptivo y observacional. Se recopilaron los pacientes egresados del Hospital México con diagnósticos de síndrome coronario agudo, infarto agudo del miocardio, angina inestable y cardiopatía isquémica, de agosto 2005 a julio 2006, analizándose los registros de la oficina de Bioestadística y Unidades (Coronaria, Terapia Intensiva, Hemodinamia y Ecocardiogramas). Resultados: el Hospital México reporto 110 pacientes con el diagnóstico de infarto agudo del miocardio. Al incluir egresados con diagnóstico de Síndrome coronario agudo, angor inestable o cardiopatía isquémica y que eran infartos agudos del miocardio, el número aumentó a 172. La muestra analizada finalmente fue de 138 pacientes al eliminar el restante por datos incompletos, significando un subregistro de al menos 36 por ciento. El 78,1 por ciento fueron hombre y la edad promedio para ambos sexos fue 65.2 años. No se le midió la troponina al 49,3 por ciento de la muestra y la cuarta parte no fueron valorados por cardiólogos. El 20,3 por ciento de los pacientes que fueron egresados con otros diagnósticos eran portadores también de infarto agudo del miocardio. Conclusiones: existe subregistro de infarto agudo del miocardio en el Hospital México y en oficinas centrales del Ministerio de Salud y la Caja Costarricense de Seguro Social. Este hallazgo también es probable que se presente en otros hospitales costarricenses...

Factors associated with nurses' reporting of patients' aggressive behavior: a cross-sectional survey.

BACKGROUND: Aggressive behavior and violence directed by patients at nurses are increasing worldwide. Aggressive behavior against nurses in their workplace can result in personal problems, such as impairment of physical and mental well-being, and, consequently, in organizational problems. Underreporting of patients' aggressive behavior is prevalent among nurses. Although underreporting might lead to inefficient attention to strategies for preventing aggressive behavior, the reasons for such behavior not being reported frequently have not been well examined. OBJECTIVES: To explore the frequency of nurses' reporting to their managers of patients' aggressive behavior by type and degree of impact suffered by the nurses, to examine the association between reporting of aggressive behavior and demographic factors, and to determine the reasons for underreporting. DESIGN: A questionnaire-based cross-sectional survey. SETTING: Six acute care hospitals in two regions in Japan. PARTICIPANTS: A total of 1953 nurses working at general acute care hospitals participated. METHODS: Data were collected through a questionnaire seeking sociodemographic information, information on experience of aggressive behavior from patients, and the frequency with which they had reported such behavior in the previous month. The questionnaire also contained items assessing barriers to reporting of patients' aggressive behavior. The association between the possible influencing factors and reporting behavior was assessed using multiple logistic regression analyses. RESULTS: Of the 1953 questionnaires distributed, 1498 (76.7%) were returned, and 1385 (70.9%) fully completed questionnaires were analyzed. More than one-third of the respondents had experienced the mildest assessed level of impact from patients' aggressive behavior, and 70% of those hardly reported any incidents. The milder the impact was, the less the nurse victims tended to report the incident. Nurse's tendency to feel that aggressive behavior was mitigated by the situation, less work experience, and lack of confidence that management would defend staff nurses from patients' aggressive behavior were found to be negatively associated with reporting behavior. CONCLUSIONS: This study identified factors associated with nurses' reporting of patients' aggressive behavior. Underreporting was found to be associated with the level of impact, managerial attitudes, nurses' work experience, and nurses' perception that the behavior was mitigated by the situation. Improving education among nurses to promote reporting incidents and establishing an organized system is needed.

Using general growth balance method and synthetic extinct generations methods to evaluate the underreporting of death at disease surveillance points from 1991 to 1998 / 中华流行病学杂志

methods had some limitations. There was big difference between the results when using SEG and GGB, suggesting that we should try to combine GGB and SEG methods to get the better results.