Exploring the relationship between falls, fall-related psychological concerns, and personality traits in adults: A scoping review protocol.

Background and Aims: Personality traits, such as neuroticism and extraversion, are emerging as important predictors of falls. Despite their significance, existing fall prevention programs often overlook these traits, creating a notable research gap. This study aims to conduct a comprehensive scoping review to explore the existing literature on the relationships among personality traits, falls, and fall-related psychological concerns (FrPCs). Methods: This scoping review will adhere to the framework established by Arksey and O'Malley, incorporating extensions recommended by the Joanna Briggs Institute and using the PRISMA-ScR checklist. A thorough search strategy will be employed, aligning with the population, concept, and context (PCC) selection criteria. Electronic databases, including MEDLINE, APA PsycINFO, Web of Science, CINAHL, and SPORTDiscus, will be searched from their inception to the present. Additionally, a manual search of the reference lists of identified and relevant full-text articles will be conducted. Two independent reviewers will screen titles and abstracts, perform full-text reviews, and extract data from pertinent articles. Discussion: Personality traits are increasingly recognized as influential predictors of falls and related psychological concerns. This review aims to make a substantial contribution to the existing literature by being the first to comprehensively explore and provide a descriptive synthesis of the relationship between personality traits and falls, as well as FrPCs in adults. It is hoped that the outcomes of this review will enhance our comprehension of the role of personality traits in falls, potentially informing future research and strategies for this critical area of study. Scoping Review Registration: This scoping review protocol was registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/KR74X).

Response shift results of quantitative research using patient-reported outcome measures: a descriptive systematic review.

PURPOSE: The objective of this systematic review was to describe the prevalence and magnitude of response shift effects, for different response shift methods, populations, study designs, and patient-reported outcome measures (PROM)s. METHODS: A literature search was performed in MEDLINE, PSYCINFO, CINAHL, EMBASE, Social Science Citation Index, and Dissertations & Theses Global to identify longitudinal quantitative studies that examined response shift using PROMs, published before 2021. The magnitude of each response shift effect (effect sizes, R-squared or percentage of respondents with response shift) was ascertained based on reported statistical information or as stated in the manuscript. Prevalence and magnitudes of response shift effects were summarized at two levels of analysis (study and effect levels), for recalibration and reprioritization/reconceptualization separately, and for different response shift methods, and population, study design, and PROM characteristics. Analyses were conducted twice: (a) including all studies and samples, and (b) including only unrelated studies and independent samples. RESULTS: Of the 150 included studies, 130 (86.7%) detected response shift effects. Of the 4868 effects investigated, 793 (16.3%) revealed response shift. Effect sizes could be determined for 105 (70.0%) of the studies for a total of 1130 effects, of which 537 (47.5%) resulted in detection of response shift. Whereas effect sizes varied widely, most median recalibration effect sizes (Cohen's d) were between 0.20 and 0.30 and median reprioritization/reconceptualization effect sizes rarely exceeded 0.15, across the characteristics. Similar results were obtained from unrelated studies. CONCLUSION: The results draw attention to the need to focus on understanding variability in response shift results: Who experience response shifts, to what extent, and under which circumstances?

Response shift in coronary artery disease.

PURPOSE: Patients with coronary artery disease (CAD) experience significant angina symptoms and lifestyle changes. Revascularization procedures can result in better patient-reported outcomes (PROs) than optimal medical therapy (OMT) alone. This study evaluates the impact of response shift (RS) on changes in PROs of patients with CAD across treatment strategies. METHODS: Data were from patients with CAD in the Alberta Provincial Project on Outcome Assessment in Coronary Heart Disease (APPROACH) registry who completed the 16-item Canadian version of the Seattle Angina Questionnaire at 2 weeks and 1 year following a coronary angiogram. Multi-group confirmatory factor analysis (MG-CFA) was used to assess measurement invariance across treatment groups at week 2. Longitudinal MG-CFA was used to test for RS according to receipt of coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or optimal medical therapy (OMT) alone. RESULTS: Of the 3116 patients included in the analysis, 443 (14.2%) received CABG, 2049(65.8%) PCI, and the remainder OMT alone. The MG-CFA revealed a partial-strong invariance across the treatment groups at 2 weeks (CFI = 0.98, RMSEA [90% CI] = 0.05 [0.03, 0.06]). Recalibration RS was detected on the Angina Symptoms and Burden subscale and its magnitude in the OMT, PCI, and CABG groups were 0.32, 0.28, and 0.53, respectively. After adjusting for RS effects, the estimated target changes were largest in the CABG group and negligible in the OMT group. CONCLUSION: Adjusting for RS is recommended in studies that use SAQ-CAN to assess changes in patients with CAD who have received revascularization versus OMT alone.

Determinants of the managerial staff's disposition towards e-payment platforms in public tertiary hospitals in Enugu, Nigeria: a cross-sectional study.

BACKGROUND: Many Nigerians pay out-of-pocket for their health care, and some hospitals have started utilising e-payment systems to increase transactional efficiency. The study investigated the type and usage of e-payment platforms in public hospitals and the factors that may influence the managerial staff's disposition towards using the e-payment system. METHODS: We conducted a cross-sectional survey of 300 managerial staff within the four public tertiary hospitals in Enugu, Nigeria, through proportionate quota sampling. The survey obtained participants' demographic characteristics, types of e-payment platforms, managerial staff's technophobia, perception of credibility, and disposition towards e-payment. Data were analysed using descriptive statistics, Spearman correlation, and hierarchical linear regression. RESULTS: The majority of the respondents (n = 278, 92.7% completion rate) aged 43.4 ± 7.6 years were females (59.0%) with a bachelor's degree (54.7%). Their disposition (80.0%±17.9%), perceptions of the usefulness (85.7 ± 13.9%), and user-friendliness (80.5 ± 18.1%) of e-payment in the hospital were positive, credibility (72.6 ± 20.1%) and technophobia (68.0 ± 20.7%) were moderate. There was a negative correlation between technophobia and disposition toward the use of e-payment (ρ = -0.50, P < 0.001). Significant multivariate predictors of managerial disposition towards e-payment were; being a woman (ß = 0.12, P = 0.033), married (ß = 0.18, P = 0.003), positive perception of usefulness (ß = 0.14, P = 0.025), and credibility (ß = 0.15, P = 0.032). CONCLUSION: Most participants had a positive disposition towards e-payment in public hospitals. However, managers with technophobia, a negative perception of e-payment usefulness, and credibility had a lesser disposition to its use. To ensure the universal implementation of e-payment in Nigerian hospitals, the service providers should make the e-payment platforms more secure and user-friendly to health services consumers and providers.

Influence of well-being and quality of work-life on quality of care among healthcare professionals in southwest, Nigeria.

The Nigerian healthcare industry is bedevilled with infrastructural dilapidations and a dysfunctional healthcare system. This study investigated the influence of healthcare professionals' well-being and quality of work-life (QoWL) on the quality of care (QoC) of patients in Nigeria. A multicentre cross-sectional study was conducted at four tertiary healthcare institutions in southwest, Nigeria. Participants' demographic information, well-being, quality of life (QoL), QoWL, and QoC were obtained using four standardised questionnaires. Data were summarised using descriptive statistics. Inferential statistics included Chi-square, Pearson's correlation, independent samples t-test, confirmatory factor analyses and structural equation model. Medical practitioners (n = 609) and nurses (n = 570) constituted 74.6% of all the healthcare professionals with physiotherapists, pharmacists, and medical laboratory scientists constituting 25.4%. The mean (SD) participants' well-being = 71.65% (14.65), QoL = 61.8% (21.31), QoWL = 65.73% (10.52) and QoC = 70.14% (12.77). Participants' QoL had a significant negative correlation with QoC while well-being and quality of work-life had a significant positive correlation with QoC. We concluded that healthcare professionals' well-being and QoWL are important factors that influence the QoC rendered to patients. Healthcare policymakers in Nigeria should ensure improved work-related factors and the well-being of healthcare professionals to ensure good QoC for patients.

Prevalence and Associated Factors of Maternal Depression and Anxiety Among African Immigrant Women in Alberta, Canada: Quantitative Cross-sectional Survey Study.

BACKGROUND: Although there is a significant body of evidence on maternal mental health, an inadequate focus has been placed on African immigrant women. This is a significant limitation given the rapidly changing demographics in Canada. The prevalence of maternal depression and anxiety among African immigrant women in Alberta and Canada, as well as the associated risk factors, are not well understood and remain largely unknown. OBJECTIVE: The purpose of this study was to investigate the prevalence and associated factors of maternal depression and anxiety among African immigrant women living in Alberta, Canada up to 2 years postpartum. METHODS: This cross-sectional study surveyed 120 African immigrant women within 2 years of delivery in Alberta, Canada from January 2020 to December 2020. The English version of the Edinburgh Postnatal Depression Scale-10 (EPDS-10), the Generalized Anxiety Disorder-7 (GAD-7) scale, and a structured questionnaire regarding associated factors were administered to all participants. A cutoff score of 13 on the EPDS-10 was indicative of depression, while a cutoff score of 10 on the GAD-7 scale was indicative of anxiety. Multivariable logistic regression was used to determine the factors significantly associated with maternal depression and anxiety. RESULTS: Among the 120 African immigrant women, 27.5% (33/120) met the EPDS-10 cutoff score for depression and 12.1% (14/116) met the GAD-7 cutoff score for anxiety. The majority of respondents with maternal depression were younger (18/33, 56%), had a total household income of CAD $60,000 or more (US $45,000 or more; 21/32, 66%), rented their homes (24/33, 73%), had an advanced degree (19/33, 58%), were married (26/31, 84%), were recent immigrants (19/30, 63%), had friends in the city (21/31, 68%), had a weak sense of belonging in the local community (26/31, 84%), were satisfied with their settlement process (17/28, 61%), and had access to a regular medical doctor (20/29, 69%). In addition, the majority of respondents with maternal anxiety were nonrecent immigrants (9/14, 64%), had friends in the city (8/13, 62%), had a weak sense of belonging in the local community (12/13, 92%), and had access to a regular medical doctor (7/12, 58%). The multivariable logistic regression model identified demographic and social factors significantly associated with maternal depression (maternal age, working status, presence of friends in the city, and access to a regular medical doctor) and maternal anxiety (access to a regular medical doctor and sense of belonging in the local community). CONCLUSIONS: Social support and community belonging initiatives may improve the maternal mental health outcomes of African immigrant women. Given the complexities immigrant women face, more research is needed on a comprehensive approach for public health and preventive strategies regarding maternal mental health after migration, including increasing access to family doctors.

Well-being of professional older adults' caregivers in Alberta's assisted living and long-term care facilities: a cross-sectional study.

BACKGROUND: For the care need of older adults, long-term care (LTC) and assisted living (AL) facilities are expanding in Alberta, but little is known about the caregivers' well-being. The purpose of the study was to investigate the physical health conditions, mental and emotional health (MEH), health behaviour, stress levels, quality of life (QOL), and turnover and absenteeism (TAA) among professional caregivers in Alberta's LTC and AL facilities. METHODS: This cross-sectional survey involved 933 conveniently selected caregivers working in Alberta's LTC and AL facilities. Standardised questions were selected from the Canadian Community Health Survey, Patient Health Questionnaire-9, and Short Form-36 QOL survey revalidated and administered to the participants. The new questionnaire was used to assess the caregivers' general health condition (GHC), physical health, health behaviour, stress level, QOL, and TAA. Data were analysed using descriptive statistics, Cronbach alpha, Pearson's correlation, one-way analysis of variance, and multiple linear regression. RESULTS: Of 1385 surveys sent to 39 facilities, 933 valid responses were received (response rate = 67.4%). The majority of the caregivers were females (90.8%) who were ≥ 35 years (73.6%), worked between 20 to 40 h weekly (67.3%), and were satisfied with their GHC (68.1%). The Registered Nurses had better GHC (mean difference [MD] = 0.18, p = 0.004) and higher TAA than the Health Care Aides (MD = 0.24, p = 0.005). There were correlations between caregivers' TAA and each of MEH (r = 0.398), QOL (r = 0.308), and stress (r = 0.251); p < 0.001. The most significant predictors of TAA were the propensity to quit a workplace or the profession, illness, job stress, and work-related injury, F (5, 551) = 76.62, p < 0.001, adjusted R2 = 0.998. CONCLUSION: Reducing the caregivers' job stressors such as work overload, inflexible schedule, and poor remuneration, and improving their quality of life, health behaviour, and mental, emotional, and physical health conditions may increase their job satisfaction and reduce turnover and absenteeism.

Association between sociodemographic factors and mobility limitation among older adults: a systematic review and meta-analysis protocol.

BACKGROUND: Mobility is an independent predictor of physical functionality, healthy ageing, and quality of life. Various literatures have associated mobility limitation in older adulthood with demographic and socioeconomic factors. Hence, we propose a systematic review and meta-analysis to synthesise the association between sociodemographic factors and mobility limitations in older adults. METHODS AND ANALYSES: This protocol was written according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. We will perform a comprehensive search of all observational studies that assessed the relationship between age, gender, race, place, education, income, occupation, social status, and walking distance, time, or speed. Electronic databases (MEDLINE, Web of Science, EMBASE, CINAHL, AgeLine, and SPORTDiscus) will be searched from inception to 28 February 2023. We will supplement the database search by manually searching the reference lists of all identified and relevant full-text articles. Two independent reviewers will be responsible for screening articles, data extraction, and assessment of bias. We will appraise the study quality and risk of bias using the Prediction Model Risk of Bias Assessment Tool (PROBAST). A meta-analysis will be considered if data from the selected studies are homogeneous, otherwise, a narrative synthesis of the extracted data will be presented. DISCUSSION: Mobility limitation leads to frequent falls, dependency, morbidity, and death among older adults. This review is necessary, to identify and prioritise important sociodemographic factors during older adults' clinical assessment and policy development. It is the first phase of a multi-methods study seeking to develop a prognostic mobility trajectory for community-dwelling older adults. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022298570.

Perceived strategies for reducing staff-turnover and improving well-being and retention among professional caregivers in Alberta's continuing-care facilities: A qualitative study.

This qualitative study explored potential factors that lead to turnover and absenteeism and how to improve well-being and retention among professional older-adult-caregivers in Alberta's assisted living (AL) and long-term care (LTC) facilities. Four hundred and forty-seven participants aged 45-54 years were interviewed through a five-item, content-validated open-ended questionnaire. The questionnaire was self-administered in the English language and the soft copy of their responses was transferred into NVIVO version 12 software for coding. A thematic narrative analysis grounded in the "happy productive worker" theory was completed. The main themes were caregivers' perception of the factors affecting their well-being, absenteeism, and turnover, and caregivers' suggestions on ways to improve their well-being and retention. Participants reported that their professional well-being was suboptimal. They suggested that their employers should provide them with the needed social, psychological, and professional support, improve wages and hire more staff to ameliorate absenteeism and turnover rates.

African Immigrant Mothers' Views of Perinatal Mental Health and Acceptability of Perinatal Mental Health Screening: Quantitative Cross-sectional Survey Study.

BACKGROUND: Mental health disorders are the most common perinatal conditions. They affect mothers, babies, partners, and support networks. However, <15% of pregnant and postpartum women seek timely help for their mental health care. Low perinatal mental health knowledge and universal screening unacceptability are cited as important deterrents to obtaining timely mental health care. OBJECTIVE: The purpose of this quantitative cross-sectional study was 2-fold: (1) to determine African immigrant mothers' views of perinatal mental health and to identify predictors of those views and (2) to identify African immigrant mothers' views regarding perinatal mental health screening and to determine factors associated with those views. METHODS: A cross-sectional survey was conducted using a convenience sample of African immigrant women from the province of Alberta, Canada. Respondents were eligible to participate if they were aged ≥18 years, had a live birth, and the infant was aged ≤2 years. Questions were drawn from the Edinburgh Postnatal Depression Scale, the Generalized Anxiety Disorder-7 scale, and additional questions were developed using the Alberta Maternal Mental Health 2012 survey as a guide and tested to reflect the immigrant context. Descriptive and multivariable regression analyses were conducted. RESULTS: Among the 120 respondents, 46.5% (53/114) were aged 31-35 years, 76.1% (89/117) were employed or on maternity leave, 92.5% (111/120) were married, and 55.6% (65/117) had younger infants aged 0 to 12 months. Significantly more respondents had higher levels of knowledge of postnatal (109/115, 94.8%) than prenatal (57/110, 51.2%) mental health (P<.001). Only 25.4% (28/110) of the respondents accurately identified that prenatal anxiety or depression could negatively impact child development. Personal knowledge of postpartum anxiety and depression was a significant predictor of prenatal and postnatal mental health knowledge. Most respondents strongly agreed or agreed that all women should be screened in the prenatal (82/109, 75.2%) and postnatal (91/110, 82.7%) periods. Respondents reported that their partner would be their first choice when seeking help and support. The acceptability of postnatal screening was a significant predictor of prenatal mental health knowledge (P<.001), whereas the acceptability of prenatal screening was a significant predictor of postnatal mental health knowledge (P=.03). Prenatal mental health knowledge was a significant predictor of both prenatal (P<.001) and postnatal (P=.001) screening acceptability. CONCLUSIONS: Although African mothers' knowledge of postnatal mental health is high, their prenatal mental health knowledge and its influence on child development are limited. Perinatal mental health interventions for African immigrant mothers in Alberta should target these knowledge gaps. The high acceptability of universal perinatal mental health screening among African mothers provides a promising strategy for perinatal mental health literacy initiatives to achieve optimal perinatal mental health.

Patients' satisfaction with physiotherapy management of chronic mechanical neck pain in physiotherapy departments of public hospitals in Ibadan, Nigeria: A mixed-method study.

INTRODUCTION: The study was aimed at determining patients' satisfaction level with physiotherapy in the management of chronic mechanical neck pain (CMNP) in physiotherapy departments of the 3 public hospitals in Ibadan, Nigeria. METHODS: A mixed-method design that involved 51 and five both purposively selected participants for the cross-sectional survey (CSS) and qualitative study, respectively. For the CSS, data was collected using the MedRisk instrument and analyzed using the Chi-square test at p ≤ .05. For the qualitative study, patients' satisfaction was explored through a focus group discussion (FGD) and analyzed using thematic analysis. RESULTS: For CSS, 49.0% and 7.8% of the participants reported excellent and fair satisfaction, respectively, with physiotherapy in the management of CMNP. There was no significant association of patients' satisfaction level with: age (p = .588); sex (p = .851); and marital status (p = .409). For the FGD, three themes (patients' experience with physiotherapists; patient satisfaction with physiotherapy services; patient satisfaction with other health care services) that emerged further explained that participants were satisfied with physiotherapy management of their CMNP. However, they were not satisfied with the attitude of the record officers, constancy of the same treating physiotherapists, and unavailability of resources. CONCLUSION: Patients with CMNP are satisfied with the physiotherapy care they received.

Pattern and perception of wellbeing, quality of work life and quality of care of health professionals in Southwest Nigeria.

BACKGROUND: Personal wellbeing (PW) including quality of life and work life is a very complex concept that influences health professionals' commitment and productivity. Improving PW may result in positive outcomes and good quality of care. Therefore, this study aimed to assess the pattern and perception of wellbeing, quality of work life (QoWL) and quality of care (QoC) of health professionals (HPs) in southwest Nigeria.  METHODS: The study was a convergent parallel mixed method design comprising a cross-sectional survey (1580 conveniently selected participants) and a focus group interview (40 purposively selected participants). Participants' PW, quality of life (QoL), QoWL, and QoC were assessed using the PW Index Scale, 5-item World Health Organization Well-Being Index, QoWL questionnaire, and Clinician QoC scale, respectively. The pattern of wellbeing, QoWL and quality of care of HPs were evaluated using t-test and ANOVA tests. Binary regression analysis was used to assess factors that could classify participants as having good or poor wellbeing, QoWL, and quality of care of HPs. The qualitative findings were thematically analyzed following two independent transcriptions. An inductive approach to naming themes was used. Codes were assigned to the data and common codes were grouped into categories, leading to themes and subthemes. RESULTS: Of 1600 administered questionnaires, 1580 were returned, giving a 98.75% response rate. Only 45.3%, 43.9%, 39.8% and 38.4% of HP reported good PW, QoL, QoC and QoWL, respectively; while 54.7%, 56.1%, 60.2% and 61.6% were poor. There were significant gender differences in PW and QoC in favor of females. With an increase in age and years of practice, there was a significant increase in PW, QoWL and QoC. As the work volume increased, there was significant decrease in QoWL. Participants with master's or Ph.D. degrees reported improved QoWL while those with diploma reported better QoC. PWI and QoC were significantly different along the type of appointment, with those who held part-time appointments having the least values. The regression models showed that participant's characteristics such as age, gender, designation, and work volume significantly classified health professionals who had good or poor QoC, QoWL, PW and QoL. The focus group interview revealed four themes and 16 sub-themes. The four themes were the definitions of QoC, QoWL, and PW, and dimensions of QoC. CONCLUSION: More than half of health professionals reported poor quality of work life, quality of life and personal wellbeing which were influenced by personal and work-related factors. All these may have influenced the poor quality of care reported, despite the finding of a good knowledge of what quality of care entails.

Transcutaneous electrical nerve stimulation effects on pain-intensity and endogenous opioids levels among chronic low-back pain patients: A randomised controlled trial.

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) is a promising non-pharmacological modality for the management of chronic low back pain (CLBP), but its efficacy and mode of action have not been clearly established. OBJECTIVE: To evaluate the responses of plasma beta-endorphin (ßE), met-enkephalin (ME), and pain intensity (PI) among patients with CLBP exposed to TENS or sham-TENS. METHODS: This double-blind trial involved 62 participants (aged 53.29 ± 5.07 years) randomised into TENS group (frequency 100 Hz, burst-rate 2 Hz, burst-width 150 µs, intensity 40 mA, duration 30 min), and sham-TENS group. The PI and plasma concentrations of ßE and ME were measured at baseline, immediately (0 hr), 1 hr, 24 hrs, and 48 hrs post-intervention. Data were analysed using general linear model repeated measures, ordinal regression, one-way analysis of variance, Kruskal-Wallis test, independent and paired samples t-tests, Mann-Whitney U test, Wilcoxon signed-rank test, and Kendall's tau coefficient. RESULTS: There was a significant temporal difference in PI between groups, F (1, 58) = 18.83, p< 0.001; the TENS group had better pain relief. The relative analgesic effect of TENS started immediately after the intervention (median difference [M⁢D] =-3, p< 0.001), peaked at 1 hr (M⁢D=-4, p< 0.001), and worn out by 24 hrs (M⁢D=-1, p= 0.029). However, there was no significant difference in ßE and ME between the groups from 0 hr to 24 hrs post interventions, and no significant correlation between the PI, and ßE, or ME. CONCLUSION: TENS significantly reduced PI up to 24 hrs after treatment.

Nursing Students Achieving Community Health Competencies through Undergraduate Clinical Experiences: A Gap Analysis.

In Canada, it is widely believed that nursing practice and health care will move from acute care into the community. At the same time, increasing numbers of nursing students are engaged in non-traditional clinical experiences for their community health rotation. These clinical experiences occur at agencies not organizationally affiliated with the health care system and typically do not employ registered nurses (RNs). What has yet to be established is the degree to which nursing students are actually being prepared for community health nursing roles through their community health clinical rotations. In this paper we report the findings of a mixed method study that explored the gap between desired and observed levels of competence in community health of senior nursing students and new graduates. The gap was quantified and then the nature of the gap further explored through focus groups.

Fear and loathing: undergraduate nursing students' experiences of a mandatory course in applied statistics.

This article describes the results of a qualitative research study evaluating nursing students' experiences of a mandatory course in applied statistics, and the perceived effectiveness of teaching methods implemented during the course. Fifteen nursing students in the third year of a four-year baccalaureate program in nursing participated in focus groups before and after taking the mandatory course in statistics. The interviews were transcribed and analyzed using content analysis to reveal four major themes: (i) "one of those courses you throw out?," (ii) "numbers and terrifying equations," (iii) "first aid for statistics casualties," and (iv) "re-thinking curriculum." Overall, the data revealed that although nursing students initially enter statistics courses with considerable skepticism, fear, and anxiety, there are a number of concrete actions statistics instructors can take to reduce student fear and increase the perceived relevance of courses in statistics.