Prevalence of Patient Suicide and Its Impact on Health Care Professionals: A Systematic Review.

OBJECTIVE: This review aimed to examine the impact of patient suicide on health care professionals (HCPs), assess available support resources, and evaluate postvention (i.e., activities designed to support HCPs after a patient suicide) efforts. METHODS: An integrative systematic review was conducted to evaluate the prevalence of patient suicide and its emotional and professional impacts on HCPs. Searches were conducted in MEDLINE, Embase, CINAHL Plus, and the Cochrane Library in October 2021 and August 2022. Index terms and keywords were related to suicide, patients, and clinicians. Each article was assessed for quality with the Mixed Methods Appraisal Tool. RESULTS: Sixty-six relevant articles were identified. Across studies, the mean±SD percentage of HCPs who experienced a patient suicide was 51%±<1%. Fifty-eight (88%) articles reported on the emotional impact of patient suicide, and 50 (76%) reported on the professional impact of patient suicide. Thirty-three articles described a change in practice habits, which occurred for 51%-100% of professionals in these samples. Perceptions of support ranged widely, with 11%-87% of HCPs feeling that they received sufficient support. HCPs wanted formal support, including referral to counseling (12%-82%), more suicide prevention or postvention training (4%-70%), debriefing or supervision (41%-75%), formal case review (18%-20%), time off (12%), and legal assistance (4%). CONCLUSIONS: HCPs can be affected by patient suicide, regardless of practice setting. More information is needed to better understand the implementation of postvention services after patient suicide and to create practical and universally deliverable support services to meet HCPs' needs.

A guided single session intervention to reduce intrusive memories of work-related trauma: a randomised controlled trial with healthcare workers in the COVID-19 pandemic.

BACKGROUND: Intrusive memories of psychologically traumatic events bring distress both sub-clinically and clinically. This parallel-group, two-arm randomised controlled trial evaluated the effect of a brief behavioural intervention on reducing intrusive memories in frontline healthcare workers exposed to traumatic events during the COVID-19 pandemic. METHODS: Participants with at least two intrusive memories of work-related trauma in the week before recruitment were randomised 1:1 to an imagery-competing task intervention (n = 73) or attention-based control task (n = 71). The number of intrusive memories was assessed at baseline and 5 weeks after the guided session (primary endpoint). RESULTS: The intervention significantly reduced intrusive memory frequency compared with control [intervention Mdn = 1.0 (IQR = 0-3), control Mdn = 5.0 (IQR = 1-17); p < 0.0001, IRR = 0.30; 95% CI = 0.17-0.53] and led to fewer post-traumatic stress-related symptoms at 1, 3 and 6 month follow-ups (secondary endpoints). Participants and statisticians were blinded to allocation. Adverse events data were acquired throughout the trial, demonstrating safety. There was high adherence and low attrition. CONCLUSIONS: This brief, single-symptom, repeatable digital intervention for subclinical-to-clinical samples after trauma allows scalability, taking a preventing-to-treating approach after trauma. TRIAL REGISTRATION: 2020-07-06, ClinicalTrials.gov identifier: NCT04460014.

Knowledge and perceptions of snakes, snakebites and their management among health care workers in Sudan.

BACKGROUND: Snakebite statistics in Sudan are lacking despite the high estimated burden of the problem. One study in Sudan reported the presence of 17 medically significant snakes belonging to three major families: Burrowing asps, Elapidae, and Viperidae. These snakes usually become abundant during and after the rainy season, and most snakebite victims are farm workers. This study was set out based on the observed snakebite management, poor outcomes and lack of information on the healthcare provider's knowledge of this serious, deadly medical and health condition in snakebite-endemic regions of Sudan. MATERIALS AND METHODS: In August 2022, a descriptive cross-sectional survey was conducted involving 394 medical and healthcare providers in snakebite-endemic regions of Sudan (Gaddarif, Sinnar, Khartoum, and Kassala). A validated questionnaire was used. It consisted of seven sections addressing the study population demographic characteristics, knowledge of snakes, snakebites, and their management. Data analysis used various statistical tests using Microsoft Excel and the Statistical Package for Social Sciences (SPSS) version 20 (IBM SPSS Inc., Chicago, IL) was done. RESULTS: Among the 394 participants (44.7% males, 53.3% females), 58.1% demonstrated adequate knowledge of snakes, and 45.3% exhibited adequate knowledge of snakebites. A mere 25.9% received training in snakebite management, with 60.4% possessing adequate knowledge in this domain. Only 14% expressed high confidence in managing snakebites, and 40.9% reported having protocols for snakebite management at their health facilities. CONCLUSION: The study highlighted the inadequacy of healthcare providers' knowledge in snakebite-endemic areas in Sudan regarding snakes, snakebites and snakebites management. Urgent interventions, such as intensive continuing professional education and training, are essential to address this neglected medical and health problem.

Why are healthcare professionals leaving NHS roles? A secondary analysis of routinely collected data.

BACKGROUND: Much policy attention focuses on increasing the supply of workers in the English NHS but there has been less attention paid to the rise in leavers. This paper seeks to explore how existing data sets can illuminate the decision-making of leavers and inform actions that could mitigate this. METHOD: Secondary analysis of routinely collected data from 79 workforce projects in the UK (n = 46 339 participants) over a 4-year (2019-2023) period was undertaken. Free text data we extracted and analysed using content analysis, sentiment analysis and text mining. Inclusion criteria were those who stated they had resigned, had confirmed retirement date, and had secured employment elsewhere either within or without the sector but had not yet resigned. Exclusion criteria were those who had not indicated they were leaving or indicated intention to leave. These findings were then compared with themes from Herzberg's work hygiene theory and Hoffat and Woods's professional practice environment theory. RESULTS: Multiple reasons were given for leaving. Findings were congruent with Herzberg's two factor work hygiene theory and demonstrate that leavers are driven by the inability to meet their intrinsic motivation to practice according to their professional standards as much as by terms and conditions. Leavers describe suboptimal professional practice environments which produce obstacles to achieving their work objectives and leaving their intrinsic motivation frustrated. CONCLUSION: Whilst reasons for leaving differ between people, there is a relationship between intrinsic motivation (why they want to do the job) and the conditions in which they try to do the job. This study suggests that looking beyond the primary reason for leaving given in the national dataset could identify how the practice environment influences the decision.

Building Relationships, Forming Collaborations: Lessons Learned From an Unconference Seeking to Cultivate Solutions in Healthcare.

INTRODUCTION: Calls for a 'major rethinking' of the delivery of healthcare services are echoed across Canada as the healthcare crisis continues. Proposed strategies to address the challenges of this crisis include: a transdisciplinary approach that is patient-focused and community-based; a representative team composed of patients, caregivers, healthcare providers, decision makers and policymakers; and authentic collaboration among stakeholder groups throughout the research cycle. OBJECTIVE: This study aimed to enable community members to take on a leading role in building capacity and to provide a space for discourse among diverse groups while respecting community wisdom, values and priorities. METHODS: The Collaborative Health Research Institute of Southern Alberta (CHRISA) organized a participant-oriented Unconference event to address the factors contributing to the healthcare crisis in Alberta, Canada. An Unconference is a participant-oriented meeting where the attendees nominate the topics, agree on the agenda and lead the sessions. This article describes the Unconference programme and presents the findings from a thematic analysis of the discussion notes from breakout sessions, feedback from participants (i.e., lessons learned) and pragmatic recommendations for future Unconference events. RESULTS: Findings from sessions included the following: (1) identifying the 'wicked' problems, (2) the factors/causes contributing to each problem (i.e., contributors) and (3) potential multifaceted solutions or ideas to remedy the problem. Lessons learned from the postevent evaluation resulted in six recommendations for organizing future Unconferences. CONCLUSION: The CHRISA Unconference achieved its goals by providing a venue for attendees to connect, engage and network on topics of interest, explore new ways of addressing challenges in healthcare and serve as a foundation for future initiatives and collaborations in healthcare research and practice. PATIENT OR PUBLIC CONTRIBUTION: The Unconference was attended by community members who identify as patients, frontline workers, programme administrators and representatives of public organizations and agencies. Participants contributed to breakout session discussions, provided feedback on the Unconference and offered recommendations for future events. The co-authors are service users, people with lived experience or those work in the healthcare setting; they have been involved in data collection, analysis and interpretation, and contributed to this report.

Australian healthcare professionals' beliefs and practice behaviours in management of chronic pelvic pain: a cross-sectional survey.

Background Chronic pelvic pain (CPP) is a common and debilitating condition, and sufferers present to healthcare professionals with variable complex symptoms and co-morbidities. This study aimed to investigate the current beliefs and practice behaviours of healthcare professionals towards the management of CPP in Australian females. Methods We distributed an online survey to Australian healthcare professionals. Participants were questioned regarding their beliefs, the importance of various contributing factors and assessment variables, and their management preferences for two CPP vignettes. Demographic information and responses were analysed with descriptive statistics. Results Complete data were obtained and analysed from 446 respondents including gynaecologists (n =75), general practitioners (GPs) (n =184) and physiotherapists (n =187). Most of the respondents were female (88.1%), with male (11.7%) and other (0.2%) making up a smaller representation. Physiotherapists rated themselves higher in understanding mechanisms of CPP (64.7% very good to excellent) compared to gynaecologists (41.3%) and GPs (22.8%). Physiotherapists also reported higher levels of confidence in managing patients with CPP (57.8% quite or extremely confident) compared to 41.3% of gynaecologists and 22.3% of GPs who reported being quite or extremely confident. All three professions rated patient's beliefs (89.8%), nervous system sensitisation (85.7%), stress/anxiety/depression (91.9%), fear avoidance (83.3%), history of sexual/emotional/physical abuse (94.1%) and pelvic floor muscle function (85.0%) as very/extremely important factors in the development of chronic pelvic pain. Most gynaecologists (71.0%) and GPs (70.2%) always referred for pelvic ultrasound during assessment. Physiotherapists assessed goal setting (88.8%) and screened for patients' beliefs (80.9%) more often than gynaecologists (30.4% and 39.1% respectively) and GPs (46.5% and 29.0% respectively). Conclusions All three groups of healthcare professionals demonstrated a good understanding of pain mechanisms and incorporated a biopsychosocial and multidisciplinary approach to management of females with chronic pelvic pain. However, both gynaecologists and GPs were less confident in their understanding of and management of CPP, and less likely to consider patient beliefs and goals. The findings of this online survey may assist in the provision of more targeted education to further improve management of this condition.

Knowledge and practice of health workers on sexual and reproductive health and rights and gender-based violence: Evidence from three municipalities in Senegal.

Adolescents in low- and middle-income countries face numerous developmental, sexual and reproductive health (SRHR) challenges, including exposure to multidimensional violence. Dealing with gender-based violence (GBV) is of great importance and health personnel are key players. The objective of this work was to study the knowledge and practices of health personnel on SRHR and gender-based violence in Guédiawaye, Kaolack and Kolda communities in Senegal. A descriptive and analytical cross-sectional study was conducted, which consisted of health professionals (general practitioners and specialists, nurses, and midwives) and community health workers (community relays, bajenu gox, matrons). All health facilities in the three communities were included. Data analysis consisted of univariate analysis and logistic regression modeling to investigate the factors associated with the knowledge and practice of health personnels. An alpha risk of 5% was taken. A total of 78 health professionals and 128 community actors were included in the study. More than half of the health personnel (56.3%) had good knowledge of policies, standards and protocols relating to sexual and reproductive health services for women (adolescents) and about 60% on conventions and laws. The level of knowledge was good among 51% of respondents and good practices among 54.9%. The factors associated with good knowledge were the municipality in which the profession was practiced, and the effects of training received in the social construction of gender. The factors associated with the practices were knowledge of policies, standards and protocols through training, training received in the provision of family planning services, and in medico-psychosocial management of cases of sexual violence. We conclude that the knowledge of stakeholders (health professionals and community health workers) about sexual and reproductive health and gender-based violence is important for better service provision and good management of cases of gender based violence.

Les adolescents des pays à revenu faible et moyen (PRFM) sont confrontés à de nombreux défis en matière de développement, de santé sexuelle et reproductive (SSR), notamment l'exposition à une violence multidimensionnelle. La prise en charge des violences de genre est d'une grande importance et le personnel de santé en constituent des acteurs clés. L'objectif de ce travail était d'étudier les connaissances et les pratiques du personnel de santé sur la santé sexuelle et reproductive (SSR) et les violences basées sur le genre dans les communes de Guédiawaye, Kaolack et Kolda au Sénégal. Une étude transversale descriptive et analytique a été menée. La population était constituée des professionnels de santé (médecins généralistes et spécialistes, infirmiers, sages-femmes) et des agents de santé communautaires (relais communautaires, bajénu gox, matrones). L'ensemble des structures de santé des trois communes ont été inclus avec un choix raisonné des cibles. Une analyse univariée une modélisation par une régression logistique a été effectuée pour rechercher les facteurs associés à la connaissance et la pratique du personnel de santé. Un risque alpha de 5% a été pris. Au total 78 professionnels de santé et 128 acteurs communautaires ont été inclus dans cette étude. Plus de la moitié du personnel de santé (56,3%) avaient une bonne connaissance des politiques, normes et protocoles (PNP) des services de santé sexuelle et reproductive des femmes (adolescentes) et environ 60% sur les conventions et Lois. Le niveau de connaissance était bon chez 51% des enquêtés et les pratiques bonnes chez 54,9%. Les facteurs associés à la bonne connaissance étaient la commune d'exercice de la profession, le fait de bénéficier d'une formation en construction sociale du genre. Les facteurs associés aux pratiques étaient la connaissance des PNP à travers la formation, les formations reçues en offre de services PF et contraception d'urgence, en prise en charge médico-psychosociale des cas de violences sexuelles. En conclusion, la connaissance des acteurs (professionnels de santé, agents de sante communautaires) sur la santé sexuelle et reproductive et les violences basées sur le genre est importante pour une meilleure offre de service et une bonne prise en charge des cas de violences. (Afr J Reprod Health 2024; 28 [8s]: 163-175).

Coverage of influenza vaccination and influencing factors among healthcare workers in Shandong Province, China, 2021-2022.

Healthcare workers (HCWs) are at increased risk of exposure to the influenza virus in their daily clinical and disease prevention activities, making them a high-risk group for influenza infection. However, the vaccination rate among HCWs has always been low. This study investigated influenza vaccination uptake and willingness among HCWs in the context of the COVID-19 pandemic. The analysis revealed that the influenza vaccination uptake among HCWs was 67.5%, with 79.6% willing to receive the influenza vaccine in 2022/2023 A significant majority (92.7%) agreed that the COVID-19 pandemic increased their willingness to receive the influenza vaccine, and 94.8% agreed with the necessity of receiving the influenza vaccine even after COVID-19 vaccination. Binary logistic regression model identified key factors that influence vaccination intentions. HCWs who perceived a high risk of influenza and its threat to health, found vaccination convenient, and believed in the safety of the influenza vaccine were more likely to be vaccinated. Conversely, the high price of the influenza vaccine was a barrier, whereas those who considered the vaccine affordable were more likely to be vaccinated. Although Changchun Changsheng vaccine incident (The Changchun Changsheng Biotechnology Company was found to have violated good manufacturing practices in 2018, leading to widespread distribution of subpotent vaccines in China.) may not significantly impact the vaccination uptake among healthcare workers, some HCWs still harbor doubts about vaccine safety, which remains a key reason for vaccine hesitancy. This study emphasizes the importance of the strict monitoring and management of vaccines, conducting clinical studies to support vaccine safety, and implementing free influenza vaccine policies, workplace vaccination requirements, and organized mass vaccinations. Educational efforts to increase HCWs' understanding of influenza and influenza vaccines are crucial to increasing vaccination uptake. Furthermore, implementing comprehensive intervention measures is essential to effectively improve the influenza vaccination uptake.

Clients' and providers' perspectives in informing a digital health intervention to improve linkage to care after Index HIV self-testing in Hai and Moshi Districts, Tanzania.

BACKGROUND: Digital health interventions have the potential to improve linkage to care after HIV self-testing (HIVST). This study aimed to understand clients' and providers' perceptions of benefits, and barriers of a digital health intervention designed to improve linkage to care after HIV self-testing in Tanzania. METHODS: This exploratory qualitative research study was conducted in Hai and Moshi, districts in Kilimanjaro region, Tanzania. Four health facilities were selected based on their involvement in an HIVST pilot program implemented by Elizabeth Glassier Pediatric AIDS Foundation (EGPAF) Tanzania through the USAID funded program. The study included female index clients and their partners, and healthcare providers at the healthcare facilities. We used a semi-structured interview guide with open-ended questions for data collection. Data collection was conducted from 16th January 2023 to 3rd February 2023. Thematic analysis of the qualitative data was conducted, guided by the Health Belief Model (HBM), and results were developed in collaboration with the community partners. RESULTS: A total of 42 participants were included in the study, comprising 9 male clients, 17 female index clients, and 16 health care workers (HCWs) (4 male and 12 female) who were involved in delivering HIVST services. The study's findings revealed mixed feelings about the use of a digital health intervention. Majority of participants perceived digital health as a valuable intervention for enhancing linkage to care, improved health outcomes, improved communication with healthcare workers, and increased privacy. Therefore, they supported scale-up of a digital health intervention. Participants also expressed that the potential benefits of a digital health intervention include the convenience of accessing healthcare services from the comfort of their homes or any location. However, a few participants expressed concerns about potential risks associated with sending health-related text messages. They feared that recipients might not be in a safe space, leading to stigma and avoidance of engagement. A few female participants expressed concerns about confidentiality breaches, particularly regarding shared phones with family or friends. Fear of being judged or misunderstood by others could deter them from reading or acting upon these messages. Most participants recommended tailored strategies that prioritize confidentiality and trust. Recognizing these psychological aspects is vital for customizing digital health interventions to effectively address participants' concerns. CONCLUSIONS: Digital health interventions may improve the linkage of HIV self-testers to care. Recommendations include personalized and culturally relevant communication and technical accessibility to make interventions effective and inclusive. This study provides valuable insights for designing patient-centered interventions for HIV care and treatment.

Stigma and discrimination by healthcare providers towards patients diagnosed with HIV and tuberculosis: A study from India.

Background High levels of human HIV and tuberculosis (TB) stigma have been reported among healthcare workers (HCWs). Methods We compared HIV and TB stigma scores reported by nursing students and ward staff from hospitals across India. Transmission worry (TW) and intent to discriminate (ID) for HIV and TB were captured using a validated stigma scale. Results A total of 3733 individuals were interviewed. Nursing students and ward staff expressed higher TW while carrying out high- and low-risk tasks on patients with HIV compared to TB. Mean scores were 2.1 and 1.86 among nursing students; 1.82 and 1.79 among ward staff (all p<0.001). Both groups expressed a significantly higher ID against patients with HIV compared to TB (mean percentage: 75.6 and 70.3 among nursing students; and 81.8 and 78.8 among ward staff; all p<0.001). Conclusion TB stigma has implications for providing quality TB care. Training of HCWs regarding transmission dynamics, the importance of standard precautions during patient care, regardless of diagnosis is essential.

'You Can Get That Person on ART but You Can't Give Them Back Their Social System': A Qualitative Analysis of Voluntary Assisted Partner Notification for HIV for Marginalised and Vulnerable Populations.

Little is known about Voluntary Assisted Partner Notification (VAPN) in groups in sub-Saharan Africa that experience marginalisation, and whether its use is suitable for referral to HIV care pathways. We conducted semi-structured in-depth interviews with purposively selected medical and health professionals (N = 15) regarding their perspectives and experiences with VAPN policy and its implementation. Data were analysed following a Reflexive Thematic Analysis approach. Respondents highlighted the flexibility in VAPN policy implementation and described adjustments made by health workers. Women were seen as vulnerable and lacked access to support against gender-based violence. Men who have sex with men could face exclusion from important social networks. Age-appropriate VAPN assistance was also considered unavailable for sexually active children. Embedding understandings of identity, belonging, and safety into VAPN could address individual priorities and needs. Community support networks, tailored care for children, and family-orientated approaches to HIV notification may overcome issues relating to vulnerability and marginalisation.

A qualitative analysis of voluntary assisted partner notificationLittle is known about Voluntary Assisted Partner Notification (VAPN) in groups in sub-Saharan Africa that experience marginalisation. We conducted semi-structured in-depth interviews with purposively selected medical and health professionals (N = 15) regarding their perspectives and experiences with VAPN policy and implementation. Data were analysed following a Reflexive Thematic Analysis approach. Respondents highlighted flexibility in VAPN policy implementation and described adjustments made by health workers. Women were seen as vulnerable and lacked access to support against gender-based violence. Men who have sex with men could face exclusion from important social networks. Age-appropriate VAPN assistance was also considered unavailable for sexually active children. Embedding understandings of identity, belonging, and safety into VAPN could address individual priorities and needs. Community support networks, tailored care for children, and family-orientated approaches to HIV notification may overcome issues relating to vulnerability and marginalisation.

Work Environment, Burnout, and Intent to Leave Current Job Among Cardiologists and Cardiology Health Care Workers: Results From the National Coping With COVID Survey.

BACKGROUND: Little is known about factors contributing to burnout and intent to leave in cardiologists and other cardiology health care workers. METHODS AND RESULTS: The Coping With COVID survey assessed work conditions, burnout, and intent to leave among physicians, nurses, advanced practice providers, and other clinical staff (OCS) from April 2020 to December 2020. Single-item measures assessed work conditions, burnout (emotional exhaustion), and intent to leave. Multilevel logistic regression examined work life variables' relationships to burnout among role types and feeling valued as a mediator. Open-ended comments analyzed via grounded theory contributed to a conceptual model. Coping With COVID was completed by 1199 US cardiology health care workers (354 physician/520 nurses/198 advanced practice providers/127 OCS). Nurses were most likely to report burnout (59% nurses, 57% OCS, 46% advanced practice providers, 40% physicians, P<0.0001). Workload correlated with burnout in all groups (adjusted odds ratios [aORs], 4.1-17.4; Ps<0.005), whereas anxiety/depression related to burnout in all except OCS (aORs, 3.9-8.3; Ps≤0.001). Feeling valued was related to lower burnout in most groups. Intent to leave was common (23%-45%) and was lower in physicians and advanced practice providers who felt valued (aORs, 0.26 and 0.22, respectively; Ps<0.05). Burnout was highest for nurses in practice 16 to 20 years, and intent to leave was highest for OCS in practice 16 to 20 years. Themes contributing to burnout included personal and patient safety, leadership, and financial issues. CONCLUSIONS: Burnout was prevalent among cardiology health care workers and highest in nurses and OCS. Addressing factors associated with burnout in different role types may improve work life sustainability for all cardiology health care workers.

"You close the door, wipe your sadness and put on a smiling face": a qualitative study of the emotional labour of healthcare professionals providing palliative care in nursing homes in France.

BACKGROUND: Palliative care provided to frail and dying older persons in nursing homes results in intense emotions for residents and their relatives as well as for healthcare professionals. In France, scant attention has been given to how nursing home professionals manage their emotions when providing palliative care. This study analysed the emotional demands of providing palliative care in the nursing home context, the emotional strategies used by healthcare professionals to navigate such demands, and how these demands affect their emotional wellbeing. METHODS: This qualitative study used a multiple case study approach. We purposively selected nine nursing homes from three geographical provinces in France with diverse ownership statuses (public, private, associative). Individual interviews and focus group discussions were held with 93 healthcare professionals from various occupational groups employed in the participating nursing homes. Data was collected from April 2021 to September 2022 and was analysed using thematic content analysis. RESULTS: Data revealed that providing palliative care to dying residents within the nursing home context results in intertwined rewarding and exhausting emotional experiences for healthcare professionals. Professionals have to utilize multifaceted emotional strategies to navigate these experiences, including suppressing and modifying emotions and distancing themselves emotionally from residents to protect themselves from emotional suffering. Participants noted a lack of formal space to express emotions. Unrecognized emotional labour undermines the wellbeing of healthcare professionals in nursing homes, whereas acknowledging emotions enhances satisfaction and gives enhanced meaning to their crucial role in resident care. CONCLUSION: Acknowledging emotional labour as an inevitable component of providing palliative care in nursing homes is critical to supporting healthcare professional wellbeing, resilience, and retention, which may ultimately improve the quality of care for dying residents. Ensuring quality care and supporting the emotional wellbeing of nursing home professionals requires an organisational culture that considers emotional expression a collective strength-building resource rather than an individual responsibility, in hopes of shaping a new culture that fully acknowledges their humanity alongside their professional skills. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT04708002; National registration: ID-RCB number: 2020-A01832-37, Registration date: 2020-12-03.

Mental Health Consequences of the COVID-19 Outbreak Among Emergency Department Healthcare Workers.

Study Objective: The present study is aimed at providing an assessment of the changes in burnout, job strain, isostrain, sleepiness, and fatigue levels over time and identifying factors associated with these symptoms among healthcare workers in French emergency departments (EDs). Method: We conducted a prospective, multicenter study in four EDs and an emergency medical service. Participants completed questionnaires at inclusion and at 90 days to assess burnout, job strain, isostrain, sleepiness, and fatigue. Results: A total of 211 respondents (43.5%) completed the questionnaires at inclusion. At the beginning of the study, 84 (40.8%) participants presented symptoms of burnout, 86 (43.2%) had symptoms of job strain, and 58 (29.4%) of isostrain. Forty-two (20.1%) healthcare workers presented symptoms of sleepiness, and 8 (3.8%) had symptoms of fatigue. We found that symptoms of burnout were more frequent for healthcare workers with a previous psychiatric history (55.3% vs. 39.1%, p = 0.02) and were lower among participants who had at least one dependent child (33.1% vs. 48.3%, p = 0.013). Symptoms of job strain were higher among administrative staff compared to physicians (55.6% vs. 28.7%, p = 0.01) and among healthcare workers with managerial responsibilities compared to those without (45.6% vs. 28.8%, p = 0.015). Symptoms of isostrain were higher among administrative staff (42.3%) compared to paramedics (34.1%) and physicians (19.8%, p = 0.026). Conclusion: We identified that potential factors associated with the emergence of symptoms of burnout and job strain are suggested, underlining several areas of improvement for the prevention against mental health disorders in the specific population of ED healthcare workers. Trial Registration: ClinicalTrials.gov identifier: NCT04383886.

Assessing Patient Safety Culture: Insights from a Neurological Institute.

Introduction-Aim: Assessment of patient safety culture is important for enhancing hospital service quality and clinical outcomes. This study aimed to evaluate the safety of patient culture among health professionals in a neurological institute, in order to identify areas of improvement. The second objective of our study was to determine the influence of the sociodemographic data of the participants on the awareness of patient safety. METHODS: A cross-sectional descriptive study was conducted among healthcare workers exercising at a neurological institution using a validated Hospital Survey of Patient Safety Culture questionnaire containing ten safety care dimensions. RESULTS: A total of 123 responses to the questionnaire were analyzed, accounting for 34.5% of the total (Cronbach's alpha=0.677). Among the participants, 61.8% considered the level of awareness regarding patient safety to be acceptable. The dimensions considered as strengths were "Organizational learning and continuous improvement" with the highest positive response (60.3%) "Relationship patient-staff member" (58.9%) and "Teamwork within units" (58.9%). However, the dimensions considered as weaknesses were "Management support for patient safety" with 28.5% of positive responses and "Communication openness and non-punitive response to error" (40%). CONCLUSION: Patient safety culture among healthcare professionals is at an average with "Organizational learning and continuous improvement" being a positive aspect. However, improvements should be made in all dimensions to enhance and promote patient safety within the institution.

The Impact of COVID-19 Fear on Mental Health of Community Behavioral Health Providers.

OBJECTIVE: The COVID-19 pandemic has impacted communities worldwide. Behavioral health providers are at the forefront providing services and are thus vulnerable to psychological sequalae. This study hypothesizes that the fear of COVID-19 predicts depression and anxiety among these providers. METHODS: A questionnaire was delivered to community behavioral health providers to assess fear of COVID-19 using the Fear of COVID-19 Scale (FCV-19S). Anxiety and depression were assessed using Generalized Anxiety Disorder (GAD-2) scale and Patient Health Questionnaire (PHQ-2). Demographic data were analyzed using descriptive statistics, and the relationship between explanatory variables and outcomes was assessed using univariate generalized linear models and 1-way analysis of variance (ANOVA). RESULTS: FCV-19S scores were significantly higher among persons who smoked (z = 2.4, P < 0.05) or had a predisposing health condition. The multivariate models showed significant association with fear of COVID-19 and having a predisposing health condition, belonging to an ethnic minority group, not been diagnosed positive, and having a high total anxiety score. CONCLUSIONS: The study indicated that 50% of the behavioral health providers screened had poor mental health owing to multiple factors identified. Hence, it is essential to strengthen their support to better mitigate situations contributing to fear.

Knowledge, attitude, and practices regarding ChatGPT among health care professionals.

OBJECTIVE: To explore the knowledge, attitudes, and practices (KAP) in regard to ChatGPT among health care professionals (HCPs). STUDY DESIGN: Cross-sectional study. METHODS: This web-based cross-sectional study included HCPs working at the First Affiliated Hospital of Anhui Medical University in China between August 2023 and September 2023. Participants unwilling to use ChatGPT were excluded. Correlations between KAP scores were evaluated by Pearson correlation analysis and structural equation modeling (SEM). RESULTS: A total of 543 valid questionnaires were collected; of these, 231 questionnaires (42.54%) were completed by male HCPs. Mean (SD) knowledge, attitude, and practice scores were 6.71 (3.24) (range, 0-12), 21.27 (2.73) (range, 6-30), and 47.91 (8.17) (range, 12-60), respectively, indicating poor knowledge (55.92%), positive attitudes (70.90%), and proactive practices (79.85%). The knowledge scores were positively correlated with attitude (Pearson r = 0.216; P < .001) and practice (Pearson r = 0.283; P < .001) scores, and the attitude scores were positively correlated with practice scores (Pearson r = 0.479; P < .001). SEM showed that knowledge influenced attitude positively (ß = 0.498; P < .001) but negatively influenced practice part 1 (improving work efficiency and patient experience) (ß = -0.301; P < .001), practice part 2 (helping advance medical research) (ß = -0.436; P < .001), practice part 3 (assisting HCPs) (ß = -0.338; P < .001), and practice part 4 (the possibilities) (ß = -0.242; P < .001). Attitude positively influenced practice part 1 (ß = 1.430; P < .001), practice part 2 (ß = 1.581; P < .001), practice part 3 (ß = 1.513; P < .001), and practice part 4 (ß = 1.387; P < .001). CONCLUSION: HCPs willing to use ChatGPT in China showed poor knowledge, positive attitudes, and proactive practices regarding ChatGPT.

Capturing Staff Perspectives on Quality Interaction With Clients With Intellectual Disability: A Diary Study.

For people with severe or profound intellectual disability (ID), support staff are important interaction partners. The quality of their interactions, a multidimensional construct, is well documented, but the staff perspective remains underexposed. This study aims to capture the behaviors, thoughts, and emotions of staff when interacting with their clients, and their views on what constitutes quality. Thirty-four support staff completed a 5-day diary about a daily interaction with a specific client. A thematic analysis was carried out. The diary entries depicted behaviors and thoughts with different foci, and emotions with positive and negative valences. The pursuit of Harmonization and the experience of Return emerged as overarching dimensions central to staff's views on quality interaction. Limitations and directions for future research are discussed.

Prevalence and determinants of occupational depression, anxiety, and stress among Ethiopian healthcare workers.

Studies on the prevalence and factors of depression, and anxiety symptoms from a work-ascribed or causal perspective are not available and studies on the prevalence of occupational stress in Ethiopia are limited. Therefore, this study aimed to determine the prevalence of occupational depression, job anxiety, and occupational stress, and to identify their determinants in healthcare workers. We conducted a multicenter cross-sectional study in selected public hospitals in the Central and Southern Ethiopia from 16th January to 28th February 2023. We used stratified random sampling to select 9 public hospitals from three strata: primary, general and tertiary hospitals. We collected data using scales of perceived occupational stress, occupational depression inventory, and job anxiety. We performed a confirmatory factor analysis followed by determining the prevalence of those mental symptoms and identifying independent factors using multiple ordinal logistic regression. Among 1426 healthcare workers, the overall prevalence of occupational depressive, job anxiety, and occupational stress symptoms were 39.0%, 57.6%, and 68.0%, respectively. Females, medical specialists, participants with a history of disease or injury, those with low job dissatisfaction, higher sleeping disorder scores, higher life-threatening events (LTEs) scores, and longer working hours were more likely to report occupational depressive symptoms. Participants with poor perceived health significantly increased the odds of reporting job anxiety symptoms. Participants with low job satisfaction, a history of workplace verbal violence, higher scores for sleep disorders, and higher LTEs score had significantly greater odds of reporting both job anxiety and occupational stress symptoms. Younger participants were also more likely to report occupational stress symptoms. Our study highlights the need to prioritize workplace mental health interventions for healthcare workers. The study also suggested the need to address gender, educational level, job satisfaction, and sleep hygiene, develop coping mechanisms for LTEs, prevent workplace violence, and manage of working hours per week to enhance the mental well-being of healthcare workers in Ethiopia.

Healthcare workers' perspectives on diabetic foot complications among type 2 diabetes mellitus patients in Fiji.

INTRODUCTION: Diabetic Foot Complications (DFCs) are a growing cause of morbidity and mortality with less than one third of physicians able to discern the signs of diabetes related peripheral neuropathy. DFCs and resultant amputations account for a considerable proportion of surgeries in Fiji, with very limited literature available to verify the factors that influence these alarming figures. This study aimed to explore Health Care Workers' (HCWs) perspectives on diabetic foot complications and challenges of foot care management in Fiji. METHOD: An exploratory descriptive qualitative design was used among HCWs at the Sigatoka Sub Divisional Hospital (SDH), Fiji in 2021. HCWs at the SDH were required to have a minimum work experience of at least six months in public health. All participants who met the inclusion criteria were selected through purposive sampling. Data was collected using a focus group discussion guide composed of semi-structured open-ended questions to guide the Focus Group Discussions (FGDs). Focus discussions were audio recorded and transcribed with thematic analysis applied to derive the themes and sub-themes outlined in the study. RESULTS: Twenty HCWs participated in four FGDs with four major themes identified. The first theme was HCWs' perceptions and practice of foot care which revealed that all participants had adequate diabetic foot care knowledge. The second theme was factors affecting foot care which was mainly focused on identified barriers such as inadequate patient foot care knowledge, the lack of resources such as manpower, and health system challenges like the COVID-19 pandemic. The third theme is creating awareness among patients and HCWs to improve foot care practices. The fourth theme is strengthening foot care practices at the different levels of health care that is aimed at optimizing diabetic foot outcomes. CONCLUSION: Various foot care barriers namely patient factors and the lack of resources is a concern depicted in this study. There is a need to address health system barriers and enforce diabetic foot education, screening and care for patients and the community.