Children, Sexual Abuse and the Emotions of the Community Health Practitioner in England and Wales, 1970-2000.

A survivor of child sexual abuse felt that doctors missed opportunities to notice her distress when, at fourteen, she had an unexplained illness that lasted for a year. The cause, she wrote, was "explained by Doctors as psychological, but nobody questioned further. WHY??? … If adults don't listen[,] then we have no one to turn to." For decades, community health practitioners have been identified as an important group in protecting children from maltreatment, but survivor testimony and agency statistics demonstrate that they rarely receive verbal disclosures or recognize the physical or behavioural warning signs of sexual abuse. The accounts we have of the 1980s tell of swiftly heightening professional awareness, followed by a visceral backlash in the latter part of the decade that discouraged practitioners from acting on their concerns. This article uses trade and professional journals, training materials, textbooks, and new oral histories to consider why community-based doctors and nurses have struggled to notice and respond to the sexually abused child. It will argue that the conceptual model of child sexual abuse that community health practitioners encountered in the workplace encouraged a mechanical and procedural response to suspicions of abuse. In a highly gendered and contested workplace, practitioners' feelings about how survivors, non-abusing family members, and perpetrators should be understood were rarely debated in training or in practice. The emotional cost to the practitioners of engagement with sexual abuse, and their need for spaces of reflexivity and structures of support, were ignored.

Traditional Health Care Practitioners' Perspectives on Applying Informed Consent During African Traditional Medical Practice in Akwa Ibom State, Nigeria: A Cross-Sectional Qualitative Study.

Introduction: This study explored the perspectives of traditional health care practitioners (THPs) practicing in the areas of herbalism, bone setting, and traditional birth attendance, from Akwa Ibom state, Nigeria, on the possibility and implications of applying informed consent (IC) during African traditional medicine (ATM) practice. Methods: Semistructured interviews were conducted with 11 THPs, consisting of 5 herbalists, 3 traditional bone setters (TBS), and 3 traditional birth attendants (TBAs), who represented the diverse groups that the study intended to cover. In-depth interviews were conducted using a semistructured guide and were recorded, transcribed, and analyzed using thematic analysis with the assistance of NVivo® qualitative analysis software. Results: Participants were seven males (64%) and four females (36%), 35-67 years of age, with 5-25 years of experience as THPs. Forty-six percent of participants were herbalists (27%), TBS, and TBAs (27%). Most participants (82%) were Annang, and (18%) were Ibibio first-language speakers. Three major themes emerged from the data analysis: (i) Existing ethical framework related to IC, (ii) knowledge of consent, and (iii) application of IC during traditional medical practice. These themes and relevant subthemes were explored. All (100%) THPs agreed that it was essential to communicate risks and benefits while allowing patients to ask questions before treatment. All participants (100%) stated that risk communication is essential in ATM, whereas 36% said they communicated all therapy benefits to their patients. Respondents believed patients could make an informed choice if they had complete information disclosure. However, THPs in this study had limited knowledge of formal IC rules and regulations. Conclusions: This study revealed that THPs in this setting disclose a diagnosis, risks, some benefits, and treatment options to patients. Consent/agreement was obtained verbally and voluntarily during ATM practice, consistent with IC doctrine. THPs had limited knowledge of the critical elements of IC. However, they suggested that a form of IC that does not conflict with traditional African norms could be applicable in ATM. IC could facilitate documentation and help reduce risks in ATM practice.

Evidence for continuing professional development standards for regulated health practitioners in Australia: a systematic review.

BACKGROUND: Health practitioner regulators throughout the world use continuing professional development (CPD) standards to ensure that registrants maintain, improve and broaden their knowledge, expertise and competence. As the CPD standard for most regulated health professions in Australia are currently under review, it is timely that an appraisal of the evidence be undertaken. METHODS: A systematic review was conducted using major databases (including MEDLINE, EMBASE, PsycInfo, and CINAHL), search engines and grey literature for evidence published between 2015 and April 2022. Publications included in the review were assessed against the relevant CASP checklist for quantitative studies and the McMaster University checklist for qualitative studies. RESULTS: The search yielded 87 abstracts of which 37 full-text articles met the inclusion criteria. The evidence showed that mandatory CPD requirements are a strong motivational factor for their completion and improves practitioners' knowledge and behaviour. CPD that is more interactive is most effective and e-learning is as effective as face-to-face CPD. There is no direct evidence to suggest the optimal quantity of CPD, although there was some evidence that complex or infrequently used skills deteriorate between 4 months to a year after training, depending on the task. CONCLUSIONS: CPD is most effective when it is interactive, uses a variety of methods and is delivered in a sequence involving multiple exposures over a period of time that is focused on outcomes considered important by practitioners. Although there is no optimal quantity of CPD, there is evidence that complex skills may require more frequent CPD.

Using Latent Profile Analysis to Understand Health Practitioners' Attitudes Toward Voluntary Assisted Dying.

Prior work has documented considerable diversity among health practitioners regarding their support for voluntary assisted dying (VAD). We examined whether their attitudes are characterised by different combinations of personal support, normative support by other health practitioners, and whether they are predisposed to vicariously experience others' emotions (i.e., empathy). We also examined whether these profiles experienced different mental health outcomes (i.e., burnout and posttraumatic stress) in relation to VAD. To test this, 104 Australian health practitioners were surveyed after VAD was legalised in Victoria, Australia in 2019. Results indicated that practitioners' attitudes were characterised by three profiles: 1) strong personal and normative support (strong VAD supporters), 2) moderate personal and normative support (moderate VAD supporters), and 3) lower personal and normative support (apprehensive practitioners). However, each profile reported similar mental health outcomes. Findings suggest that the normative environments in which health practitioners operate may explain their diverse attitudes on VAD.

Evidence for recency of practice standards for regulated health practitioners in Australia: a systematic review.

BACKGROUND: Health practitioner regulators throughout the world use registration standards to define the requirements health practitioners need to meet for registration. These standards commonly include recency of practice (ROP) standards designed to ensure that registrants have sufficient recent practice in the scope in which they intend to work to practise safely. As the ROP registration standards for most National Boards are currently under review, it is timely that an appraisal of current evidence be carried out. METHODS: A systematic review was conducted using databases (including MEDLINE, EMBASE, PsycInfo, and CINAHL), search engines, and a review of grey literature published between 2015 and April 2022. Publications included in the review were assessed against the relevant CASP checklist for quantitative studies and the Joanna Briggs Institute checklist for analytical cross-sectional studies. RESULTS: The search yielded 65 abstracts of which 12 full-text articles met the inclusion criteria. Factors that appear to influence skills retention include the length of time away from practice, level of previous professional experience and age, as well as the complexity of the intervention. The review was unable to find a clear consensus on the period of elapsed time after which a competency assessment should be completed. CONCLUSIONS: Factors that need to be taken into consideration in developing ROP standards include length of time away from practice, previous experience, age and the complexity of the intervention, however, there is a need for further research in this area.

Psychometric properties of questionnaires to assess evidence-based practice among occupational, physical and speech therapists: A systematic review.

INTRODUCTION: Evidence-based practice (EBP) is an important aspect of healthcare work, but the clinical implementation is complex. To be able to facilitate EBP implementation, valid measurement of the "EBP status quo" is essential. Therefore, we aimed to identify valid tools for EBP status assessment among occupational, physical and speech therapists in Germany. METHODS: The databases PubMed, Cochrane Library, PsycINFO, and CINAHL were systematically searched from August 2011 until July 2022. Methodological quality and evidence level were scored by two independent raters via: i) the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist, ii) updated criteria for good measurement properties, and iii) modified GRADE criteria. RESULTS: Overall, 57 reports describing the development or validation of 31 EBP questionnaires were included. Six questionnaires showed "sufficient" evidence for content validity, three questionnaires showed "sufficient" evidence for reliability, two questionnaires showed "sufficient" evidence for structural validity as well as internal consistency, and nine questionnaires showed "sufficient" evidence for construct validity. Most questionnaires demonstrated moderate or low-quality evidence for the psychometric properties tested. DISCUSSION: Overall, the present review found a lack of sufficient evidence on the psychometric properties of most questionnaires. The Evidence-Based Practice Inventory (EBPI), the Evidence-based Practice Confidence (EPIC) scale and the Health Sciences-Evidence-Based Practice (HS-EBP) questionnaire were the only questionnaires with "sufficient" content validity and, in addition, "sufficient" reliability or "sufficient" internal consistency. CONCLUSION: Although a lack of high-quality psychometric properties of EBP tools became apparent, the EBPI, the EPIC scale and the HS-EBP questionnaire currently appear to be the best validated tools to assess EBP behavior/attitude and implementation in occupational, physical and speech therapists.

Child abuse knowledge and attitudes among dental and oral health therapists in Aotearoa New Zealand: a cross-sectional study.

BACKGROUND: Child abuse and neglect are significant social and health issues in New Zealand. As the government provides free oral care to children and adolescents, oral health practitioners are positioned to respond to child protection concerns. However, research on the knowledge and attitudes of oral health practitioners is limited. This study aimed to understand the knowledge and attitudes of New Zealand dental and oral health therapists in detecting and reporting child abuse and neglect. METHODS: In this descriptive exploratory cross-sectional study, we invited registered New Zealand dental and oral health therapists treating children and adolescents to the anonymous online survey. RESULTS: Among the 92 dental and oral health therapists, 72% agreed that they could recognise the signs and symptoms of child abuse and neglect. Yet, only 48% agreed they were familiar with the reporting process. During their professional careers, 62% had at least 1 suspected case; and only 21% had ever reported their concerns. Fear of false reporting (70%) was the most significant barrier. CONCLUSIONS: Participants understood child abuse and neglect as significant social issues; however, the knowledge and attitudes to respond were limited. Efforts to enhance the knowledge and attitudes will be necessary to promote child safety and wellbeing.

Knowledge, attitude and practices on notifiable diseases among environmental health practitioners in the City of Johannesburg: A cross-sectional study.

Background: Notifiable diseases, a public health challenge in low- and middle-income countries, require mandatory reporting and play a significant role in disease prevention and control. Environmental health practitioners are responsible for reporting and investigating notifiable diseases. Aim: The study aimed to assess the knowledge, attitude and practices on notifiable diseases among environmental health practitioners within a metropolitan municipality. Setting: The study was conducted in the seven regions of the City of Johannesburg in Gauteng province, South Africa. Methods: A cross-sectional and descriptive study was used. One hundred and thirty-five participants were randomly sampled. The data were collected using a semi-structured questionnaire and analysed using version 27 of the Statistical Package for the Social Sciences (SPSS) software. All ethical considerations such as permissions, ethical clearance and informed consent were observed throughout the study. Results: The majority of participants (n = 64; 47.4%) were aged between 30 and 39 years and had a BTech/Honours degree (n = 106; 78.5%). A total of 106 (78.5%) participants had received formal training, while 83.7% (n = 113) of the participants understood notifiable diseases. Years of experience had a significant negative correlation with the 'need to report notifiable diseases' (r = -0.193; p = 0.025). Conclusion: The results could facilitate a knowledge improvement programme that includes a structured training programme and standard operating procedures. The study results cannot be generalised to the whole country; hence, the recommendation of a national survey on similar phenomena should be considered. Contribution: The study findings could assist in improving the role of environmental health services in reporting and investigating notifiable diseases.

Psychiatrists' Experience of a Peer Support Group for Reflecting on Patient Suicide and Homicide: A Qualitative Study.

There is a lack of support for mental health professionals who experience a patient suicide or homicide. This is despite a high likelihood of such an occurrence and the heavy professional and personal toll the experience can take. We conducted 15 interviews with members of a facilitated peer support group run for consultant psychiatrists who have experienced a patient homicide or suicide. Our interviews explored the trauma of the experience as well as the effectiveness of the group in helping the clinician heal. Our results echoed previous research that the experience can be profoundly traumatic. A professionally facilitated, consultant-only peer group specifically dedicated to suicide and homicide were the key components helping participants to process their grief. Mental health trusts should consider setting up facilitated peer support groups for clinicians who experience patient suicide or homicide.

School-Based Mental Health Practitioners: A Resource Guide for Educational Leaders.

School-based mental health practitioners can offer enhanced support to schools and students; yet their training, roles, and expertise vary. The roles of these professionals are often conflated, misunderstood, or marginalized in their utility throughout the school system. The purpose of this manuscript is to enhance the capacity of educational leaders to make informed hiring, contracting, and role assignment decisions that best fit school and student needs regarding school mental health services. We clarify the landscape of two distinct groups of qualified school mental health professionals-those who are education certified and those who are independently licensed; each group represents professionals from multiple disciplines. We illuminate similarities and differences of these professionals and juxtapose the utility of traditional mental health versus school-based mental health. We then discuss the similarities and differences of qualified school mental health professionals described within the context of traditional and school-based mental health preparation and service delivery. We conclude by contributing three resources for educational leaders to support the process of engaging school-based mental health practitioners. First, we offer a planning guide to understand state variations in certification requirements across professionals. Second, we provide a hiring guide primer that summarizes education requirements and delineates role orientations for school mental health practitioners. Third, we provide an interview guide to help clarify a candidate's experience and skills useful to contemporary school needs. We conclude by offering recommendations for educational leaders to become more effective consumers of school-based mental health services. Supplementary Information: The online version contains supplementary material available at 10.1007/s12310-022-09530-5.

Structural stigma and its impact on healthcare for borderline personality disorder: a scoping review.

BACKGROUND: People with Borderline Personality Disorder (BPD) and their carers/families continue to experience structural stigma when accessing health services. Structural stigma involves societal-level conditions, cultural norms, and organizational policies that inhibit the opportunities, resources, and wellbeing of people living with attributes that are the object of stigma. BPD is a serious mental illness characterized by pervasive psychosocial dysfunction including, problems regulating emotions and suicidality. This scoping review aimed to identify, map, and explore the international literature on structural stigma associated with BPD and its impact on healthcare for consumers with BPD, their carers/families, and health practitioners. METHODS: A comprehensive search of the literature encompassed MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI Evidence-Based databases (from inception to February 28th 2022). The search strategy also included grey literature searches and handsearching the references of included studies. Eligibility criteria included citations relevant to structural stigma associated with BPD and health and crisis care services. Quality appraisal of included citations were completed using the Mixed Methods Appraisal Tool 2018 version (MMAT v.18), the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Research Syntheses Tool, and the AGREE II: advancing guideline development, reporting, and evaluation in health care tool. Thematic Analysis was used to inform data extraction, analysis, interpretation, and synthesis of the data. RESULTS: A total of 57 citations were included in the review comprising empirical peer-reviewed articles (n = 55), and reports (n = 2). Studies included quantitative, qualitative, mixed methods, and systematic review designs. Review findings identified several extant macro- and micro-level structural mechanisms, challenges, and barriers contributing to BPD-related stigma in health systems. These structural factors have a substantial impact on health service access and care for BPD. Key themes that emerged from the data comprised: structural stigma and the BPD diagnosis and BPD-related stigma surrounding health and crisis care services. CONCLUSION: Narrative synthesis of the findings provide evidence about the impact of structural stigma on healthcare for BPD. It is anticipated that results of this review will inform future research, policy, and practice to address BPD-related stigma in health systems, as well as approaches for improving the delivery of responsive health services and care for consumers with BPD and their carers/families. REVIEW REGISTRATION: Open Science Framework ( https://osf.io/bhpg4 ).

Promoting blue-collar employees' work ability: A qualitative study on occupational health practitioners' perspective on feasible interventions.

BACKGROUND: Work in the industrial sector underlies deep structural changes triggered by demographic and societal transformations. These developments require tailored measures for maintaining employees' work ability by reacting to new demands and overcoming barriers in organizational implementation. Previous research lacks in considering practitioners' perspective in terms of tailoring effective interventions to the workplace conditions of blue-collar employees. OBJECTIVE: This study aims to enrich the understanding of work ability by using the job-demands-resources (JDR)-theory and the work ability house concept as basis and considering aspects of organizational measures' feasibility. METHODS: Data results from observations of the collaboration between occupational health professionals and supervisors on the shop-floor and n = 18 semi-structured interviews with different occupational health stakeholders. A participatory and qualitative approach characterizes this study. RESULTS: The study participants report on how increasing organizational demands of efficiency and uncertainty affect workability promotion of blue-collar employees. Furthermore, the findings imply aspects regarding feasible interventions. For designing effective interventions, specifically psychosocial aspects such as work intensification, job uncertainty, work-life-conflicts, and inter-personal trust need to be addressed. Measures need to be aligned better to the industrial setting with specific focus on decision-makers' interests and intra-organizational collaboration. CONCLUSION: Further research should investigate interrelationships between relevant psycho-social job demands and resources. Moreover, additional aspects, which are related to measures implementation in the organizational sphere, need to be identified. Practical implications connect organizational sciences with the workability theory and the job-demands-resources (JDR)-theory by focusing more on psychological work design and intra-organizational collaboration.

Interprofessional collaboration in the breast cancer unit: how do healthcare workers see it?

BACKGROUND: Interprofessional collaboration has an important role in health care for breast cancer patients who are undergoing treatment at the hospital. Interprofessional collaboration has been reported to provide significant benefits for patients. However, qualitative research on interprofessional collaboration in the breast cancer department is rarely done, therefore, a study was conducted to determine the perception of health practitioners about interprofessional collaboration in the breast care unit at a referral centre hospital in West Java, Indonesia. METHODS: A qualitative study was carried out using in-depth interviews and focus group discussions (FGDs) with 15 healthcare personnel using total sampling. Participants were chosen among healthcare professionals who treat and in charge for outpatient breast cancer, but were not resident physicians. The FGD approach was used for nurses and pharmacists, and interviews were used for oncologists. The audio recordings of all interviews and FGDs were transcribed verbatim and evaluated using thematic analysis. RESULT: The findings were categorized into two categories to obtain health care workers' perspectives on interprofessional collaboration: (1) impediment factors: personality, lack of leadership, seniority, healthcare workers with double positions, the need for a clinical meeting, hospital bureaucracy, national health insurance implementation, issues with patients, hospital infrastructure, and evaluation and synchronisation; (2) existing supportive elements: effective cooperation, effective communication, clear job description, interpersonal relationships, Standard Operational Procedure (SOP) for cancer therapy, legality for inter-discipline cancer team, professional responsibility, integrated clinical pathway, patient centred care, and comprehensive health services. CONCLUSIONS: Interprofessional collaboration was seen positively by the respondents. However, there are several hurdles that must be overcome to apply interprofessional collaboration works effectively. The findings of this study can be used to build interprofessional collaborations targeted at enhancing quality health care in breast cancer units.

Development and initial validation of a measure of cross-lingual practice among mental health practitioners.

OBJECTIVE: Despite the importance of spoken language in psychotherapy processes with clients whose native language is distinct from the language of therapy, there is a dearth of research on mental health practitioners (MHPs) language competence. This research aimed to develop the Perceptions of Cross-lingual Practice (PCLP) scale designed to aid MHPs' cross-lingual practice. METHOD: Study 1 developed items and collected data from Australian MHPs (n = 155) to test the scale's factor structure through exploratory factor analysis. Study 2 (n = 257) confirmed the emergent factor structure of the scale through confirmatory factor analysis and further assessed its reliability and convergent validity. RESULTS: The final 23-item measure had good reliability and validity. Three factors emerged; MHPs' perceptions of self-competence, MHPs' perceptions of difficulties faced by clients, and MHPs' perceptions of barriers for themselves imposed by language. The perceptions of self-competence subscale was weakly related to the other subscales highlighting a disconnect between MHPs' self-perceptions and perceptions of contextual factors. CONCLUSION: The PCLP is a reliable and valid measure of MHPs' perceptions of cross-lingual practice composed of three subscales each with good psychometric properties that can be used for various purposes in the evaluation and development of MHPs in post-graduate and professional settings.

Perceptions of Barriers: An Examination of Public Health Practice in Kansas.

Public health and healthcare professionals perform a wide variety of services for their communities, and serve in important and often overlapping roles, particularly in rural communities. In this qualitative study, public health practitioners in Kansas were asked about their perceptions of barriers to public health and vulnerable people in their communities. Participants from across Kansas were interviewed via teleconferencing, telephone, or email, and emergent themes were identified using qualitative thematic analysis. While asked about public health specifically, during interviews, many participants discussed barriers to healthcare as well. The top barriers to effective public health practice identified in this study were funding, education, accessibility, and affordability. Others included politics, transportation, and the need to expand Medicare and Medicaid. The populations believed most vulnerable in their communities were community members living in poverty, elderly people, and other marginalized populations. Our findings suggest public health practitioners in Kansas observe a lack of understanding and knowledge in their communities about public health, along with the recognition that a lack of accessibility and affordability to health services are barriers to effective public health practice.

Public healthcare practitioners' knowledge, attitudes and practices related to oral antibiotic prescriptions for dental use in Pietermaritzburg, KwaZulu-Natal.

Background: There is limited published evidence on health workers' perspectives on trends in oral antibiotic prescription for dental conditions in the public health sector. Aim: This study set to determine healthcare practitioners' knowledge, attitudes and practices related to oral antibiotic prescriptions for dental use. Setting: This included two public hospitals in Pietermaritzburg. Methods: This was a cross-sectional study using quantitative data. Purposive sampling was used to select medical and dental practitioners from Institution A and B (n = 122). A self-administered questionnaire was developed using open and close-ended questions. Data were collected and analysed using the Statistical Package for Social Sciences (IBM SPSS version 25R). Results: The response rate for the study was 72.1%. The majority of study participants (n = 72, 81.8%) indicated awareness of an antibiotic stewardship programme in their respective institutions. However, a significant number (n = 42; 47.7%) of participants were unsure of whether this programme was active. Most participants (n = 80, 90.9%) indicated the need for improving oral antibiotic prescription for dental conditions. Participants indicated prescription of antibiotics for orofacial swellings (n = 52; 59.0%) and dental pain related to irreversible pulpitis (n = 29; 32.9%), reversible pulpitis (n = 33; 37.5%) and dental fillings (n = 15; 17.0%). Antibiotics were also prescribed for pericoronitis (n = 58; 65.9%), periodontitis (n = 57; 64.7%) and impacted teeth (n = 21; 23.8%). All dental practitioners (n = 14) supported the need for antibiotic cover for pericoronitis and periodontitis. Conclusion: The results indicated inconsistencies in healthcare practitioners' reported knowledge, attitudes and practices related to antibiotic prescription patterns. Contribution: This study highlights the need for clear evidence-based guidelines for antibiotic prescription for dental conditions.

Evidence for Continuing Professional Development and Recency of Practice Standards for Regulated Health Professionals in Australia: Protocol for a Systematic Review.

BACKGROUND: Continuing professional development (CPD) and recency of practice (ROP) standards are components of health practitioner regulation in Australia. The CPD and ROP standards are currently under review, and an evidence base to assist the development of consistent standards is required. Preliminary searching was unable to find a recent systematic review of the literature to provide an evidence base to underpin the standards review. OBJECTIVE: This paper presents the protocol for a systematic review that aims to develop a current evidence base that will support the National Boards to develop more consistent, evidence-based, effective standards that are clear and easy to understand and operationalize. METHODS: Research questions were developed to support the planned review of CPD and ROP registration standards. Major databases and relevant journals were searched for articles published in English between 2015 and 2021, using key search terms based on previous unpublished reviews of the CPD and ROP registration standards. The quality of the articles retrieved will be assessed using an instrument suitable for use in the development of public policy. The findings will be published in a peer-reviewed journal. RESULTS: In September 2021, our search strategy identified 18,002 studies for the CPD-related research questions after removal of duplicates. Of these, 509 records were screened based on their title, and 66 full-text articles were assessed for eligibility based on their abstract, of which 31 met the inclusion criteria. A further 291 articles were identified as relevant to the ROP research questions. Of these, 87 records were screened based on their title, and 46 full-text articles were assessed for eligibility based on their abstract, of which 8 studies met our inclusion criteria. CONCLUSIONS: This protocol outlines the scope and methodology that will be used to conduct a systematic review of evidence for CPD and ROP and inform a review of the standards for regulated health professionals in Australia. Previous research has shown that while CPD improves practitioner knowledge, the link to public safety is unclear. While there has been a greater focus on maintenance of certification and other quality assurance activities over the past 10 years, there remains great variability in CPD requirements across both professions and jurisdictions. ROP was found to be a poorly researched area with most research concentrating on medical practitioners, nurses, and midwives and no clear consensus about the optimal time period after which retraining or an assessment of competence should be introduced. As the CPD and ROP standards are currently under review, it is timely that a review of current evidence be undertaken. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/28625.

Criminal Convictions of Disciplined Health Practitioners in New Zealand.

This study investigates the rates and types of criminal convictions encountered by New Zealand's Health Practitioners Disciplinary Tribunal (HPDT) over a 15-year period. Criminal convictions appeared in 24% (n = 101) of cases, with male practitioners (p < 0.01) and pharmacists (p < 0.05) being significantly over-represented. The most frequent types of convictions included crimes against rights of property (33.6%), sexual/morality/decency crimes (21.9%) and misuse of drugs (8.4%). Criminal behaviour settings were evenly split between personal and professional life for medical practitioners (56.5% professional life) and nurses (56.5% professional life) but disproportionately in professional life (85%) for pharmacists. Criminal conviction cases were significantly more likely to result in registration cancellation (p < 0.001) and practice suspensions (p < 0.05) when compared with non-criminal cases, although fewer fines were ordered (p < 0.001). Profession-specific risk factors, alongside how to rehabilitate members of the subgroup who may later seek to renew their practice are areas for further research, are discussed.

The Influence of Saudi National COVID-19 Preparedness Programs on Triage Decision-Making Skills of Healthcare Practitioners During the 2020 Peak of the 1st Wave of COVID-19.

Background: As part of the national COVID-19 preparedness efforts in Kingdom of Saudi Arabia to overcome the crisis of the COVID-19 pandemic, emergency rooms' (ERs) health-care providers were required by their health institutions to receive a triage training program (TTP) as well as involving on a disaster preparedness program (DPP) and/or participation in a mock drill towards disaster response. These efforts attempted to enhance skills of ER health-care providers to make triage decisions, and, consequently, improve patient flow in ERs during the COVID-19 pandemic. However, the influence of these hospitals' educational efforts on the decision-making skills of ERs' health-care providers has not yet been reported. Purpose: To identify the effect of hospitals' COVID-19 preparedness educational efforts on triage decisions by ERs' health-care practitioners during the crisis of the COVID-19 pandemic. Methods: A one-group posttest-only design was conducted in ERs of regional hospitals in which Triage Decision-Making Inventory (TDMI) was used to collect data. Results: About 78%, 70% and 78% of participants had taken TTP, DPP or were involved in mock drills, respectively. Skills of triage decision-makers in critical thinking and confidence have higher mean scores than cognitive and intuition skills. A positive relationship was found between TTP and participants' cognitive (p=0.01), critical thinking (p=0.03), confidence (p=0.01) and intuition (p=0.02) skills as pertained to triage decision-making. Also, a positive relationship was found between DPP and cognitive abilities (p=0.04), as well as those involved in mock drills and measures of confidence (p=0.03). Conclusion: TTP may enhance triage decision-making abilities of health-care professionals and contribute in delivering rapid and safe care service during disasters.

Relating to moral injuries: Dutch mental health practitioners on moral injury among military and police workers.

In recent years the concept of moral injury has become a common term to describe the lasting impact of moral transgressions on frontline workers. This article aims to broaden the largely clinical debate by involving the views of a diverse group of mental health practitioners who support military and police personnel in the Netherlands. These practitioners are chaplains, confidential counsellors, social workers, psychologists and integrity officers. How do these practitioners describe the moral injuries of servicemen and police officers and how do they think these should be approached? Through interviews with thirty different practitioners this study shows that definitions of moral injuries diverge considerably. In addition, the article analyses six different approaches to moral injuries. These range from framing moral injury as an exceptional problem that requires specific expertise, to seeing it as a broad issue that places workers in a larger moral community. An analysis of this variety both serves as an indication of possible ways to deal with moral injuries, and as a basis for a critical reflection on the implications of various approaches.