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OBJECTIVES: This study examined the relationship between moral distress, individual and professional values in oncology nurses. METHODS: Employing structural equation modeling, a descriptive-correlational study was conducted among 116 oncology nurses. Data were collected using the Moral Distress Scale-Revised Adult Nurses, the Nursing Professional Values Scale, and the Values Scale. RESULTS: The mean moral distress frequency was evaluated as low (1.6 ± 0.7) and the intensity as moderate (1.9 ± 0.8). Both the Nursing Professional Values Scale and Values Scale subdimension mean scores were at levels evaluated as high. There was no specific value that stood out from the others. Structural equation modeling analysis showed that individual values were found to have a direct and negative significant effect on moral distress intensity (ß = -0.70, p < 0.01) and frequency (ß = -0.58, p <0.01) and professional values had a direct positive and significant effect on moral distress intensity (ß = 0.37, p < 0.05) and frequency (ß = 0.25, p < 0.05). SIGNIFICANCE OF RESULTS: It is believed that more national and international studies need to be conducted to examine the relationship between the moral distress concept and values. While individual values were found to have a direct and negative significant effect on moral distress, professional values had a direct positive and significant effect on moral distress.
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Princípios Morais, Enfermeiras e Enfermeiros, Adulto, Humanos, Estresse Psicológico/complicações, Atitude do Pessoal de Saúde, Estudos Transversais, Inquéritos e QuestionáriosRESUMO
Anatomical pathology (AP) is an anatomy-centric medical specialty devoted to tissue-based diagnosis of disease. The field faces a current and predicted workforce shortage, likely increasing diagnostic wait times and delaying patient access to urgent treatment. A lack of AP exposure is proposed to preclude recruitment to the field, as medical students are afforded only a limited understanding of who a pathologist is and what they do (their professional identity/PI and role). Anatomical sciences educators may be well placed to increase student understanding of anatomical pathologists' PI features, but until features of anatomical pathologists' PI are understood, recommendations for anatomy educators are premature. Thus, this scoping review asked: "What are the professional identity features of anatomical pathologists reported in the literature, and how have these changed over time?" A six-stage scoping review was performed. Medline and PubMed, Global Health, and Embase were used to identify relevant studies (n = 74). Team-based framework analysis identified that features of anatomical pathologists' professional identity encompass five overarching themes: professional practice, views about the role, training and education, personal implications, and technology. Technology was identified as an important theme of anatomical pathologists' PI, as it intersected with many other PI feature themes, including diagnosis and collaboration. This review found that pathologists may sometimes perceive professional competition with technology, such as artificial intelligence. These findings suggest unique opportunities for integrating AP-specific PI features into anatomy teaching, which may foster student interest in AP, and potentially increase recruitment into the field.
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Anatomia, Estudantes de Medicina, Humanos, Patologistas, Inteligência Artificial, Anatomia/educação, Atitude do Pessoal de Saúde, Recursos HumanosRESUMO
PURPOSE: We sought to describe factors influencing reduced rates of obesity screening for patients with spinal cord injury (SCI) in the United States Veterans Health Administration (VA) and to foster potential solutions. MATERIALS AND METHODS: Semi-structured interviews with healthcare providers and patients with SCI who were recruited nationally from diverse VAs. We performed rapid qualitative analysis using content analysis of interview data. RESULTS: There were 36 providers and 37 patients. We identified provider, patient, and system level barriers to obesity screening for individuals with SCI. Overarching barriers involved provider and patient perceptions that obesity screening is a low priority compared to other health conditions, and body mass index is of low utility. Other obesity screening barriers were related to measuring weight (i.e., insufficient equipment, unknown wheelchair weight, staffing shortages, measurement errors, reduced access to annual screening, insufficient time, patient preference not to be weighed) and measuring height (i.e., insufficient guidance and equipment to this population, measurement errors). CONCLUSIONS: Barriers to obesity screenings exist for patients with SCI receiving care in VA. Healthcare provider and patient interviews suggest possible solutions, including standardizing height and weight measurement processes, ensuring equipment availability in clinics, clarifying guidelines, and offering support to providers and patients.IMPLICATIONS FOR REHABILITATIONIndividuals with spinal cord injury (SCI) have higher rates of obesity, but are often overlooked for annual obesity screening, even in clinic settings designed to care for individuals with SCI.Results may help tailor guidelines/education for healthcare and rehabilitation providers offering them guidance for improving obesity screening for individuals with SCI by standardizing weight and height measurement and documentation. To facilitate this, findings highlight the need for resources, such as ensuring clinics have necessary equipment, and increasing patient access to support and equipment.Improving the provision of obesity screening for individuals with SCI is necessary to improve health outcomes and patient satisfaction with care.
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Traumatismos da Medula Espinal, Saúde dos Veteranos, Humanos, Pesquisa Qualitativa, Pessoal de Saúde, Atitude do Pessoal de SaúdeRESUMO
The purpose of this study is to advance theory concerning the experiences of couples and therapists involved in online couple therapy and the meanings they assign to them, with a particular focus on the therapeutic alliance. Using constructivist grounded theory methodology, in-depth semi-structured online interviews were conducted with 36 individuals, including 18 couples who had participated in online couple therapy via videoconference. Additionally, 15 couple and family therapists were interviewed in four online focus groups. Our analysis indicates three dimensions that impact the formation of the therapeutic alliance in online couple therapy: (1) emotional closeness, as a conduit for establishing physical or emotional space; (2) limited care, due to the therapist's difficulty providing comfort and security; and (3) body language, as reflected in the lack of physical presence and the close inspection of the face, at two opposite ends of a continuum. We discuss our findings through the lens of the closeness-distance dynamic, which posits that therapists' ability to regulate themselves depends on their clients' emotional needs. We conclude with implications for clinical practice.
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Terapia de Casal, Aliança Terapêutica, Humanos, Relações Profissional-Paciente, Terapia de Casal/métodos, Emoções, Atitude do Pessoal de SaúdeRESUMO
To examine the knowledge, behavior, and attitudes toward medical genetics among obstetrics and gynecology, pediatrics, and neurology residents and specialists, who encounter the highest number of patients with specific genetic disorders, in their everyday practice. The cross-sectional study involved 182 nongenetic residents and specialists in the Republic of Croatia, who completed a validated online questionnaire anonymously and voluntarily. The questionnaire consisted of five groups of questions: general information, knowledge, behavior in practice, attitude toward genetic testing, and additional education in medical genetics. The median score for overall knowledge of medical genetics was 70.2% among obstetrician-gynecologists, 80.5% among pediatricians, and 76.7% among neurologists (Pâ¯< 0.001, lowest median in obstetrician-gynecologists). When asked about their behavior in daily practice, around 90% of respondents admitted the possibility of not recognizing patients with genetic disorders, which is why more than 90% emphasized the need for additional education in medical genetics. In addition, the respondents showed a positive attitude toward genetic testing, but they did not feel educated enough to interpret the results of genetic testing. The results highlight the need for further genetic education of non-genetic health professionals, which would lead to greater confidence and ability to recognize patients with genetic disorders, select the appropriate genetic testing method and achieve more efficient communication with patients.
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Genética Médica, Ginecologia, Obstetrícia, Médicos, Feminino, Gravidez, Humanos, Criança, Conhecimentos, Atitudes e Prática em Saúde, Estudos Transversais, Inquéritos e Questionários, Atitude do Pessoal de SaúdeRESUMO
AIM: The aim of this study was to investigate the knowledge, attitudes, and behaviors of dysphagia clinicians regarding oral health care. METHODOLOGY AND RESULTS: An 11-question and 37-statement survey inquiring the clinicians' descriptive information, knowledge, attitudes, and behaviors related to oral health was administered via Google forms. A total of 234 dysphagia clinicians responded on behalf of themselves. The findings showed that 41.5% (n = 97) of the clinicians had a high level of knowledge about oral health. There was a significant relationship between the level of oral health knowledge and the clinicians' oral health education (p < .05). A percentage of 6.4 (n = 15) of the clinicians had a high level of attitude toward oral health. Oral health education status of clinicians and their profession was significantly related to the attitude toward oral health (p < .05). Most of the clinicians (44.0%, n = 103) had low behavior level. The level of behavior was significantly associated with status of receiving oral health education, their professions, duration of experience, and institution (p < .05). CONCLUSIONS: The study showed that clinicians exhibit moderate mean knowledge, attitudes, and behaviors scores, and these states are significantly associated with oral health education. This can serve as a stimulus for clinicians caring for dysphagia patients to receive oral health education during their university education.
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Transtornos de Deglutição, Saúde Bucal, Humanos, Conhecimentos, Atitudes e Prática em Saúde, Higiene Bucal, Inquéritos e Questionários, Atitude do Pessoal de SaúdeRESUMO
OBJECTIVES: To address the following research questions: (i) What is the current situation and future vision on oral healthcare service in nursing homes (NHs) in Singapore? (ii) What are the enablers to achieve the future vision? (iii) How do views differ between dentists with and without clinical experiences in NHs? BACKGROUND: Oral healthcare services in NHs need to reflect the perspectives of a diverse range of stakeholders and establish shared goals, however there is scarce evidence of in-depth dentists' insights. MATERIAL AND METHODS: Dentists were purposively recruited. Focus group discussions with 4-5 participants each were conducted via teleconferencing. Data were analysed thematically. RESULTS: The participants (n = 19, median 36.0 years) recognised the need of comprehensive reform of the oral healthcare paradigm in NHs: symptomatic care to preventive care, disease-oriented care to person-centred care and more active collaborative care. Overall, five domains of enabling factors emerged: (1) to improve general system of oral healthcare in NHs, (2) to increase the number of dentists engaging in NHs, (3) to improve the quality of dental practice, (4) to improve the quality of daily oral care and (5) to promote seniors' cooperative attitude to oral healthcare. There was a noticeable difference in the perception on how to encourage dentists to serve in NHs. CONCLUSION: There is a need for a comprehensive reform of the oral healthcare paradigm for seniors in NHs in Singapore. A multi-tiered strategy using both top-down and bottom-up approaches is required.
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Atenção à Saúde, Casas de Saúde, Humanos, Singapura, Grupos Focais, Odontólogos, Atitude do Pessoal de SaúdeRESUMO
OBJECTIVE: We aimed to capture General Dental Practitioners' (GDPs) views on delivering dietary advice to older adults in combination with treatment to replace missing teeth and identify solutions to help inform the development and implementation of future dietary interventions within primary dental care. BACKGROUND: As natural teeth are lost, older adults may need to choose softer, more manageable foods which might be of lower nutrient density. Previous research has indicated that prosthodontic rehabilitation can improve masticatory function but not the intake of nutrients, highlighting a potential need for a combined approach of oral rehabilitation and dietary counselling. MATERIALS AND METHODS: Semi-structured telephone interviews were conducted with a purposive sampling strategy of 12 GDPs. Interviews were digitally recorded and transcribed verbatim. An iterative coding process using theme-analytic methods was used. RESULTS: Twelve interviews were conducted with GDPs in the United Kingdom. The themes that emerged from the interviews included: the awareness of the importance of dietary advice among GDPs; the concerns GDPs had on patients' adherence to dietary advice; uncertainty over roles and responsibilities in the provision of dietary advice; and the limited time and remuneration for dietary advice in dental practice. A minor theme identified was the motivation of GDPs to implement dietary advice alongside oral rehabilitation. All reported that they were already providing dietary advice to their patients but that this was limited to caries prevention. CONCLUSION: The GDPs interviewed expressed positive attitudes towards providing dietary advice alongside oral rehabilitation for older adults. However, a lack of confidence, awareness, time and remuneration are barriers to its provision in primary dental care. To facilitate the implementation of dietary advice alongside oral rehabilitation, clear guidance on and training in delivering dietary advice and multidisciplinary cooperation are required.
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Cárie Dentária, Odontólogos, Humanos, Idoso, Atitude do Pessoal de Saúde, Papel Profissional, Aconselhamento, Cárie Dentária/prevenção & controle, Odontologia GeralRESUMO
BACKGROUND: Nurses are in a unique position to achieve the Sustainable Development Goals, and to prevent and intervene in climate change. Determining nursing students' levels of attitudes and knowledge on this subject is important in determining the content of nursing education programs. OBJECTIVES: To determine the nursing students' attitudes towards sustainable development and their knowledge of climate change, and to identify determinants associated with these parameters. DESIGN: A descriptive and correlational design was used. SETTINGS: National Student Nurses' Association in Turkey. PARTICIPANTS: The sample of study consisted of 481 nursing students who were members of the National Student Nurses' Association. METHODS: Data were collected online with the descriptive characteristics' questionnaire, the Attitudes Towards Sustainable Development Scale, and the Climate Change Knowledge Test. We used Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation analysis to analyze the data obtained from the scales. RESULTS: The participants' mean sustainable development attitude score was 82.61 ± 12.69 and mean climate change knowledge score was 6.47 ± 1.44. There was a relationship between the sustainable development attitude and the variables such as gender, grade, warning people around them to be sensitive about environmental pollution, following the news about environmental problems, taking precautions about sustainable development and climate change in daily life, and receiving education about sustainable development and climate change in the nursing education. There was a relationship between climate change knowledge and the variables such as gender, grade, membership in an environmental organization, method of keeping up with environmental issues, and receiving education on sustainable development and climate change in nursing education. CONCLUSION: Although the students displayed favorable attitudes towards sustainable development at a good level, their knowledge of climate change was not adequate. Thus, we recommend that sustainable development and climate change issues should be integrated into nursing education curricula to improve students' attitudes towards and knowledge and awareness of sustainable development and climate change.
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Bacharelado em Enfermagem, Estudantes de Enfermagem, Humanos, Desenvolvimento Sustentável, Turquia, Mudança Climática, Atitude, Inquéritos e Questionários, Atitude do Pessoal de SaúdeRESUMO
While carers' vulnerability has often been neglected in the literature, the recent COVID-19 pandemic brought this issue to the fore. This article explores why it has been so often ignored and how could it be dealt with differently. It does so in the form of a philosophical and conceptual investigation illustrated by various examples and situations, related primarily, but not exclusively, to the COVID period. Criticising a property-based view, and based on examples of carers' vulnerability during the pandemic, our investigation suggests that carers' vulnerability is relationally constructed and played out on multiple interwoven dimensions that may contradict each other. Our examples also suggest that the relational construction of vulnerabilities is socially and organisationally mediated, calling for the development of social and organisational forms of mediation that may help carers deal with their vulnerabilities. Second, and rather counterintuitively with regard to the COVID-period, we question the negative valence usually associated with vulnerability and analyse how this affects ways of dealing with carers' vulnerabilities and the co-creation of care. Finally, following Gilson (2014), we propose an ambivalent, relational conception of vulnerability, considered as 'openness to affectation by' and offer some theoretical and practical implications. Theoretically, this conception also allows us to consider such openness as an ability that may nurture carers' 'response-ability'. It also allows us to develop specific relational ethics for and in care relationships. Practically, this re-conceptualisation may help carers better embrace and process their vulnerabilities, including responses to negative affectations following exposure to carees. It may also facilitate their 'reception' of carees, and help co-create and adapt responses to carees' calls, thus avoiding paternalistic responses.
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Cuidadores, Pandemias, Humanos, Atitude do Pessoal de SaúdeRESUMO
BACKGROUND: Effective neonatal pain management is reliant upon the expert care of nurses and midwives working in neonatal intensive care units (NICUs). Previous research has explored barriers, facilitators, and some aspects of nurse competence in managing neonatal pain; however, this research has been predominantly performed in Western countries. To date, little is known about the barriers, facilitators, and perceived competence of Thai nurses and midwives in relation to neonatal pain management in NICUs. Exploring Thai nurses' and midwives' perceptions in these areas is crucial for understanding the contextual nuances of neonatal pain management, which can guide the provision of care for these high-risk neonates. PURPOSE: To investigate nurses' and midwives' perceptions of barriers, facilitators, and competence regarding effective neonatal pain management in Thai NICUs. METHODS: Data were collected using virtual one-to-one, semistructured interviews with 12 neonatal nurses and midwives between July and August 2021 in 3 units of 2 tertiary hospitals in Southern Thailand. Inductive thematic analysis was used to examine interview data. RESULTS: These data revealed following 3 major themes: ( a ) barriers to effective neonatal pain management, ( b ) facilitators of effective neonatal pain management, and ( c ) perceptions of competence. IMPLICATIONS FOR PRACTICE: Assisting nurses and midwives in overcoming barriers and strengthening facilitators while enhancing their competence may result in better neonatal pain management. IMPLICATIONS FOR RESEARCH: This study adds to our understanding that further research is needed to develop the interventions designed to change at individual, unit, and organizational levels, particularly implementing parent-friendly visitation and ongoing professional development in neonatal pain management.
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Tocologia, Enfermeiros Neonatologistas, Gravidez, Recém-Nascido, Humanos, Feminino, Manejo da Dor, Tailândia, Atitude do Pessoal de Saúde, Pesquisa QualitativaRESUMO
INTRODUCTION: Obesity bias exists in healthcare professionals and students from numerous disciplines and negatively impacts the quality of care, outcomes, engagement, and satisfaction of their patients. With obesity rates continuing to rise in the United Kingdom (UK), more patients will be affected than ever, and it is becoming an increasingly important issue to tackle. This study aims to assess the attitudes to obesity of student diagnostic radiographers and determine if obesity bias exists in this population. METHOD: Student radiographers (n = 140) at a single university in the UK were invited to complete an online survey comprising measures designed to assess levels of bias and attitudes towards obesity, including the Attitude Towards Obese Persons (ATOP) scale. Likert-type scales were used to collect quantitative data, and data analysis included descriptive statistics, frequencies, and Spearman's rank correlation coefficient. RESULTS: Responses were received from n = 38 students. The mean ATOP score for participants was 70.37 (SD = 19.26). With 26 % (n = 10) scoring below 60, demonstrating strong negative attitudes towards obese individuals. Additionally, students (76.3 %; n = 29) indicated that they observed high levels of obesity bias whilst on clinical placement. There was a statistically significant correlation between levels of weight bias and students' confidence in working with obese patients (r(36) = 0.4, p 0.01). Students who are less confident working with obese patients had higher levels of obesity bias. CONCLUSIONS: Obesity bias exists in radiography students at levels comparable to those that have been found previously in other healthcare professionals and students. Furthermore, radiography students lacked confidence in their technical ability to work with obese patients and lower confidence levels were associated with higher levels of obesity bias. IMPLICATIONS FOR PRACTICE: The findings of this study provide preliminary knowledge upon which future research can be built.
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Preconceito de Peso, Humanos, Atitude do Pessoal de Saúde, Obesidade, Estudantes, RadiografiaRESUMO
AIMS AND OBJECTIVE: To evaluate the attitudes of Indian nurses towards the importance of family involvement in nursing care and the association between nurse attitudes and sociodemographic characteristics. BACKGROUND: Involving the family in the care process is crucial for delivering family- and patient-centred care and ensuring the best possible patient outcomes. Nevertheless, published literature revealed that the nurses may lack clarity regarding the role of family members in the patient's care, which in turn hinders families' participation in care. DESIGN: Cross-sectional descriptive study. The STROBE checklist was used to report the present study. METHODS: A total of 203 Nurses participated in a prospective cross-sectional study between May 2022 and August 2022. They were recruited through convenience sampling from two tertiary care centres in India. A two-part questionnaire was used to gather the data; the first section contained questions for gathering sociodemographic information, and the second part contained the standardized FINC-NA scale. RESULTS: The mean age of the nurses was (28.08 ± 4.722) years, and their median professional experience was 2.5 (1-5.5) years. Nurses' attitude regarding family's importance in patient care was found to be significantly associated (p ≤ .05) with education level, marital status, religion and hometown region. CONCLUSION: In several items Indian nurses have positive attitudes towards family involvement in care but some of the lower scoring items can present opportunities for focused improvement. Continuing development programmes about family-centered care can constitute important strategies to improve the positive attitudes of nurses towards families in practice. PATIENT AND PUBLIC CONTRIBUTION: No patient or public contribution.
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Enfermeiras e Enfermeiros, Cuidados de Enfermagem, Humanos, Adulto Jovem, Adulto, Estudos Transversais, Atitude do Pessoal de Saúde, Estudos Prospectivos, Relações Profissional-Família, Inquéritos e QuestionáriosRESUMO
OBJECTIVE: The study's objective was to explore Filipino physical therapists' views on social responsibility and the competencies it entails. METHODS: This study employed a constructivism-based qualitative design to inquire into the perspectives of physical therapist leaders and practitioners in the Philippines on Filipino physical therapists' social responsibility. Leaders were invited for their macro perspectives and influence on the profession; practitioners were invited to provide more practical viewpoints. Participants were interviewed one-on-one online. Interviews were transcribed, translated to English, and subjected to thematic analysis. RESULTS: Sixteen participants agreed to share their perspectives. Six themes were generated. Participants viewed the social responsibility of physical therapists in the Philippines as a professional duty that requires altruistic and social justice motivations. Socially responsible actions should address pressing issues affecting Filipino people's access to physical therapy and experience of health. CONCLUSION: The social responsibility of physical therapists in the Philippines entails engaging in roles aside from clinical practice to contribute to Filipino people's attainment of health. This calls for the expansion of their ethical and practice frameworks to include addressing not only client issues, but also the wider societal barriers to equitable access to physical therapy and better experiences of health. IMPACT: This study contributes to professional discourse on the increasing importance of social responsibility in the physical therapist profession amidst increasing rehabilitation needs and growing concerns on health inequity locally and globally, especially as worsened by the novel coronavirus disease (COVID-19) pandemic. It informs the development of a societal practice framework for physical therapists in the Philippines and the desired changes in physical therapist policies and education to facilitate fulfillment of their societal obligations.
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Fisioterapeutas, Responsabilidade Social, População do Sudeste Asiático, Humanos, Filipinas, Fisioterapeutas/educação, Pesquisa Qualitativa, Atitude do Pessoal de SaúdeRESUMO
OBJECTIVE: This study aimed to explore nurse leader attitudes and beliefs about medical errors. BACKGROUND: The perfectibility model suggests errors are avoidable if nurses are trained and follow safety guidelines. This impacts how nurse leaders approach medical errors. Nurse leaders (NLs) may be the first person to whom a nurse reports an error. Leaders support nurses through the investigation process and subsequent recovery. METHODS: A cross-sectional quantitative study was conducted to determine NL attitudes toward medical errors using the Medical Error Attitude Scale (MEAS). RESULTS: MEAS scores were high in all categories. Medical error perception was significant for NLs with institutional support programs and when compared with job titles. Medical error approach and perception were significant for NLs with direct reports who had committed a medical error. CONCLUSION: This study provides insight into NLs' views on medical errors, awareness of NLs who have had nurses involved in medical errors, and formal caregiver support programs.
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Atitude do Pessoal de Saúde, Erros Médicos, Humanos, Estudos Transversais, Inquéritos e QuestionáriosRESUMO
BACKGROUND: Sexual and gender minorities (SGM) encompass individuals identifying as lesbian, gay, bisexual, transgender, and queer (LGBTQ). SGM patients experience difficulties in accessing healthcare and may face discrimination, impacting their overall health outcomes. Enhancing healthcare professionals' knowledge is the initial step in dismantling these barriers. MATERIALS AND METHODS: The study has been conducted on the neurologists of the Italian Society of Neurology (SIN). We utilized a survey instrument comprising 24 Likert-type questions to investigate knowledge, attitudes, and practices concerning sexual orientation and gender identity minorities. Likert scales were assessed with scores 1 and 2 as negative response, 3 as neutral, and 4 and 5 as positive responses. RESULTS: A total of 177 neurologists (103 women; 58.2%) participated, with a mean age of 44.3 ± 14.6 years answered the survey. Over half recognized sexual and gender orientation as social determinants of health, yet only a minority acknowledged the elevated prevalence of physical and mental health issues in SGM populations. Nearly, all respondents felt confident in examining a sexual minority patient, while only half felt the same regarding transgender patients. The majority of neurologists expressed a need for more comprehensive training and supervision in treating SGM patients. CONCLUSION: To enhance healthcare quality for SGM populations, healthcare professionals must receive appropriate training in how to approach, assess, and treat patients within this demographic.
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Identidade de Gênero, Minorias Sexuais e de Gênero, Humanos, Feminino, Masculino, Adulto, Pessoa de Meia-Idade, Neurologistas, Conhecimentos, Atitudes e Prática em Saúde, Atitude do Pessoal de Saúde, Comportamento Sexual, Inquéritos e Questionários, ItáliaRESUMO
BACKGROUND: The recent passage of the Mainstreaming Addiction Treatment (MAT) Act could increase the number of patients seeking to fill buprenorphine prescriptions at community pharmacies; however, multiple barriers limit community pharmacists' ability and willingness to dispense buprenorphine. We assess whether a brief online buprenorphine training program (Buprenorphine Understanding in the Pharmacy Environment) improves community pharmacists' outcomes, including willingness to dispense buprenorphine. METHODS: A convenience sample of practicing community pharmacists participated in a 30-minute buprenorphine training. The training was codeveloped with pharmacy advisors and presented solutions to common buprenorphine dispensing barriers. Participants completed a pretest and posttest that assessed their buprenorphine knowledge (5 multiple-choice items based on training content), self-efficacy to engage in various buprenorphine-related behaviors (7 items), buprenorphine attitudes (8 items), and willingness to dispense buprenorphine to 4 different types of customers. Descriptive statistics were calculated, and paired-samples t tests were used to evaluate the impact of the training on pharmacist outcomes. RESULTS: Of 266 individuals who accessed the pretest, 104 responses were included in the analysis (response rate, 39%). Buprenorphine Understanding in the Pharmacy Environment improved pharmacists' mean buprenorphine knowledge scores (pretest, 2.2; posttest, 3.5; P < 0.001), all 7 self-efficacy items (all P < 0.001), mean buprenorphine attitudes (pretest, 3.1; posttest, 3.4; P < 0.001), and willingness to dispense to all four types of buprenorphine customers (all P < 0.01). CONCLUSIONS: A brief buprenorphine training increased pharmacists' willingness to dispense buprenorphine. Although generalizability of the results may be limited by use of a convenience sample, our pharmacist-oriented training showed promising results and may be an important step in increasing availability of buprenorphine in community pharmacies.
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Buprenorfina, Assistência Farmacêutica, Farmácias, Humanos, Buprenorfina/uso terapêutico, Farmacêuticos, Atitude do Pessoal de SaúdeRESUMO
Service providers have a unique understanding of older homeless adults' challenges and service needs. However, research on the experiences of health care providers (HCPs) who work with this population is limited. We aimed to gain a better understanding of the experiences (roles, challenges, and rewards) of HCPs who work with older homeless adults (age 50 and over) in outreach settings. We conducted individual semi-structured interviews with 10 HCPs who worked in these roles. Four themes emerged: (a) the client-provider relationship as an essential building block to HCPs' work; (b) progression of care that acknowledges the "whole person"; (c) collaboration as integral to providers' work; and (d) the importance of system navigation. Providers found their work personally and professionally fulfilling but were frustrated by system-level challenges. Findings can be used to identify strategies on how to further support providers in their roles and enhance service provision for older homeless individuals.
