RESUMEN

Purpose: To provide real-world data on patient perceptions and experiences with subcutaneous (SC) versus intravenous (IV) daratumumab. Patients and Methods: This was a cross-sectional, mixed-method (qualitative/quantitative) survey conducted in France, Germany, Spain and the United Kingdom involving multiple myeloma (MM) patients who switched from IV to SC daratumumab in the last 12 months (qualitative phase) or 24 months (quantitative phase [26 months in the UK]) prior to enrollment in the study. Results: Nine patients (mean age 65 years) participated in the qualitative phase and 113 patients (mean age 65.1 years) in the quantitative phase. Qualitative study results provided insights for the quantitative study and highlighted the benefits of switching from daratumumab IV to daratumumab SC as an improvement and a satisfactory change in patients' treatment journey. Quantitative survey showed that patients were significantly less anxious, stressed and nervous before SC injections than IV infusions (mean score: 1.3, 1.1, 1.4 versus 2.1, 2.0, 2.0 respectively, p<0.001), and significantly more reassured, ready/well-prepared, usual self and relieved (mean score: 3.8, 4.3, 3.7, 3.6 versus 3.0, 3.6, 3.1, 3.0 respectively, p<0.001). Immediately after SC first injection, 96.5% patients were feeling well or very well versus 77.9% immediately after IV first infusion (p<0.001). 97.3% patients were satisfied with their SC treatment versus 89.4% for the IV injection (p<0.001). Patients spent significantly less time in hospital for an SC injection of daratumumab than for an IV infusion, 1.5 hours and 5.0 hours respectively (p<0.001). In the UK, the differences between the two administration forms were less visible, likely because of confounding factors including a longer time passed since the switch from the IV to the SC form and administration of the survey. Conclusion: In line with results from other studies, the SC form of daratumumab had less impact on patients' emotional burden than the IV form.

RESUMEN

Introduction: The COVID-19 pandemic has affected nearly every facet of life, constituting a "new normal" and prompting an ongoing collective psychological crisis. People's ways of coping with the pandemic and corresponding well-being are of particular research interest; however, these constructs have largely been examined using deductive quantitative approaches, deficit-based lenses, and mononational samples. Methods: The current mixed-methods study used inductive-sequential (QUAL → QUAN) approaches to explore positive coping strategies (approach coping style and COVID-related connection appraisal) and well-being (loneliness, distress, and happiness) across individuals from the United States, Japan, and Mexico. Qualitative data were gathered from N = 141 U.S., Japanese, and Mexican adults to examine how people perceived connection during the pandemic. Results: Qualitative analyses illuminated common themes in which people appraised the pandemic as an opportunity for connection and strengthened interpersonal relationships. Quantitative measures, including a newly-developed questionnaire on COVID-related connection appraisal, were then administered to a separate sample of N = 302 adults in the U.S, Japan, and Mexico to assess associations among approach coping style, COVID-related connection appraisal, and well-being outcomes (loneliness, distress, happiness). Quantitative analyses found significant associations among approach coping style, COVID-related connection appraisal, and all well-being outcomes. Of note, these associations did not differ by country. COVID-related connection appraisal mediated the relationship between approach coping style and two well-being outcomes (loneliness and happiness). Discussion: Findings point to approach coping style and connection appraisal as pathways for resilience and growth in the face of global suffering.

RESUMEN

Introduction: Healthcare workers (HCWs) are on the frontline of infections. To safeguard HCWs from occupational exposure to infections and to curb nosocomial infection a set of vaccines has been recommended for them by the WHO. Hence, we aimed to assess the vaccination status, awareness, and its correlates amongst HCWs in the Delhi-NCR. Method: The study used a cross-sectional mixed-method approach from January to April 2023. For the quantitative arm, a structured questionnaire was circulated to the participants in conveniently-selected private and government tertiary care hospitals of the Delhi-NCR, both through e-survey using Google form, and in person, data were collected on socio-demographics, vaccination status, and awareness. SPSS version 25 was used for the analysis. For the qualitative arm, in-depth interviews were conducted and data were analyzed manually. Results: Out of 387 participants (62.8% males, 37.2% females), the awareness about the vaccines recommended for HCWs was 64.1%. However, only 15.3% of HCWs were completely aware of all the recommended vaccines. SARS CoV-2, Polio, Hepatitis B, and BCG had the highest vaccination coverage, 97.4%, 87.9%, 83.7%, and 50.9%, respectively. It was found that gender, education, type (private or governmental) of tertiary care hospital, and profession had a significance (p<0.05) on the vaccination status score and awareness of all WHO-recommended vaccines (AOR=7.6, 95% CI, 3.24-18.0). The qualitative arm further augmented the findings. Conclusion: The study reveals insufficient awareness and vaccination status regarding recommended vaccines. Prioritizing the preparation of unified standard guidelines for Indian HCWs and involving concerned stakeholders is crucial.

RESUMEN

AIM: To conduct a comprehensive review of Undergraduate Nursing and Midwifery Curricula leading to registration in Ireland. DESIGN: A mixed methods approach using a curriculum evaluation framework that was underpinned by the philosophy and principles of appreciative inquiry. METHODS: Five separate workstreams completed an evaluation of national policy documents and international curriculum documents, a literature review and two phases of stakeholder engagement including a graduate survey and peer-grouped stakeholder focus groups. The workstreams were emulated for the professions of nursing and midwifery. RESULTS: National policy indicates a significant shift in healthcare delivery to the community environment, with a strong focus on the social determinants of health and a flexible interprofessional workforce. International curricula review revealed that nursing and midwifery education was split equally between academia and clinical practice at bachelor's degree level. Graduates were assessed for clinical competence with a variance of four to seven domains of competence evident for nurses and five principles for midwives. Direct entry midwifery was not widely available. The graduate survey identified that students were satisfied with the academic components of the curriculum; however, significant challenges in clinical placement were reported. Stakeholder focus groups reported a need for a learner-focused approach to the curricula, increased access to education, a deeper understanding and appreciation of the various roles required to educate nurses and midwives and a recognition of midwifery as a separate profession. CONCLUSION: There is a need for a significant revision of the current nursing and midwifery curricula to meet the future healthcare needs of the diverse patient population with a community-focused delivery. REPORTING METHOD: The good reporting of a mixed methods study was used to guide the development of this manuscript. PATIENT OR PUBLIC CONTRIBUTION: An Expert Advisory Group (EAG) was appointed to oversee the conduct of the research project and advise the research team as requested. There were five service user representatives included in the membership of the EAG. This included one representative from each of the divisions of the nursing and midwifery register in Ireland. A separate stakeholder engagement focus group was also conducted for the research upon the request from the service users.

RESUMEN

BACKGROUND: Research identified preliminary evidence that artificial intelligence (AI) has emerged as a transformative force in healthcare, revolutionising various aspects of healthcare delivery, from diagnostics to treatment planning. However, integrating AI into healthcare systems in Egypt is challenging, particularly concerning healthcare professionals' acceptance and adoption of these technologies. This mixed-method study aimed to explore the sentiment of nurses at different organisational levels towards AI and resistance to change in healthcare organisations. METHODS: A mixed-method design was employed, with quantitative data collected through a survey of 500 nurses using the general attitudes towards AI and resistance to change scale and qualitative data from semi-structured interviews with 17 nurses. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed thematically. RESULTS: The survey demonstrated that positive attitudes were inversely correlated with resistance behaviour and resistance to change. Additionally, perceptions of AI's usefulness, ease of use and value were strongly and positively correlated with positive attitudes and negatively correlated with negative attitudes. Moreover, the influence of colleagues' opinions, self-efficacy for change and organisational support showed significant positive correlations with positive attitudes towards AI and negative correlations with negative attitudes. Qualitatively, nurses cited obstacles such as lack of familiarity with AI technologies, biases affecting decision-making, technological challenges, inadequate training and fear of technology replacing human interaction. Readiness for AI integration was associated with the necessity of training and the timing of AI use. CONCLUSION: Nurses demonstrated varied understanding of AI's applications and benefits. Some acknowledged its potential for efficiency and time-saving, while others highlighted a need for up-to-date knowledge. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

RESUMEN

BACKGROUND: The digital transformation in health care requires training nursing and health professionals in the digitally competent use of digital assistive technologies (DAT). The continuing education training "Beratende für digitale Gesundheitsversorgung" ("Consultant for Digital Healthcare") was developed to fill this gap. The effectiveness of the training program will be assessed in this study. OBJECTIVE: The primary objective is to record and measure the participants' learning success. We will assess whether the previously defined teaching intentions, learning objectives, competencies, and participants' expectations have been achieved and whether a transfer of learning occurred. The secondary objective is participant satisfaction and feasibility of the training. The tertiary objective is the successful transfer of DAT by participants in their institutions. METHODS: Approximately 65 nursing and health care professionals will participate in the pilot phase of the further training and evaluation process, which is planned in a mixed methods design in a nonsequential manner. The different methods will be combined in the interpretation of the results to achieve a synaptic view of the training program. We plan to conduct pre-post surveys in the form of participant self-assessments about dealing with DAT and content-related knowledge levels. Exploratory individual interviews will also be conducted to build theory, to examine whether and to what extent competence (cognition) has increased, and whether dealing (affect) with DAT has changed. Furthermore, an interim evaluation within the framework of the Teaching Analysis Poll (TAP) will occur. The knowledge thereby gained will be used to revise and adapt the modules for future courses. To assess the transfer success, the participants create a practical project, which is carried out within the training framework, observed by the lecturers, and subsequently evaluated and adapted. RESULTS: We expect that the learning objectives for the continuing education training will be met. The attendees are expected to increase their level of digital competence in different skills areas: (1) theoretical knowledge, (2) hands-on skills for planning the application and practical use of DAT, (3) reflective skills and applying ethical and legal considerations in their use, (4) applying all that in a structured process of technology implementation within their practical sphere of work. CONCLUSIONS: The aim of this study and appropriate further training program are to educate nursing and health care professionals in the use of DAT, thereby empowering them for a structured change process toward digitally aided care. This focus gives rise to the following research questions: First, how should further training programs be developed, and which focus is appropriate for addressee-appropriate learning goals, course structure, and general curriculum? Second, how should a training program with this specific content and area be evaluated? Third, what are the conditions to offer a continued program? INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/57860.

Asunto(s)

RESUMEN

BACKGROUND: In Senegalese high-burden regions, the existing package of interventions is insufficient to reach the malaria elimination goal. Asymptomatic carriers of Plasmodium contribute significantly to malaria persistence and are not targeted by current interventions. The systematic treatment of all individuals in a community (mass drug administration, MDA) is a relevant intervention to tackle asymptomatic infections. The intervention can only be effective with a high participation of the population and, therefore, depends largely on its acceptability. This study aims to investigate the prospective acceptability of MDA in the Kedougou region to inform its potential use in a future strategy. METHODS: Following a 7-construct theoretical framework, prospective acceptability of MDA implemented in the rainy season was studied. In four villages, a sequential mixed design, from qualitative to quantitative, was used. In November 2021, interviews with healthcare professionals and focus groups with villagers were conducted. Findings from thematic analysis informed the development of a questionnaire administered to individuals aged ≥ 15 years in March 2022. Based on the questionnaire, an acceptability score was constructed and associations with socio-demographic factors were investigated using a linear mixed model. RESULTS: The 7 interviews, the 12 focus groups, and the questionnaire administered to 289 individuals demonstrated a good acceptability of MDA. Two potential barriers were identified: the contradiction of taking a medication without feeling sick and the occurrence of side effects; and four facilitators: the perception of malaria as a burden, a good understanding of MDA, a good perceived effectiveness, and the resulting economic benefits. The average acceptability score was 3.5 (range from -7 to + 7). Young adults aged 15 to 21 had a lower acceptability score compared to the other age groups, indicating an additional barrier to acceptability (ß = -0.78 [-1.67;0.1]). CONCLUSION: MDA is a priori acceptable to communities of Kedougou region in Senegal. Sensitization campaigns co-constructed with the communities, especially targeting young adults, are essential to ensure good acceptability.

Asunto(s)

RESUMEN

This article describes the development of an instrument used to evaluate the perceived self-efficacy of school staff in addressing dating violence (DV) among youth. The study employed a mixed exploratory sequential design. First, a series of items was elaborated upon based on the scientific literature on self-efficacy and material from 15 semi-structured interviews conducted with school staff. Then, a sample of 110 school staff members answered an online survey. An exploratory factor analysis revealed a two-factor structure reflecting dimensions of self-efficacy in addressing DV: communicating DV content to youth (α = .93) and the ability to intervene with youth who experience DV (α = .91). The scale could offer a means to assess the effectiveness of training offered to school counselors and teachers regarding DV prevention.

RESUMEN

BACKGROUND: Lack of patient contact in the pre-clinical prosthodontics curriculum makes it difficult for the students to comprehend and correlate the series of complex steps involved in complete denture fabrication. Early clinical exposure in the second year of the undergraduate program will facilitate a smooth transition of dental students from pre-clinics to clinics, thereby helping to mitigate the lacunae existing in the present curriculum. MATERIALS AND METHODS: A non-randomized prospective educational interventional study was conducted among 50 second-year dental students. Early clinical exposure in the form of clinical demonstration for complete denture steps of border molding and jaw relation was given subsequent to the completion of didactic and laboratory sessions. Pre- and post-multiple-choice question tests were conducted to explore students' knowledge. Student perception towards early clinical exposure was assessed using a self-administered anonymous questionnaire, while faculty perception was gauged with the help of in-depth interviews. RESULTS: A statistically significant difference was observed when pre- and post-multiple-choice question test mean scores were compared, showing an overall improvement in students' knowledge following early clinical exposure. Students and faculty held a positive perception towards the program and found it to be useful in enhancing the overall learning experience of the students. Faculty expressed their concern regarding limited manpower, paucity of time, and difficulty in integrating early clinical exposure into the present timetable. CONCLUSION: Early clinical exposure can be integrated into the traditional pre-clinical prosthodontics curriculum with appropriate time and manpower allocation. Faculty sensitization and training workshops need to be conducted before implementing this program.

RESUMEN

English for Specific Purposes (ESP) and Needs Analysis (NA) have been of significant interest to researchers for decades. Reviewing related studies strongly emphasizes NA as the foundational step in ESP course development. However, the task-based language needs (TBLNs) of philosophy students have yet to be thoroughly examined from the perspectives of both teachers and undergraduate students. Employing a mixed-method research design, 30 informants were selected via theoretical sampling for the qualitative phase and interviewed to elucidate TBLNs at the university level. In the quantitative phase, a researcher-developed scale was administered to 450 philosophy teachers and students, but 405 returned the completely filled-in questionnaires. Data analysis involved exploratory factor analysis and independent samples t-tests. Results indicated that philosophy students' TBLNs encompassed seven main themes comprising 27 distinct needs. Furthermore, the developed scale demonstrated acceptable reliability, divergent validity, and convergent validity. Statistical analysis also revealed significant differences in mean scores between students and teachers across most identified tasks. These findings suggest that philosophy students require proficiency in all language skills and sub-skills to succeed in their studies. The implications of these findings are significant for ESP educators, university administrators, policymakers, and administrators within philosophy departments, both theoretically and pedagogically.

RESUMEN

BACKGROUND: Academic nurse educators play a crucial role in the educational environment, but the demands of their profession can lead to workaholism, which could result in an imbalance between work and personal life. PURPOSE: The study aimed to explore workaholism and life balance among academic nursing educators, as well as investigate the factors associated with workaholism. METHODS: A mixed-methods design based on the "concurrent triangulation" approach was employed. A convenience sample of 76 nurse educators completed the Dutch Work Addiction Scale (DUWAS) and the Life Balance Inventory (LBI), while a purposive sample of 20 nurse educators participated in semi-structured interviews. Inferential statistics and thematic analysis were used to analyze the data. RESULTS: The researchers found a notable prevalence of workaholism among nurse educators, with 59.0 % reporting a mean score above 2.5 and 86.8 % perceiving an unbalanced life. Regression analysis indicated that workaholism negatively predicted life balance (B = -0.404, p < 0.001). The qualitative findings derived three themes as determinants of workaholism: antecedents, consequences, personal and institutional strategies to mitigate workaholism among nursing educators. CONCLUSION: Educational institutions should develop comprehensive approaches to support and develop their academicians, fostering a positive work environment, work-life balance, employee well-being, and professional development.

Asunto(s)

RESUMEN

Background and objective: Cancer-related fatigue (CRF) affects the quality of life after breast cancer. In a previous study, we developed a 72-item questionnaire that assesses CRF from a holistic point of view; named the Holistic Assessment of CRF (HA-CRF) questionnaire. The current study assessed the face and content validity of the HA-CRF questionnaire. Methods: Using a mixed-method approach, ten breast cancer survivors (BCS) did a cognitive walkthrough of the HA-CRF via an app followed by a semi-structured interview about relevancy and essentiality (qualitative). In addition, ten health care professionals (HCPs) assessed the relevancy, clarity, and essentiality of each item via a questionnaire (quantitative). Results: BCS indicated minor textual improvement for four items and six items were not completely clear. The app was considered easy to use and the HC-CRF was on average completed in 18 minutes. The HA-CRF questionnaire provided openness about fatigue and gave the feeling of being heard. The items were helpful and induced self-awareness. HCPs indicated 71% of items being very clear or minor revisions proposed by the minority, with 64% of items being essential and 92% considered relevant. Conclusions: The HA-CRF showed good face and excellent content validity. Further research is needed to assess its ability to monitor in daily life.

RESUMEN

BACKGROUND: Approximately 1 in 6 cannabis users develop a cannabis use disorder (CUD) and the odds increase to 1 in 2 for daily users. OBJECTIVE: The Dual use of Cannabis and Tobacco Monitoreing through a Gamified Web app (DuCATA_GAM-CaT) project aims to identify cannabis-tobacco patterns of use and withdrawal symptoms among individuals with CUD who are attending substance abuse programs. METHODS: The project uses a mixed methods approach consisting of 3 studies. First, a participatory qualitative study involves focus groups comprising individuals with CUD, clinicians, project researchers, and an expert gamification company to co-design a gamified web app. Second, a longitudinal prospective study to follow up individuals over 6 weeks with CUD attending substance abuse programs . Participants report their cannabis-tobacco usage patterns, type and frequency of tobacco use, nicotine dependence, withdrawal symptoms, psychoemotional factors, and motivation to quit both substances. Predictive analysis techniques are used to analyze clinical, demographic, psychological, and environmental data to predict the probability of achieving abstinence. Third, homogeneous focus groups to explore participants' experiences during their CUD treatment. RESULTS: By June 2024, the project had completed the first study, defining eligible cannabis user profiles, developed the initial web app prototype, and initiated recruitment across 10 centers, with 74 participants enrolled, aiming to reach 150 participants in total. CONCLUSIONS: All participants are required to provide informed consent, and their information is kept confidential and anonymized following confidentiality rules. The research team is committed to disseminating the results obtained to professional and patient groups, as well as informing public health agents, to positively influence political and social decision makers and design programmers. Additionally, we aim to prioritize the publication of the results in high-impact journals specialized in drug abuse, public health, and health care services research. TRIAL REGISTRATION: ClinicalTrials.gov NCT05512091; https://clinicaltrials.gov/study/NCT05512091. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58335.

Asunto(s)

RESUMEN

BACKGROUND: Caring profession students require skills and competencies to proficiently use information technologies for providing high-quality and effective care. However, there is a gap in exploring the perceptions and experiences of students in developing virtual care skills within online environments. OBJECTIVE: This study aims to better understand caring professional students' online learning experiences with developing virtual care skills and competencies. METHODS: A sequential explanatory mixed methods approach, integrating both a cross-sectional survey and individual interviews, was used to better understand caring professional students' online learning experiences with developing virtual care skills and competencies. RESULTS: A total of 93 survey and 9 interview participants were drawn from various faculties, including students from education, nursing, medicine, and allied health. These participants identified the barriers, facilitators, principles, and skills related to learning about and delivering virtual care, including teaching methods and educational technologies. CONCLUSIONS: This study contributes to the growing body of educational research on virtual care skills by offering student insights and suggestions for improved teaching and learning strategies in caring professions' programs.

Asunto(s)

RESUMEN

BACKGROUND: Starting in the 1990s in the United States, individuals with lived experience of mental health crises and recovery have been employed as peer support workers (PSWs) internationally. However, the implementation of PSW in clinical contexts remains challenging. METHODS: This manuscript presents and discusses the methodological framework of the ImpPeer-Psy5 study on the PSW implementation in the German mental healthcare sector. This study used a mixed-methods and collaborative research approach, as well as participatory research strategies. After describing the study design, populations, teamwork and assessments, the epistemic challenges of its methodological framework will be critically discussed and how it has iteratively shaped the object of study. DISCUSSION AND PRACTICAL IMPLICATIONS: The healthcare, policy and funding context of PSW implementation as well as the study's methodological framework have differently influenced the ways in which the implementation of PSW has been conceived in this study. The choice of a collaborative or participatory methodological framework is advised to better align research questions and procedures to the specific needs and challenges of PSWs and other stakeholders concerned with PSW implementation. PATIENT AND PUBLIC CONTRIBUTION: The research team of the ImpPeer-Psy5 study was collaboratively staffed by a portion of researchers who also identify as users or survivors of psychiatric services. A nonprofit organization for the training of PSWs served as a practice partner throughout the research process. Different participatory formats involve a significant number of diverse stakeholders relevant to PSW implementation.

Asunto(s)

RESUMEN

BACKGROUND: The current literature inadequately addresses the extent to which remote monitoring should be integrated into care models for chronic respiratory diseases (CRDs). OBJECTIVE: This study examined a remote monitoring program (RMP) in cystic fibrosis (CF) by exploring experiences, future perspectives, and use behavior over 3 years, with the aim of developing future directions for remote monitoring in CRDs. METHODS: This was a mixed methods, multicenter, observational study in 5 Dutch CF centers following a sequential explanatory design. Self-designed questionnaires using the technology acceptance model were sent out to people with CF who had a minimum of 12 months of experience with the RMP and local health care professionals (HCPs). Questionnaire outcomes were used to inform semistructured interviews with HCPs and people with CF. Qualitative findings were reported following the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. Anonymous data on use frequency of all people with CF were analyzed. RESULTS: Between the second quarter of 2020 and the end of 2022, a total of 608 people with CF were enrolled in the program, and a total of 9418 lung function tests and 2631 symptom surveys were conducted. In total, 65% (24/37) of HCPs and 89% (72/81) of people with CF responded to the questionnaire, and 7 HCPs and 12 people with CF participated in semistructured interviews. Both people with CF and HCPs were positive about remote monitoring in CF care and found the RMP a good addition to daily care (people with CF: 44/72, 61%; HCPs: 21/24, 88%). Benefits ranged from supporting individual patients to reducing health care consumption. The most valued monitoring tool was home spirometry by both people with CF (66/72, 92%) and HCPs (22/24, 92%). Downsides included the potential to lose sight of patients and negative psychosocial effects, as 17% (12/72) of people with CF experienced some form of stress due to the RMP. A large majority of people with CF (59/72, 82%) and HCPs (22/24, 92%) wanted to keep using the RMP in future, with 79% (19/24) of HCPs and 75% (54/72) of people with CF looking forward to more replacement of in-person care with digital care during periods of well-being. Future perspectives for the RMP were centered on creating hybrid care models, personalizing remote care, and balancing individual benefits with monitoring burden. CONCLUSIONS: Remote monitoring has considerable potential in supporting people with CF and HCPs within the CF care model. We identified 4 practice-based future directions for remote monitoring in CF and CRD care. The strategies, ranging from patient driven to prediction driven, can help clinicians, researchers, and policy makers navigate the rapidly changing digital health field, integrate remote monitoring into local care models, and align remote care with patient and clinician needs.

Asunto(s)

RESUMEN

Many older adults are increasingly embracing digital technology in the Republic of Korea. This study investigated the relationship between the digital skills of Korean older adults and their perceived health status and digital technology application for health promotion. This mixed-method study comprised a community survey of 434 older adults aged ≥65 in two cities in South Korea, followed by focus group interviews. Five types of digital skills, 'operational internet skills', 'information navigation skills', 'social skills', 'creative skills', and 'mobile skills', were measured using the LSE digital skill measurement instrument. Multivariable analysis identified the influence of digital skills on health-related outcomes. Among them, 'social skills' associated positively with self-rated health (ß 0.37, 95%CI 0.08, 0.65). 'Information navigation skills' contributed positively to the use of digital technology and the internet for a healthy lifestyle in terms of improving eating habits (ß 0.43, 95%CI 0.09, 0.77), accessing healthcare (ß 0.53, 95%CI 0.21, 0.85), and accessing long-term care services (ß 0.45, 95%CI 0.11, 0.79). Thematic analysis revealed that the study participants use Korean language-based resources such as Naver and Kakao Talk for social connection to promote a healthy lifestyle. This study concludes that encouraging initial and sustained use of the internet and enhancing digital skills among Korean older adults can promote active and healthy aging.

RESUMEN

LGBTQ+ patients exhibit higher rates of mental disorder relative to the general population. This is particularly concerning since deficiencies in mental health practitioners' skills and knowledge, along with negative attitudes and behaviors, are associated with a decreased likelihood of LGBTQ+ patients seeking mental healthcare services and an increased likelihood of reporting unmet mental healthcare needs. To address these concerns, a mixed-method systematic review was conducted to evaluate mental health practitioners' attitudes towards and knowledge of LGBTQ+ patients and the impact of these factors on service utilization. Thirty-two relevant empirical qualitative and quantitative studies were retrieved from five databases following PRISMA guidelines, for a total of N = 13,110 mental health practitioners included. The results indicated that mental health practitioners generally hold affirming attitudes towards LGBTQ+ patients. However, significant gaps in practitioners' knowledge and skills emerged, describing feelings of inadequate skill, lack of competence, low clinical preparedness in addressing specific LGBTQ+ needs, insufficient training opportunities, and desire for further education on LGBTQ+ issues. These findings underscore the need to enhance inclusivity and cultural competence at both organizational and educational levels. Such improvements are essential to better care for LGBTQ+ patients and reduce disparities in access to mental health services.

Asunto(s)

RESUMEN

Aim: This pilot examined the effect of online peer support on mental health problems among individuals with post-acute sequelae of COVID-2019 (PASC). Methods: A single-arm pre-post design of online peer-support design consisting of eight sessions of 1 h per week with three to six participants and two facilitators per group was performed. Participants were recruited from online communities, social media, and medical clinics for the PASC between May and August 2023. The degrees of depression, anxiety, loneliness, social withdrawal, and self-esteem were measured pre- and post-intervention. Participants' statements during the sessions were analyzed using thematic analyses. Results: Of the 18 participants, three dropped out of the interventions, and 17 (including two participants who dropped out) completed the pre- and post-intervention questionnaires. Depression severity significantly decreased in the paired t-test and linear mixed model. The following interactions were extracted: conveying the same feelings, dealing with difficulties, showing empathy, enhancing the atmosphere, and adapting to suit health conditions. Impressions extracted from participating in the interventions included feelings of emotional support, a sense of bonding, changes in perspective, changes in behaviors or new actions through participation, inadequacy during sessions, and adverse effects associated with participation. Conclusion: Online peer support may be helpful in treating depression in individuals with PASC.

RESUMEN

Background: The need for palliative care is ever-increasing globally. However, it is least developed or not available in most low-and-middle-income-countries including Bhutan. Objective: This study was aimed at exploring the perspectives of Bhutanese healthcare professionals on the need for palliative care in the country. Design: This is a cross-sectional, mixed-method study. Setting/subjects: The study sites included all levels of healthcare in Bhutan and involved doctors, nurses, physiotherapists, pharmacists, health assistants and Drungtshos (traditional physicians). Data were collected through surveys, focus group discussions and in-depth interviews. Results: While the majority of the participants were directly involved in taking care of terminally ill and dying patients, only 14% had received some form of palliative care training for a duration ranging from 1 day to 6 weeks. Ninety-five percent of the participants reported that they faced challenges related to lack of palliative care knowledge and skills; limited resources including analgesics; shortage of doctors and nurses and lack of a palliative care team; issues with low illiteracy and financial challenges among patients; and policies and other systemic issues. The qualitative data generated four major themes: past adverse experiences; unique and complex needs for palliative care; challenges faced while caring for terminally ill and dying patients; and the urgent need for palliative care in Bhutan. Conclusion: Bhutanese healthcare professionals had very limited exposure to palliative care. This study identified a crucial need for palliative care and informs the development of an appropriate palliative care model for Bhutan.

'There is no such word as palliative care for us at the moment': A study exploring the perceptions of healthcare professionals on the need for palliative care in Bhutan Palliative care is least developed in most low-and-middle-income-countries. This study was aimed at exploring the perspectives of healthcare professionals on the need for palliative care in Bhutan. Utilising both quantitative and qualitative approaches, the study sites included all levels of healthcare in Bhutan and involved doctors, nurses, physiotherapists, pharmacists, health assistants and Drungtshos (traditional physicians). Data were collected through surveys, focus group discussions and in-depth interviews. While the majority of the participants were directly involved in taking care of terminally ill and dying patients, only 14% had received some form of palliative care training for a duration ranging from one day to six weeks. Ninety five percent of the participants reported that they faced challenges related to lack of palliative care knowledge and skills; limited resources including analgesics; shortage of doctors and nurses and lack of a palliative care team; issues with low illiteracy and financial challenges among patients; and policies and other systemic issues. The qualitative data generated four major themes: past adverse experiences; unique and complex needs for palliative care; challenges faced while caring for terminally ill and dying patients; and the urgent need for palliative care in Bhutan. Bhutanese healthcare professionals had very limited exposure to palliative care. This study identified a crucial need for palliative care and informs the development of an appropriate palliative care model for Bhutan.