SAGE Open Medicine最新文献

Background: Clinical empathy is a crucial skill for healthcare professionals, enhancing patient outcomes, and satisfaction. However, existing scales, such as the Jefferson Scale of Empathy, focus primarily on cognitive empathy, overlooking the affective component. This gap highlights the need for a validated tool that measures both cognitive and affective empathy in healthcare professionals. This study developed and validated a multidimensional scale-the Multidimensional Clinical Empathy Scale-for assessing both cognitive and affective empathy in healthcare professionals and students.

Methods: This three-phase study involved item generation, reduction, and validation, using literature reviews, qualitative studies, and survey methodologies. Exploratory factor analysis and confirmatory factor analysis were applied to test the scale's validity. The Multidimensional Clinical Empathy Scale was constructed using a five-domain theoretical model: Empathetic Connections, Valuing Empathy, Empathetic Behaviours, Genuine Concern, and Perspective Taking. After content validation and exploratory factor analysis, the scale was reduced to 26 items with high internal consistency (Cronbach alpha of 0.94).

Results: There were a total of 977 participants, comprising doctors, medical students, nurses, and nursing students from acute hospitals, community hospitals, medical schools, and nursing schools. The final 26-item Multidimensional Clinical Empathy Scale demonstrated strong psychometric properties, with factor loadings confirming the multidimensionality of clinical empathy. Confirmatory factor analysis confirmed the scale's four-factor structure, and the scale was validated across diverse healthcare settings with robust reliability and Content Validity Index (0.90).

Conclusions: The Multidimensional Clinical Empathy Scale provides a comprehensive, validated tool for measuring both cognitive and affective empathy in healthcare professionals and students. Its multidimensional structure offers potential for broader applications in clinical education and research.

Introduction: Preconception care involves measures to enhance a woman's physical, psychological, and nutritional health before pregnancy. Despite various observational studies assessing healthcare practitioners' knowledge of preconception care in East Africa, the overall pooled knowledge level remains unclear, and the studies often report inconsistent associated factors. This systematic review and meta-analysis aimed to determine the aggregated knowledge of preconception care among healthcare providers in East Africa and identify influencing factors.

Method: We searched studies using PubMed, Scopus, Embase, and Google Scholar that were published between January 01, 2018 and November 30, 2024. This study used the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The quality of studies was evaluated using the modified Newcastle-Ottawa quality assessment tool. The data were extracted by two authors independently using Microsoft Excel and analyzed by Stata version 17. A random effects model was applied to calculate the pooled level of knowledge and its associated factors. The International Prospective Register of Systematic Review registration number for the review was CRD42024608878.

Results: A total of 12 studies comprising 4892 participants were involved in this meta-analysis. The pooled knowledge of preconception care among healthcare providers was 56% (95% CI: 45%-66%). This study showed that gender (odds ratio (OR) = 1.35), educational level (OR = 3.52), monthly salary (OR), work experience (OR = 1.77), Internet access (OR = 3.41), ever read the preconception care guideline (OR = 2.77), having Smartphone (OR = 1.70), working institution (OR = 2.05), Training on HIV testing and management (OR = 4.28), training on providing alcohol or tobacco cessation service (OR = 1.14), the presence of a library in a working health facility (OR = 1.98), taking training on preconception care education and counseling (OR = 3.44) were significant factors associated with knowledge of preconception care.

Conclusion: The findings indicate that healthcare providers in East Africa have limited knowledge of preconception care. Gender, educational level, monthly salary, previous work experience, internet connection, awareness of preconception care policy, smartphone possession, type of work schedule, prior HIV testing, and management training, library access in healthcare facilities, and involvement in preconception care training meetings and counseling sessions are significant factors of the knowledge of preconception care among healthcare providers.

Background: Organizational effectiveness is vital in public hospitals, especially in low- and middle-income countries, including Ghana, where healthcare delivery faces resource constraints and high disease burdens. This study evaluates the organizational effectiveness of public hospitals in Ghana from the perspective of frontline healthcare workers.

Methods: A cross-sectional study was conducted in four public hospitals using a validated World Health Organization questionnaire. A total of 477 frontline healthcare workers participated, assessing the perceived gap between current effectiveness ("as-is") and ideal expectations ("should-be") across 15 items. Data were analyzed using descriptive statistics and paired Student's t-tests.

Results: Significant gaps were identified between current organizational effectiveness and ideal expectations. The mean score for current effectiveness was 2.75 ± 0.63, while the ideal state scored 5.20 ± 0.43, yielding a significant mean difference of 2.45 ± 0.58 (p = 0.001). Major gaps were noted in conflict management, support for continuous learning, and valuing individual contributions. Only 8.4% rated their organizations as "extremely effective," with 31% indicating a need for significant improvement.

Conclusion: The findings reveal substantial gaps between current effectiveness and expectations, emphasizing the need for urgent reforms in conflict resolution, staff development, and fostering a learning-oriented culture to enhance hospital effectiveness and healthcare delivery in Ghana.

Objective: To investigate whether centrality bias is one of the contributing factors for patient mistriage in the emergency department.

Methods: A randomized, controlled, single-blinded trial was conducted in an emergency department triage station between April 1 and November 3, 2021. Experienced triage nurses were divided into control and treatment groups. The control group triaged patients using the Canadian Triage and Acuity Scale 1-5 triage scale, and the treatment group used a four-level triage scale (created by removing level 3 from the original Canadian Triage and Acuity Scale). Neither group was exposed to the other's ranking and the control group determined the patient's actual triage ranking. The accuracy of each group's ranking was determined by triage experts. Triage nurses' levels of confidence was investigated, as was the correlation between triage ranking accuracy and confidence level.

Results: After excluding 58 patients with missing data, 146 assessments were analyzed. Statistical analysis was performed to compare three different aspects of triage rankings between the nurses' groups and the control group. In the first and second analyses, accuracy levels of 49% and 68% (p = 0.003), 43% and 68% (p < 0.0001) were found for the control and experimental groups, respectively. The third aspect showed no significant differences. Within the control and experimental groups, the difference in accuracy rate at levels 2 and 5 was the most significant, with 13% and 75% (p = 0.40), 29% and 67% (p = 0.009), respectively.

Conclusions: Central tendency has the potential to affect the accuracy of ranking among triage nurses in the emergency department. Further research is needed.

Background: Depression affects 38%-80% of end-stage renal disease patients on dialysis, causing increased hospitalizations, treatment nonadherence, and mortality rates. While various interventions have been researched, a comprehensive assessment remains necessary to address the psychological burden effectively.

Objective: To assess previous research from 2017 to 2023 on the efficacy of pharmacological and non-pharmacological interventions for depressive symptoms in this group.

Methods: A systematic review was performed across PubMed, ScienceDirect, Clinical Key, and Web of Science. Citations for inclusion and abstract extraction were assessed and confirmed by two independent researchers. Inclusion criteria consisted of clinical trials, randomized controlled trials, and prospective studies written in English. We excluded studies that were review articles, case reports, or editorials, or did not examine antidepressants, exercise, or other mental health interventions in dialysis patients. To assess risk of bias, the Risk of Bias 2 and the Risk of Bias in Non-randomized Studies of Interventions tools were utilized. Depressive symptoms were measured using different scales.

Results: Among 911 screened citations, 30 articles were included, involving 1815 participants across 17 countries. Publications on antidepressant medication (n = 4), exercise (n = 9), music therapy (n = 4), and psychotherapy (n = 13) were included.

Conclusion: While interventions like antidepressants, intradialytic exercise, music therapy, and psychotherapy show potential for managing depression in dialysis patients, small sample sizes, lack of control groups, and short treatment durations continue to limit current studies. Future research should focus on multicenter trials with larger, more diversified populations and stronger study designs.

Objective: To comprehensively analyze the factors associated with anemia among adolescent girls in Pekanbaru, with a focus on nutritional status and anthropometric factors.

Methods: A cross-sectional study was conducted among 230 adolescent girls aged 10-19 years in Pekanbaru from six State Senior High Schools. Simple random sampling technique with proportional allocation to size was used to select the participants. Anemia was defined as hemoglobin levels below the WHO cut-off point. Data on age, menstrual patterns, iron supplementation, and knowledge of anemia were collected from structured interviews, dietary intake from 24-h food recall questionnaires, anthropometric measurements from height, weight, body mass index, mid-upper arm circumference.

Results: The prevalence of anemia among adolescent girls in Pekanbaru was 19.9%. The average age of the adolescent girls was 15 years with a menarche age of 12 years. Although statistically insignificant through bivariate testing, it was found that negative attitudes toward iron supplementation, noncompliance in taking iron supplements, and low mid-upper arm circumference may increase the risk of anemia among respondents. Multivariate analysis showed that variables that significantly influenced anemia were low mid-upper arm circumference (PR = 1.951, 95% CI: 1.05-3.60), nutritional status underweight (PR = 0.506, 95% CI: 0.26-0.96), and vitamin B12 intake (PR = 0.558, 95% CI: 0.31-0.97). Adolescent girls with low mid-upper arm circumference had a 1.95 times higher risk of experiencing anemia after controlling for other variables.

Conclusion: Anemia among adolescent girls in Pekanbaru were significantly associated with low mid-upper arm circumference (<22 cm), nutritional status (underweight), and vitamin B12 intake. A comprehensive and sustained approach is recommended, including enhanced nutrition education, and dietary diversification.

Objectives: The outbreak of COVID-19 in 2020 resulted in closed universities, digital teaching and restricted social contact. The students may encounter psychological stress and worries about their careers ahead, and some may experience feelings of doubt and helplessness while studying. Little is known about this closure's impact on undergraduate nursing students writing their bachelor's theses. This study aimed to explore how undergraduate nursing students in Norway, writing their bachelor's theses, experienced coping with the impact of COVID-19 on their social and academic lives.

Methods: We used qualitative individual in-depth interviews, and 14 undergraduate nursing students participated. Data were analyzed using content analysis based on Brinkmann and Kvale.

Results: The analyses showed that the social restrictions demanded that the students had to cope with several challenges related to their social and academic lives. Two main categories and four subcategories emerged during the analysis. The main categories were (1) Practical challenges, with Physical restrictions and digitalisation and Circadian rhythm and sleep deprivation as subcategories and (2) Mental challenges, with the sub-categories' Social isolation and loneliness, and Motivational and emotional challenges.

Conclusion: When the universities closed, the students struggled with loneliness, sleep deprivation, keeping their routines, and being motivated to complete their bachelor's theses. The universities must develop strategies to ensure that the students receive satisfactory information, support and guidance.

Background: Diabetes self-management education supports healthy dietary behaviors but often lacks food skill-building education to plan, budget for, select, and prepare (cook) healthier food.

Objectives: This study examined the relationship between food skills, diabetes self-management, and stress with medically underinsured patients with type-2 diabetes mellitus within the Fresh Start Food is Medicine (FIM) program. A secondary objective was to examine the impact on diet quality and clinical outcomes.

Methods: Adults (n = 150) with type-2 diabetes mellitus participated in the 20-week Fresh Start FIM intervention, which included nine group education classes, a produce prescription, and telephone-based health coaching. Group education and skill-building centered around food skills and diabetes self-management. Measures included surveys (e.g., food skills confidence, diet quality, and stress) and clinical measures (e.g., weight, HbA1c, and blood pressure). Data analysis included paired t-tests, Wilcoxon signed-rank tests, and linear regression.

Results: Significant improvements were observed in food skills confidence (p < 0.001), diet quality (e.g., fruit p = 0.03; vegetable p < 0.001; whole grain p < 0.001 consumption), diabetes self-management (p < 0.001), and perceived stress (p = 0.01). Food skills confidence and diabetes self-management were significant predictors of perceived stress (p = 0.05 and 0.009, respectively). Blood pressure significantly declined (systolic: -6.7 mmHg, p = 0.007; diastolic, p = 0.02).

Conclusion: Integrating food skills education and individualized behavioral support within an FIM intervention improved food skills confidence, diabetes self-management, and diet quality while reducing perceived stress among medically underinsured patients with type-2 diabetes mellitus. Enhanced self-efficacy in diabetes management and food skills were key contributors to stress reduction, emphasizing the importance of skill-oriented education within diabetes self-management education. These findings underscore the critical role of food skills in building capacity to improve dietary behaviors and health with resource-limited populations.

Objectives: The tobacco epidemic represents one of the most significant public health challenges faced globally. Nicotine replacement therapy was developed to substitute for the nicotine contained in tobacco products temporarily. The objective of this study was to investigate pharmacists' knowledge, attitudes, and practices regarding the utilization of nicotine replacement therapy in Iraq.

Methods: This cross-sectional study involved 300 pharmacists across five provinces from October 1, 2023 to December 31, 2023.

Results: Indicate that 300 pharmacists participated in the analysis, with approximately two-thirds identifying as male. About two-thirds of the participants (95% confidence interval: 65.3%) expressed that they knew how to use nicotine replacement therapy. Furthermore, about half of them (95% confidence interval: 50.3%) reported their awareness of how to make dose titration, with a majority agreeing that the assessment of nicotine dependence influences the selection of nicotine replacement therapy products. Fair knowledge was associated with each degree of education, not attending training programs, and the availability of nicotine replacement therapy in their pharmacies (0.01, 0.002, 0.003, respectively).

Conclusions: There exists a critical necessity for pharmacists to augment their comprehension of the medications utilized in smoking cessation. Such enhancement is essential to improve their practices and, consequently, to attain superior outcomes in supporting individuals in their efforts to quit smoking.

Objective: This study aimed to develop an observational tool to assess the social interactive behaviors of children with special education needs during animal-assisted activity and to examine its reliability and validity.

Methods: The study comprised two phases: developing and evaluating the measurement tool. The tool was created through literature reviews and expert interviews. The pilot observational study was conducted in a special educational school in Hong Kong, China, involving 138 children with intellectual disability participating in animal-assisted activity sessions to examine the tool's reliability and validity.

Results: Initially, the measurement tool included 26 observational variables across three dimensions (inter-rater reliability of 0.74). After excluding variables with low discriminability, the final tool contained seven observational variables. The tool demonstrated strong reliability (inter-rater reliability of 0.81) and satisfactory validity, significantly discriminating among different intellectually disabled students (ps < 0.05).

Conclusions: This study developed and validated an observational tool for measuring the social behaviors of children with special education need during animal-assisted activity sessions. More extensive studies are needed to further evaluate the instrument.